HEALTH

Traveling in Bali today can be medically safe-if you take precautionary steps regarding transport, food, drink, and hygiene. If you work it right, you could even return in better health than before you left. The truth is that the traveler is much more likely to get hurt or killed riding a motorcycle on Bali, which snuffs out about three tourists per month, than to contract some hideous tropical disease.
     For example, a common injury is the "Bali Kiss," a dreaded motorcycle burn on the inside of the calf. Drink lots of bottled water right away, then apply an antiseptic cream with lidocaine or benzocaine. After two days, start applying aloe vera or papaya compresses. To prevent this injury, wear long pants. Flying bugs are another hazard-wear sunglasses to protect your eyes while riding a motorcycle at dusk.
     Start out on your trip as healthy as possible. Amp up your immune system. The most common ailments afflicting travelers and tourists are diarrhea ("Bali Belly"), parasitic diseases, and gastrointestinal infections. Thank god the island is free of rabies; its population of scavenging dogs is enormous.
     Take common-sense precautions but avoid paranoia ("How were these dishes washed? Was this tea boiled long enough?")-it will spoil your trip. Even in upscale hotels, hygienic techniques aren't always followed, so if it's your turn to get sick, you'll get sick. But once you have your first bout with diarrhea or prickly heat, it seldom recurs.
     Staying Healthy in Asia, Africa, and Latin America, produced by Volunteers in Asia, is packed with important information that's basic enough for the short-term traveler, yet complete enough for someone living in Bali. It's a very compact and well organized little book. Your own doctor won't be able to supply you with this hard-to-get information because he doesn't have it. Order a copy through Moon Publications, tel. (800) 345-5473.

Prevention
If you take care with personal hygiene, use caution in what you eat and drink, and get plenty of rest, you'll be safe from most health problems while traveling in Bali. Most illnesses travelers suffer are resistance diseases, a result of their health running down, poor eating, unrestrained self-indulgence, or overexposure to heat and sun.
     Upon arrival, you owe it to yourself to become acclimated to the tropical environment: maintain adequate fluid and salt intakes, avoid fatigue, dress light. Jet lag may change your sleeping patterns and eating habits, so at first, plan extra rest. To avoid undergoing dental treatment in Indonesia, go for a complete dental checkup before your trip.
     Knowing what and where the risks are and how to avoid them is your very best protection. What's wrong with walking barefoot in the tropics? Several different types of infectives that can enter the body through the skin, such as cutaneous larva migrans, thrive here. An Indonesian's left hand is unclean because it's used to clean himself, with water, after using the toilet. Vendors selling bottled drinks on the beach and on the streets use the straws again and again. Throw the straw away or bend it before giving the bottle back so it can't be used again.
     On Bali, scruffy cats roam everywhere. They hang around restaurants, warung, and family-style hotels. Pregnant women, or those who are planning to be so, should avoid contact with these animals and their excretions because of the risk of toxoplasmosis infection. This parasitical disease can cause abortion or early birth, or the unborn child could contract congenital toxoplasmosis, possibly resulting in death or serious central nerve system disorders.
     If you're staying in a budget hotel in the Kintamani area or down on Lake Batur, don't leave food open in your room but seal it in solid containers-rats can even chew through backpack canvas. If you're going to one of Bali's monkey temples, remember monkeys are wild animals. Don't take any food with you, and don't hide food in your pockets because monkeys can smell it. Their eye teeth are very sharp. When feeding them, always look out for the dominant male. He should be given food first to avoid fighting. Never show your teeth while smiling at monkeys-this is regarded as an aggressive gesture. Don't touch their young or they may savage you.
     Street lighting is generally very poor at night. Watch out for drainage ditches. You hear tales of tourists falling two meters into ditches. A flashlight must be carried at all times; you need it also to protect you against cars, motorcycles, and other pedestrians.
     Another common threat to health is the treacherously slippery tiles found gracing the floors of Bali's hotels-on bathrooms, steps, stairways, verandas. Even when not wet they are slick and dangerous. When wet, they can be life-threatening. Don't wear hard-soled leather or plastic shoes on them; soft-soled rubber sandals or bare feet offer a little better traction.

