As many young nurses and midwives travel far and wide, often en route to jobs abroad, Maria Callaghan offers advice that might save a life

Three years ago, Rachel Craig finished her university studies and decided to travel. Her vaccinations and travel health plans were taken care of at Our Lady of Lourdes Hospital, Drogheda, where her mother and I are work colleagues, and off she went with adventure in mind...

Rachel had travelled widely all over Europe, Asia and South America. She had a passion for travelling and meeting new people. She was a wise and responsible traveller who avoided risks. But on May 31, 2009, Theresa and Noel Craig received the news that is every parent’s worst nightmare: Their daughter Rachel had died on the island of Gili Trawangen near Bali, Indonesia.

Rachel was a victim of methanol poisoning after she unwittingly consumed it in an alcoholic beverage.

It has taken until now for Rachel’s parents to come forward and talk about the tragedy which struck their lives. Noel, Rachel’s dad, had this to say: “Initially we thought this was a once-off tragedy and local authorities did nothing to dispel that idea. However, we now know that this is still continuing to happen.”

Tourists to the Indonesian island of Bali have been warned against drinking the local spirit ‘Arak’ after a number of people died of alcohol poisoning in May 2009. ‘Arak’ is a potent alcoholic drink, popular in Indonesia, brewed from coconut, palm sap, rice or fruit and is a much cheaper alternative to imported spirits or beers. It should not be confused with true Arak or ‘Araq’, an aniseed flavour spirit, similar to the French drink Pastis, that is popular in Middle-Eastern countries.

The main risk of Arak, other than the often very high alcohol level, is the process of adding other substances to it in order to drastically increase its potency and reduce its cost, which has become frighteningly common in South East Asia.

A bottle of vodka is equal to one month’s wages in Bali. Arak might be distilled, or adulterated, locally as a cheaper alternative to imported alcohol which is heavily taxed. Some local distillers therefore add methanol to fortify the drink. Methanol, commonly used as a fuel, has a high toxicity in humans. As little as 10ml of pure methanol can break down into formic acid, which can cause permanent blindness by destruction of the optic nerve and 30ml is potentially fatal.

Noel warns that “there is no discernible smell, taste or colour. This is not a case of naive tourists taking a risk for a cheap drink; the risk to life is real. There is no way of knowing if a drink is contaminated or not”.

Drinking cheap alcohol in many areas is risky, particularly where medical assistance is limited as in Rachel’s case. Follow-up investigations by local authorities were ineffective. To date, Noel and Theresa have received no official report of the investigation into the Rachel’s death. No criminal proceedings have taken place and nobody has been held responsible.

In April 2010, 22 people died by drinking contaminated alcohol. May 2010 saw the death of eight more victims of Arak poisoning and in June 2010, 23 people died and 500 were severely affected by drinking contaminated rice wine. More incidents occurred throughout 2011 and 2012. It seems people of all nationalities and professions are becoming victims of ‘Arak Attack’ or methanol poisoning. The latest being a 19-year-old from Perth, Australia, who was poisoned on the island of Lombok on New Year’s Day, 2013.

Methanol poisoning is still a threat to tourists and information is hard to come by. Friends and relatives of the victims are using Facebook to raise awareness: www.facebook.com/ADrinkToDieFrom

The increased number of cases has caused a travel warning to be placed on the website of the Irish Department of Foreign Affairs as well as the backpacking website, Lonely Planet.

Rachel’s relat i ves, including Noel and Theresa, will continue to highlight this problem and inform people of the risks by any means necessary. “My family and I never thought we would live the rest of our lives without our treasured daughter. I will do my best to ensure no other parent or family has to experience the heartbreak we feel each minute of every day,” said Noel.

Death drink - The drink that can kill