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Berastagi, Tanah Karo, Sumatra, Indonesia

Berastagi, Tanah Karo, Sumatra, Indonesia

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By: Neneng Tarigan
Visiting India especially the Taz Mahal is always in my dream. In my childhood we used to have calendars with pictures about interesting places all over the world. Watching the pictures I got the feeling as if I were living there once in the past, because those pictures seemed so close to my heart. Some pictures were about few places in my country but most of them were about interesting and historical places abroad. I wonder if reincarnation is a true story, but as a Christian I would rather trust, that was only because my heart and soul was extremely possessed by the beauty of the places and the history behind it, that was why I feel so close with the pictures. As it proved, I was lucky to have been visited more than 40 countries in the world.
It was 09.00 pm when I landed at Indira Gandhi International, the new airport of New Delhi, India, on 30th September 2010. The airport is huge and it has just been operational since early of August 2010. The size maybe equal to Suvarnabhum airport in Bangkok and the floor was totally covered by wall to wall carpet like Changi airport of Singapore. The security check was so tight, may be it happens after India has a very bad experience with the Mumbai terrorist attack. (Mumbai is the second largest city of India)
Upon arrival, I was fetched up by the Embassy people who then brought me with Toyota old van 1990 to Ramada Hotel which I booked through the Internet. It took about 30 minutes from the airport to the hotel and my eyes caught by the glitter of the road studs. I also observed that many fully equipped military guards stand between the airport to the centre of New Delhi. Later, I knew that they guarded the city day and night. Incredible!
When I arrived, there were so many cars queuing at the hotel gate, a wedding party of the rich had taken place in the hotel, so I asked the driver to just drop me, so that we would not blocked other cars to get in.
After passing the scanning machines, I went inside then submitted the hotel voucher and asked for the room. Unfortunately however, the receptionist told me that I was not registered in that hotel but to another Ramada Hotel in Gurgeon about 2 hours from Ramada Hotel New Delhi.
I showed them that what was written on the voucher is clearly Ramada Gurgeon New Delhi, and since I had never been to India before, I presumed that the one I booked was totally correct, which is the one that I stand now; I had no idea, that there are two different Ramada hotel in Delhi. (Well, if they assumed that Guergeon which is 2 hours from Delhi is also in Delhi)
Feeling tired and sleepy, I then asked them whether I can simply move to this hotel instead of staying at the other Ramada in Gurgeon, of course with additional cost I don't mind. Again, according to the hotel management I can't do that, simply because the two Ramada is only the same hotel chain under the same franchise system and name but different ownership. How incredible! They are very strict with the rule here, the cancellation meant that all of the booking cost for 4 days stay which I have already made with Ramada Gurgeon that cost USD 400.- will automatically deducted from my credit card and gone, if I stay in Ramada New Delhi! (Well, that is their rule)
After long arguments, they advice me to use a hotel taxi to bring me to Ramada Gurgeon. I said: “Okay no problem, how much would the price be?” and then they said:”7000 rupees or about USD 170” I answered:”Well, that will be the problem, just get me another taxi not from this hotel.” They nodded, then I got an outside taxi with the price of only 900 rupees” Can you imagine the price different just in a minute? Well, that was incredible!
After about one hour drive, I then arrived at Ramada Hotel Gurgeon. There the manager said: I can't cancel my booking, so I had to stay in the hotel for the 4 nights I booked to stay in the first place. It was already 01.00 am. Feeling tired and disappointed, I could do nothing than to accept their policy. Here I am, in the middle of nowhere; I then called the embassy personnel to inform them about the situation and where I am about. Of course the embassy staff offered me the transportation facility, but knowing the distance and the fact that I had already chartered a taxi for pick and drop during I stay in the hotel, I gently refuse the offer and ask them to only fetch and drop me when I was about going back to Indonesia later.
Before sleeping, I asked the hotel manager for the free internet facility as they promoted in the web . We worked on it, and after one hour my laptop get connected with the internet, but with very low signal or meaning no connection at all! Another incredible story.
Gurgeon itself is a new industrialized modern city in the outskirt of New Delhi. It will take only 45 to 90 minutes from Ramada Hotel Gurgeon to Ramada Hotel New Delhi, depends on the traffic. There will be a small metro train station located in front of the Ramada Gurgeon once it is finished in early 2011. The Ramada Gurgeon Hotel is a small 8 stories 3.5 star hotel, built about 2 years ago. It is a very clean hotel and with a very helpful and polite staff too. I had no complain at all about the hotel condition. It is a good hotel to stay, especially for businessmen or investors who have business in Gurgeon; and else the infrastructure facilities in India is good or at least better than in Indonesia, so almost every part of India is reachable.
The next morning, I went to the meeting with the chartered taxi as recommended by the hotel manager. It was a small car with a Nepalis driver named Tapha who only speak a little English. No smile in his face, he seemed full with anger. he didn't even greet me a good morning but just drove and murmured, may be because I was a bit late for our appointment that morning.
Arriving at the toll gate, Tapha asked me to pay 20 rupees for the toll. Getting furious, I sternly said to him: “You know what, why are you so impolite to your costumer? I supposed to pay only 800 rupees for pick and drop, but the manager then told me to add 500 rupees more, for toll, parking and bla bla bla. I have already agreed about that and now with your long face you force me to pay more and more. Why don't you just check to the hotel manager?” He called and check and the with grim he said: “Okay, okay”
On the way to the meeting, I asked Tapha whether he can stop the taxi at Ramada Hotel Delhi, just to check, whether the meeting will be taken place at Ramada or Le Meridian. Actually they are at the same direction, and we can pass Ramada Delhi before Le Meridian, however he said: “No, no, no, miles, miles, miles”. “Okay” I said: “no problem, just drop me at Le Meridien”. (Gohst, it was incredible!)
At Le Meridian, I check, whether the venue of the meeting is in their hotel or in Ramada Delhi. They politely check and inform me that, it is not in their hotel, so I phoned the committee and they told me that the venue is at Ramada Delhi.
