HEALTH AND SAFETY
We recommend vaccines such as Poliomyelitis (childhood booster), Tetanus (childhood booster), Typhoid (food & water borne diseases) and Hepatitis A (food and water borne diseases).
For those venturing outside cities and towns, further recommended vaccines are Hepatitis B, Rabies, Japanese B Encephalitis, Tuberculosis, Meningitis and Malaria prophylaxis.
2. DENGUE FEVER AND MALARIA
Dengue Fever and Malaria are present in Borneo. Dengue Fever is a viral disease with flu like symptoms that is transmitted by mosquitoes that bite during the DAYTIME and in URBAN regions. There is no vaccine for dengue fever and prevention is based upon insect repellents, nets and insecticides.
Malaria is transmitted by a type of NIGHT biting mosquito. Risk of malaria is relatively HIGH in deep jungle, hinterland and remote areas that are NOT commonly visited by visitors. Whilst cases of malaria do occur in rural and undeveloped areas of Borneo, risk of malaria is LOW in towns, cities and touristy areas. Nonetheless, it is advisable to have anti-malarial medication.
When TAKING anti-malarial medication:
- Make sure you get the right anti-malarial tablets before you go (check with your GP or pharmacist if you are unsure).
- Follow the instructions included with your tablets carefully.
- Continue to take your tablets for up to FOUR (4) weeks (depending on the type you are taking) AFTER returning from your trip to cover the incubation period of the disease.
- If you become ill while travelling in an area where malaria is found or after returning from travelling, you MUST IMMEDIATELY seek medical help (even if you have been taking anti-malarial tablets).
- If you develop symptoms of malaria while still taking anti-malarial tablets (either while you are travelling or in the days and weeks after you return), remember to tell the doctor which type you have been taking – the same type of anti-malaria medication should NOT be used to treat you as well.
- If you have taken anti-malarial medication in the past, do not assume that it is suitable for future trips.
3. PRECAUTIONS AGAINST DENGUE FEVER, MALARIA AND OTHER MOSQUITO-BORNE DISEASES
- Apply insect repellent to all exposed areas of skin, avoiding eyes and mouth. We advise the use of DEET (diethyltoluamide) containing products, which has shown to be one of the most effective repellent products. The use of 50% DEET products is usually sufficient and they are available in sprays, roll-ons, sticks and creams. Please make sure you apply DEET AFTER applying sunscreen and re-apply it frequently. For those allergic to DEET, alternatives include Dimethyl Pthalate or Eucalyptus oil.
- Wear long sleeve shirts and long trousers as these cover most of the body. Mosquitoes may be able to bite through thin clothing, so spraying clothing treatment will help to repel biting insects. Ideally, wear light coloured clothing during the day as these attract less mosquitoes than dark clothing.
- Please avoid aftershave or perfumes. These smells can attract mosquitoes, especially during the evenings.
- Please avoid flooded or areas close to water. Mosquitoes and other biting insects breed or hatch eggs around watered areas, which will increase the risk of being bitten.
- Stay somewhere that has effective air conditioning and screening on doors and windows. If this is not possible, make sure that doors and windows are closed properly.
- If you are not sleeping in an air-conditioned room, sleep under an intact mosquito net that has been treated with insecticide.
- Plug-in mosquito repellents can help to reduce the risk as they release an insecticide vapour.
4. YELLOW FEVER VACCINATION CERTIFICATE
There is NO risk of yellow fever in Borneo.
There are at least nine species of leeches that have been found in Borneo. Leeches usually prefer muddy waters, damp forests, lowlands and coastal areas where the water buffaloes hang out. Leeches do not have to be fed often, but when they find their victim, they take in as much as they can. Leech bites can sometimes hurt when a slight stinging sensation is experienced as the leech punctures the skin. Other times leeches inject an anesthetic so the bite is not felt at all. Itching is sometimes experienced around the wound after the leech has fallen off. The best way to remove leeches is to not get them attached in the first place.
To Protect Yourself From Leeches:
- Wear long pants and squeeze them into the socks or purchase leech proof socks*. They are light calico socks, which you can wear over your normal socks, inside your boots and they tie tightly at the top of the calf outside your trousers.
- Spray insect repellent onto your clothes and shoes before trekking/hiking.
- In a pinch, putting some tobacco into your socks has been known to repel leeches.
- Rub detergent soap into your socks and trousers before trekking/hiking.
- Wear closed shoes, not sandals.
*Leech socks are available for sale in Borneo Eco Tours (BET) and Sukau Rainforest Lodge (SRL) for RM20 a pair. If you wish to purchase leech socks from BET and SRL, please notify your tour consultant in advance. Please note that some of our tour packages are INCLUSIVE of leech socks (please refer to your tour itinerary).
