Archive for the Health/Diseases Category

Noise Pollution in Southeast Asia

Posted in Health/Diseases, Latest of Asienreisender with tags , , , , on March 13, 2014 by Thim Kwai

Among all the pollutants we are exposed to, noise pollution is certainly the most nerve-wrecking. Here a party, there a marriage, a funeral, a disco, karaoke, temple festival, a mosque, private house music, a fair, a building site, dog’s barking and howling at night, traffic, TV, radio, a workshop, a lawnmower, a truck’s engine running while the driver is anywhere around… everyday over hours, day for day, week for week, month for month – it never stops here. And the people of Southeast Asia don’t know any limits when it comes to noise pollution.

There is no privacy for the people here, they are not individualized. All is a common matter, mostly family matter. On the other hand there is no respect for public space or public concern. As they use the sidewalks in front of their houses as whatever they want, an extension of their homes or as a metal workshop, so they make a hell of a noise, pesting squaremiles with it, just for – well, for what? Just so…

What makes these miserable people so relentlessly noisy? Well, primitive people are noisy. That’s an observation many Westerners documented already centuries ago. Friedrich Gerstaecker describes an evening in a Javanese village, when he couldn’t stand the partying in the place where he had an overnight, but had to pack his belongings and to escape to the village’s edge to find some rest there. Franz Wilhelm Junghuhn depicts a village in which he came after days of hiking through Java and where he actually planned to rest for a few days. He left it early instead, for the locals had a three-days festival and the party noise was not to stand (Licht- und Schattenbilder aus dem Innern Java’s).

What was a nuisance in the 19th century or former times generally, is a monstrous pest in our days. Nowadays everybody can produce a hell of a noise with just a flasdisk and an integrated loudspeaker. Hours over hours over hours until deep into the night all kind of crap is blasted out now. Sometimes it starts already early in the morning, when the muezzin cries out his message (not seldom also mp3 based), Buddhists produce radio music, advertisements and long-lasting announcements via loudspeakers or the national anthem is played, accompanied by radio broadcasting. Or a neighbour can’t sleep and starts playing his favourit techno music, high volume, basses turned on maximum.

A great deal of the population is dull and literally retarded. They suffer inner emptiness. They don’t find any meaning in their lifes. They have no sense for what is good in life, no taste, have no values nor virtues. They suffer a very low IQ and have no morals. They can not love anything and they are not lovable. They are irresponsible and give a damn for the sake of others. Nobody ever cared for them, why should they care? Most people never ever read a book in their live, not even the lousy newspapers they have here. They watch TV of the lowest kind, not interested in anything of substance. The highest imaginable art for them is business, or better fraud. Cheating ranks high. Cheating and taking advantage of each other is common in families and among acquaintances. Gambling for money is a main passion. They live miserable lifes without any perspective. Lack of reason is replaced by superstition.

Deprivation plays a central role in it’s explanation, but it’s not only the material poverty what explains the misery. When people grow wealthy, what not seldom happens in booming Southeast Asia, they still remain dull. Deprivation is not simply material. Generation long deprivation is conserved in their heads and outlives wealth. Once wealthy, they want ever more and more. The dullness, the inner emptiness, the absense of anything what makes humans human, what creates a life what can be called somehow fullfilled, is replaced by superficial fun. Booze and noise are a central part of that. The seemingly happy people with their superficial friendliness and smiles cover a black hole behind the facade. Happy looking people are not necessarily happy. They have little control over their lives, they are uncertain and know extremely little about the world they live in. They suffer oppression, structural and open violence, physical threats, fraud, humiliations, and can do little about it. That’s scaring. Are they aware of that? Here and there it’s certainly dawning, but it’s not a nice feeling, though. But they can beat it down. Being noisy makes feeling powerfull. One can forget. At least for a short time. And then one can repeat it…


This is only a part of the richly illustrated article ‘Noise Pollution in Southeast Asia’. Read here the whole article on Noise Pollution.

