Q & A’s The Holiday Blues!

Q. My son is prone to swimmers ear infections and I usually prevent this from occurring by using ear drops from Australia called “Aqua Ear”. I have tried just about every pharmacy on the Island but I cannot get them or anything similar here. Do you have any other tips on how to prevent the ear infection? My son is a surfer will not stay out of the water and refuses to wear ear plugs!

A. Oh how I dream of having a pharmacy with the selection of over the counter goods that you can get overseas! Even the newer pharmaceutical chains here have their shelves stacked with shampoos, hair colors and vitamins. “Aqua-ear” are ear drops that contain alcohol to dry the ear canal, and acetic acid that changes the pH making it unfavorable for infection. If you cannot purchase Aqua-ear at the chemist, go to your kitchen cupboard and find some vinegar (acetic acid), and get hold of some surgical alcohol 70% (available at any “apotik”), and mix up a solution. Remember that this is a preventative and not a cure. If signs of infection are already present, you must have your ear examined by a doctor to determine what kind of ear infection that you have, and what kind of treatment is appropriate. Never start ear drops before the ear is inspected. If the ear drum has ruptured, chemicals my reach the delicate nerves of the inner ear causing irreparable damage.

Q. Before we left for Bali we visited a travel clinic, as well as checked out several travel healthweb-sites. There seems to be conflicting information regarding the risk of contracting rabies in Bali. Some say that there is no rabies on the Island and therefore no need for vaccines, and yet some say the vaccine IS recommended. Which is correct?

A. Neither. According to the local health authorities there have been no reported cases of rabies in Bali for at least 10 years. There had been no reported cases of rabies in Scotland for 200 years, and yet last month this horrific disease claimed its first victim for two centuries. Can you be absolutely sure that you will not contract the disease here, or any where else for that matter? I think not. To treat this horrific, deadly disease with complacency would be flagrant. I think that vaccinating everyone that visits Bali is an over reaction. A good travel clinic will assess your risk. For example if you are here studying the mating habits of monkeys or the nocturnal movements of the native bats I would definitely be immunized. Anyone who is push-biking, or trekking (local canines snapping at your ankles), should also consider the vaccine. For honeymooners staying at the Four Seasons?…Forget it, you won’t get rabies! Remember that rabies is carried in the saliva of any mammal, not just dogs and bats. If anyone is bitten or scratched (deep enough to draw blood) I would recommend that the wound be thoroughly scrubbed with a betadine solution and a series of post exposure vaccines administered just to make absolutely sure that you are protected. Rabies, once you are infected is ALWAYS fatal.

Q. I have a very itchy lumpy red rash all over the backs of my legs. It started last night after dinner at a local restaurant, and my travel companion says they are bug bites, but I don’t recall seeing any bugs?

A. Ahhh….you have been nibbled by the elusive “cane bug” that hides itself in cane furniture just waiting for the next butt to bite. I suggest that if you are sitting or lying on unfamiliar furniture that you wear long pants, use a pillow, or carry along a sarong that you can fold under yourself ( they can still bite through fine fabrics). If you have already been bitten, I would suggest a mild steroid cream (Hydrocortisone 1%), or a local antihistamine (“Phenergan” cream). Over the counter anti-histamines such as dextromethorphan containing medications (“Benadryl”), may help but may also make you sleepy. Try not to scratch the area (this is difficult as I know the bites are extremely itchy) as a secondary skin infection may set in.

Q. My baby is 5 months old and has not yet completed her 6 month immunization schedule. Is it safe to take her in the swimming pool at this stage?

A. There are several considerations when taking young ones in for their first dip. Firstly babies skin is very sensitive so make sure that you stay out of direct sunlight, use a good block out lotion that is specifically for babies (harsh chemicals in adult formulas can penetrate the porous skin of infants). Stick to early mornings (before 10am) or late afternoons (after 5pm) to avoid the harsh rays of the sun. Don’t forget that babies sensitive skin can just as easily be burned by indirect (reflected light) as by direct sunlight. Another consideration would be spread of disease by water that is not properly treated. Most higher quality hotels and resorts have strict controls on their pool cleaning services. As no 100% guarantees can ever be made in public swimming places, I would still recommend that the babies head not be submerged under the water. Drowning is a tragedy that happens all too often. Young children seem to see no danger in water, and can often wander to the pools edge or into the shallows of the ocean. Beware the inflatable sit-in swim rings. Some can tip forward when the baby leans forward to look at the dancing light reflecting on the water. Young children must have uninterrupted supervision even around shallow waters.

Q. My flight to the States next month is a very long one, and I am taking my two amd half year old with me. My friend told me that there is a sleeping syrup that I can get to settle him during the flight. What is the name of this syrup?

A. Hmmmm. Sounds attractive. A sound sleeping child on a very long and tedious journey. Unfortunately the medication that is commonly used for sedation (antihistamine syrups), can often have the opposite effect. The child may react by becoming hyper-active! Now wouldn’t that turn your dream flight into a nightmare journey. I suggest that you take a lot of activities to do with him. Invest in some new games or toys that will get his attention and bring them out one at the time, not all at once as he will quickly become bored. Don’t have unrealistic expectations about him sleeping for 15 hour stretches. Children just don’t do that in the air or on the ground. Flying, especially for the first time is a very exciting adventure for a child and he is likely to want to see and experience everything. Sleeping will probably be the last thing on his mind. If you are lucky the cabin staff may delight in taking this little fellow off your hands for a short while.

Kim Patra is a qualified Registered Nurse / Midwife, and mother of three, who has been living and working in Bali for past 15 years. She has assisted many traveller (… and others) either as a flying medical escort or just a voice on the end of the phone! Kim is happy to discuss any health concerns that your may have. Her e-mail contact is info@chcbali.com

Copyright © 2002 Kim Patra