Travel Insurance
Check whether your health insurance entitles you to reimbursement of medical and evacuation expenses incurred overseas. If not, get special health or travel insurance to cover your trip for as little as US$3 per day. Short-term insurance, covering medical emergencies, loss of possessions, flight cancellation penalties, is sold by STA Travel, other student travel organizations, and Cigna Travel Guard (tel. 800-826-1300), International SOS Assistance (tel. 800-523-8930), and Access America (tel. 800-284-8300).
      Be sure to get a policy which includes access to one of the medical evacuation services available on Bali-AEA (Asian Emergency Assistance), International SOS Assistance, and WAI (World Access International). Read very carefully the policy small print for exclusions. Evidently, insurance companies have been taken to the cleaners by people involved in accidents who obtained an easy-to-get Balinese license and drove a motorcycle for the first time on Bali.

IMMUNIZATION AND SERIOUS DISEASES

Get the latest World Immunization Chart of IAMAT (International Association for Medical Assistance to Travelers, 417 Centre St., Lewiston, NY 14092), which indicates the immunizations currently recommended for travel to Indonesia (double-check with the Indonesian Embassy). Another good place to check in the U.S. is the Centers for Disease Control in Atlanta (tel. 404-639-3311). Get your immunizations through your doctor or local health center.
     Tetanus, polio, and yellow fever are not a big threat; immunizing against them is only necessary if you're going to the Outer Islands of Indonesia. Among travelers who stay in tourist accommodations and avoid potentially contaminated food and water, the risk of cholera is very small. Among all the foreign tourists flocking to Bali, it appears that only the Japanese appear to be coming down with cholera (150 people in 1995). Cholera vaccine is only about 40% effective anyway. Typhoid and paratyphoid vaccinations are also optional.

Malaria
The malarial season in Indonesia lasts all year and the whole country is affected below 1,200 meters altitude. Risk is low on Bali, especially if you sleep in a room with screened windows, keep well-covered after dusk, and use insect repellents and electric anti-mosquito mats. Take along chloroquine or chloroquine-substitute to prevent malaria. The mainstay of state-of-the-art protection is Larium, taken once weekly. A doctor's prescription of 20 tablets costs a devilish US$77, or US$3.85 per tablet! Don't use Fansidar; it's dangerous.

Hepatitis
One must exercise all the same precautions against this disease as one does in preventing dysentery and diarrhea. Unsanitary eating utensils and unwashed salads and fruits are prime suspects. Hepatitis is a debilitating liver disease which turns the skin and whites of the eyes yellow, the feces whitish, and the urine deep orange or brown. These symptoms-as well as sleepiness, chills, nausea, headaches, weakness, depression, and a dramatically diminished appetite-appear around three weeks after infection.
See a doctor immediately. Don't drink alcohol, eat fatty foods, use tobacco, or take antibiotics while under treatment. Get plenty of rest and drinks lots of fluids. Though it doesn't prevent the disease, a gammaglobulin injection will give you about six months' protection against the worst symptoms of hepatitis only; this shot, however, only gives protection against infectious type A hepatitis and not serum hepatitis. Consider getting it if you're going beyond Bali.

FOOD AND DRINK

Food- and water-borne infections are one of the greatest threats to the traveler in the tropics. Bacterial infections (typhoid, paratyphoid, cholera, salmonella, shigella), infectious hepatitis, and such lovely parasitic infections as guineaworm, bilharzia, bacillary or amoebic dysentery, worms, and giardia can all be transmitted by contaminated food and water.
     In restaurants unboiled water is still used for washing dishes and cooking certain foods, but an increasing number of restaurants in Kuta, Legian, Ubud, Lovina, and Candidasa brag about the fact that the ice used in their juices and cocktails is made from purified water and that they don't use unboiled water (or MSG) in their cooking.
     As dairy products are often made with untreated water and unpasteurized milk, they are outstanding media for the breeding of many pathogenic bacteria. It's advisable not to drink local fresh milk or eat ice cream sold by street vendors. Stick to dairy products labeled as pasteurized. Diamond, Peters, and Campina are quality brand-name ice cream products sold on Bali. Hotel ice creams should be safe.
     Powdered whole milk (Dancow brand), cartons of long-life milk, or sweetened condensed milk (Indomilk) are safe for kids or morning coffee, but don't mix with tap water! A great many restaurants on Bali specialize in delicious homemade yogurt. Being relatively more acidic, yogurt is safer, and in fact is a remedy against upset stomach.
     All vegetables and fruit eaten raw should be thoroughly washed, rinsed, or peeled before eating. Vegetables used in raw salads may have contaminating organisms remaining on the vegetable surface. Lettuce and cabbage are particularly difficult to clean. Salad dressings (particularly mayonnaise-based ones) may be a potential source of bacterial infection, especially after sitting out. Avoid sandwiches made with mayonnaise.
     Seafood should be eaten while fresh; shellfish should never be exposed to the hot sun and should always be thoroughly cooked. All meat should be well cooked or you stand the chance of being infested by worms. Cold meats, in particular, provide an excellent medium for the multiplication of bacteria in the heat and humidity of Bali. If you have to eat meat, stick to well-cooked meals served hot. Stay away from rare meats and cold buffets.

