Добавил:
Upload Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:
Скачиваний:
6
Добавлен:
16.05.2015
Размер:
669.51 Кб
Скачать

T R A N S P O R T

928 G E T T I N G A R O U N D • • B i c y c l e l o n e l y p l a n e t . c o m

Southeast Asia. Visit Thai Airways International

travel by air; check with the airline about extra

(THAI, code THA; www.thaiair.com) for more details.

charges and shipment specifications.

BICYCLE

Touring Southeast Asia on a bicycle has been gaining more and more supporters. Many long-distance cyclists start in Thailand and head south through Malaysia to Singapore. Road conditions are good enough for touring bicycles in most places, but mountain bikes are recommended for forays off the beaten track.

Vietnam is a great place to travel by bicycle – you can take bikes on buses, and the entire coastal route is feasible. If flat-land cycling is not your style, then Indonesia might be the challenge you’re looking for. Road conditions are bad and inclines steep, but the Sumatran jungle is still deep and dark. In Laos and Cambodia, road conditions can impede two wheeling, but light traffic, especially in Laos, makes pedalling more pleasant than elsewhere. Mr Pumpy (www.mrpumpy.net) provides all the inside information to get your wheels spinning.

Top-quality bicycles and components can be bought in major cities such as Bangkok but, generally, fittings are hard to find. Bicycles can

BOAT

Ferries and boats make trips between Singapore and Indonesia, Malaysia and Indonesia, and Thailand and Malaysia.

Typically, guesthouses or travel agents sell tickets and can provide updated departure times. Be sure to check the visa regulations at port cities.

BORDER CROSSINGS

Going through the region overland is getting easier as potholed ditches become major highways. The border crossings for the region are listed here by country; the following abbreviations are used for convenience: B (Brunei), ET (East Timor), C (Cambodia), I (Indonesia), L (Laos), M (Malaysia), My (Myanmar), P (Philippines), T (Thailand) and V (Vietnam).

Be aware of border closing times, visa regulations and any transport scams by asking your fellow travellers before making a longdistance trip or by referring to the relevant country chapters.

SOUTHEAST ASIAN AIR FARES

 

 

0

500 miles

 

 

 

 

 

 

 

 

0

800 km

 

 

 

 

 

 

 

TAIWAN

 

 

 

 

 

 

CHINA

 

 

 

 

 

MYANMAR

Luang

 

 

 

 

 

 

 

 

(BURMA)

 

 

HANOI

 

 

 

 

 

 

Prabang

 

 

 

 

 

 

 

 

 

120

 

 

 

 

 

 

VIENTIANE

 

 

 

 

 

 

 

 

YANGON

220

 

50 LAOS

 

 

 

 

 

 

 

 

 

MANILA

 

 

THAILAND 100

150

 

 

 

 

PHILIPPINES

90

 

VIETNAM

 

 

 

 

 

 

 

 

 

 

 

BANGKOK

CAMBODIA

64

 

 

 

 

 

 

 

 

 

 

 

 

120

PHNOM PENH

 

 

 

 

 

 

 

 

 

 

 

 

150

Ho Chi

 

 

 

 

Cebu

 

 

 

 

250

 

 

 

 

 

 

Minh City

 

 

 

30

 

 

 

 

 

50

 

 

 

 

 

30

 

 

 

 

 

 

 

 

60

 

 

60

 

 

 

 

 

 

 

 

BANDAR SERI

 

 

 

 

 

 

50

 

 

 

 

Penang

 

 

 

 

 

BEGAWAN

 

 

MALAYSIA

 

 

 

BRUNEI

 

 

 

 

 

 

 

 

 

KUALA

 

 

60

 

 

 

 

Manado

LUMPUR

 

 

260

MALAYSIA

70

 

 

 

 

 

 

Medan

50

 

 

 

 

70

 

 

 

SINGAPORE

 

 

Borneo

 

 

400

 

 

 

 

 

 

Sumatra

 

 

 

300

Sulawesi

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

130

130

 

 

 

 

 

 

 

 

 

 

 

 

 

EAST

 

 

 

 

 

 

 

 

300

TIMOR

 

 

 

 

 

 

 

 

DILI

Full one-way economy fares in US$

 

 

JAKARTA

Java

Bali

 

 

 

 

 

(discounts available on most flights).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fares vary enormously depending on

 

 

INDONESIA

 

Denpasar

 

500

season and carrier.

 

 

 

 

 

 

To Darwin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Australia)

l o n e l y p l a n e t . c o m

Brunei

The Malaysian states of Sarawak and Sabah form a C clamp around Brunei. All border crossings feed into the Brunei capital of Bandar Seri Begawan.