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Check the list of recently published articles on a great variety of Southeast Asian themes. All of them are richly illustrated: Asienreisender

Dust Pollution in Southeast Asia

Posted in Health/Diseases, Latest of Asienreisender with tags , , , , , , , , , , on March 3, 2014 by Thim Kwai

Pollution is rampant in our times. Particularly in Southeast Asia with it’s economic boom and the low (or often: not existing) environmental standards. There are many different kinds of pollutions and pollutants. One of which it’s less known even being a pollutant is dust.

Dust consists of small particles of the most different kinds. They are smaller than 10 micrometer, some are as small as being measured in nanometers (ultrafine particles) – no more to see with the bare eye. Generally spoken, as smaller a particle is, as more dangerous it is for the health of a living being. For humans and animals it’s so that bigger particles can be physically absorbed, but very small ones penetrate the lungs deeply. The level of danger is also dependent on the shape, better the surface of the particles. Some are much more dangerous than others. So does soot for example consists of a very dangerous variety of fine dust particles (fine particulate).

A heavy or longer lasting impact of fine particulate can cause serious diseases, from caughing up to pneumoconiosis and cancer. In Germany the populations life expectancy is in average reduced by ten month due to it. According to the European Commission there are annually 310,000 people in the EU dying untimely due to dust pollution. In Southeast Asia the number will doubtlessly be much higher.

There is no harmless concentration for fine dust – it’s always harmful, and it’s harm increases by the degree of concentration and the time of exposure to it.


Sources of Dust Pollution
Health Impact
Dust Circulation


This is only a part of the richly illustrated article ‘Dust Pollution’. Read here the whole article on Dust Pollution.

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Check the list of recently published articles on a great variety of Southeast Asian themes. All of them are richly illustrated: Asienreisender

Chikungunya Fever

Posted in Health/Diseases, Latest of Asienreisender with tags , , , , , , , , , , , , , , , , , , , , , , , on August 8, 2013 by Thim Kwai

Chikungunya fever is another tropical, mosquito-born disease. It’s endemic in Southeast Asia, India and great parts of Africa.

Chikungunya is a virus which was discovered in 1953, first documented in Thailand in 1958. Most of the population in Indochina is probably immune against the disease. Though, tourists and travellers from other world regions are usually not immune. The disease is spreading out to the southern parts of Southeast Asia. In the last years there were considerable numbers of cases of chikungunya in Indonesia, Malaysia, the Philippines, Burma/Myanmar, Cambodia and Thailand, certainly also in Singapore. Between 2001 and 2003 there was a chikungunya epidemy on Java. In May 2009 there was an outbreak in Trang / Thailand, in 2012 in parts of Cambodia with 1,500 reported cases. Chikungunya appeared the first time in Cambodia in 1961.

Chikungunya is transfered by various kinds of mosquitoes, including the aggressive Asian tiger mosquito (Stegomyia albopicta, or aedes albopictus), which transferes dengue fever and a number of other diseases as well. Other vectors of the chikungunya virus are primates and rodents.

Recently a virus mutation happened, which is particularly well transfered by the Asian tiger mosquito. It’s pathogenicity is higher than those of the other, older variations.

The outspread of the Asian tiger mosquito in the last years, also into south Europe, is supposed to be responsible for the chikungunya epidemy in summer 2007 in Ravenna, Italy. Possibly the disease will spread out into more regions in Europe and north America in the next years.


Course of Disease






This is only a part of the illustrated article ‘Chikungunya’. Read the whole article on Chikungunya Fever by Asienreisender.

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Check the list of recently published articles on a great variety of Southeast Asian themes. All of them are richly illustrated: Asienreisender

Dengue Fever

Posted in Health/Diseases, Latest of Asienreisender with tags , , , , , , , , , , , , , , , , , , , , , on August 7, 2013 by Thim Kwai

In difference to malaria, which vector is a parasite, dengue fever is a viral disease. It’s hosts are exclusively primates, mostly humans and some kinds of mosquitoes of the family aedes, who transfer it. There are four different subspecies of the virus.

