22 Body & Spirit
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IN SICKNESS & IN HEALTH
IN SICKNESS & IN HEALTH
WHAT’S YOUR POISON??
PARADISE...
PARADISE...
By Kim A. Patra SRN/RM.
Tainted arak supplies causing deaths in Bali AGAIN!
A year ago, almost to the day, dozens of people were poisoned by arak tainted with methanol. As many as 26 people including tourists and expatriates died.
Now, it seems that this nightmarish situation is happening again. How many of you have, or know someone that has had a nip of the local brew since all this happened? And who can tell me what is soooooo good about this brew that it is worth risking your life for ?????? I have told this to my boys over and over until I am blue in the face, but I get the same old answers. “The crisis is over and arak is ok now”, “my friend knows where they make the good stuff”, “we only buy sealed bottles so it must be ok”.
Ok, so no-one has died from tainted arak for 12 months, BUT do you want to be the fi rst to go toes up when the next bad batch comes along? Regular spirits such as whisky, vodka etc are terribly over-priced. Rp 500,000 for a bottle of plonk is just ridiculous. Not only is it greedy on the part of sales and import tax, but it is pushing people to drink home made brews that at the best leave your kidneys shot, and at the worst leave you dead.
At the end of the day you are left with little choice. Cough up for the expensive stuff or dice with your life on the rough stuff. You could of course give up drinking, but tell that to a bunch of young men on a weekend that just want to go out and have fun. On limited funds and a burning desire to party they will surely opt for the cheaper brew and throw caution to the wind.
So where does this leave us as parents? I can hear many of you thinking “well my child doesn’t drink”. Good on you if this is really the truth, but I can tell you from the little gatherings that I see on the beach come late evening on the weekend, that most teens and young adults are having a nip of something to get the party started. Be open and honest with your family. Don’t condone or forbid the consumption of alcohol. You need to know what is going on so an open honest relationship is the best way to go. Teach your child to drink sensibly and if they confess to drinking arak, warn them of the dangers and give them a budget for drinking safer drinks such as beer, wine or the occasional
spirit. Avoid arak, even in sealed commercially prepared bottles.
What is methanol poisoning?
Methanol also referred to as methyl alcohol or wood alcohol is widely used in commercial and industrial settings and can also be found in the home. Methanol is found as a component of many paint removers, varnishes, shellacs, windshield washing fl uid and antifreeze, and now it seems even in arak. Methanol is derived as a by-product of wood distillation. Poisoning occurs with consumption of contaminated spirits, accidental ingestion’s, and suicide attempts. Toxicity of methanol is due to the formation of toxic metabolites; formaldehyde and formic acid.
The onsets of symptoms are associated with the accumulation of formic acid. Formate inhibits cellular respiration leading to tissue hypoxia and lactate formation. Formate production occurs in the retina and usually causes blindness, one of the initial symptoms of methanol poisoning.
Symptoms
Initial symptoms may develop anywhere from 40 minutes to 72 hours after ingestion. The usual latent period is 12 to 18 hours. Co-ingestion with alcohol may delay symptoms. These signs and symptoms include: • Headache, vertigo, lethargy, confusion, coma, and seizures. Initial symptoms may resemble ethanol intoxication. • Visual effects. Patient usually reports “Looking into a snow fi eld”, & blurred vision. • Nausea, vomiting, abdominal pain. • Severe acidosis.
First aid
• Get the victim to a hospital ASAP. The patient will probably need renal dialysis, so Sanglah, Prima Medika, or Bali Med hospitals are your best bet as they all have dialysis machines. • DO NOT make a person throw up unless told to do so by Poison Control or a health care professional. • Charcoal (norit) tablets are not effective in methanol poisoning.
What to Expect at the Emergency Room
• Dialysis
• Medicine (antidote) to reverse the effect of the poison (fomepizole or ethanol) • Medicines to treat symptoms • Tube through the nose or mouth into the stomach to wash out the stomach (gastric lavage) • Oxygen and breathing support
• Other medications (folinic acid, bicarbonate)
Outlook (Prognosis)
Methanol is extremely poisonous. As little as 2 tablespoons can be deadly to a child. About 2 to 8 ounces can be deadly for an adult. The ultimate outcome depends on how much poison was swallowed and how soon treatment was received.
Kim Patra is a qualifi ed registered nurse and midwife who has been living and working in Bali for almost 20 years. She now runs her own private practice and medical referral service from her Kuta offi ce. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at
info@chcbali.com or Hp. 081 2366 0000.
Copyright © 2010 Kim Patra
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Paradise...in Sickness & in Health at
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