In all likelihood you will have a holiday with no more of a health or safety drama than a spot of Bali Belly, but that’s not to say nothing can go wrong. It can. Here is a roundup on medical in the region along with some of the most common dangers you might face.
More than anything else, using good sense will help keep you safe and healthy on the road. The most essential thing, given the tropical climate, is to stay well hydrated by drinking plenty of water.
Proper sanitation will also help reduce the risk of the most common traveller’s illnesses, such as diarrhoea. Use good judgment when selecting where to eat, particularly when buying food from street vendors (make sure anywhere you eat is busy), and wash your hands or use hand sanitiser often, including every time before you have a meal. It should be noted that medication for diarrhoea won't actually “fix” your problem, rather it “slows everything down”—so is only really for use before long trips or in cases where you’ve really lost control. If you’re not doing any travelling, you’re better off to bring your diet back to basics till your system settles down rather than pop a pill and keep cramming new food into your system.
Use sunscreen and wear sunglasses and a hat when necessary to protect yourself from the strong tropical sun. Eating a healthy, balanced diet, drinking alcohol in moderation and getting plenty of rest will help you feel better too, particularly on extended journeys.
Easily the most common insect-borne illness you are likely to encounter in Southeast Asia is dengue fever. Spread by mosquito, dengue fever it is a debilitating and potentially fatal virus that can take months to recover from fully. We’ve had it twice and we do not recommend it. The only way to avoid catching dengue is to avoid being bitten by mosquitoes (a vaccine is now available in a handful of countries only). This comes with the added bonus of protecting yourself from other viruses including malaria and Zika.
Dengue is found right across Southeast Asia—including Singapore. It has an incubation period of up to seven days and presents itself with a very high fever, severe pain behind the eyes and an extremely painful dull ache in the joints (hence its nickname, “breakbone fever”). There is no treatment for it save rest and keeping your fluids up. Hospitalisation is common.
If you start to show dengue symptoms after returning home, it is important that you tell your doctor you’ve recently been in Southeast Asia and possibly exposed to dengue, to make sure you receive the appropriate care.
Malaria is far less prevalent in Southeast Asia than dengue fever and unless you are spending prolonged periods of time in the border areas between Thailand and Burma, Laos and Cambodia, or are travelling extensively in eastern Indonesia (essentially anything north or east of Bali) then the chances of you contracting, or even coming into contact with malaria-carrying mosquitoes is low.
Travel doctors in the West can be a bit trigger happy when it comes to prescribing malaria prophylactics and we would be cautious of any advice suggesting malaria meds for a general purpose holiday to Thailand. If the doctor knows what they are on about they will ask very specifically where you are going before suggesting these pills. When prescribed, pills are taken on a preventative basis (daily and weekly are the most common) along with an emergency dose should you actually come down with malaria.
The next most common way you’re likely to come unstuck is in having a scooter accident. Scooter accidents are the number one cause of death among travellers in Southeast Asia. As we've said repeatedly, always wear a helmet. Also, dress sensibly. Never ride a motorbike barefoot. Ideally already know how to ride a motorbike and if you want your travel insurance to be valid, have a license.
After dengue fever and scooter accidents you fall into a far broader spread of talks of woe and stupidity. If you are hospitalised in Southeast Asia for any kind of serious accident or illness, the first thing you need to do is alert your travel insurance company. This is critical as decisions made can impact on compensation and some insurers may require you seek care in specific hospitals and so on.
Generally speaking, Singapore has the highest standard of medicare in the region, closely followed by Thailand, then Malaysia, Vietnam, Indonesia, Cambodia, Laos and Burma—in that order. If we were to be involved in a serious accident we would want to be shifted to Bangkok or Singapore as soon as possible. To emphasise this, we would move aggressively to get out of the healthcare of Cambodia, Laos and Burma as soon as it could be done safely.
Medical care is more affordable than in many countries in the West, but costs still add up and in the case of serious accidents the costs can quickly reach the tens of thousands of dollars. Because of this, as mentioned above, alerting your insurer upfront and keeping them up to date on developments is crucial.
Your insurer may work to get you stabilised before suggesting you are transferred back to your home country (and into your national health scheme’s responsibility). This can be a source of friction between you, your hospital and your insurers and it pays to read the small print of your policy carefully.
Short of catastrophic accidents, medical clinics able to deal with minor ailments, scratches and abrasions and so on are relatively common place across the region. For anything that requires setting bones or opening (or closing) you up, we’d definitely be aiming for Singapore or Bangkok.