From Le Meridian I walked about 3 minutes to Ramada Delhi, because the two hotels are very closed by. The problem is, no one at Ramada Delhi knows where the meeting would take place when I asked them at the night when I firstly arrived in their hotel where the meeting would be. (Another incredible story!)
In the afternoon, I called the manager of Ramada Gurgeon to ask Tapha to fetch me at 05.30 pm; and there Tapha came with a man whom he called his body guard. They both have very strong sweating smell which made me almost choked to death. I just sat quietly till I arrived at Ramada Gurgeon and paid Tapha 1300 rupees (+ USD 32) for the transportation I made with him that day.
The next morning, Tapha was totally 100% changed. He came alone and became so very polite and full with smile. He asked me to talk to his wife who is Indian and has two master degree and of course she speaks very fluent English much better than me. After talking in the phone to his wife then I chat with Tapha and from his broken English I knew that he has one beautiful 9 years old daughter and 3 of his siblings married to different nationalities such as married to a Malaysian, a Kuwaiti, a Saudi Arabian and he himself married to a beautiful and smart Indian lady. Well, that was really a beautiful incredible story.
Along the way back from Ramada Delhi to Ramada Gurgeon I sang along with Tapha a beautiful Indian song entitled Kuch-Kuch Hota Hae which is originally sung by a famous Indian actor Shah Rukh Khan. It was like an ice breaking song that we both enjoy. We sang and dance along the way and every car just looked at us dancing and singing and beep us to be careful because we disturbed other cars to pass by.
It was a pity because the next day, I had to go with the embassy van to visit the famous Taz Mahal, and the day after that I had to go back to my beautiful country Indonesia. So no more Tapha.
It takes 4 hours to go to the Taz Mahal from Ramada Gurgeon. I had to pay about 12,000.- rupees (+USD 300.-) if I use the hotel taxi (not Tapha taxi), or I pay only USD 75.- per person if I use tourist bus, that is already included lunch and entrance tickets. With the embassy car the two of us (me and my colleague) pay only USD 150.- for the tip, since 2nd September was a holiday all over India as they celebrating the Khrisna day.
Along the way to Taz Mahal, we pass by the country sides. They are all green but also dusty and rocky. The Northern parts of India are quite dusty because they are close to Gobi desert, one of the largest desert in the world. Sometimes, we can see sky scrapers enacted in the middle of nowhere. The way they built them there were to create equal distribution of wealth across the states.
Not many houses exist along the way. With 1.2 million people, India seems so quiet. Most Indians seems tend to live in the cities rather than in the country sides. Well that is my observation at glance and that may not be 100% correct.
The road to Agra is full with trucks. Well, I am sorry to say that most of the trucks or vehicles in India seemed old but still work well. The bus there all surrounded by concrete bars, so it seems like a jail bus to me, but they say it was because India has a large poor population and the majority of them use buses as main transportation, so in order to avoid them from falling out of the bus, they put bars in all of the windows, so that they would be more secure inside. The famous public vehicle is the three wheels Bajaj. (We also have Bajaj in Indonesia, as one of our public transportation in the cities. We import it a lot from India, but the size of the Indonesian Bajaj is smaller than the Indian one). What amazed me is the Indian Bajaj fit for 12 persons and still moving, whereas in Indonesia may be for 6 or 7 person can fully pack in one roof. Wow, another incredible story!
Agra is one of the 28 states of India. It has about 130 million people, who live in trade, crafting, agriculture and mining. The majority of Agra people is Moslem, but they seem so poor, or at least that was I observed along the way. The Taz Mahal built by King Shah Jahan (a Moslem King) in 17 century as a dedication to his most beloved queen Mumtaz. (The King himself has + 200 wives, according to our driver). Incredible! It took 22 years to build such a magnificent and beautiful landmark. As everyone knows, Mumtaz died when delivering her 14th baby much earlier before the Taz Mahal itself finished.
The king himself then murdered by his own son who disagreed with his royal father lavish live and plan to built another Taz Mahal for himself. If you go to Taz Mahal compound, there is no other Taz Mahal or the black Taz Mahal around. Every building in Taz Mahal compound was built asymmetrically and in harmony with its surrounding. The buildings erected in the edge of the river, so it has incredibly beautiful natural landscape in itself.
Made of first class marble and crafted and decorated with semi precious stones such as Lapis Lazuli, Malachite etc, it makes Taz Mahal one of the world expensive and grandeur royal tomb ever exist and made by man!
The King and his Queen buried in the ground of Taz Mahal. What we can see in the first floor or the entrance is the replica of their tombs. The entrance fee is 750 rupees for an adult, that is included a bottle of small mineral water and a pair of wet shoe cover since the temperature around Agra could reach up to 50 centigrade degree Celsius; and no chewing gum is allowed into the Taz also no pictures taken inside the building in order to maintain the color of the stone. The marble wall itself is translucent, it gives white color in the morning, yellow to light orange in the afternoon and blue in the evening. When we pointed out our light or lit the matches to the wall, the light can go through the wall, so it is magnificently incredible!
There are many professional photographer around the The Taz Mahal, so we don't have to worry if we forget to bring our camera along. It will costs us only 700 rupees for ten pictures, so its no money at all considering the professional result we could get. The pictures will turn to be very fantastic!
On the way back to the hotel, our tour guide, the one who has been recommended by the embassy, led us to the handicraft shop, who sell some souvenirs made of translucent marble. The handicraft men ancestors were the one who crafted the Taz Mahal, so according to our guide they produce only high quality handicrafts, but the price is extremely expensive, especially for a civil servant like me. I bought the cheapest one, not so nice, but it cost me already USD 150.- only for a simple marble plate and small elephant crafts. Gee...that was only some I could bring from India since I had a condense meeting and must commute every day from Gurgeon to the meeting venue in New Delhi. I didn't even know how New Delhi actually looks, but I thanks God and my government and myself because of the small mistake I made in booking the hotel, I was then able to commute and see how the real India looks and I could take some pictures which you can see in this website.
I return home on 3rd September to Indonesia and stayed over night in Bangkok Thailand. I bring along a beautiful and incredible memory of India which I will treasure the beauty of India until I die.

