TRAVELER’S HEALTH IN BRUNEI

Brunei is free from malaria and many other tropical diseases, and the nation’s healthcare system ranks among the best in Asia. However, Brunei is a tropical country with a wide variety of wildlife, including venomous snakes and crocodiles. RIPAS hospital carries anti-venom for most locally found snake species. Yellow fever inoculation may be required for visitors over one year of age coming from infected areas, mostly in Africa and South America.

Visitors to Brunei generally don’t have health problems. The food and health standards are as good as those of European or North American countries. Diseases for which appropriate precautionary measures are recommended include dengue fever, hepatitis A, hepatitis B and Japanese encephalitis. To be on the safe side, it is a good idea to make sure you are up to date with shots and are prepared for both travel-related and serious sicknesses.

Healthcare in Brunei is of a high quality but expensive. Make sure you covered by your health insurance policy or have supplemental travel insurance with god medical coverage. You should take enough medication to cover your stay and carry it in your hand baggage. Not all prescribed drugs are available in Brunei. Some over-the-counter medications need a prescription. Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and that your travel insurance also covers costs for medical repatriation.

General Health Tips

You should be aware of the following health concerns in Brunei: 1) Occasional outbreaks of mosquito-transmitted illnesses; 2) Air pollution and haze if there are fires in Borneo; 3) Vaccinations: Be up-to-date on all vaccinations recommended by the U.S. Centers for Disease Control and Prevention. Further health information: World Health Organization, U.S. Centers for Disease Control and Prevention (CDC).

According to expat-blog.com: Rule no 1 …..Drink lots of water, especially in the first few weeks as you adapt. You may think that you are not sweating, but believe me, you are. You lose tons of water and if you don’t replenish, you are in for tough times. Dehydration causes all sorts of hassles [Source: expat-blog.com]

“Rule no 2…..Use a good sunscreen and insect repellent (included). Mozzies and all sorts are freely available and bite without invitation. The sun is fierce and usually right above you. Look at your shadow…in the UK you have a long shadow, usually pointing somewhere Northwards because you are about 50° north of the Equator and the sun is never closer than 23 N. Here, you have a small shadow, just a blob near your feet, because you are 5° north of the equator.

“DO NOT be fooled by cloud cover! That is when you really burn viciously. The humidity and sea breeze can lull you into a false sense of security for which you will pay dearly with red, blistered skin and severe pain. It is advisable to get a good anti-histamine prescription before you come. Start taking them about 2 days before you travel. This prevents allergic reactions to the sun and anything else.

“Water – It depends on where you live, the state of the pipes etc, but we found no bad effects from drinking tap water. Hygiene – Please be aware and very sensitive of the fact that this climate causes you to perspire – a lot! It is absolutely essential to bathe/shower at LEAST once a day, preferably twice. The use of a very good deodorant is extremely important and clothes should never be worn for more than one occasion. Synthetic fabrics are not a good idea. Cotton or linen is best.”

Inoculations and Health Entry Issues for Brunei

No vaccinations are required unless you entering Brunei from a country infected with yellow fever (usually in tropical Africa or South America) and then you need a yellow fever vaccination and documentation of it. It is a good idea to make sure you are up to date with your typhus, diphtheria and tetanus inoculations.

Try to get the new inoculations for food- and water-borne hepatitis A and blood-carried hepatitis B. The hepatitis B vaccination is worthwhile in case you have an accident and need blood transfusions. It may be worthwhile to get a vaccination for Japanese encephalitis, a mosquito-borne disease that is very rare but found in Brunei.

At least eight weeks before your trip, check the latest country-specific health advice from the Centers for Disease Control (CDC) in the United States and National Travel Health Network and Centre (NaTHNaC) on the TravelHealthPro website in Britain. Traveler doctors can tell you what shots and medications you need for specific countries. For information about travelers inoculations inquire first at your county, community or city clinic, or local university. Shots from these sources are generally much cheaper than those given at a hospital or from a private doctor. With inoculations, plan ahead. Some immunization require a series of shots that require more than a month to complete.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to Brunei. Foreign workers applying for an employment pass may have to undergo a medical screening for HIV/AIDS and a positive test will result in the rejection of a foreign worker’s application. If you’re arriving from an airport in the Middle East, you may be subject to screening for Middle East Respiratory Syndrome (MERS). If you display symptoms, you may face quarantine or further testing. Employment pass holders are subject to medical exams and may be denied or deported on medical grounds, including for HIV infection.