Mosquito larvas in a washing basin in Cambodia. Images by Asienreisender, 2013

Dengue fever is a very dangerous and painful disease. It is also an emerging disease, in fact the fastest dispersing disease in the world transfered by mosquitoes. In the fifty years between 1960 and 2010 dengue cases rose up thirty fold worldwide. In the ten years between 2000 and 2010 the number of cases doubled. That has to do with the expansion of the vector mosquito, what is in Southeast Asia (mostly) the Asian tiger mosquito, in general mosquitoes of the aedes family. This mosquito kind thrives in urban regions, and it’s very adaptable. Since urbanisation is rampant in Southeast Asia, the Asian tiger mosquito has a rapidly growing habitat. But it’s also worldwide spreading out. Globalization promotes the outspread of the tiger mosquito and the disease. Increased mobility as travel activities, population growth and global warming play a role as well.

Particularly the Philippines and Laos are in the center of the emerge, but also Thailand, Malaysia, Singapore and Vietnam have all reported an increase in cases.

The World Health Organization (WHO) estimates between 50 to 100 million annual cases of dengue worldwide, of whome half a million suffer a heavy course of disease and 22.000 people die; most of the victims are children. In Asia more than 90% of the heavy course of the disease hit children. The magazine ‘Nature’ wrote in it’s April 2013 issue that even 390 million people get infected annually, referring to the studies of the scientific authors of the article.

Dengue is endemic in 110 countries in the tropical and subtropical regions of the earth; 75% of the dengue cases appear in the Asia/Pacific region.

Dengue fever is commonly also called the ‘breakbone disease’ or ‘dandy fever’.


The disease is mostly transfered by the Egyptian tiger mosquito, also known as dengue mosquito or yellow-fever mosquito and, here in Southeast Asia, by the Asian tiger mosquito (lat. Stegomyia albopicta, aedes albopictus). There are some other mosquitoes who transfer the disease, particularly in New Guinea and in the south Pacific (the Polynesian tiger mosquito).

The circle of reproduction is similar to those of other mosquito-born diseases. A female mosquito sucks blood from an infected person and gets the virus in it’s stomach. If the virus concentration is high enough, it can befall the mosquito’s stomach cells and reach it’s own blood circulation and contamine the mosquito’s saliva. The extrinsic incubation time inside the mosquito is eight to ten days, means that the virus is then mature and harmful. Next time when it’s biting someone, the infection is transfered to him or her. That’s because at any bite a mosquito does, first it’s injecting some saliva into the victims blood. A single bite of an infected mosquito is sufficient to transfer the disease, but not necessarily does. The virus can also be transfered from the mosquito to it’s lavaes.

Although the mosquito gets itself infected by the dengue virus, there are no harming effects for the mosquito.

Dengue can’t spread directly from one person to another one. But, if there is someone around who has dengue fever it is most important to protect everybody from the mosquitoes around, particularly the patient. They can transfer the virus from the infected person to other people around.

Dengue can also be transfered by blood transfusions and organ donations if the donator was infected himself.

The risk of an infection is highest in the rainy season (monsoon), for the mosquitoes then find the most breeding places and florish. The tiger mosquitoes prefer living indoor in urban regions and their daily peak periods of biting are around sunrise and up to two hours later and around sunset. Though, it can bite at any time of the day.

Course of the Disease

After getting bitten by a mosquito and infected, dengue has a latent period between three and fourteen days. Most of the cases are mild and not to distinguish from a normal flu. One get’s fever (up to 40 degree C) with ague, headache, eye- muscle- and limbpains. It comes together with a rash. After three to seven days it’s easing off. Though, in two to four percent of the cases the course of disease continues heavy. A ‘dengue hemorrhagic fever’ (DHF), also called ‘dengue shock syndrome’ can appear. One to five percent of the heavy cases are lethal.

Dengue hemorrhagic fever is an acute shock syndrom with uncontrollable inner and outer bleedings; the blood circulation breaks down, abdominal pain, fever and headache, dehydration, brain caused spasms, coma, bloody vomiting, bleeding gums, a swollen liver and many more symptoms appear.

The shock occurs two to six days after infection with sudden collapses, cool clammy extremities, weak thready pulse and blueness around the mouth, blood spots in the skin, spitting blood, blood in the stool, bleeding gums and noise bleeding. It can lead to pneumonia and heart inflammation. The mortality rate at this stage is announced by the WHO by between 2.5% with proper medical treatment up to twenty percent, without. Letal cases are mostly among children.