The first four of the following crossings are from Sarawak, while the fifth is from Sabah:

Kuala Baram (M) to Kuala Belait (B), from Miri (M); see p50, p506

Limbang (M) to Kuala Lurah (B); see p49, p508

Limbang (M) to Bangar (B); see p51, p508

Lawas (M) to Bangar (B); see p51, p509

Pulau Labuan (M) to Muara Port (B); see p49, p484

Cambodia

FROM LAOS

The only border passage to Cambodia is south of Si Phan Don (Four Thousand Islands) through Voen Kham (L) to Dom Kralor (C); see p115, p402. The main town on the Cambodian side is Stung Teng.

FROM THAILAND

There are five border crossings between Thailand and Cambodia:

Aranya Prathet (T) to Poipet (C), which links Bangkok (T) to Siem Reap (C); see p97, p709

Hat Lek (T) to Krong Koh Kong (C), which runs along the coast; see p113, p765

There are also three crossings in remote areas:

Chong Jom (T) to O Smach (C); see p89, p753

Choam Srawngam (T) to Choam (C); see p101, p755

Ban Pakard (T) to Psar Pruhm (C); see p101, p765

FROM VIETNAM

There are three border-crossing options and word of a fourth:

Moc Bai (V) to Bavet (C), for quick passage between Ho Chi Minh City (V) and Phnom Penh (C); see p79, see p893

Vinh Xuong (V) to Kaam Samnor (C), linking Chau Doc (V) in the Mekong Delta to Phnom Penh (C); see p79, p900

Tinh Bien (V) to Phnom Den (C), a remote crossing; see p81, p901

G E T T I N G A R O U N D • • B o r d e r C r o s s i n g s 929

Prek Chek (C) to Xa Xia (V), a possible new border crossing

East Timor

The Motoain (I) to Batugade (ET) border crossing (between East Timor and Indonesian West Timor) is open and serviced by bus; see p141, p297.

Indonesia

FROM EAST TIMOR

See the entry under East Timor.

FROM MALAYSIA

High-speed ferries run between Malaysia and the Indonesian island of Sumatra:

Pulau Penang (M) and Belawan (I), which links to Medan (I); see p262, p451

Melaka (M) and Dumai (I), which links to Bukittinggi (I); see p267, p438

Johor Bahru (M) to Pulau Bintan and Pulau Batam in the Riau Islands (I); see p267, p456

On the island of Borneo, the Indonesia– Malaysia border can be crossed at the following spots:

Tawau (M) to Nunukan (I), linking to Tarakan (I); see p304, p492

Tebedu (M) and Entikong (I), which links to Kuching (M); see p310, p498

FROM SINGAPORE

Ferries run from Singapore to Pulau Bintan and Pulau Batam in the Riau Islands (I); see p267, p654.

Laos

FROM CAMBODIA

See the entry under Cambodia.

FROM THAILAND

There are five border crossings into Laos:

Chiang Khong (T) to Huay Xai (L), which links northern Thailand to Luang Prabang (L) via boat; see p390, p744

Nong Khai (T) to Vientiane (L); see p362, p758

Mukdahan (T) to Savannakhet (L), a popular route between southern Laos and northeast Thailand; see p394, p756

Chong Mek (T) to Vang Tao (L), which links Ubon Ratchathani (T) to Pakse (L); see p398, p755

T R O P S N A R T

930 G E T T I N G A R O U N D • • B o r d e r C r o s s i n g s

l o n e l y p l a n e t . c o m

T R A N S P O R T

Nakhon Phanom (T) to Tha Khaek (L), a far-flung river crossing in the northeast of Thailand; see p394, p757

FROM VIETNAM

There are five land crossings from Vietnam, but only three are easily accessible:

BORDER CROSSINGS

Lao Bao (V) to Dansavanh (L), an easy border crossing linking to Savannakhet (L); see p394, p858

Dien Bien Phu (V) to Tay Trang (L), gateway to Phongsali province (L); see p384, p839

 

 

 

 

 

 

 

 

 

 

CHINA

 

 

 

 

 

 

 

 

Lao Cai (V)

 

 

Dong Dang (V)

 

 

 

 

 

 

 

 

Hekou (China)

 

 

 

 

 

 

Boten (L)

 

 

 

 

 

 

Pingxiang (China)

 

 

MYANMAR

 

 

 

 

 

 

 

 

 

 

 

Mohan (China)

Dien Bien Phu (V)

HANOI

 

 

 

(BURMA)

 

 

 

Mong Cai (V)

 

 

 

 

 

Tay Trang (L)

 

 

 

 

 

 

Chiang Khong (T)

 

 

 

 

 

 