U.S. Centers for Disease Control and Prevention (CDC)

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control at https: //wwwnc.cdc.gov/travel. For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http: //www.who.int/en. Further health information for travelers is available at http: //www.who.int/ith.

1) Looking for travel health information for a particular area of the world? Please refer to Traveler's Health Destination Information. 2) Looking for a yellow fever vaccine clinic? Visit our national registry of official yellow fever vaccine providers. 3) Because Travel Medicine is a complex field, we advise consulting a travel medicine specialist or health-care provider 4–6 weeks before international travel to allow time for maximum benefit before you depart. Even if your trip is last minute, there is still benefit in consulting a travel medicine specialist.

4) See the Travel Medicine Clinics page for links to directories of private travel clinics and state health department websites (many state and county health departments also provide travel immunizations). Health-care providers can contact their state epidemiologist or local health department on the page of the Association of State and Territorial Health Officials.

For questions about travel, or comments, questions, or suggestions regarding our website, please contact CDC-INFO at: 1-800-CDC-INFO (1-800-232-4636), 1-888-232-6348 (TTY). Website: cdcinfo@cdc.gov

Haze and Humidity in Brunei

From June to October Brunei can experience high levels of pollution (haze) from land clearance fires in Indonesia. The haze can cause disruption to local and regional air travel, and the air pollution may have an impact on public health. Keep up-to-date with local information and seek medical advice on appropriate precautions.

Even in a relatively clean country like Brunei, the tropical climate seems to foster diseases; germs and viruses thrive here. Many people who have scant history of illness complain of recurring colds and other infections. Enthusiastic air conditioning probably contributes to respiratory problems. Many restaurants and shops are uncomfortably overcooled. Humidity makes mildew a problem—books, records, leather items, or anything that is not used or aired regularly or stored in air conditioning is vulnerable. Closets and bureau drawers take on a musty odor that is difficult to eliminate. Rust is also a problem; metal items that are not painted or tropicalized begin to rust in a short time.

Brunei, like every other tropical area, has its share of cockroaches, water bugs, small pesky ants, and termites. Flies are almost nonexistent. Mosquitoes can be annoying despite strenuous efforts to control them, but malaria is not a problem. [Source: Cities of the World, Gale Group Inc., 2002, adapted from a U.S. Department of State report]

Food, Water and Diarrhea Issues

The tap water is generally safe to drink but should be regarded with suspicion To play it safe, it is a good idea to drink bottled water and use it to brush your teeth. Also, be cautious about bottled water. Make sure the cap is sealed shut and buy the water at places regarded as trustworthy. In other words, don't buy it on the streets or in kiosks. This is generally not a problem in Brunei.

Some visitors have stomach- and bowel-related problems. To avoid this from happening use common sense. Avoid salads, ice, street food, sea food, and uncooked food. Never eat anything raw. Peel vegetables and fruit. Make sure meals are hot and recently prepared, preferably right in front of you. Don't eat anything that looks questionable or looks as if it had been sitting around for a while.

Keep your hands clean by washing with soap or a liquid sanitizer like Purell. Many people worried about hygiene bring their own chopsticks or carry swabs and packets of alcohol to wipe off chopsticks and rims of glasses in restaurant. Make sure you are inoculated against hepatitis A. Some people bring their own syringes.

If you are going into the rain forest be prepared to clean water with purification tablets or a filtration system. In regard to water purification tablets, iodine kills bacteria, dysentery amebas and giardia parasites. It is safe for short term. Long term use is dangerous to pregnant women and people who have thyroid problems. Chlorine kills amebas and giardia. Water filtration systems often don't remove all pathogens. Boiled water is safest. A heating coil is useful for heating water.

Many visitors have stomach- and bowel-related problems. Some get stomach parasites. To avoid this from happening use common sense. Avoid salads, ice, street food, sea food, and uncooked food. Never anything raw. Peel vegetables and fruit. Make sure meals are hot and recently prepared, preferably right in front of you. Don't eat anything that looks questionable or looks as if it had been sitting around for a while.