Contaminated Water
One of the biggest culprits in transmitting such diseases as cholera, typhoid fever, bacillary dysentery, and giardiasis, well water and tap water must be considered unsafe to drink on Bali because of poor sewage disposal and improperly treated water supplies. Ice served in restaurants is okay. To assure cleanliness and safety, all ice production is controlled by the provincial government.
     Hot beverages carry fewer disease-causing organisms than cold beverages. Beer, non-carbonated plastic bottled water, or plain soda water are about the only non-sweet beverages available to drink. Though it contains a load of sugar, Fanta is safe for kids to drink, hydrates the body, and has no caffeine. Fruit juices in cardboard boxes are fine but invariably oversweet.
     The freezing of water does not kill the organisms within, nor does the alcohol in a drink. Consider only plastic bottled water (Agua) safe. Noncarbonated glass-bottled drinks may or may not be safe. Use carbonated, bottled, or boiled water instead of tap water for brushing your teeth.

Diarrhea
Traveler's diarrhea constitutes 90% of health problems for the traveler. Diarrhea often begins within a few days of arrival in a tropical climate because travelers are exposed to organisms they're not used to. Many stomach troubles like diarrhea are often a result of sudden changes of climate, food, and water, rather than poor hygiene during food preparation. This is equally true for travelers from Bali visiting the West.
     People frequently refer to acute diarrhea as dysentery, but this is a misnomer. Diarrhea is much more common than dysentery. Diarrhea is generally a self-limiting disease lasting only a few days. Dysentery, on the other hand, is a serious, highly contagious disease characterized by blood or mucus in the stool. If you have severe diarrhea that lasts more than two to three days, accompanied by fever, headache, black-colored stools, or painful stomach cramps, you may have amoebic or bacillary dysentery. Seek medical attention as this disease can cause severe damage to your intestines and general health.
     Take antibiotics to treat diarrhea, not to prevent it. Don't overconsume fruits, especially during December and January. Even the Balinese get the infamous "Bali Belly" during this epidemic season. Avoid all obvious sources of contaminated food and drink. Before you consider eating in a warung or restaurant, look closely at the faces and hands of the cooks and people who will be serving you. They also eat the food they sell. If their faces reflect ill health, their fingernails are dirty, and their establishment is unkempt and unsanitary, walk on by.
     If diarrhea does strike, you will lose a considerable amount of fluid and salt. These must be replenished by immediately drinking lots of fluids (but not alcohol or strong coffee) to avoid dehydration. The best liquid is an oral rehydration solution, available in pharmacies, which contains the necessary salts. Take in clear fluids such as water, weak tea, juice, clear soup or broth (no milk), or soda that has stood awhile and gone flat.
     Gradually add such plain foods as biscuits, boiled rice, bread, boiled eggs, adding other solid foods until you recover. Balinese, if they eat at all, drink jamu and eat the young jambu fruit and plain rice. Bananas are also good because they're bland and contain the binding agent pectin. Papaya contains digestive enzymes, so it's easily digested. Avoid fatty or spicy foods and stick to bland foods while under treatment. Add milk products last.
     An over-the-counter drug sold in Bali which clears up diarrhea is Diatabs. One ounce of Pepto-Bismol liquid taken every 30 minutes provides symptomatic relief for most people with diarrhea. If your immune system can handle it, a well-tried and effective remedy is codeine-phosphate, available only by prescription.
     For even stronger stuff, Lomotil comes in the form of minuscule white tablets. The A-Bomb of diarrheatic medicines, Lomotil shouldn't be used for more than a day or two since it only relieves the symptoms and has the potential of locking in the infection. It usually completely stops bowel movements for two or more days. Imodium is one of the best non-antibiotic treatments for diarrhea. Milder than Lomotil, it allows you at least to go on functioning, but is counter-indicated if the patient is severely dehydrated or has a high fever.