Dongxing (China)

 

 

Tachilek (My)

 

 

 

 

Nam Xoi (V)

 

 

 

 

Mae Sai (T)

 

Huay Xai (L)

 

 

 

Na Maew (L)

 

 

 

 

 

 

 

Luang

 

 

 

 

 

 

 

 

 

 

 

 

Prabang (L)

Nam Can (V)

 

 

 

 

 

 

 

 

LAOS

 

 

 

 

 

 

 

 

 

 

 

 

Nam Khan (L)

 

 

 

 

 

 

VIENTIANE Kaew Neua (L)

Vinh (V)

 

 

 

 

 

 

 

Cau Treo (V)

 

 

 

 

 

Myawaddy (My)

 

Nong Khai (T)

 

 

Nakhon Phanom (T)

 

 

 

Vientiane (L)

 

 

Tha Khaek (L)

 

 

 

 

Mae Sot (T)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THAILAND

Mukdahan (T)

 

 

 

Lao Bao (L)

 

 

 

Savannakhet (L)

 

 

 

 

 

 

 

 

 

Dansavanh (L)

 

 

Payathonzu (My)

 

 

Ubon

Chong Mek (T)

 

 

 

Three Pagodas Pass (T)

Rachathani (T)

Vang Tao (L)

 

VIETNAM

S O U T H

 

 

 

 

 

 

 

 

Chong Jom (T)

 

 

 

 

Pakse (L)

 

 

 

 

 

 

 

 

 

 

 

 

 

O Smach (C)

 

 

 

 

Voen Kham (L)

C H I N A

BANGKOK

 

Choam Srawngam (T)

Aranya Prathet (T)

Choam (C)

Dom Kralor (C)

S E A

 

 

 

 

Siem Reap (C)

Stung Treng (C)

 

 

 

Poipet (C)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ban Pakard (T)

CAMBODIA

 

 

 

 

 

 

Psar Pruhm (C)

 

 

 

 

Krong Koh Kong (C)

 

 

 

PHNOM PENH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hat Lek (T)

 

 

 

 

 

 

 

 

 

 

 

 

Kaam Samnor (C)

Bavet (C)

 

 

Kawthoung (My)

 

Vinh Xuong (V)

Moc Bai (V)

 

 

 

Prek Chek (C)

Chau

 

Ho Chi

 

 

Ranong (T)

 

Xa Xia (V)

 

Minh City (V)

 

 

 

Doc (V)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phnom Den (C)

 

 

 

 

 

 

 

 

 

 

Tinh Bien (V)

 

 

 

 

 

 

Kanger (T)

 

 

 

 

 

 

 

 

 

 

Padang Besar (M)

 

 

 

 

 

 

 

 

 

 

Satun (T)

 

 

 

 

 

 

 

 

 

 

 

 

 

Hat Yai (T)

 

 

 

 

 

 

 

0

500 km

 

Sadao (T)

 

 

 

 

 

 

 

0

300 miles

Pulau

Bukit Kayu Hitam (M)

 

 

 

 

 

 

 

 

 

Langkawi (M)

Betong (T)

Kota Bharu (M)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pulau

Keroh (M) Sungai Kolok (T)

 

 

 

 

 

 

 

 

 

Penang (M)

 

Rantau Panjang (M)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Butterworth (M)

 

 

 

 

 

 

 

Pulau Labuan (M)

Belawan (I)

MALAYSIA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Muara Port (B)

 

 

 

 

 

 

 

 

 

 

 

BANDAR SERI

Bangar (B)

Medan (I)

 

 

 

 

 

 

 

 

 

 

BEGAWAN

 

 

 

 

 

 

 

 

 

 

Lawas (M)

 

 

KUALA LUMPUR

 

 

 

 

 

 

Kuala Belait (B)

 

 

 

 

 

 

 

 

BRUNEI

 

 

 

 

 

 

 

 

 

 

 

Kuala Baram (M)

 

 

Melaka (M)

 

 

 

 

 

 

 

Miri (M)

Bangar (B)

 

 

 

 

 

 

 

 

 

Limbang (M)

 

 

 

 

 

 

 

 

 

Kuala Lurah (B)

 

 

 

 

 

 

 

 

 

 

 

 

Dumai (I)

 

Johor

 

 

 

 

 

 

Limbang (M)

 

 

 

 

 

 

 

 

 

 

 

Bahru (M)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tanjung Kupang (M)

 

 

 

 

 

 

 

MALAYSIA

 

 

 

 

 

 

 

 

Kuching (M)

 

 

 

 

SINGAPORE

 

Riau Islands (I)

 

 

 

 

 

 

 

 

 

 

 

 

 