Violent crime aimed specifically at foreigners is extremely rare while petty theft, especially snatch and grab thefts and crimes of opportunity are very common, especially in capital cities and heavily touristed areas.
Snatch and grab attacks deserve particular warnings for Phnom Penh in Cambodia, Saigon and Nha Trang in Vietnam and Ubud in Bali, Indonesia. These can of course take place anywhere, and it pays to be an alert traveller. The thieves are generally on motorbikes and aim to rip the bag off the shoulder of an unsuspecting tourist (whom they approach from behind). Trying to hang onto the bag can be fatal as the victim can be dragged onto the road and into the path of oncoming traffic—don’t try to hang onto the bag thinking you’ll pull them off the bike—physics doesn’t work that way.
The best preventative method for snatch and grab is to always keep your bag, purse or handbag on your off-road shoulder as this makes it far more difficult to snatch from a passing motorbike. Nothing is too small—we once had motorbike thieves try to snatch our phone out of our hand while standing on a street corner in Kuala Lumpur.
Likewise keep in mind your surroundings and consider the implications of flaunting your wealth. Petty theft is often a crime of opportunity—the chances of which are best minimised by not leaving your smartphone on a table while you go to the bar, avoiding wearing excessive jewellery or dragging around ridiculous amounts of camera gear.
Rape and other sexual assaults are notoriously underreported, making it difficult to make anything more specific than broad warnings as you would hear about anywhere else. Drink spiking remain a considerable problem in heavily touristed areas as does sexual assault in more isolated areas, deserted beaches and so on. Single female travellers should be wary of others showing undue attention. If a situation becomes uncomfortable, leave, preferably not alone.
Don’t put yourself in situations of extreme vulnerability—walking home alone at 3am along a deserted beach while heavily intoxicated, for example. We’re not saying you don’t have the right to do this safely, which you most certainly do, but rather that you may be putting yourself in a more vulnerable position, whether talking about robbery or physical safety, by doing so.
Rabies is endemic in some parts of Southeast Asia. The best way to avoid rabies is to keep your distance from common carriers such as monkeys, dogs and people foaming at the mouth. It is possible to get preventative shots but unless you’re planning on having contact with animals or are travelling to a particular area with a current rabies outbreak, this may be an unnecessary expense. Our family had the shots a couple of years ago in the middle of a rabies outbreak in Bali, Indonesia, but we’d lived for over a decade previously in Asia without them (and without coming into contact with animals regularly).
Armed robbery in broad daylight in Southeast Asia is thankfully very rare, but robbery of rooms unfortunately is less so. If you wake up in your bungalow to find thieves rustling through your stuff, do not resist nor try to fight them. In many cases they have far more to lose than you (if they’re caught by locals they may be beaten to within an inch of their life) and so may turn violent. In rare cases travellers have been killed when a robbery went bad. Our advice, unless totally unavoidable, is to avoid confrontation. In cases where you feel you have no choice and you feel they plan to physically do you harm, fight for your life or flee. Lock your room at night when you’re asleep and obviously lock it when you go out. Don’t leave valuables in positions where they can be reached from the window.
Southeast Asia has some extremely harsh drug laws. The laws regarding entrapment which may apply in your home country may not in Southeast Asia. Just because the tuk tuk driver offers you a bag of weed doesn’t mean it is legal nor that he won’t give your room number to the police after dropping you off. Never travel with drugs. In Cambodia, especially Phnom Penh, heroin is often passed off as cocaine—travellers die every year because of this. Don’t work on the assumption you’ll always be able to pay your way out.
Scammers can be found in most tourist destinations around the globe, and Southeast Asia is no exception. The first and most important point is DON’T BUY GEMSTONES. There’s all manner of scams revolving around convincing people to buy stones to smuggle home and see a grand profit. If it was so easy we'd be smuggling gems ourselves, not running a travel website. See the Thai Gem Scam group website for more information.
Other scams include card-playing affairs, where you're invited to play cards and end up being cleaned out, being invited into “official TAT” agencies (where you pay through the nose for overpriced tours), being told a certain attraction is closed (so you can be shuffled off to a gem store, card game or travel agency) or being invited to drink with a bunch of complete strangers (where you'll be liberated from your money, sometimes by being drugged).
At the end of the day, use your common sense. If a complete stranger approached you in your home town and started chatting away about how they'd love to show you around town, how would you react?
It is important though to remember that only a minuscule minority of people are involved in scamming tourists. Use your judgement and don't let these warnings colour your reaction to all people you meet.
Planning well is an integral part of getting the most out of your trip. Be it picking the right backpack, the right vaccinations or the right country, the simple decisions are often the most important.