Travelers Diarrhea is something travelers sometimes get in Brunei get but less than in Thailand, Malaysia and Indonesia. If the diarrhea is accompanied by sulphur tasting burps it probably means you have giardia. The best remedy for any kind of diarrhea problem is to flush your system by going 24 hours, or as long possible, drinking clear fluids. If the diarrhea persists you may need to take strong antibiotics. Immodium is only good for temporarily stopping you up. It is good for bus rides but once the medication wears off your diarrhea returns. If you have blood in your stool it means you may have dysentery; see a doctor immediately.

According to “Cities of the World”: “Sanitation of human waste has improved over the years. However, other waste carried by contaminated water often runs in the open storm drainage system, resulting in chronic unpleasant odors. Some town and residential areas are marred by indiscriminate dumping of waste and garbage.[Source: Cities of the World, The Gale Group Inc., 2002]

In regards to water, expat-blog.com reported: “It depends on where you live, the state of the pipes etc, but we found no bad effects from drinking tap water.”

Sun and Heat Issues in Brunei

Sun Protection: Make sure to bring a sun screen rated "15" or above and drink plenty of water if you are traveling in hot areas. Sun glasses and protection for your lips are a "must." Hats and long sleeve shirt are also a good idea.

Heat Protection: Dehydration can be is a serious problem in hot weather. It goes without saying to bring lots of water, at least 5 liters per person a day, and have access to shade. To avoid heat exhaustion and heat stroke stay in shade as much as possible, get enough salt, replace electrolytes with fruit juices or prepared drinks that replace the salts you lose, stay out of the sun and don't do strenuous exercise after 10:00am and before 4:00pm. If you do physical activity when it is hot it is good idea to go out early, right after sunrise if you can, and take a rest or a nap in the shade in the afternoon, and continue on in the late afternoon.

Heat Exhaustion: Heat cramps are the least dangerous of the heat-related conditions. They serves as a warning that more serious things might happen. The symptoms include cramps, muscle twitching, and lightheadedness. If you have any of these symptoms immediately cool down your body with some water or shade.

Heat exhaustion is a serious condition. It is characterized by severe fatigue, headaches, confusion, nausea, weak pulse, cold clammy skin, and giddiness. Heat stroke is a very dangerous and potentially fatal condition characterized by a high body temperature and no sweating. People with heat stroke need immediate hospitalization; and should be cooled with wet towels until then.

Fungal Infections are common in hot, humid places. They include athlete’s foot, ringworm and infections in the groin, scalp and between the fingers and toes. They can be avoided by keeping as dry as possible and washing frequently and drying well afterwards. Treatment usually involves using an anti-fungal cream or powder such as tolnaftate (Tinaderm).

Prickly Heat is a temporary but irritating condition caused by blocked sweat-gland pores and is characterized by tiny blisters on the skin. It is caused by sweat that can't work its way out of the body and usually occurs under thick skin or calluses. It sometimes afflicts people from temperate climates while they are hot climate. Drinking liquids to promote sweating makes it worse. Loose fitting clothing and scrubbing to open up clogged pores helps. Some medications offer relief. The condition goes away when the individual becomes acclimated to his or her hot surroundings.

Snake and Scorpion Bites

Brunei is a tropical country with a wide variety of wildlife, including venomous snakes and crocodiles. RIPAS hospital carries anti-venom for most locally found snake species. Snakes and scorpions are mainly active at night. Bites from scorpions are often painful but rarely dangerous although some species can be dangerous. Snakes bites are generally a much more serious matter. Wearing thick boots is good preventative measure. Snakes and scorpions sometimes rest in shoes and clothes. It is a good idea to carefully shake your clothes and shoes before you put them on. There are antivenoms for most poisonous snakes but they are not always available. If you are really concerned you may want to bring snake anti-venom and scorpion anti-venom for the snakes and scorpions you might encounter. These sometimes need to refrigerated.