Bukitinggi (I)

 

 

 

 

 

 

 

Tebedu (M)

 

 

 

 

 

 

 

 

 

 

 

 

Entikong (I)

 

 

INDONESIA

INDONESIA

l o n e l y p l a n e t . c o m

G E T T I N G A R O U N D • • B o r d e r C r o s s i n g s 931

Cau Treo (V) to Kaew Neua (L), linking

Malaysia

to Vinh (V); see p362, p838

FROM BRUNEI

Nam Can (V) to Nam Khan (L), a remote

See the entry under Brunei.

crossing; see p380, p838

 

Nam Xoi (V) to Na Maew (L), another

FROM INDONESIA

remote crossing; see p383, p839

See the entry under Indonesia

Jayapura (I)

Vanimo (PNG)

INDONESIA

PAPUA NEW

GUINEA

0

 

 

500 km

 

0

 

 

300 miles

AUSTRALIA

 

 

 

 

 

 

PHILIPPINES

P H I L I P P I N E S

S E A

 

Zamboanga (P)

 

 

Motoain (I)

DILI

 

 

 

Batugade (ET)

EAST TIMOR

Sandakan (M)

 

Tawau (M)

INDONESIA

Nunukan (I)

C E L E B E S

 

S E A

 

 

 

Tarakan (I)

 

 

T R O P S N A R T

INDONESIA

932 G E T T I N G A R O U N D • • B u s

FROM THE PHILIPPINES

There are infrequent passenger ferries from Zamboanga (P) on Mindanao to Sandakan

(M) in Sabah; see p488, p635.

 

FROM SINGAPORE

 

A 1km-long causeway connects the northern

 

end of Singapore in the suburb of Wood-

 

lands to Johor Bahru (M). To the west

 

another bridge connects Singapore in the

 

suburb of Tuas with Tanjung Kupang (M).

T

For details, see p456, p654.

S P O R

FROM THAILAND

A N

The crossings between Thailand and Ma-

T R

laysia are by road, boat and train. Until the

 

safety situation improves, avoid train travel

 

via Sungai Kolok (T) in the restive Muslim-

 

majority provinces of southern Thailand.

 

The crossings include the following:

 

Satun (T) to Pulau Langkawi (M); see p455, p803

Sungai Kolok (T) to Rantau Panjang (M), linking to Kota Bharu (M); see p470, p786

Kanger (T) to Padang Besar (M), linking Hat Yai (T) to Butterworth (M); see p453, p784

Sadao (T) to Bukit Kayu Hitam (M), linking Hat Yai (T) to Butterworth (M); see p453, p784

There is also a crossing between Betong (T) and Keroh (M), but using this crossing was extremely inadvisable at the time of writing due to violence in Yala Province.

l o n e l y p l a n e t . c o m

Philippines

See the entry under Malaysia.

Singapore

Singapore has land crossings into Malaysia and sea crossings into Indonesia; see the entries under those countries.

Thailand

Thailand has border crossings to/from Cambodia, Laos, Malaysia and Myanmar; see the entries under those countries.

Vietnam

Vietnam has open borders with Cambodia and Laos; see the entries under those countries.

BUS

In most cases, land borders are crossed via bus, which either travels straight through the two countries with a stop for border formalities or requires a change of buses at the appropriate border towns.

Bus travellers will enjoy a higher standard of luxury in Thailand, the Philippines and Malaysia, where roads are well paved, reliable schedules exist and, sometimes, snacks are distributed. Be aware that theft does occur on some long-distance buses, especially those departing from Bangkok’s Th Khao San heading south; keep all valuables on your person, not in a stowed locked bag.

Local buses in Laos, Cambodia and Vietnam are like moving sardine cans, but that is part of their charm.

Myanmar

Myanmar has land borders with Thailand, but most are either closed or have travelling restrictions. There are two legitimate crossings:

Mae Sai (T) to Tachilek (My); see p552, p746

Ranong (T) to Kawthoung (My); see p546, p787

There are also two day-pass points, but travellers can only travel from Thailand to Myanmar (and not the other way round):

Mae Sot (T) to Myawaddy (My); see p726

Three Pagodas Pass (T) to Payathonzu (My); see p716

CAR & MOTORCYCLE

What is the sound of freedom in Southeast Asia? The put-put noise of a motorcycle. Convenient for getting around the beaches or touring in the country, motorcycles are available for hire or purchase, but they require a lot more investment and safety precautions than many visitors realise.

It is advisable to hire a car or motorcycle for local sightseeing rather than depend on it for long-distance travel. You could hit Thailand and Malaysia by car pretty easily, enjoying well-signposted, well-paved roads. Road conditions in Laos and Cambodia vary, although sealed roads are becoming the norm. Indonesia and the Philippines have roads that vary between islands but most are

l o n e l y p l a n e t . c o m

in need of repair. Vietnam’s major highways are in relatively good health.