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Located 300m above sea level and just an hour's train journey from South of Jakarta, BOGOR enjoys a cool, wet climate and is home to the famously lush Botanical Garden (Kebun Raya Bogor). The Botanical Garden open daily from 08.00am to 05.00pm; with an entrance fee about US $ 1.- plus 20cent dollar for entering the orchid house. You can go by train, bus or private car to Bogor and enjoy the beautiful scenery on the way. Some rest areas offer you not only local and Indonesian cuisines but also western one. You don’t have to worry about hotels or restaurants in Bogor. There are a lot of Hotels available nearby the Botanical Garden. Some Hotels I could highly recommend for its cleanliness and conveniences are Santika Hotel (a three star hotel with mall, cinema and restaurants at the same compound), Salak Hotel (a four star hotel built since colonial time located right in front of Presidential Palace and nearby Botanical Garden) and Novotel Golf Course Hotel (a five star hotel located near by the traditional market and not far from the Botanical Garden). These hotels are all between reasonable prices and their foods are yummy and it is almost at no price at all. In the Botanical Garden, some pathways lie in between towering bamboo stands and climbing bougainvillea, passing through a small tropical rainforest, and ponds full of water lilies and fountains. Perhaps the garden's best-known occupant is the Titan Arun flower family or the giant Rafflesia (Bunga Bangkai), the world's largest and smelliest flower. Near the gardens' main entrance, the rather dilapidated Zoological Museum (open daily from 08.00am to 04.00pm) full with 30,000 specimens, including a complete skeleton of a blue whale, a stuffed of Javanese rhino and most impressively the remains of a huge coconut crab. Outside of the garden, there are plenty of vendors and workshop selling among others Wayang golek or Indonesian traditional puppets and local made souvenirs. If you're interested in gamelan or Javanese gongs that are using traditional methods, are also for sale around here.