EXHAUSTION AND HEAT EXPOSURE

Bali can be hot, particularly from February to May, and travelers need to adjust to a climate that is extreme by temperate zone standards, possibly producing fatigue and loss of appetite for the new arrival. Even after two weeks, it doesn't seem to get any easier. For some, acclimating to the enervating heat and humidity can take months.
     First, slow down the pace. Don't exert yourself. No one else does. Don't go on extended walks at your normal pace between 1000 and 1600. Persuade yourself to follow the Balinese custom of tidur siang (napping) sometime between 1200 and 1600, the hottest part of the day, or at least lie low during this time.
     It's not uncommon for a Balinese to take a mandi up to three times a day to stay cool. Balinese women put rice powder on their faces to protect their skin from the sun and to keep their complexions from turning dark. Travel in very hot areas only at dawn or dusk. Walk slow in the shade, fast in the sun. Prevent travel exhaustion by breaking up cross-island trips with stopovers.
     Adapt yourself to exposure to the sun gradually; you'll be able to stay out in it more and more. It's healthy to be out in the sun's torrid heat for a while during the day; it has a purifying, acclimatizing effect. Use sunblock, zinc oxide, or coconut oil as protection against the sun. Small children should be especially careful. Wear loose cotton clothing, light in color and weight. Wear a hat. If you carry an umbrella, you'll always be walking in the shade.
     Apply sunblock to your feet and bald spots on your head. Protect your nose and lips with zinc cream. Drink increased amounts of water with fresh lemon and lime juice, and make sure there's salt in your diet. Restrict alcohol and smoking. Avoid rich, fatty foods and stick to a light diet of rice, vegetables, and fish. Don't eat too much fruit as this can cause stomachaches and diarrhea.

Heatstroke Prevention
Heatstroke is caused by the breakdown of the body's cooling mechanism. Symptoms are a marked increase in body temperature to over 40° C (105° F) accompanied by flushed red skin, extreme lethargy, reduction in perspiration, and sometimes nausea, muscle cramps, or vomiting. Avoid heatstroke by drinking plenty of fluids, taking in enough salt, wearing light clothing, and moderating your intake of alcohol. Though rare, heatstroke could be an emergency. The victim should be taken to a cool room, doused with cold water, covered with a wet sheet, the body fanned and sponged until the temperature drops to at least 39° C (102° F), at which point the sponging should stop. Keep the patient at rest.

Salt
When your body sweats under the tropical sun you lose salt, so more should be added to your diet. Initial jet lag and fatigue might simply be caused by salt deprivation. Loss of body fluids as a result of diarrhea or dysentery also calls for increased salt consumption. Salt tablets are not really necessary, but after heavy physical exercise you might add a little extra salt to your food. If trekking into the Bali Barat National Park or climbing one of Bali's volcanoes, take along ordinary sea salt. A mixture of salt and water also serves as a mild antiseptic. If you have a sore throat, gargle with this solution.

WESTERN-STYLE MEDICAL TREATMENT

Pharmacies
There are plenty of pharmacies (apotik) in Bali's tourist and urban centers. The majority of the island's international-standard hotels have pharmacies, and the state-owned pharmaceutical company Kimia Farma has an big retail outlet in Denpasar (Jl. Diponegoro 125, tel. 0361-227811).
     On Jl. Raya in Ubud, near Ganesha Bookstore, is a very good pharmacy (tel. 0361-974214). Indonesian pharmacies carry the most common prescribed and over-the-counter brand names like Anusol, and Benadryl. As in the West, the more potent medications require a prescription.
     Because brand names for many drugs might be different, it helps to know your medicine's generic name. If you can't read the Indonesian on the container, have the pharmacist explain the proper dosage, which might be different from what you're accustomed to. Ask to read the leaflet (usually in English) that comes in the medication's packaging to make sure it's what you need. American drug companies have manufacturing subsidiaries in Indonesia, mostly in Jakarta, so many U.S. drugs are available at prices only slightly less expensive than in the U.S.A.
     The Temuku Health Food Shop & Bakery, in the Krakatoa Business Center at Jl. Raya Seminyak (tel. 0361-730849), carries a whole range of vitamins, homeopathic remedies and creams, as well as organic whole foods and health teas.

