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Come si vive a Jakarta main

Claudiaexpat shares her health experience in Jakarta, and some good pieces of advice.

 

A while ago, I wrote an article in French about the status of health structures in Jakarta.  A few months into writing the article, I learnt that it was really a matter of survival of the fittest, or more a case of how well prepared you are.  I am happy to share with you the more delicate but essential aspects of life in Jakarta.

Salute a Jakarta2I do need to point out that the status of any form of health care in Jakarta is somewhat ambiguous.  During my time there I have contracted various ailments of some sort or another. Suspected Dengue, amoeba infections and other mysterious illnesses amongst others.  It took us at least a year to acclimatize and it wasn’t easy.  My husband still suffers regularly with a virus that attacks his respiratory system. But, we are not alone.  Typically you find out the truth usually from the expat circle, that everyone has experienced some kind of viral attack in some form or another.  The upshot is,  that settling in Jakarta is difficult.  Bacteria and germs proliferate in this unhealthy city and it’s not difficult to see why.  In the streets there are open gulleys full of rubbish infested by rats.  Add humidity and a rainy climate, the microbes and bacteria festering in the unfettered garbage lying around multiply unchecked at an alarming rate.  The continuous swing in Jakarta’s intemperate tropical climate and the unregulated use of air conditioners, only adds fuel to the already dangerously unhealthy conditions.

Unfortunately, there is little one can do about the situation.  No expat would even dare drink the tap water let alone eat anything from the street vendors.  However, isolation in a septic environment isn’t possible and sooner or later succumbing to something ‘not very nice’, is inevitable.

This ‘something’ can take hold at anytime and usually does in an unsuspecting manner, totally flooring you from one moment to the next.  You may be lying comfortably on the sofa watching TV and find yourself half an hour later drenched in sweat rolling around on the bed clutching your stomach because of terrible cramps. The fever reaches disturbing levels as it takes hold giving you no time to think rationally about an emergency plan. This happened to me and I found out afterwards that the malaise is sudden, strong and total.

When this happens there really is only one option; to seek emergency assistance.  You’re terrified because of the symptoms and scared because you have absolutely no idea what’s going on in your body. But, in Jakarta there are no clinics that you could even contemplate visiting.   The expats I talked to certainly weren’t aware of any that could be trusted with your health.  The only place vaguely reliable is SOS International and it’s full of expats in similar situations to yours.

At SOS International they can’t actually treat serious cases, but they have an emergency unit and a battery of Indonesian and foreign doctors, plus a 24 hour laboratory. Foreign doctors in Indonesia by law are not allowed to treat patients. They have a simple role of mediation and support to local doctors, but when you are writhing in pain or shivering with fever, their presence is very welcome, simply because of their familiar approach.  I strongly suggest you look up Dr Mike Turner, who is absolutely the best because of his participative approach and his genuine warmth as a doctor. I also wholeheartedly advise you to seek a reliable and renowned medical insurance cover before you arrive, or at the very least sign up with SOS International upon arrival.  Sometimes medical evacuation is necessary, and costs are exorbitant.

Salute a Jakarta3I have medical insurance through my husband’s organization in Switzerland (I pay myself), which has saved me on more than one occasion: it has covered the cost of an expensive shoulder surgery and my evacuation and stay at a hospital in Singapore. There was a time when I was actually hit by a series of infections simultaneously. Doctors also suspected Dengue fever due to the dramatic decrease in blood platelets. They decided to evacuate me because they feared a sudden hemorrhage would have required a transfusion. A simple transfusion can obviously be made in Jakarta, but blood treatment is safer in Singapore.  So I ended up in Singapore, and for the first time in my life, unable to enjoy the experience, I travelled business class.  I was accompanied by an Indonesian doctor who took wonderful care of me and wouldn’t leave until he saw I was safely tucked up in my hospital bed.  I have to report that the service offered by SOS International was flawless. They took care of everything. They met me at the airport in Singapore, and during my whole solitary stay, they called me every day to inquire how I was. The only negative note in the whole process was at the end, when doctors declared me out of danger and discharged me from the hospital.  The insurance company told me I had to reach the airport by myself because I was “fit to fly”.  Several times whilst going through boarding procedures, I nearly fainted because I felt so weak (and abandoned).

Me in my hospital bed in Singapore

Me in my hospital bed in Singapore

In Jakarta it is almost a given that travel to Singapore for health problems is inevitable and is as common as drinking a cappuccino in Italy. All expats do it sooner or later. There are many inexpensive flights, and it’s perfectly organized so that a full check up doesn’t take up too much time. I actually had the impression that medicine is the hard-core business of the city: there are private hospitals that look like luxurious hotels, and tariffs are exorbitant.  Doctors seem good – they are certainly recognized as amongst the best in the world.  Both the doctor who operated on my shoulder and the one who took care of me during my other health problems, have been extremely nice, and very professional (after all their fees widely justify a first-class treatment). The trend in the hospitals though is to stuff you with drugs. During my unlucky stay, the thing that most filled me with anguish was the quantity of chemicals they made me have, both orally and intravenously. When I finally left the hated bed, they gave me so many (basically useless) drugs to take back to Jakarta, that I could have opened a drugstore.

Anyway, luckily we have Singapore. I end by giving some good advice for those that are about to move to Jakarta:

  • Do not get scared if you feel sick very suddenly. Don’t forget that everything here is virulent and strong, but that it does goes away
  • Stipulate a medical insurance. If you do not have one when you arrive, sign up with SOS International
  • Should you identify a doctor you feel you can trust, stick with him and keep him as a reference point all the time
  • Never forget that the traffic in Jakarta is impossible, so it will probably take you a while to reach an emergency destination. Take a sick bag and any other items that may give you some relief during the trip
  • Be careful of what you eat and drink, but don’t become obsessive. You have to allow your body to build a minimum defense.
  • Organise a first aid kit at home. Since you risk getting stuck in traffic, it’s always best to give first aid at home before embarking on the long trip to your emergency destination
  • Dengue is present here, so try all you can to avoid being bitten by mosquitoes

I recently got in touch with two great women doctors: Dr Inneke, generalist, and Dr Inge, gynaecologist, both at SOS International. I will keep adding whatever good resource I find. If you need anything in the meantime, please do not hesitate to contact me.

 

Good health everyone!

Claudiaexpat (Claudia Landini)
Jakarta, Indonesia
June 2016

Article proofread by Sally, in Harare

Photo credit ©Jean Clauzet