The Giant Rafflesia or Bunga Bangkai

The Giant Rafflesia and Bunga Bangkai may be included in the family of Amorphophallus titanium or Titan Arum - is indeed considered as one of the largest flower in the world. Also known as the "Corpse Flower" because of its foul smell, Amorphophallus titanium is a prized addition to a number of well-known botanical gardens around the world, including London's Kew Gardens, California's Huntington Botanical Gardens and Sydney's Royal Botanic Gardens as well as at Bogor Botanical Garden Indonesia. The plants have become quite famous and always attract large crowds when a particular specimen blooms at one of the above locations or at a number of others gardens around the world. One such plant was also featured in Sir David Attenborough's outstanding BBC documentary The Private Life of Plants. In fact, the native habitat of Amorphophallus titanium is the rainforest's of Sumatra, Indonesia.
Below, the photograph of the Titan Arum taken at Stuttgart, Germany's Wilhelma Botanical and Zoological Gardens by Lothar Grünz in October 2005.

The same photograph along with details about where, when and by whom the picture was taken, is available on the Wikimedia Commons website. And, another shot published on the Wilhelma website clearly shows the same building in the background as that shown in this photograph.

The blooming of the Amorphophallus titanium is certainly rare, and the flowers only last for two or three days. The specimens kept in various botanical gardens often go for several years between blooms. In "The Private Life of Plants", David Attenborough suggests that Amorphophallus titanium in the wild, bloom about once every 1000 days.

So, welcome and visit Bogor Botanical Garden, Indonesia, to explore more about the Titan Arun flowers!!!

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by: Neneng Tarigan

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It was 25th June 2010, still sundown at 18.00 pm, I and Angie hurriedly driving through the traffic jam of the capital city in order to promptly arrive at the Haji Usmar Ismail Film Head Quarter, so that we would not be late for the REVIVE BATAK CULTURE program.

As a Batak Karo people I am and Batak Tapanuli for Angie, we were both quite rare to attend or even almost had never been to any particular Batak program like this one. However that night was so special for us to support the Maranatha Choir mission to Austria to compete in the World Choir competition together with the group of churches choirs from all over the world. Whatever the reason was, the effort of Maranatha group would have crafted a good name for Indonesia as a country and a nation that has been so pluralistic.