See p919 for driving licence laws.

Hire

There are Western car-hire chains camped out at Southeast Asian airports, capital cities and major tourist destinations. On many tourist islands, guesthouses and locals will hire motorcycles and cars for an affordable rate.

Insurance

Get insurance with a motorcycle if at all possible. The more reputable motorcyclehire places insure all their motorcycles; some will do it for an extra charge. Without insurance you’re responsible for anything that happens to the bike. To be absolutely clear about your liability, ask for a written estimate of the replacement cost for a similar bike – take photos as a guarantee. Some agencies will only accept the replacement cost of a new motorcycle.

Insurance for a hired car is also necessary. Be sure to ask the car-hire agent about liability and damage coverage.

Road Rules

Drive carefully and defensively; lives are lost at astounding rates on Southeast Asian highways. Remember too that smaller vehicles yield to bigger vehicles regardless of circumstances – on the road, might is right. The middle of the road is typically used as a passing lane, even if there is oncoming traffic, and your horn is used to notify other vehicles that you intend to pass them.

Safety

Always check a machine thoroughly before you take it out. Look at the tyres for treads, check for oil leaks, test the brakes. You may be held liable for any problems that weren’t duly noted before your departure.

When riding a motorcycle, wear protective clothing and a helmet; long pants, long-sleeved shirts and shoes are highly recommended as sunburn protection and as a second skin if you fall. If your helmet doesn’t have a visor, wear goggles, glasses or sunglasses to keep bugs, dust and other debris out of your eyes.

HITCHING

Hitching is never entirely safe in any country in the world, and is not recommended. Trav-

© Lonely Planet Publications

G E T T I N G A R O U N D • • H i t c h i n g 933

MOTORCYCLE TIP

 

Most Asians are so adept at driving and

 

riding on motorcycles that they can bal-

 

ance the whole family on the front bumper

 

or even take a quick nap as a passenger.

 

Foreigners unaccustomed to motorcycles

 

are not as graceful. If you’re riding on the

 

back of a motorcycle remember to relax.

 

For balance hold on to the back bar, not

 

the driver’s waist. Tall people should keep

 

their long legs tucked in as most drivers are

RT

used to shorter passengers. Women wear-

ing skirts should collect loose material so

A

S N

that it doesn’t catch in the wheel or drive

O P

chain. Now enjoy the ride.

 

T R

 

ellers who decide to hitch should understand that they are taking a small but potentially serious risk. People who do choose to hitch will be safer if they travel in pairs and let someone know where they are planning to go.

LOCAL TRANSPORT

Because personal ownership of cars in Southeast Asia is limited, local transport within a town is a roaring business. For the right price, drivers will haul you from the bus station to town, around town, around the corner, or around in circles. The bicycle rickshaw still survives in the region, assuming such aliases as sǎamláw in Thailand and cyclo in Vietnam. Anything motorised is often modified to carry passengers

– from Thailand’s obnoxious three-wheeled chariots known as túk-túk to the Philippines’ altered US Army jeeps. In large cities, extensive public bus systems either travel on fixed routes or do informal loops around the city, picking up passengers along the way. Bangkok, Kuala Lumpur and Singapore also boast state-of-the- art light-rail systems that make zipping around town feel like time travel.

TRAIN

For intercountry travel, the International Express train travels from Thailand all the way through the Malay peninsula, ending its journey in Singapore. Trains also serve Nong Khai, on the Thailand–Cambodia border, and Aranya Prathet, on the Thailand– Laos border.

You’ll find that Thailand and then Malaysia have the most extensive intracountry rail systems, although trains rarely run on time.

H E A L T H

© Lonely Planet Publications

934

Health Dr Trish Batchelor

 

 

CONTENTS

 

names, is a good idea. If carrying syringes

 

or needles, have a physician’s letter stating

 

Before You Go

934

their medical necessity. If you have a heart

 

 

condition, bring a copy of your ECG.

 

Insurance

934

 

If you take any regular medication, bring a

 

Vaccinations

934

 

double supply in case of loss or theft. In most

 

Medical Checklist

935

 

Southeast Asian countries, excluding Singa-

 

Online Resources

936

 

pore, you can buy many medications over the

 

Further Reading

936

 

counter, but it can be difficult to find some of

 

In Transit

936

 

the newer drugs, particularly the latest anti-

 

Deep Vein Thrombosis (DVT)

936

 

depressants, blood-pressure medications and

 

Jet Lag & Motion Sickness

936

 

contraceptive pills.