The disease is very painful. The acute phase lasts between one to two weeks, but can extend much longer (four to six weeks). If the infection is survived, the patient is immune against all four dengue viruses for a short time and for the certain virus which caused the acute disease a live long.

When suffering the first typical symptoms it makes sense to have it checked by a doctor to make certain what it exactly is.






This is only a part of the illustrated article ‘Dengue Fever’. Read the whole article on Dengue Fever by Asienreisender.

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Check the list of recently published articles on a great variety of Southeast Asian themes. All of them are richly illustrated: Asienreisender

Malaria by Asienreisender

Posted in Health/Diseases, Latest of Asienreisender with tags , , , , , , , , , , , , , , , , , , , , , , on July 29, 2013 by Thim Kwai

Malaria is an infectious parasitic disease. It’s naturally transfered by a female mosquito of the kind anopheles from man to man. Another way of transfer can be by blood transfusion or other injections (with used syringes) with parasite – containing blood. Smallest amounts of blood already allow a transfer. Pregnant mothers can in certain cases transfer malaria to their child, but it’s not necessarily so.

A poster warning before mosquitoes. Seen at a hospital in Chumpon, south Thailand. Image by Asienreisender, 2012

The development of the parasite happens exclusively inside anopheles mosquitoes and human bodies. There are three different kinds of malaria. Meaningful for travellers in Southeast Asia is malaria tropica, the most dangerous one. The others are malaria tertiana (which was widespread also in Europe, up to middle- and northern Europe until the first half of the 20th century) and malaria quartana.

Famous malaria patients of the European past were Albrecht Duerer, Oliver Cromwell and Friedrich Schiller. Malaria was finally extinct from Europe not before the 1960s due to the ‘Global Malaria Eradiction Program’ (see below).

A famous Asian malaria victim was Mohandas Gandhi (1869 – 1948), who suffered a severe attack in Aga Khan Palace in Pune in 1942, where he was held as a political prisoner.

All these three kinds of malaria are human-specific, means they don’t infect animals (apart from very few exceptions at monkeys, some of them observed at macaques in Southeast Asia).

Anopheles mosquitoes are (together with aedes und culex mosquitoes) among the most widespread mosquito kinds. There are 360 different kinds of anopheles mosquitoes alone in the world, of whom 45 potentially carry malaria. Their habitats are not limited to the tropes and subtropes, but spread out until the borders of arctic regions.

Around 40% of the global human population lives in areas infested with malaria, of whom 300 – 500 million people are infected (according to the Robert Koch Institute, Berlin). More than 80% of them live in tropical Africa, 13.8% live in Asia.

In mountainous areas above 1.500m, near the equator from 2.500m on anopheles mosquitoes do not appear anymore. Malaria is pandemic in almost whole Southeast Asia. Indonesia and Burma / Myanmar have here by distance the most cases in percentage of the population. A growing resistance to antimalarials are a challenge in the Greater Mekong Sub-Region.

The exciter for malaria tropica is the parasite plasmodium falciparum, the most lethal one among the four plasmodium parasites. Estimated 1.8 million people died in 2004 worldwide, 1.2 million in 2010 due to malaria.

Let’s assume that a biting mosquito is sucking blood. When the bitten human is malaria infected, the mosquito sucks with the blood the exciters which transfer within 8 to 16 days inside the mosquito into another phase and next to it’s final stage. When it gets injected then into another humans blood circulation, reaching there the human liver, it’s again breeding and spreading out into the vascular system. The perpetuation of the circle is then completed.

Read here more on the feeding habits of mosquitoes.


This is only the first chapter of the illustrated article ‘Malaria in Southeast Asia’. Read the whole article on Malaria in Southeast Asia by Asienreisender.

The following chapters are:

Malaria Prevention by Asienreisender
Malaria Immunity Asienreisender
Malaria Diagnosis by Asienreisender
Malaria Pathogenesis by Asienreisender
Malaria Therapy by Asienreisender
The ‘Global Malaria Eradiction Program’ by Asienreisender

Keep yourself up-to-date

Check the list of recently published articles on a great variety of Southeast Asian themes. All of them are richly illustrated: Asienreisender