At 19.00 pm, we arrived at the Usmar Ismail Film Head Quarter. Not so many guests arrived yet; what it seen was the busy of the committee and the Batak Tapanuli's traditional percussion players named Batara Guru. Hm... that is quite similar with the name of a wise god in the Mahabharata epics. In the lobby of the building, Batara Guru play some of lovely Batak's songs with their traditional percussion, whereas just in front of them lies an exhibition of beautiful Batak woven clothes created by Batak designer Merdi Sihombing. Merdi used to live in Austria to deepen his study on textile; his Batak woven creation which used Swarowzky beads in most of his design has already have special costumers in Europe.

Beside of getting fund for the Maranataha Choir Group mission to Austria; The Revive Batak Culture program was also aimed at raising fund for building a school for children at Samosir Isle in Toba lake. A sincere idea of Merdi Sihombing.

The Revive Batak Culture program itself begun at 20.00 pm. Not many audiences present in the program, since almost all eyes of the people at that time were focused on South Africa where the world football match or the World Cup taken place. I my self is a great fan of the World Cup. Ever since the television exist, the World Cup event which is conducted every 4 years became my most awaited event ever. Nevertheless, that night I feel I was called to watch the Batak's Cultural Performance, beside of that my niece Lulu the daughter of my late cousin Maria Erbina Barus with late Singarimbun was also taken part as a committee of the program and she will join the Maranatha Group mission to Austria in July 2010. Few years ago, this group and Lulu were also went to Austria and won as the first winner of the world choir competition that time. What a prestige indeed.

That night the program was filled with Batak modernized dances, but oooiiii... besides the beautiful dances, the dancers also wore the unique, lovely and attractive Merdi's hand woven colorful clothes. The MC was also funny, the songs were also exclusively special especially those songs sung by Ramona Purba with his traditional Batak Karo Band Endakustik, and most specially the songs sang by Victor Hutabarat and Tio Fanta Pinem.

That night I really was swayed and admired by the uniqueness, and the beauty as well as the friendliness of Batak Lima Puak/the Five Tribes of Batak (Tapanuli, Karo, Simalungun, Dairi and sorry if Dairi is not the same with Simalungun). I felt so convenient with the ambiance and the songs because they were so lively and melodious. What sad was, although I am the product of mix marriage of Ambonese + Mandailing from my mom's side and Karo from my father's side. These tribes are famous in producing the top Indonesian singers, however none in our family has the talent.

Beside of dancing and singing performance the program was also interlude with the fashion show of well known beautiful models of the capital. They performed the Merdi Sihombing's creations. Ooooiii...although I am not rich, I was really eager to have just a master piece of this great young designer creations. He dreams to promote the traditional Batak's woven to international market. A solemnly idea indeed.
How lucky I was at the bid that night, because of the pro gesture of the young designer Merdi Sihombing and my favorite singer Victor Hutabarat, at last I was able to win a master piece of one of Merdi Sihombing's design. For me, that was the most expensive cloth I had ever bailed, although the historical value, the culture and uniqueness of the piece must have priced higher than what I paid. Thanks God I had the opportunity to have that Batak cultural creation.

The efforts and the results of the program was not really met with all of the efforts taken by the committee, the sponsors, the models, the designer, the singers and all of the artists who were present that night. Just if I am rich, I was able to help ..................
Nevertheless, it was such a wonderful night that I will treasure in my life together with my kid/niece Angie.



Otaru is a harbor city that once known as the centre of economy of Hokkaido’s region. The Otaru’s harbor developed about 150 years ago during Meiji Restoration Era as one of the busiest distribution and logistics centre for fishery and agricultural products of the Northern Part of Japan.

In the old day, according to the tour guide, many warehouses and banks were built to meet the demand of consumers as well as traders that came not only throughout Japan but also from neighboring countries and Europe. That is why we can see many building that had been constructed century ago as well as the canal and the warehouses looked rather similar with those that we can find in Europe or Netherlands in particular.
Nowadays, due to its isolated area in the North, many old banks and warehouses turned to be souvenir shop and restaurants as Otaru is now more popular as tourist destination for winter sports since Winter Olympic Games had taken place in Sapporo once in 1972 as well as for candies, chocolates, glassware, ice cream, etc.
To reach Otaru, the easiest and most efficient way is by bus or by train. First, go to Hokkaido by air depends on where you live, then  take a bus or train to Sapporo that only will cost you Y 1000. - one way (if you go by taxi, that will cost you around Y 12,000.-). Don’t worry, even you are the only passenger on board, the bus or the train will continue their journey to take you to the bus stop according to their schedule, so watch carefully for the bus and the train schedules and where they stop. The distance between Hokkaido and Sapporo is about one hour drive. From Sapporo you can join the tour  or take  another bus to Otaru and this will cost less; as for me I only pay Y 700 for return bus ticket to Otaru  that is already including the entrance ticket to Mount Tengu ski slope.
The rest, I hope you enjoy your trip.