6. HOW TO REMOVE LEECHES
When a leech has already gotten to you, do not panic! We strongly recommend that you DO NOT Pull, Burn or Squeeze the leech out. This will result in the leech vomiting harmful bacteria back into your system. Leeches fall out on their own once full. If you can continue hiking with the thought of a small Dracula hanging off your body, do so. It will not take longer than 20 minutes for the leech to give up and remove itself safely.
If you wish to remove a leech BEFORE it is full, here are some safe tips:
- Locate the head with a sucker attached to the wound. It will be the narrow end of leech’s body.
- Slide a sharp object or your fingernail under the sucker. Be quick, so the leech will not have time to vomit the blood back into your wound.
- Slide the body off with the same object or your fingernail.
- Quickly flick the leech away before it bites you again and reattaches.
- Treat the wound with wipes or soap and water; use a bandage to stop bleeding. Extra bleeding is normal because there are anti-clotting enzymes in the leech’s mouth.
If you are careful while removing leeches, the risk of an infection is minimal. If fever, rash, dizziness and sweating occur, it might be an allergic reaction to the bite. Take anti-histamines and seek care immediately at the nearest medical facility.
If you somehow get a leech into your mouth or throat – yes it is possible – try to find the strongest alcoholic drink and gargle. It’s not easy to find bars in the rainforests, so carrying a small preventive bottle in your backpack is a good start.
7. ALTITUDE SICKNESS WHEN CLIMBING MOUNT KINABALU
Altitude Sickness or Acute Mountain Sickness (AMS) is an illness that ranges from a mild headache and weariness to a life-threatening build-up of fluid in the lungs or brain at high altitudes.
The risk of getting AMS is present for anyone thinking of climbing Mount Kinabalu. Mount Kinabalu is categorised in Very High Altitude scale of 12,000 – 18,000 feet (3,648 – 5,487 metres) while Laban Rata – the place for you to stay overnight before ascending to Low’s Peak – is categorised in High Altitude scale of 8,000 – 12,000 feet (2,438 – 3,658 metres). AMS is rare below 2,400 metres and mostly starts to occur between 2,400 metres and 5,500 metres.
The occurrence of AMS is dependent upon the elevation, the rate of ascent and individual susceptibility. Many people will experience mild AMS during the acclimatisation process. The symptoms of Mild AMS are headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise. Symptoms tend to be worse at night and when respiratory drive is decreased.
If you experience the above symptoms, you should attempt one of the following:
- Descend by at least 1,600 feet (500 metres). DO NOT attempt to climb again until your symptoms have completely disappeared.
- Take painkillers such as paracetamol or ibuprofen, can be used to treat mild headaches.
- If you’re experiencing nausea or vomiting, a type of medication called an anti-emetic may be useful. Promethazine is an anti-emetic medicine often used by people with altitude sickness.
- Increase your oxygen intake with bottled oxygen or portable hyperbaric chambers (also known as Gamow or Certec bags) can help to temporarily improve some of the symptoms of altitude sickness. A portable hyperbaric chamber is a bag you’re zipped into, which is then pumped full of air. After one or two hours of treatment, your symptoms should improve significantly. The effect of the treatment is equivalent to descending about 6,500 feet (2,000 feet).
- Take Acetazolamide. Altitude sickness can change the chemical balance of your blood. Acetazolamide helps correct this chemical imbalance.
- Take Nifedipine – often used to treat high blood pressure (hypertension), but it can also be useful in treating high altitude pulmonary oedema. This medication decreases the narrowing of the artery that supplies blood to the lungs, helping to reduce chest tightness and ease breathing. It is usually taken as a tablet at 6 – 8 hours intervals. However, it can cause a sudden drop in blood pressure, so it is important not to get up too quickly from a lying or sitting position if you take it.
If you have severe symptoms or your symptoms are getting worse, descend immediately by as much height as possible. This is because severe altitude sickness can be fatal if not treated quickly. Seek immediate medical help when you reach a low altitude.
8. HOW TO AVOID ALTITUDE SICKNESS
- If you begin to show symptoms of moderate altitude sickness, do not go higher until symptoms decrease.
- Stay properly hydrated. Acclimatisation is often accompanied by fluid loss, so you need to drink lots of fluids to remain properly hydrated (at least 3 – 4 quarts per day).
- Light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
- Avoid tobacco, alcohol and other depressant drugs including sleeping pills, tranquilizers and barbiturates. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
- Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates).
- Make sure everyone you are travelling with has fully acclimatised before going any higher.
- If you go above 10,000 feet (3,000 metres), only increase your altitude by 1,000 feet (300 metres) per day, and for every 3,000 feet (900 metres) of elevation gained, take a rest day to acclimatise.