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Bali Health Risks

There are two nouns synonymous with "Bali"; "paradise" and "belly". To be fair "Bali belly" is often caused by foreign visitors experiencing a change in diet with more fruit and / or a reaction to many herbs and spices used in traditional Balinese and Indonesian food. But clearly, as everyone who hears that expression knows, much is to do with bad food and poor food hygiene (washing salad items with unsterilized water, cross contamination between cooked and uncooked meats, food preparers being unsanitary, food left uncovered, food being kept longer than it should, etc.). And bacteria laden food is only part of the problem.

BLTF believes the Indonesian Government and Authorities have a culture of covering up health problems, possibly because they feel it might negatively impact their tourism industry or undermine their claims to be running their various departments effectively; but health cover ups are a recorded fact of life in Indonesia. With the spread of drug resistant malaria strains (malaria is believed to infect 15 million and kill 30,000 Indonesians each year) and tuberculosis throughout tropical climates, in particular SE Asia, not to mention chicken flu viruses, unfortunately this culture actually puts the foreign visitor at increased risk.

Regarding mosquito born disease, the cleaner the area the less chance the mosquitoes will carry the deadly viruses. The less stagnant water there is around, the less chance mosquitoes have to breed. Unfortunately Bali is often a very dirty place where litter is dropped wherever what is inside it was consumed; it is the plastic and polystyrene litter particularly that creates perfect breeding grounds for mosquitoes. So the cleaner the area, the lesser the risk. It is also prudent to find out what hotels anti-mosquito measures are; some will spray or smoke the grounds (best not to come in contact with what they put down however), many offer mosquito nets. Mosquito coils are potentially hazardous to your health and should be avoided. Electric mosquito deterrents do not work at all. Western high (tropical) strength mosquito sprays, etc. are essential in most cases although people with sensitive skins may suffer from their use. Avon Skin So Soft is a moisturizing cream which many people report is also an effective mosquito repellent.

Tropical climates such as Bali's, especially during the monsoon (rainy) season create natural prolific breeding grounds for bacteria and viruses. The problem is made worse by ineffective policing most probably due to laziness and corruption. For example the illegal dumping of effluence and other unsavory waste in and around the Bukit Peninsula creates a credible health risk for the whole tourism area (Tanjung Benoa, Nusa Dua, Sanur, Jimbaran). The discharge of raw sewerage into the sea, especially in the mass tourism areas, creates a health problem for bathers and the marine life immediately offshore, which is why the local fisherman are meant to fish miles out to sea but reports indicate they do not always do this. Even if fish is caught from clean waters, it only takes a drive past a roadside stall with the vendor swishing the flies away from fish left to stagnate without ice or any form of refrigeration in the tropical heat to begin to understand the risks. In addition, because of the impoverished state of many farmers, etc. reports state that infected meat, often from animals which die from disease, plus fruit and vegetables grown with the use of pesticides and insecticides that are not permitted in other countries are sold into the human food chain.

The use of Monosodium Glutamate (MSG AKA "Fetzin" / "Fetsin" locally) is widespread throughout Bali where many people believe it to be a spice; it is often referred to as "Super seasoning". MSG affects the nervous system and many food sellers in Bali add large amounts of this cheap chemical to enhance the flavour of otherwise bland food due mostly to it being well past its "sell by date".

Finding good restaurants is therefore difficult and it is not a simple case of how much you pay, BLTF has seen credible reports of customers at one of the island's most fashionable restaurants contracting Typhoid; reported by one of the chefs no less. It is often therefore best to order something grilled and well cooked, even if it is not your first menu choice. BLTF believes it is also highly prudent to ask to inspect a restaurant's kitchen before eating there, even if it is the restaurant of a 5 star hotel. In many cases you will be glad you checked first, not just for the number which clearly are unclean or disorganized, but also for the many that use bulk pack tasteless food products "enhanced" with MSG. Of course official restaurant inspections are much rarer and less stringent than in western countries, and whatever inspections there may be are still subject to the same old intrinsic Indonesian problem, corruption; paying a bribe in order for health offences to be ignored, which is why you need to check kitchens yourselves.

Despite having said this, Bali can and does offer some spectacular food, but you really have to be careful in finding the right place. BLTF considered offering suggestions to certain restaurants but decided it could not, as what is good one day can go horribly wrong the next. BLTF used to suggest finding popular western targeted restaurants in order to find safe ones, but we know of examples where that really does not apply and the restaurants seem only to be busy based on previous standards or fashion. BLTF does believe however that finding busy restaurants filled with Indonesians is generally a very good sign that the food will be excellent, authentic, cheaper and safer (less likely to be targeted by terrorists). But be warned, the local population accept monosodium glutamate seemingly without question and will have a tolerance to locally prominent food bacteria, so be prepared to look hard for restaurants that offer food with MSG and expect a rough first few nights until your stomach becomes used to the local everyday bacteria too! And of course, Indonesian customers at restaurants generally spend a lot less money then foreign tourists do when they eat out, so you will likely not find fashionable decor and / or prime locations if you decide to go it local style.

If you want to eat at a western standard restaurant BLTF believes a quick kitchen inspection and careful questioning such as "How long do you boil the water to sterilize it?" will yield results both in the quality and safety of the food you eat while on holiday in Bali & Lombok. Don't be put off by BLTF's general warnings, just remember you are eating in a tropical climate often without the same high and rigorously enforced food standards as western countries. Find the clean kitchens with fresh foods and enjoy a Balinese culinary experience you will choose to remember rather than one your would rather forget!

To understand some of the safety problems that result from corruption that affect foreign travellers to Bali, please see: Bali Safety Risks.