 

In Southeast Asia

936

 

 

 

Availability of Health Care

936

INSURANCE

 

Infectious Diseases

937

 

Even if you are fit and healthy, don’t travel

 

Traveller’s Diarrhoea

941

 

without health insurance – accidents do

 

Environmental Hazards

941

 

happen. Declare any existing medical condi-

 

Women’s Health

843

 

tions you have – the insurance company will

 

Traditional Medicine

844

 

 

 

check if your problem is pre-existing and will

Health issues and the quality of medical fa-

not cover you if it is undeclared. You may

require extra cover for adventure activities

cilities vary enormously depending on where

such as rock climbing. If your health insur-

you travel in Southeast Asia. Many of the

ance doesn’t cover you for medical expenses

major cities are now very well developed, al-

abroad, consider getting extra insurance. If

though travel to rural areas can expose you

you’re uninsured, emergency evacuation is

to a variety of health risks and inadequate

expensive – bills of more than US$100,000

medical care.

 

 

are not uncommon.

 

Travellers tend to worry about contracting

 

Find out in advance if your insurance plan

infectious diseases when in the tropics, but

will make payments directly to providers or

infections are a rare cause of serious illness

reimburse you later for overseas health ex-

or death in travellers. Pre-existing medical

penditures. (In many countries doctors expect

conditions, such as heart disease, and ac-

payment in cash.) You may prefer a policy that

cidental injury (especially traffic accidents)

pays doctors or hospitals directly rather than

account for most life-threatening problems.

you having to pay on the spot and claim later.

Becoming ill in some way, however, is rela-

If you have to claim later, make sure you keep

tively common. Fortunately, most common

all documentation. Some policies ask you to

illnesses can be either prevented with some

call (reverse charges) a centre in your home

common-sense behaviour or treated easily

country, where an immediate assessment of

with a well-stocked traveller’s medical kit.

your problem is made. Some policies offer a

 

The following advice is a general guide

 

range of medical-expense options; the higher

and does not replace the advice of a doctor

ones are chiefly for countries that have ex-

trained in travel medicine.

 

 

tremely high medical costs, such as the USA.

 

 

 

BEFORE YOU GO

Pack medications in their original, clearly labelled containers. A signed, dated letter from your physician describing your medical conditions and medications, including generic

VACCINATIONS

Specialised travel-medicine clinics are your best source of information; they stock all available vaccines and will be able to give recommendations specifically for you and your trip. The doctors will take into account factors such as past vaccination history, the length

l o n e l y p l a n e t . c o m

B E F O R E Y O U G O • • M e d i c a l C h e c k l i s t 935

of your trip, activities you may be undertaking and underlying medical conditions, such as pregnancy.

Most vaccines don’t produce immunity until at least two weeks after they’re given, so visit a doctor four to eight weeks before departure. Ask your doctor for an International Certificate of Vaccination (otherwise known as the yellow booklet), which will list all the vaccinations you’ve received.

protection, while the meningitis group C vaccine gives around 10 years’ protection. Recommended for long-term backpackers aged under 25.

Rabies Three injections in all. A booster after one year will then provide 10 years’ protection. Side effects are rare – occasionally a headache and a sore arm.

Tuberculosis (TB) A complex issue. It is usually recommended that long-term adult travellers have a TB skin test before and after travel, rather than vaccination. Only one vaccine is given in a lifetime.

Recommended Vaccinations

The World Health Organization (WHO) recommends the following vaccinations for travellers to Southeast Asia:

Adult diphtheria and tetanus Single booster recommended if you haven’t had one in the previous 10 years. Side effects include a sore arm and fever. Hepatitis A Provides almost 100% protection for up to a year; a booster after 12 months provides at least another 20 years’ protection. Mild side effects such as a headache and a sore arm occur in 5% to 10% of people.

Hepatitis B Now considered routine for most travellers. Given as three shots over six months. A rapid schedule is also available, as is a combined vaccination with Hepatitis A. Side effects are mild and uncommon, usually a headache and a sore arm. Lifetime protection occurs in 95% of people.

Measles, mumps and rubella (MMR) Two doses of MMR are required unless you have had the diseases.

Occasionally a rash and a flulike illness can develop a week after receiving the vaccine. Many young adults require a booster.

Polio Only one booster is required as an adult for lifetime protection. Inactivated polio vaccine is safe during pregnancy.

Typhoid Recommended unless your trip is less than a week long and is only to developed cities. The vaccine offers around 70% protection, lasts for two to three years and comes as a single shot. Tablets are also available. However, the injection is usually recommended as it has fewer side effects. A sore arm and fever may occur. Varicella If you haven’t had chickenpox, discuss this vaccination with your doctor.