Doctors
Doctors' offices are open in the evening, from around 1700 to 2000; to avoid a long wait, get there 15 minutes before opening and sign up on the list. The charge is Rp5000-15,000 per visit, depending on the doctor's specialty. Drugs (if needed) are usually the more expensive cost. If it's a hospital or clinic, drugs are dispensed from a pharmacy right on the premises for an additional cost.
     To make up for their dearth of diagnostic skill, doctors tend to prescribe a standard recipe of antibiotics, antihistamines, tranquilizers, and vitamins for periods of three days or longer. They figure this recipe covers just about anything that could go wrong with you. And whatever problem you have, the Indonesian doctor is going to stick a needle in you. Make sure that he uses a new syringe, even if you have to buy it yourself at a pharmacy.
     If you're systemically ill, insist on a blood or stool test if you suspect it's dysentery because they seldom order one. Perhaps as effective as taking pills and succumbing to injections is to choose a natural treatment of jamu (see above). Recommended doctors: Dr. Hendra Santoso (children), Jl. Suli 42, Denpasar, tel. (0361) 234794; Dr. Otong Wirawan, Jl. Br. Semawang, Denpasar, tel. (0361) 287482. Ask around to see if any foreign-trained physicians are serving as house doctors in the four- and five-star hotels of Sanur and Nusa Dua.
     The proprietor of your hotel or homestay can come up with the name of a reliable and reasonably priced dokter or two. Specialists are found in the Bali telephone directory under "Medical Practitioners." If you feel that language will be a problem, get the names of English-, German-, or French-speaking doctors from your respective country's consulate (see "Foreign Consulates in Bali" under "Information and Services" later in this chapter).

Specialists
Routine dental care such as cleaning and fillings can be performed by dentists (dokter gigi) in Denpasar. Recommended dentists: Drg. Gede Winasa Kesama, Jl. Diponegoro 115 A, Denpasar, tel. (0361) 233907, appointments 0900-1400; Drg. Retno W. Agung, Jl. Bypass, Sanur, tel. (0361) 288501; Drg. Ritje Rihartinah, Jl. Pratama 81 A, Nusa Dua Clinic, tel. (0361) 71324; Drg. Rudita, Jl. M.H. Thamrin, tel. (0361) 226255. For emergency dental treatment, contact Dr. Indra Guizot, Jl. Patimura 19, tel. (0361) 222445 or 226445. You can also locate a good dokter gigi through your consulate (see "Foreign Consulates in Bali" under "Information and Services" later in this chapter).
     If you need complicated root-canal therapy, surgery, or bridge construction and repair, you will often be referred to specialists in Singapore. No certified orthodontists work in Bali. Dental floss is hard to find, so bring an ample supply. It's wise to attend to all your dental needs before arriving in Indonesia. Also take an extra pair of glasses or contact lenses, as well as contact lens cleaning and storage fluids. Acquiring new glasses is cheap and fast in Bali, but no need to go through the time and trouble.

Hospitals
If you get really sick or injured, fly home for treatment. If you want to remain in Indonesia, Jakarta offers Indonesia's best medical services. Your first choice for emergencies should be St. Carolus Hospital, Jl. Salemba Raya 41, Menteng (tel. 021-858 0091) or Pertamina, Jl. Kyai Maja 43, Kebayoran Baru (tel. 021-707211). Particularly good for cardiac cases is Dr. Cipto Mangunkusumo ICCU, Jl. Diponegoro 69, Menteng (tel. 021-334636). Sumber Waras, Jl. Kyai Tapa, Grogol (tel. 021-596011) also has a sound reputation, as does RS Pondok Indah, Jl. Metro Dua, Kava UE (tel. 021-769 7525). Closer to Bali is the Catholic Hospital St. Vicentius a Laulo (tel. 021-7562) in Surabaya (East Java).
     Despite Bali's being Indonesia's top tourist destination, the general hospital in Denpasar, Sanglah (Jl. Bali 5, tel. 0361-235456), offers inconsistent medical services. The new Japanese-built emergency unit, Unit Gawat Darurat, has very sophisticated, high-tech equipment.
     For really quality care, private clinics are your best bet because they offer doctors on-call 24 hours, radiology, pharmacies, laboratories, as well as ambulance service. Manuaba Clinic, Jl. Cokroaminoto 28, Denpasar (tel. 0361-426393) gets high marks; they have a branch clinic on Jl. Raya Kuta-Tuban (tel. 0361-754748).
     In Kuta visit Kuta Clinic, Jl. Raya Kuta 10 X (tel. 0361-753268). In Nusa Dua is Nusa Dua Clinic, Jl. Pratama 81 A-B (tel. 0361-771324); see Dr. Ritje Rihatinah. In Ubud, go to Darma Usadha, Jl. Abangan Tjampuhan (open 24 hours), tel. (0361) 975235. In Ubud, go to Darma Usadha, Jl. Abangan Tjampuhan, tel. (0361) 975235. Open 24 hours.
     Bali's regency (kabupaten) capitals also have hospitals: in Klungkung (Klungkung Regency) at Jl. Flamboyan 40-42 (tel. 0366-21172), in Singaraja (Buleleng Regency) at Jl. Jen. A. Yani 108 (tel. 0362-22396), in Gianyar (Gianyar Regency) at Jl. Ciung Wanara (tel. 0361-93049), in Bangli (Bangli Regency) at Jl. Kusumayudha 27 (tel. 0366-91043), in Amlapura (Karangasem Regency) at Jl. Ngurah Rai (tel. 0366-21011). In smaller district seats, it might be necessary to ask the assistance of the local Department of Health-ask for Dinas Kesehatan Kabupaten. In remote areas, the only treatment available is at small, crowded, poorly outfitted government health centers (puskemas) who employ medicos who are overworked, underqualified, and trained only in first-aid. The equipment can be pretty rustic. A doctor will not be in attendance.
     If you've been struck by a bemo, a puskemas won't take you. Only a rumah sakit (hospital) will accept emergency cases (the stitching used more resembles thick twine than suturing thread). Mental hospitals are found only in Bangli and in Denpasar (Wong Aya). A multilingual Dutch psychiatrist, Dr. Robert Riverger, works in Denpasar (tel. 0361-434543).