Among the species of venomous snakes found in Borneo are the Wagler’s pit viper and several species of krait. Kraits are among the world's deadliest snakes. They are found in southern Asia. Their bite causes rapid onset of sleepiness and numbness. The mortality rate is 50 percent even with treatment from antivenin. American soldiers in Vietnam used to call the krait the 5 Step, meaning that if you got bitten by a krait you would take five steps and then die Kraits belong to the same family of snakes as cobras. They are often strikingly colored. Most are black with white and yellow bands. They sometimes get into to battles with king cobras. In most cases they lose and are eaten by the much larger snake. Kraits inhabit a wide variety of habitat in its range: fields, low scrub jungle as well as inhabited areas. They are known to take up residence in termite mounds, brick piles, rat holes and also inside houses. It is fond of water and is frequently found in it or within proximity to a water source.

Wagler’s pit viper belong to a group of tree- dwelling snakes called lance-headed pit vipers. General characteristics of this group of snakes include a broad, flattened head, very distinct from the narrow neck, with a moderately compressed, cylindrical body, and a prehensile tail of moderate length. Their eyes are small to moderate in size with vertically elliptical pupils. Pit vipers have a pair of heat sensing pits located between each eye and nostril. Wagler’s pit vipers have a green or blue-green background color with black-edged scales; the top of the head is black with yellow-green markings and the chin is yellow. Pit vipers possess a very sophisticated venom delivery system. Large tubular fangs are placed in the front of the mouth and they are hinged, allowing them to be folded back when not in use. Their venom is primarily hemotoxic and all of the lance-headed pit vipers of the Philippines are capable of inflicting a dangerous bite. Primarily nocturnal in habit, these snakes are sluggish and docile during the day but will bite when threatened at night. [Source: U.S. Army, Center for Health Promotion and Preventive Medicine (Usachppm) Entomological Sciences Program, Aberdeen Proving Ground, Maryland]

Diseases in Brunei

Dengue fever occurs in Brunei but is not serious a problem as is elsewhere in Southeast Asia. Hepatitis is sometimes spread because dishes are often washed in dirty water and chopsticks and utensils are simply wiped off and reused. Many travelers carry their own chopsticks. Respiratory infections, colds, coughs, sore throats, Middle-ear and external-ear infections, sinusitis and bronchitis are somewhat common as they are everywhere in the world. [Source: Travel.State.Gov, U.S. Department of State, May 2019]

Otherwise Brunei has few health hazards. Malaria has been eradicated, although it may be picked up in some remote areas of Malaysia and Indonesia. Dengue fever is more of a problem. Like malaria, it is transmitted by mosquitoes and is enervating, lasting two or three months.

Children sometimes contract tropical fevers of unknown origin which may last from one to three days but, in general, Brunei provides a good environment for young children. Serious dysentery is rare. The heat and humidity increase the incidence of skin problems; treatment should be sought at the first sign of trouble, since infections spread quickly. Mosquito-borne illnesses like dengue fever occur all year round. You should take appropriate precautions to avoid being bitten by mosquitoes. [Source: Countries of the World and Their Leaders Yearbook 2009, 2008 Gale]

Rabies can be found in dogs, bats, and other mammals in Brunei, so CDC recommends this vaccine for the following groups: 1) Travelers involved in outdoor and other activities (such as camping, hiking, biking, adventure travel, and caving) that put them at risk for animal bites; 2) People who will be working with or around animals (such as veterinarians, wildlife professionals, and researchers); 3) People who are taking long trips or moving to Brunei; 4) Children, because they tend to play with animals, might not report bites, and are more likely to have animal bites on their head and neck.

Insect Protection: Wear protective clothing. Use a spray like "Coulston's Duranon Tick Repellent" on your clothes. Use a 95 percent to 100 percent DEET insect repellents on your skin. Electric fans are an effective in keeping mosquitos away.

Dengue Fever

From time to time Brunei experiences a spike in the number of dengue fever cases. Dengue fever is a nasty, viral disease transmitted by the Aedes mosquito, usually the Aedes aegypti , the same mosquito that often carries yellow fever. Sometimes called "breakbone fever" or "break-heart" because of the intense pain it can produce, the disease is characterized by sudden onset of fever; intense pounding, frontal headaches; aching bones and joints; nausea and vomiting; and a feeling of being too sick to eat anything. Other symptoms include severe sweats, symptoms: eye pain, rash, chills, and excruciating chest pains. Tests foe dengue rely on the presence of antibodies, which can take up to a week to develop.