The following immunisations are recommended for long-term travellers (more than one month) or those at special risk:

Japanese B Encephalitis Three injections in all. A booster is recommended after two years. A sore arm and headache are the most common side effects, although a rare allergic reaction comprising hives and swelling can occur up to 10 days after any of the three doses. Meningitis Single injection. There are two types of vaccination: the quadrivalent vaccine gives two to three years’

Required Vaccinations

The only vaccine required by international regulations is for yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days before entering Southeast Asia. If you are travelling to Southeast Asia from Africa or South America you should check to see if you require proof of vaccination.

MEDICAL CHECKLIST

Recommended items for a personal medical kit:

antibacterial cream, eg mupirocin

antibiotic for skin infections, eg amoxicillin/clavulanate or cephalexin

antibiotics for diarrhoea, such as norfloxacin or ciprofloxacin; azithromycinfor bacterial diarrhoea; tinidazole for giardiasis or amoebic dysentery

antifungal cream, eg clotrimazole

antihistamine, such as cetirizine for daytime and promethazine for night

anti-inflammatory such as ibuprofen

antiseptic, eg Betadine

antispasmodic for stomach cramps, eg Buscopan

contraceptives

decongestant, eg pseudoephedrine

DEET-based insect repellent

diarrhoea treatment; consider bringing an oral rehydration solution (eg Gastrolyte), diarrhoea ‘stopper’ (eg loperamide) and antinausea medication (eg prochlorperazine)

first-aid items such as scissors, plasters, bandages, gauze, thermometer (but not one with mercury), sterile needles and syringes, safety pins and tweezers

indigestion medication, eg Quick Eze or Mylanta

iodine tablets (unless you are pregnant or have a thyroid problem) to purify water

laxative, eg Coloxyl

H T L A E H

H E A L T H

936 I N T R A N S I T • • D e e p Ve i n T h r o m b o s i s ( D V T )

migraine medication; sufferers should take their personal medicine

paracetamol

permethrin to impregnate clothing and mosquito nets

steroid cream for allergic or itchy rashes, eg 1% to 2% hydrocortisone

sunscreen and hat

throat lozenges

thrush (vaginal yeast infection) treatment, eg Clotrimazole pessaries or Diflucan tablet

Ural or equivalent if you’re prone to urine infections

ONLINE RESOURCES

There is a wealth of travel health advice on the internet. For further information, Lonely Planet (www.lonelyplanet.com) is a good place to start. The World Health Organization (www.who

.int/ith) publishes a superb book called International Travel & Health, which is revised annually and is available online at no cost. Another website of general interest is MD Travel Health (www.mdtravelhealth.com), which provides complete travel health recommendations for every country and is updated daily. The Centers for Disease Control and Prevention (CDC; www.cdc.gov) website also has good general information.

FURTHER READING

Lonely Planet’s Healthy Travel – Asia & India is a handy pocket-size book that is packed with useful information, including pretrip planning, emergency first aid, immunisation and disease information, and what to do if you get sick on the road. Other recommended references include Traveller’s Health by Dr Richard Dawood and Travelling Well by Dr Deborah Mills – check out www.travellingwell.com.au.

IN TRANSIT

DEEP VEIN THROMBOSIS (DVT)

Deep vein thrombosis (DVT) occurs when blood clots form in the legs during plane flights, chiefly because of prolonged immobility. The longer the flight, the greater the risk. Although most blood clots are reabsorbed uneventfully, some may break off and travel through the blood ves-

l o n e l y p l a n e t . c o m

sels to the lungs, where they may cause life-threatening complications.

The chief symptom of DVT is swelling of or pain in the foot, ankle or calf, usually but not always on just one side. When a blood clot travels to the lungs, it may cause chest pain and difficulty in breathing. Travellers with any of these symptoms should immediately seek medical attention.

To prevent the development of DVT on long flights you should walk about the cabin, perform isometric compressions of the leg muscles (ie contract the leg muscles while sitting), drink plenty of fluids and avoid alcohol.

JET LAG & MOTION SICKNESS

Jet lag is common when crossing more than five time zones; it causes symptoms including insomnia, fatigue, malaise or nausea. To avoid jet lag, try drinking plenty of (nonalcoholic) fluids and eating light meals. Upon arrival seek exposure to natural sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.

Antihistamines such as dimenhydrinate (Dramamine) and meclizine (Antivert or Bonine) are usually the first choice for treating motion sickness. Their main side effect is drowsiness. A herbal alternative is ginger, which works like a charm for some people.

