What To Do If Your Child Has a Fever

There is some medical disagreement concerning the medical need for Temperature control. Some doctors recommend paracetamol to lower temperature others do not. Usually children and adults feel better and function better it their temperature is reduced to near normal


Remember paracetamol is very dangerous in overdoseIf your child's temperature is above 37.5⁰C, give Paracetamol ("Panadol" is a common brand) in a dose according to your child's age - follow the dose instructions on the label and repeat the dose every four hours if necessary.
Do NOT give more frequently.

Remember:
Place body temperature is 37⁰C. If you take the temperature by placing the thermometer under the arm then add IC to obtain the Internal Temperature.  For example: If the underarm Temperature is 36.8⁰C then add 1⁰C to obtain the internal temperature of 37.8⁰C which is the temperature you act on. If your child's temperature is above 38.5⁰C, give Paracetamol and then a tepid sponge bath: Fill the bath with tepid water (not cold water).

Place the child in the bath and wet the child's head with a face cloth. Continue to run the water over the head and body until your child's temperature comes down to 37.5⁰C or less. This may take 20 minutes or more. Do not leave the child unattended in the bath. Take the child's temperature every 10 minutes while in the bath. If the child is shivering then remove the child from the bath immediately.

Shivering increases internal body temperature. Pat the child dry - rubbing dry also increases body heat. Alternatively, you can just let the water evaporate without drying your child.


If your child has a fit because of the high fever, immediately lie the child on its side - this will protect the airway and the child will not swallow its tongue. Do not place objects such as spoons or fingers in the child's mouth. It is very frightening to see a fit but try to stay calm and keep reassuring yourself it is unlikely your child will have any lasting effects from that fit. It is unlikely epilepsy will follow. However subsequent fits with high fevers are more likely.


If the child's fit lasts longer than 5 minutes, call a doctor or take the child to the Hospital Accident & Emergency or call an ambulance.

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How to manage Your Own Health

Why will I have to manage my own health?
During a pandemic, it is likely that health care services will be overburdened. Your usual medical provider may be extremely overwhelmed with serious cases.
If your symptoms are mild, you should avoid medial facilities.
Visiting such facilities may further expose you to infectious diseases,
and may provide an opportunity for you to pass your illness to other people.

How will I know that I have influenza?
- During phase 6, the pandemic flu will be circulating widely across the globe.
If you develop the following symptoms it is likely that you have influenza.

- A sudden onset of a temperature over 38° C / 100.4° F

AND
One or more of the following symptoms:
- Cough
- Sore throat
- Generalised aches and pains
- Shortness of breath
- Nausea / vomiting / diarrhea
Your local medical facility may have a designated influenza center that may offer testing.

What should I do?
- If you have antiviral drugs available, decide whether you should take them as soon as possible since their effects are time-sensitive.
- If you decide to use the drugs, contact a doctor.
- Monitor your health actively. Keep a daily log of symptoms and record your temperature twice a day.
- Do not measure your temperature within 30 minutes of eating or drinking.
- Get adequate rest and plenty of sleep.
- Drink 8 – 12 standard glasses of fluids a day, unless you have been told to restrict your fluid intake for medical reasons.
- If you have gastrointestinal symptoms (nausea, vomiting, diarrhea) avoid fatty, spicy or fried foods. Drink liquids or eat soft, easily-digested foods such as biscuits, toast, bananas, rice, cooked cereal, and applesauce.
Eat smaller, more frequent meals.
- Use warm salt water gargles as needed (2 teaspoons of salt in a standard glass of water).
- Suck on hard candy, herbal throat lozenges, or over-the-counter throat lozenges (sugar free if you have diabetes).
- Take acetaminophen / paracetamol or ibuprofen. Follow the manufacturer’s labelling for dosage.

When do I need to see a doctor?
Most people will get better without any intervention within 5 to 10 days.
However, you may need to telephone a doctor for further advice.
If possible, phone first before going to a facility for care, and let the staff know that you believe you have influenza.

Seek further advice:
- If antiviral drugs may be available (best taken in first 48 hours of the illness)
- If symptoms last longer than 10 days
- If illness becomes worse after 5 days
- If breathing is difficult or coughing produces yellow / green phlegm or blood
- If experiencing severe or persistent vomiting
- If fever is high or prolonged
- If you are worried - If you are severely unwell, go straight to a hospital.

How do I minimize the chance of infecting others?
- Isolate yourself as much as possible while you are ill.
Avoid close face-to-face contact (within 1 meter/ 3 feet).
- Stay home.
Do not go to work, and try not to go to areas where people will be gathering. - Within your home, isolate yourself as much as you can. Sleep in a separate room.

Ensure your room is well-ventilated.
- If you must have face-to-face contact with others, wear a mask.
Avoid touching, do not shake hands.
Pay attention to hygiene
– Cover your cough, use disposable tissues, wash your hands frequently and encourage others to do the same.

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Health Consideration

CONSIDERATIONS:

Lifestyle:
· Expatriates often have an unhealthy lifestyle in Indonesia.
· Many people do not exercise sufficiently because of the heat and pollution.
· Excessive alcohol consumption, smoking and overeating are common.
· Many people gain weight.
· Try to moderate your diet and exercise regularly.

Vaccinations:
· Start all vaccinations well before posting as you may need a course of injections.
· Check with your doctor that all previous vaccinations are up to date.
· All adult and childhood vaccinations can be given in Jakarta, Indonesia

Medications:
· Most medications are available in Indonesia.

Doctors and Clinics:
· Expatriate doctors generally can not practise in Indonesia but there are exceptions.
Contact the International Clinic for assistance if necessary.
· Some local Clinics are well equipped but generally not of Western standard.
· Most clinics other than International Clinics are Indonesian with associate cultural and language problems.
· Ensure disposable needles and syringes and sterile instruments are used.
· Try to avoid any surgical procedures in a small clinics or small hospital.

House and Hotel Calls:
· Home visits are usually not available except International Clinics in Jakarta.
· Hotels have a doctor on call or a hotel clinic. Expect high fees.
· It is often preferable to proceed directly to the clinic or hospital.

Ambulance:
· Ambulance services are usually owned by hospitals or private clinics and are often not of Western standard. Payment before service is normal.
· It may be faster to go by car or taxi to a clinic or hospital.

Blood Bank:
· The Red Cross monitors blood banks. Standards are variable.
Blood supply is not a free service.
· Avoid blood transfusion if possible. Insist blood is re screened by the hospital before transfusion. Contact the Home GP first.
· Rh -ve blood is rare in Asia and difficult to obtain.

Dentists:
· Good quality treatment is available in Jakarta at recommended dental clinics. Request an indication of likely fees before starting treatment.

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A Health Guide For Visitors to Indonesia

GENERAL: Healthy Living in Jakarta,

Air:
- All major Indonesian cities have severe atmospheric pollution. This can be unpleasant but exposure during a normal 2-3 year posting is unlikely to cause new health problems.
- Pre existing respiratory problems may be aggravated but asthma is very common in Indonesia also Hay fever is common.

Water:
Do not drink tap water anywhere in Indonesia.
- Bottled water is widely available and should be used for drinking, tooth brushing and for a final rinse after washing fruit and vegetables.

Food:
· Most foods are available.
· Fruit and vegetables are of reasonable quality.
· Meat and fish from public markets should generally be avoided.
· Supermarkets offer much higher food handling standards.

Restaurants:
· Many restaurants have acceptable hygiene standards. These standards vary daily and with food type irrespective of the quality of the restaurant or hotel.
· Roadside food stalls should be avoided especially Padang food stalls.
· Shellfish, snails and uncooked fish should not be eaten.

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