Health & Safety for Travelers to Lake Toba

Lake Toba has not matched international standards when it comes to hygiene, cleanliness, and safety. For example, water from the tab is not suitable for drinking. Street food is not clean enough, so you must avoid it. Safety is lacking due to inadequate procedures or weak law enforcement. You need to know some details so that you can plan your trip accordingly.

Vaccination

We recommend that you consult a certified physician regarding vaccination before traveling to Lake Toba. Because vaccines need a few days or even weeks to work inside your body, you need to get the vaccines 4-8 weeks before arrival.

Recommended Vaccination and Vaccines for Your Trip to Lake Toba
Tetanus Diphteria Standard, last immunization should not be older than ten years Vaccination strongly recommended
Measles-mumps-rubella (MMR) Standard also in “first world countries” Vaccination recommended
Typhoid Typhoid fever is linked to a salmonella species known as Salmonella typhi. Common symptoms are fever muscle aches, nausea, abdominal pain and problems with the stool (diarrhea or constipation). The salmonella is transmitted by contaminated food or water. People can transmit the disease without knowing that they have it. So a cook in a restaurant can have no symptoms but because he is handling your food can still spread typhoid. If you stay only a short while on Lake Toba and eat and drink mainly in the hotels and resorts, then a vaccination is usually not recommended by most doctors. Strongly recommended if you wish to eat street food.
Hepatitis A Instead, they high recommend Hepatitis A vaccine for travelers to developing countries including Indonesia. Hepatitis A is a viral infection of the liver. It’s after diarrhea simply the most common travel related disease globally. Like typhoid-fever it is also transmitted by contaminated water and food. It might also be acquired by direct contact with infected people. If farmers or food stall owners are infected and handle their food, then their products could also be contaminated. Symptoms are usually fever, nausea, vomiting and pain in your abdomen. Sometimes Hepatitis A can result in a more sever liver damage but in most cases there are no complications. Vaccination strongly recommended
Other medical conditions and diseases
Rabies Recent outbreaks of rabies in 2008 and 2010 raised concerns among travelers to Lake Toba. A rabies vaccination is still not a must if you come to Lake Toba but considering the fact that dogs (and monkeys) who could interact with tourists can have rabies, and that Lake Toba’s dog population is estimated at 500.000, a vaccination is not a bad thing before coming here. Avoid the street dogs, don’t get too near to them. When you raise your hand as if you would throw a stone, they usually run away. Watch your children not to get too close to them. Lake Toba vaccinates every year tens of thousands of dogs and by now government estimates that around 50% of the dogs have been vaccinated. Which leaves another 50%. Lake Toba got some bad press of culling street dogs after the outbreak in 2010. Vaccination slightly recommended
Malaria The general risk to catch malaria on Lake Toba is small. In the main resorts area the risk is close to zero. If you plan to visit rural areas for a longer period, or do a lot of mountain trekking, etc then you could consider malaria prophylaxis. No vaccination is available for malaria! The best protection is still not to get bitten by mosquitoes and make use of mosquito nets, wear long sleeves, long trousers etc when you take a jungle hike for example. Low risk, vaccine not available, prophylaxis not necessary
Dengue Fever Beside traffic accidents – the most imminent health hazard to Lake Tobans and visitors is most likely Dengue fever. There is no vaccine against it, therefore the best way to prevent Dengue is like with Malaria not to get bitten by mosquitoes. Dengue fever is a flu-like illness and not uncommon on Lake Toba. Like malaria, dengue is transmitted by mosquitoes although of a different type.  They can be found mainly in densely populated areas like the capital Medan. The disease is observed all year-round. It can be very painful, and can in some cases be fatal. Main symptoms are beside fever, aching joints and muscles, vomiting, severe headaches, nausea. Usually it takes a few days for the symptoms to subside and there won’t be complications. If one gets his first Dengue infection as an adult, most likely one would not experience significant complications. For patients who have had a Dengue infection before the age of 15 and get a second one as adults, the risk for complications is higher. High risk, no vaccine available, general mosquito bite precautions.
Diarrhea Diarrhea is globally the number one travel related disease due to contaminated water and food, mainly because of hygiene reasons. Diarrhea can strike you in Italy, Egypt, Mexico, all over the world when traveling. Bring some general anti-diarrhea drugs along. Although diarrhea is in most cases not dangerous and only keeps you suffering for a day or two, one should be aware that the condition can become dangerous. If symptoms persist for more than 3 days (72h) then go to a doctor. Also, if you experience within 8 hours three more loose stools, vomiting, strong cramps, blood in the stool and fever then you might need antibiotics. Medium risk, don’t drink water from tab, careful with street food
HIV Lake Toba has limited prostitution. Some studies suggest that HIV is widespread among the prostitutes (up to 30%!). There are several other sexual transmitted diseases (STD) that are not uncommon among working girls (and boys) which will be difficult to explain back home. Be cautious and conscious.
Yellow Fever Vaccination not required generally for Lake Toba

Courtesy Bali.com

Only required for travelers arriving from yellow-fever infected countries (Africa, Americas)

Health Centers

Community health centers (puskesmas) provide emergency assistance for all travelers experiencing injuries. But for serious health problems, hospitals are available in Parapat (east side of Lake Toba), Samosir (inside), and Balige (west side). Here are some useful numbers in case of emergency:

General Hospital (Parapat)
Dr. Hadrianus Hospital (Samosir)
HKBP Hospital (Balige)
Address: Jl. Op. Ranjo Sinaga, Parapat, North Sumatra, Indonesia
Address: Jl. Dr Hadrianus, Samosir, North Sumatra, Indonesia
Address: Jl. Gereja No.17, Balige II, Balige, North Sumatra, Indonesia
Phone: +62 625 41332
Phone: +62 626 20106
Phone: +62 632 21043

Safety

If you are a first traveler to Lake Toba, we suggest that you travel in group of at least 2 people for your safety. But if you cannot have any of your friends and family members join the trip, consider booking guided tours. All guided tours will involve local guides who know other local people and safe places so you won’t have to worry. The main risk is robbery, especially against those going out at night.

Ferry crossings to Samosir and cruise tours are also a risk as live vests are not immediately reachable or available if unexpected situations occur. As soon as you get onto the deck, look for yellow tire-shaped vests usually hung on the ceilings. The operator will not announce any safety procedures while you are on board. The lake is calm so the risk is relatively low.

Emergency Assistance

Call 112 from any device for emergency support. You can connect to police, fire fighters and ambulance from that line. It is equivalent to 911 in the United States.

See also Traveling with Kids to Lake Toba.