IN SOUTHEAST ASIA

AVAILABILITY OF HEALTH CARE

Most capital cities in Southeast Asia now have clinics that cater specifically to travellers and expats. These clinics are usually more expensive than local medical facilities, but are worth utilising as they will offer a superior standard of care. Additionally, they understand the local system and are aware of the safest local hospitals and best specialists. They can also liaise with insurance companies should you require evacuation. Recommended clinics are listed under Information in the capital city sections of country chapters in this book.

It is difficult to find reliable medical care in rural areas. Your embassy and insurance company are good contacts.

Self-treatment may be appropriate if your problem is minor (eg traveller’s di-

l o n e l y p l a n e t . c o m

arrhoea), you are carrying the appropriate medication and you cannot attend a recommended clinic. If you think you may have a serious disease, especially malaria, do not waste time – travel to the nearest quality facility to receive attention. It is always better to be assessed by a doctor than to rely on self-treatment.

Buying medication over the counter is not recommended, as fake medications and poorly stored or out-of-date drugs are common.

The standard of care in Southeast Asia varies from country to country:

Brunei General care is reasonable. There is no local medical university, so expats and foreign-trained locals run the health-care system. Serious or complex cases are better managed in Singapore, but adequate primary health care and stabilisation is available.

Cambodia There are a couple of international clinics in Phnom Penh, and one in Siem Reap, that provide primary care and emergency stabilisation.

East Timor No private clinics. The government hospital is basic and should be avoided. Contact your embassy or insurance company for advice.

Indonesia Local medical care in general is not yet up to international standards. Foreign doctors are not allowed to work in Indonesia, but some clinics catering to foreigners have ‘international advisers’. Almost all Indonesian doctors work at government hospitals during the day and in private practices at night. This means that private hospitals often don’t have their best staff available during the day. Serious cases are evacuated to Australia or Singapore.

I N S O U T H E A S T A S I A • • I n f e c t i o u s D i s e a s e s 937

Laos There are no good facilities in Laos; the nearest acceptable facilities are in northern Thailand. The Australian Embassy Clinic in Vientiane treats citizens of Commonwealth countries.

Malaysia Medical care in the major centres is good, and most problems can be adequately dealt with in Kuala Lumpur.

Myanmar (Burma) Local medical care is dismal and local hospitals should only be used in desperation. There is an international medical clinic in Yangon (Rangoon). Contact your embassy for advice.

Philippines Good medical care is available in most major cities.

Singapore Has excellent medical facilities, and it acts as the referral centre for most of Southeast Asia.

Thailand There are some very good facilities in Thailand, particularly in Bangkok. After Singapore this is the city

of choice for expats living in Southeast Asia who require specialised care.

Vietnam Government hospitals are overcrowded and basic. In order to treat foreigners, the facility needs to obtain a special licence, and so far only a few have been provided. The private clinics in Hanoi and Ho Chi Minh City should be your first port of call. They are familiar with the local resources and can organise evacuations if necessary.

INFECTIOUS DISEASES

Cutaneous Larva Migrans

Risk areas All countries except Singapore. This disease, caused by dog hookworm, is particularly common on the beaches of Thailand. The rash starts as a small lump, then

AVIAN INFLUENZA (BIRD FLU)

Six Southeast Asian countries (Cambodia, Indonesia, Laos, Thailand, Vietnam and Myanmar), plus China, Japan and South Korea, reported an outbreak of avian influenza (bird flu). The strain in question, known as ‘Influenza A H5N1’ or simply ‘the H5N1 virus’, is a highly contagious form of avian influenza that has since spread as far as Europe to the west. Throughout the region, government officials are scrambling to contain the spread of the disease, which wreaks havoc with domesticated bird populations.

While the avian influenza virus usually poses little risk to humans, there have been several recorded cases of the H5N1 virus spreading from birds to humans. Human cases of avian influenza in the region have been reported from Indonesia and Thailand. At the time of writing, Thailand had reported 25 cases of humans contracting the virus since 2003, with 17 deaths. In Indonesia, there had been more than 100 cases, with more than 80 deaths, since July 2005. The main risk is to people who directly handle infected birds, or come into contact with contaminated bird faeces or carcasses. Because heat kills the virus, there is no risk of infection from cooked poultry.

There is no clear evidence that the H5N1 virus can be transmitted between humans. However, the main fear is that this highly adaptable virus may mutate and be passed between humans, perhaps leading to a worldwide influenza pandemic.

Thus far, however, infection rates are limited and the risk to travellers is low. Travellers to the region should avoid contact with any birds and should ensure that any poultry is thoroughly cooked before consumption.

H T L A E H

Соседние файлы в папке Southeast Asia 14th Edition, March 2008 [PDF]