Travel Medicine and Infections Disease (2015) 13, 507–508

LETTER TO THE EDITOR

A drink to die for: Arak and and blurred vision. This may lead to permanent blindness or
methanol poisoning in Indonesia can be fatal if the poisoning is not treated quickly. ‘Arak’ is
an already potent alcoholic drink mostly brewed from
coconut and very popular in Indonesia given that it is a
Dear Editor, much cheaper alternative to imported spirits. The process
of adding other substances to Arak in order to drastically
I would like to draw the readers' attention to the problem of increase its potency and reduce its cost has become
methanol poisoning which is affecting tourists who are frighteningly more common. It has varying high alcohol
traveling to the Islands of Indonesia; Bali, Lombak and Gili content, generally between 20 and 50%, making it the drink
Islands in particular. of choice among tourists. As a bottle of vodka is equal to
I first learned about this problem three years ago when one months wages in Bali so it is brewed by locals who find it
the daughter of my work colleague embarked on the trip of as a cheaper alternative to imported alcohol which is
a lifetime after completing her university studies. I was the heavily taxed. The problem is that there no way for tourists
one who took care of Rachel's necessary vaccinations to to know what exactly they are putting into their bodies.
ensure a safe trip. It never crossed my mind that Rachel Rachel's dad warns that "there is no discernible smell, taste
would become the victim of a methanol poisoning outbreak or colour. This is not a case of naïve tourists taking a risk for
on the island of Gili Trawangen, May 30th 2009. a cheap drink; the risk to life is real. There is no way of
Rachel's dad had this to say "Initially we thought this was knowing if a drink is contaminated or not".
a once off tragedy and local authorities did nothing to dispel "Drinking in Bali and its surroundings is like playing
that idea. However we now know that this is a regular Russian Roulette. If something goes wrong, medical assis-
occurrence and is still continuing to happen. I would like to tance is very limited or even non-existent as in Rachel's
highlight this problem in order to save others from this case. Follow up by authorities is an ineffective cosmetic
major threat." It is clear that tourists to the Indonesian exercise." To this date Rachel's parents have received no
islands need to be better educated regarding the serious result of the investigation into the Rachel's death. No
health risks associated with consuming alcoholic beverages criminal proceedings have taken place and nobody has been
and locally brewed spirits such as ‘Arak’. held responsible. These days, methanol poisoning is still a
In March 2010, Rachel's parents began to realize the major threat to tourists. Friends and relatives of the victims
extent of the problem. They began to track reports of are trying to raise awareness by bringing all of the informa-
methanol poisoning in Indonesia and were astounded by the tion to one location. Anyone intending to travel to these
scale of the problem. In April 2010, 22 people died by areas should visit; [Link]/ADrinkToDieFrom. It
drinking contaminated alcohol. May 2010, saw the death of is advised that travellers to destinations such as Bali take
8 people more victims of Arak poisoning. Statistics released extreme caution when delving into the nightlife of these
on [Link] suggest that 280 people have died from areas. It is recommended for tourists to drink from
methanol poisoning since 2011 and many more have been well-known beers and sealed cap trusted spirits instead of
hospitalized from drinking counterfeit alcohol. People of all locally brewed alcohol. The message seems to be that if the
nationalities and professions are becoming victims of metha price of the drink seems too good to be true then it
nol poisoning or, what is known now as ‘Arak Attack' which is probably is.
why we need to educate people on the risks of consuming An increased number of cases led to a travel warning to be
spirits and generate awareness. placed on the website for the Irish Department of Foreign
It seems that local brewers do not have access to the Affairs as well as the famous back-packing website Lonely
same brewing technologies as larger alcohol manufacturing Planet. However, this information would require someone to be
companies. The problem is that local brewers produce actively searching for it. Rachel's parent endeavor to highlight
spirits at home and therefore it is almost impossible to this problem and inform people of the risks by any means
ensure that the methanol has been separated from the necessary. "My family and I never thought we would live the rest
ethanol in the correct way. When ingested, methanol is of our lives without our treasured daughter. I will do my best to
highly toxic to the body causing abdominal pain, headaches, ensure no other parent or family have to experience the

[Link]
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508 Letter to the Editor

heartbreak we feel each minute of every day". I would like to Maria Callaghan
thank you for reading this and I hope that this piece will urge Our Lady of Lourdes Hospital, Drogheda, Ireland
young tourists and backpackers to be more cautious while E-mail address: mcallagh213@[Link]
drinking alcohol abroad as this information may save their life
or the life of another. 3 November 2015
Further references [Link] jun 16 2014. Available online 7 November 2015
[Link] nov 21 2012.
[Link] jun 2009.
Yours sincerely,

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