How do you avoid getting sick in Bali?

"Bali belly" covers everything from a bad afternoon to something that needs a drip. Most cases are preventable with three habits, and most of what people blame is not the cause.

Do not drink the tap water

Bali's mains water is not safe to drink, in hotels, villas or anywhere else. That means:

• Drink bottled or filtered water. Large refillable containers are standard in villas and better for the island than cases of small bottles.
• Brush your teeth with bottled water if your stomach is sensitive.
• Skip ice only where the ice is not tube ice. The cylindrical ice with a hole through it, which is what almost every restaurant and bar uses, is made commercially from treated water and is fine. Crushed or irregular ice in a very rural place is the one to think twice about.
• Be careful with salads and fruit washed in tap water in places with low turnover. A busy warung is safer than a quiet one.

Street food is not the problem people think

The single biggest predictor of a safe meal is turnover. A busy warung cooking to order, in front of you, at lunchtime, is safer than a hotel buffet holding food at ambiguous temperatures for three hours. Eat where Indonesians are eating, eat food that is hot, and be wary of anything that has been sitting out.

The other causes nobody mentions

Alcohol and heat. A lot of what gets called Bali belly is dehydration plus sunburn plus a long day of drinking.

A change of diet and chilli. If you have not eaten sambal at every meal before, your digestion notices.

Air conditioning at 17 degrees after a day in 32-degree heat is how people get the sore throat that ruins the second half of a trip.

Treating it

For a standard case: stop eating rich food, drink oral rehydration salts, which every pharmacy sells for a few thousand rupiah, and rest. Charcoal tablets are widely sold and popular locally. It usually passes in 24 to 48 hours.

See a doctor if there is blood, a high fever, severe abdominal pain, symptoms beyond two or three days, signs of real dehydration, or if it is a young child or an older traveller. Dengue also starts with fever and aches, and it is common here.

Where to go

Bali has international-standard clinics in the south used to treating visitors and dealing with insurers: BIMC in Kuta, Nusa Dua and Ubud, and Siloam hospitals in Denpasar and Nusa Dua, among others. Most tourist areas also have 24-hour clinics that will put up a drip for dehydration.

Pharmacies, marked apotek, are everywhere, and Kimia Farma and Guardian are the reliable chains. Pharmacists here are helpful and many speak English.

Insurance, briefly

Get travel insurance that covers medical treatment and evacuation, and read the motorcycle clause. The two lines that matter in Bali are whether you were licensed to ride the machine and whether you had been drinking. A drip at a clinic costs a few hundred dollars. A serious road accident with a medical evacuation costs tens of thousands.

Rabies, dengue and the rest

Rabies exists in Bali. Any bite or deep scratch from a dog, cat or monkey should be treated as urgent: wash thoroughly with soap and water for 15 minutes and get to a clinic the same day for post-exposure treatment. This is not a wait-and-see situation.

Dengue is endemic and the mosquitoes that carry it bite during the day. Repellent in the mornings and evenings, particularly in Ubud and anywhere green.

Sunburn. Eight degrees south of the equator, an overcast day still burns.

Monkeys at Uluwatu and the Ubud forest steal sunglasses and phones and will bite if you resist. Nothing shiny in your hands and nothing loose on your head.

Ask a travel clinic at home about vaccinations well before you fly; some courses take weeks.