Rescue and Medical Evacuation Services
The AEA (Asian Emergency Assistance) can often work with an accident victim's or sick person's insurance carrier. If not covered by insurance, have your foreign consulate on Bali contact your relatives back home. AEA has an office in the Denpasar side of Sanur and can offer 24 hour medical advice (tel. 0361-231443 or 227271).
     Don't even entertain the thought of being rescued if you are swept out to sea off the extremely dangerous beaches of southern Bali. The Indonesians have only one rusty helicopter for marine rescue operations, and most of the time it's down. The ocean undertows are deceptively strong and every year as many as 40 swimmers are carried out and lost. No one seems to be aware of how treacherous these waters can be.
     Note: Always swim within the safety zones demarcated by the red and yellow flags!

FOLK MEDICINE

Herbal Medicines
Found in the markets of Bali, traditional medicines are said to cure anything from nosebleeds to fainting spells. Spices are an important ingredient in these Balinese folk remedies, and families still grow their own medicinal plants and grind their own medicinal pastes on flat stones in the corner of the bale. Headaches are cured by spraying the head with a mixture of crushed ginger and mashed bedbugs; a heated or irritated condition is cured with a cooling medicine.
     Other formulas include plain soft-boiled rice porridge (bubur), used to remedy diarrhea, and the leaves of the tall punyan kolor tree are laid on the site of a dog bite in order to "draw the blood out" and relieve pain. The palm spirit arak is popularly used for both external and internal maladies. If a person eats the leaves of the papaya tree, it's believed that mosquitoes will not bite him as his blood "turns bitter." Kayu sepang is for stomachaches and headaches. Wearing garlic around your neck or ear is believed to ward off evil spirits. Sacred pools (Tampaksiring), hot springs (Toya Bungkah), and natural spas (Yeh Panas) are said to have magic or curative powers.
     If symptoms persist after seeking help from family members, neighbors, and doctors, the patient then employs the magico-medico skills of indigenous healers, the balian. It's believed that-like landslides or being struck by lightning-there's a supernatural cause. Ritual neglect, the wrath of ancestors, or witchcraft has led to the "faulty illness," and it's now outside the expertise of Western-style medicine to effect a cure. Even a sick child is not innocent-he's suffering for some crime he committed in a past life.