Dengue fever is found in 100 countries and kills about 20,000 people annually. Nine out of 10 people who get dengue fever don't even feel it or get a mild case in which they feel something akin to a slight flu. People who get full-blown dengue fever are sick for a week or more. Many patients have a rash, which appears 3 to 5 days after the onset of the disease, and experience severe emotional and mental depression during the recovery period. Most cases of the disease are benign and self-limiting although convalescence may take a long time.

A few people with dengue fever suffer gastrointestinal bleeding. Fewer still suffer brain hemorrhages. In about 1 percent of cases dengue fever can cause a severe and often fatal hemorrhagic disease called dengue hemorrhagic fever (DHF) that occurs when capillaries leak and the circulatory system collapses.. Those that die of dengue fever often get DHF hemorrhaging in the final stage of the sickness. Failing to realize they are infected, they go don't get treatment soon enough and lose blood plasma and go into shock after the initial fever passes. Some victims die within 10 hours of developing serious symptoms if they don't get appropriate treatment.

See Dengue Fever article factsanddetails.com

Japanese Encephalitis

Culex vishui mosquito Japanese encephalitis is a mosquito-born viral disease that usually infects people in rural areas in the summer and autumn in temperate regions and northern tropical zones of Bangladesh, China, India, Cambodia, Korea, Laos, Myanmar, Nepal, Thailand, Vietnam and eastern Russia. It is sometimes present in the wet season in the tropical zones of south India, Indonesia, Malaysia, the Philippines, Brunei, Sri Lanka. Taiwan and south Thailand.

Japanese encephalitis is transmitted chiefly by the Culex vishui and Culex tritaeniorhyncus mosquitos, which bite mainly in the afternoon and evening and develop from larvae found mainly in cultivated rice fields and marshes. People traveling in rural areas have a stronger likelihood of contacting the disease than those who stay in urban areas.

Most people who are infected display no symptoms, but the fatality rate is as high as 30 percent among victims who are hospitalized. Severe swelling in the head and central nervous system are manifestations of severe cases of the disease.

There is a vaccine that is given in a series of two or three injections one or two weeks apart. There is no medical cure but most victims recover on their own with rest and hospital care.

Encephalitis is a tick-bourne disease that often produces fatal swelling of the brain. Symptoms include fever, headache vomiting, neck stiffness, pain in the eyes when looking at light, alterations in consciousness, seizures, paralysis or muscle weakness. Correct diagnosis requires hospitalization. There are vaccines for encephalitis and specific tick-borne encephalitis immune globulin. Encephalitis prevention includes avoiding places with ticks such as high grass, edges of forests, clearings.

Hepatitis

Hepatitis is a viral disease that affects the liver. There are at least six known kinds of hepatitis (hepatitises A, B, C, D, E and F). Hepatitis A, hepatitis B and Hepatitis C (which wasn't even identified until 1989) are relatively common in some places. Hepatitis D and hepatitis E are very rare. Hepatitis may be infectious or noninfectious. Six or seven virus are usually responsible for the infectious versions although other viruses, parasites, fungi may cause it.

Hepatitis is debilitating disease that can last for months. It often creeps up slowly (between 15 to 50 days, usually around 25 days), peaks, sometimes with pronounced symptoms, and fades away slowly. leaving victims feeling weak and tired for a long time.

Hepatitis generally begins with mild symptoms that may or may not become severe. Hepatitis can go on a long time and cause considerable damage before people realize they have it. Early symptoms include a slight fever, achy joints, abdominal pain, lethargy and aversion to cigarette smoke. One telltale sign of hepatitis is urine that is deep orange in color regardless of how much liquid has been consumed (if you think you may have hepatitis drink a lot of water, if you urine is still really orange or yellow see a doctor).

Hepatitis A is contacted from contaminated water and hepatitis B is contacted from infected blood or bodily fluids. Both diseases can be very serious and debilitating and often include jaundice (yellowing of the skin and the whites of the eyes). Immunizations, consisting of a series of shots given over several weeks, are available for both diseases. If you are getting these shots for traveling make sure you get them well advance of your departure date.

The Hepatitis A vaccine consists of a single dosage given two weeks prior to exposure. A booster is recommended anytime between six and 12 months later to assure the best protection. The side affects are generally mild.

Hepatitis B kills or contributes to the death of at least 600,000 and maybe as many a million adults every year. It is transmitted by body fluids, primarily blood and semen but occasionally saliva, and is contacted by direct contact with an infected person's blood or contact with the infected person's bodily fluids, such as through sharing needles or having sex. Transmission is mainly through blood contact, such as a blood transfusion, or to a lesser extent from infected unsterilized needles, acupuncture and tattooing. Transmission through sex is rare. It can not be contacted through casual contact such as shaking hands.

Hepatitis B is incurable but it can be prevented with a vaccine. The Hepatitis B vaccine is made two ways: 1) the plasma-derived vaccine is made with hepatitis B virus particles taken from the blood of carriers, with all viruses in the vaccine being killed; and 2) the recombinant vaccine made from common bakers yeast through genetic engineering.

Medication in Brunei

Bring enough of any prescription medicine that you take as well an extra set of glasses or contact lenses, and maybe a first aid kit. If you or a family member are taking long-term medications or allergy injections, bring a supply and arrange beforehand for regular refills. You should take enough medication to cover your stay and carry it in your hand baggage. Not all prescribed drugs are available in Brunei. Some over-the-counter medications need a prescription. On the other hand, many medicines that are obtained with a prescription in Western countries, including birth control pills, can be obtained over the counter in Brunei. Pharmacies are usually well stocked.

Medication and prescriptions are readily available but may not be the same brands as those found in the United States. If traveling with prescription medication, check with the Embassy of Brunei in Washington, D.C., to ensure the medication is legal in Brunei. Always carry your prescription medication in original packaging with your doctor’s prescription. Vaccinations: Be up-to-date on all vaccinations recommended by the U.S. Centers for Disease Control and Prevention. [Source: Travel.State.Gov, U.S. Department of State, May 2019]

The legal status and regulation of some medicines prescribed or purchased in the UK can be different in other countries. If you’re travelling with prescription or over-the-counter medicine, read this guidance from NaTHNaC on best practice when travelling with medicines. For further information on the legal status of a specific medicine, you’ll need to contact the embassy, high commission or consulate of the country or territory you’re travelling to. [Source: gov.uk United Kingdom government, Foreign travel advice, 2019]

Medical Facilities in Brunei

If you need emergency medical assistance during your trip, dial 991 and ask for an ambulance. You should contact your insurance/medical assistance company promptly if you are referred to a medical facility for treatment.

Medical Facilities are generally excellent but expensive in the major cities but are limited in some rural areas. Many doctors speak English and have received foreign training. Larger hotels often have a list of English-speaking doctors that are on call for visitors. They are often the best doctors in town. Sometimes they are not. Before you leave on your trip find out where NGO workers and diplomats receive medical help. Some people advise getting emergency evacuation insurance in case of illness

There is adequate care for basic medical conditions in Brunei; however, for certain elective surgery or complicated care the best medical care in the region is obtained in Singapore. Medical care is generally good in Brunei and relatively reasonable unless you opt for private hospital services. Healthcare is not provided free of charge in Brunei but the government run hospital would extend their treatment without the need for any form of payment guarantee. You are expected to settle your bill prior to your discharge.

Standards of healthcare in Brunei are generally acceptable, though basic hospital supplies can run low from time to time. There are two significant medical facilities, the Government General Hospital (RIPAS) in Bandar Seri Begawan and the private Jerudong Park Medical Centre (JPMC). Should complications arise, medical evacuation to Singapore may be necessary. Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation.Emergency dental treatment can be provided either at Jerudong Park Medical Centre (JPMC) or from local private dentists. Most branded pharmaceuticals are readily available though some items that are available without a prescription in the UK, like decongestants or anti histamines may require a Doctor’s prescription in Brunei. [Source: gov.uk United Kingdom government, Foreign travel advice, 2019]