Jamu
These are over-the-counter herbal medicines derived from the forests of Indonesia-hidden pharmacies of potent medicines in the form of plants, grasses, minerals, fungi, roots, barks, twigs, dried flowers, and parts of mammals, birds, reptiles. They come in the form of pills, capsules, powders, beans, peas, flat seeds, or can look like tea leaves.
     Jamu shops are found in Denpasar (one is opposite Pasar Badung on Jl. Sulawesi, others include Toko Jaya Abadi and Toko Sentosa on Jl. Gajah Mada) with row upon row of small packages and little jars and bottles lining the shelves. You need no doctor's prescription. Explain your problem to the vendor and he'll know what you'll need. Follow the dosage directions on the packet or bottle. Jamu is cheap, about Rp500-750 per packet. The "super" is served with an egg, two kinds of wine, a cup of sweet tea, and a piece of candy afterwards, all for Rp3000-4000.
     There are hundreds of different jamu, one for seemingly every conceivable malady. Women over 40 drink a special jamu to keep themselves from getting too thin. Jelok temu is given to year-old babies for strength. Jantung fortifies the heart. Lular paste, made from rice mixed with pulverized bark and flowers, slows the wrinkling and aging process. Mangir is a yellow powder put on the skin to make it clear, fragrant, refined. Ginjal is for an inflamed appendix. Kumis kucing (cat whiskers) is for urinary tract infections. Beras kencur peps you up all day.
     Other jamu treat colds, tightness or dizziness in the head, runny nose, bronchitis, flu, and even "starry eyes." There are anticough herbs and others for sore bones, backaches, and listlessness. Men's tonics increase strength, and an aphrodisiacal jamu increases sex appeal and fertility. They've even got a jamu for men who do extreme physical labor, as well as special herbs ("Magic Formula No. 125") for hard-working mothers with many children that will make their husbands more considerate.

Balian
A great number of Bali's rural people put their faith in the balian, the Balinese folk doctor. For the villager he's cheap and on the spot-they'll go to him before a hospital or clinic. The balian receives a voluntary consultation fee, or he may accept payment in commodities, food, or labor. He also derives income from the sale of his herbs and potions. In the balian's home there's a sitting room just like at a doctor's office where patients are willing to wait hours if the balian is busy.
     Long-established opponents of Western medicine, these barefoot doctors have used locally made remedies and treatments for hundreds of years. Though most of the balian<\#213>s medicines have never been laboratory tested, many have a sound scientific basis in modern medicine. Most have inherited their practices from older male relatives, while others come to their calling after a visionary dream.
     Some combine practical folk medicine (barks, herbs, roots, other curative substances) with religious magic learned from detailed and lengthy lontar usada books. It's claimed some balian tulang can set bones so well that a broken leg can heal in two weeks. Balian apun (masseuse) have developed massage into a high science, even for orthopedic problems and headcolds.
     Both revered and feared, it's believed that certain balian are men of supernatural powers who have the power and specialist knowledge necessary for diagnosis and treatment of illnesses not curable by ordinary means. The better known of these spirit mediums (balian taksu) attract clientele from all over the island. At times, they prescribe treatments while in a state of trance.
     Other balian are inspired diviners (balian tenung) who embody the souls of dead people who "speak in tongues" through them. They also use horoscopes and offerings to practice both "right" and "left" magic, love-magic using prayers, medicinal recipes, as well as amulets, talismans, a ring, or some other magical object or figurative diagram (rarajahan) to exorcize evil spirits from houses. Balian kebal specialize in imbuing their clients with strength (kemasukan kekuatan) in order to protect them from their enemies.
     Balian mediate between the natural or human world and that of the supernatural. Mantras and supplicatory prayers are sometimes employed to negotiate or entreat malignant forces to vacate the body. They dispense holy water and oil in order to heal illnesses by faith or achieve success in a university exam. If a baby is sick too often, the balian may simply change his name, or place a slice of onion on her fontanelle to prevent entry by a leyak.
     Among the balians are shamans who claim to be able to cure people who have been secretly poisoned or purge them of spells cast on them by less powerful balian. Balian can also improve a client's sex appeal. A "diamond blown onto the lips" by a balian will give his customer an irresistible smile and fascination for the opposite sex.
     Don't confuse the balian with pedanda (high-caste Brahman priests) and pemangku (lay priests), as their social and religious function lies somewhere in between. The term balian actually applies to a variety of healing practitioners. Some are total quacks. The Ubud area has always attracted talented natural healing practitioners from the West-in a sense, Western balian-who conduct regular workshops and sabbaticals.