According to “Cities of the World”: Health services are free for Brunei citizens with a nominal charge for permanent residents and expatriates. Health care is a three-tier system, with health clinics providing primary care, health centers providing secondary care, and district hospitals providing tertiary and specialized care. The most important medical facility in Brunei is the 550-bed central referral hospital in Bandar Seri Begawan known as Raja Isteri Pengiran Anak Saleha Hospital (RIPAS Hospital). Most doctors and dentists in the country are non-Western expatriates. For specialized care, patients are sent abroad. Routine dentistry is available. Opticians and optometrists are available, and there are many doctors in private practice.” [Source: Cities of the World, Gale Group Inc., 2002, adapted from a U.S. Department of State report]

Doctors and hospitals expect immediate payment for health services by credit card or cash and generally do not accept U.S. health insurance. Check with your medical insurance company to make sure you are covered overseas. Hospitals may require a substantial deposit before admitting you for any major medical treatment. The U.S. government does not pay medical bills and cannot provide a letter of guarantee for payment. Be aware that U.S. Medicare does not apply overseas. [Source: Travel.State.Gov, U.S. Department of State, May 2019]

English-Speaking Doctors: You can gain access to a worldwide list of recommended doctors 24 hours a day by contacting the International Association for Medical Assistance for Travelers (IAMAT, www.iamat.org , 1623 Military Rd. #279 Niagara Falls, NY 14304-1745; Tel: (716)-754-4883. You can also contact the U.S. Embassy or consulates in Brunei or try the International Society of Travel Medicine (www.istm.org ).

Emergency Medical Care and Services in Brunei

The emergency medical phone number is 991. There is adequate care for basic medical conditions. However, due to unpredictable shortages of materials and uncertain support staff, travelers should undergo surgeries or complicated care in a country with a better-developed healthcare system, such as Singapore. [Source: Travel.State.Gov, U.S. Department of State, May 2019]

Jerudong Park Medical Centre (JPMC) in Kampong Jerudong is a private hospital operating as a joint venture with Gleneagles of Singapore. JPMC offers a comprehensive range of medical and surgical facilities that include an internationally-recognized specialized cardiology and cardiothoracic surgical care unit. JPMC has routine medical care facilities that can accommodate those cases from the simplest of conditions to the most severe. However, JPMC does not have a trauma unit.

Raja Isteri Pengiran Anak Saleha (RIPAS) in Bandar Seri Begawan has emergency room services and screened blood supplies. RIPAS is a large government hospital with a surgical ICU, a pediatric ward, and an Accident and Emergency unit. RIPAS and JPMC share many of the same doctors. Although there are no air ambulance services based in Brunei, service can be coordinated out of Singapore.

Medical Insurance

Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and that your travel insurance also covers costs for medical repatriation. There is no reciprocal agreement between the national health plan in many countries and those in Brunei. Medical costs are to be borne by the individual. Insurance is essential, therefore, ensure that comprehensive travel insurance is taken out before you travel. Make sure that your policy provides for the following: 1) an air ambulance, in case you need to be flown home; 2) full medical coverage (bills can be expensive); 3) bringing the body home, in the event of death; 4) bringing your family home, in the event of your illness or injury.

Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments. The U.S. Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. The U.S. Department of State strongly recommend supplemental insurance to cover medical evacuation. It is also not a bad idea to get Travel Health Insurance. Medicare and Medicaid do not cover medical expenses rendered outside the U.S. Often what you do is pay for the medical costs with cash or credit card at the time services are rendered and then do the paperwork and file a claim when you return home and are reimbursed for a percentage of your costs. Some policies will make a payments directly to hospitals. [Source: Travel.State.Gov, U.S. Department of State, May 2019]

Things to consider when deciding about travel insurance: Medical Evacuation Insurance: 1) Pays for medical care and emergency transportation. 2) If you are traveling to a remote destination or to a place where care is not likely to be up to U.S. standards, consider buying medical evacuation insurance. 3) It can be purchased separately or as part of your travel health insurance policy.

Travel Health Insurance: 1) Pays for emergency and/or routine medical services overseas. 2) If you have health insurance in the United States, find out if it covers emergencies that happen abroad. More information is available on our page about your health abroad. 3) If your health insurance coverage is not adequate, consider buying a short-term supplemental policy. 4) Look for a policy that will make payments to hospitals directly.

Travel insurance varies widely and one should carefully read the terms of an insurance policy to make sure it fits the needs of the traveler. For example, does it cover: 1) Emergency medical care; 2) Medical transport back to the United States; 3) Travel/accommodation costs; 4) 24 hour contact line; 5) Sufficient financial coverage; 6) The region(s) you travel in; 7) Duration of travel; 8) Pre-existing conditions; 9) Activities you plan on engaging in;

For medical assistance you can try the International SOS website (a travel insurance company, www.sosinternational.com ); MedicAlert (www.medicalert.org ) Tel: 1-800- 432-5378, 8:00 AM - 4:30 PM PT, Mon-Fri, Pacific Time); National Patient Travel center (www.patienttravel.org, Tel: 757-318-9174).

Hospitals, Medical Centers and Clinics in Brunei

The Raja Isteri Pengiran Anak Saleha hospital (RIPAS, www.moh.gov.bn, Tel: 2242424) in the capital Bandar Seri Begawan is equipped with highly modern medical facilities. This hospital, built at US$95 million, provides diagnostic and therapeutic facilities for the entire country. Raja Isteri Pengiran Anak Saleha (RIPAS) has emergency room services and screened blood supplies. RIPAS is a large government hospital with a surgical ICU, a pediatric ward, and an Accident and Emergency unit.

Other Hospitals and Medical Centres (Name, Address or Website Contact Number): 1) Gleaneagles JPMC www.gleneaglesjpmc.com.bn, Tel. 2611212; 2) Hospital PIHM Temburong (Pengiran Isteri Hajjah Mariam Hospital), Tel: 522 1526 ext 127; 3) Jerudong Park Medical Centre (JPMC) www.jpmc.com.bn Tel: 261 1433; 4) Panaga Health Centre Seria, KB3534 , Tel: 334 1302; 5) Pengiran Muda MahkotaPengiran Muda Haji Al-Muhtadee Billah, Tutong Hospital, Tel: 422 1336 ext 991; 6) Suri Seri Begawan Hospital (Belait), Tel: 333 2366 ext 991

Clinics (Name, Address or Website Contact Number): 1) Amir's Clinic 1st Floor, Unit 5 PAP Hajah Norain Shopping Complex, Bandar Seri Begawan Tel: 222 8002; 2) CY Lim Clinic Unit 16, Block J, Ground Floor, Abdul Razak Complex, Gadong Tel: 244 9488; 3) Dr Haji Asri Clinic No. 2, Simpang 161, Jalan Pasir Berakas Tel: 242 2788; 4) Dr Lim Medical Clinic, 1st Floor, Block D, Complex Abdul Razak, Gadong Tel: 242 2788; 5) Dr Prema Clinic Unit D, Bangunan Pengiran Haji Mohd Daud, Bandar Seri Begawan Tel: 242 1727; 6) Lee Clinic & Dispensary Unit C-1, Ground Floor, Abdul Razak Complex, Bandar Seri Begawan Tel: 242 8428; 7) Lim's Clinic & Dispensary 2.26 Level 2, Block C, Bangunan Yayasan SHHB, Bandar Seri Begawan Tel: 222 2181; 8) Luke Tan Clinic 47A, 1st Floor, Jalan Bunga Melor, Kuala Belait Tel: 322 5601; 9) Riverview Medical Centre Riverview Hotel, kilometers. 1, Jalan Gadong, Bandar Seri Begawan Tel: 223 8018 ext 8816; 10) TK Chan Clinic Unit 9, Ground Floor, Block C, Kiarong Complex, Bandar Seri Begawan Tel: 242 2141; 11) Yong Clinic & Dispensary Block 1, Room 1, PAP Hajah Norain Complex, Bandar Seri Begawan 222 0284.

Image Sources: Wikimedia Commons

Text Sources: Brunei Darussalam tourism websites, Brunei Darussalam government websites, Wikitravel, Wiki Voyage, UNESCO, Wikipedia, Lonely Planet guides, New York Times, Washington Post, Los Angeles Times, National Geographic, The New Yorker, Bloomberg, Reuters, Associated Press, AFP, Japan News, Yomiuri Shimbun, Compton's Encyclopedia and various books and other publications.

Updated in August 2020