COMFORT

On Bali, the battle never ends against fried food, sugar, fat, and meat in food, noxious cigarette smoke, noise, heat and humidity, insecticide spray cans, and over-air-conditioned rooms. Do what Balinese do to maintain comfort: notice that while relaxing they wear sarung and kain, ideal for this climate. Synthetic fabrics are too hot and sticky, so just wear drip-dry, loose-fitting, light-colored cotton or rayon clothes.
     Choose a room with a split-level air-conditioner so that the noise stays outside. In other situations, it can be too cool. All performances on Bali, as well as many restaurants and bathrooms, are open-air, so in the uplands (Ubud area) from July to September always take along a light jacket. If your room is damp, clammy, and dark, get in the habit of in the mornings airing out all your bedding on a line in the sterilizing sun; the Balinese do.
     Like the Balinese, take a mandi as frequently as you need to stay cool and grunge free. The verb is mandi, to bathe. The place where you go to bathe is called a tempat mandi, which could be a river, a well, or a kamar mandi (bathroom). In almost any hotel you may pay Rp2000-6000 (including towel) to enter the swimming pool without being a hotel guest.
     Beards can be quite itchy in the heat (and scare Indonesian children). Bring your inner body temperature up to the outside temperature by drinking water or hot tea. Sugary, ice-cold sodas just make you thirstier. If the food is too spicy hot (pedas) drink hot water; it will sting at first, but the spiciness will go away faster.
     In Kuta, Legian, or Ubud, you'll find half a dozen beauty salons where you can indulge yourself with a manicure, hand massage, or pedicure for around Rp10,000. Exercise classes and health salons are popping up all over Bali now. To experience the nimbleness and strength of Balinese women, get your hair plaited on Kuta Beach (Rp5000 is the correct price, Japanese pay Rp20,000).
     Spas: Bali's spas offer a dazzling and sophisticated menu of holistic healing therapies-aromatherapy, massage, herbal wraps, thermal mud treatments, saltwater jacuzzis. To take advantage of this New Age trend, hotels in the Nusa Dua area have incorporated "spa" in the name of their health clubs. In Tabanan Regency in the small village of Penatahan, the natural hot springs of Yeh Panas have been developed into a modern, open-air spa, set in manicured gardens-Bali's leading natural spa facility.

Massage
To improve circulation and muscle tone, try a massage. Get a personal recommendation for a masseuse through your homestay, beach inn, or hotel reception-the best are old, blind women. For example, Pak Guru Rasin renders superb traditional massages for Rp8000 at BeeBee's in Tibubiyu (Tabanana). The staff of almost any hotel knows a professional masseuse or two.
     One also encounters scores of practitioners on the beaches of Kuta, Legian, and Sanur where mature women with distinctive hats and T-shirts stroll the beach with bottles of coconut oil mixed with herbs. They generally have numbers on their hats or preposterous nicknames like "Hot Dog," or "Go-Go." Men are very seldom seen performing massage on the beach.
     Prices vary from masseuse to masseuse depending on how business is and how much they think you're willing to pay-anywhere from Rp7000 to Rp15,000 for 30-45 minutes. Bargain. Always be sure of the price first; otherwise you could be ripped off. If you find a good one, stick with her. Don't worry-she'll stick to you too.
     The incredibly strong hands of these women gently knead your body from head to toe, rubbing in boreh, which consists of coconut oil, flowers, aromatic roots, cloves, nutmeg, kunyit (turmeric, for coloring), and lulur-a yellow paste from Java made from mashed don kolor leaves-part of the beauty care of royal families. When rubbed in vigorously, this concoction tingles and refreshes the skin when you're hot or gives it heat after you've been out in the rain. You come out smelling like a flower. Balinese masseuse are also adept at skin rolling and "percussion"-hands, palms together, chopping over a particular area.
     The culmination is the cracking of virtually every joint in your body. Massages may last from a half hour to an hour and a half, depending upon how wrapped up you get in conversation. Try to concentrate while being hit on to buy bikinis, watches, and woodcarvings from an unending line of vendors.

Anti-Mosquito Aids
On Bali, mosquitoes are only bad at dusk on the coast. In cheap hotels, keep what mosquitoes there are off you by moving your bed under a fan or by using mosquito coils (obat nyamuk), which are quite effective, slightly nauseating, and available anywhere for Rp800 for a box of five. Far superior are electrically powered (Baygon brand) anti-mosquito mats, much easier to take and not nearly as toxic. The whole setup-device, cord, small sealed packages of tabs-costs around Rp12,000.
     Before stepping out at night, apply Autan spray or citronella oil to the skin. Also extremely effective is Minyak Angin (Eagle Brand Medicated Oil), which can be purchased at any Chinese apothecary. If unprotected while sleeping at night, use a mosquito net (kelambu), which can be bought for around Rp20,000 in any supermarket.
     A repugnant habit of the hotel staff is the spraying of insecticide (Baygon) all over your room and under your bed before you go to sleep at night. This problem is easily remedied by simply telling the person armed with the sprayer, "Tak usah, terimah kasih" ("Thank you, but it's not necessary").