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A truly happy person is one who can enjoy the scenery on a detour." ~ Unknown

"Happiness cannot be traveled to, owned, earned, worn or consumed. Happiness is the spiritual experience of living every minute with love, grace, and gratitude." ~ Denis Waitley


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Website for up to date information from tourist information centers, and information necessary for tourists, please see at:


"To live happily is an inward power of the soul." ~ Aristotle

"The art of being happy lies in the power of extracting happiness from common things." ~ Henry Ward Beecher

"What is happiness and unhappiness? It depends so little on the circumstances; it depends really only on what happens inside a person. I am grateful for every day... and that makes me happy." ~ Dietrich Bonhoeffer

"Earth laughs in flowers." ~ Ralph Waldo Emerson

"Happiness is a butterfly which, when pursued, is always beyond our grasp, but which, if you sit down quietly, may alight on you." ~ Nathaniel Hawthorne

"Happiness is not the acquisition of anything; it’s the understanding of something.” ~ Vernon Howard

"It is not what we see and touch or that which others do for us which makes us happy; it is that which we think and feel and do, first for the other fellow and then for ourselves." ~ Helen Keller

"You don't become happy by pursuing happiness. You become happy by living a life that means something." ~ Harold S. Kushner

"Realize that true happiness lies within you. Waste no time and effort searching for peace and contentment and joy in the world outside. Remember that there is no happiness in getting, but only in giving. Reach out. Share. Smile. Hug. Happiness is a perfume you cannot pour on others without getting a few drops on yourself." ~ Og Mandino

"Real happiness is so simple that most people do not recognize it. They think it comes from doing something on a big scale, from a big fortune, or from some great achievement, when, in fact, it is derived from the simplest, the quietest, the most unpretentious things in the world.” ~ Orison S. Marden

"Realize that if you want joy in your soul, you will have to choose to bring it there." ~ Joseph J. Mazzella

"Happiness is not a matter of events; it depends upon the tides of the mind."
~ Alice Meynell


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Switzerland is one of the most officials visited countries in the world. Why so, because hundreds of international organizations based here and of course million of diplomats, government officials, head of states, CEOs and prominent business people visit this country for international congress or other meetings.

Aside of its status as international organizations based camps Switzerland is in the top list of most visited countries for hi jet and world celebrities especially for winter sports, but I don’t want to touch that part because I am not part of that society. I have no knowledge to tell the situation and condition of the places they have visited here, but I am sure that must be fantastic and beyond our dreams as back packers and mid class official.

Does it meant then we lost our opportunity to enjoy our stay in this beautiful country? Not at all, like many European countries, Swiss has many open public facilities that we really can enjoy without any cost. Here are some examples:

For tourist promotion, Swiss (the Geneva Tourism & Bureau Des Congress) provides many leniency for their visitors. For example, once you are registered in a hotel in Geneva, automatically then you are eligible for a 10 zones free bus and 2nd class train ticket during your stay in the hotel. 10 zones covered the whole part of Geneva, you can then visit the famous fountain in the centre of the city Mont Blank, the shopping passage nearby central station Gar Cornavin, the shopping centre Bel Air or Ballexert. You can visit the Jardin Botanical Garden in Geneva, or The UN building and any other international bodies under UN (United Nations) such as WIPO (World Intellectual Property Organization), ILO (International Labor Organization), WHO (World Health Organization), WTO (World Trade Organization) and UNCTAD (United Nations Council for Trade and Development).

Where to stay? Well, there are many hotels here provide back packers and mid class official a reasonable price to stay, among others Etap Hotel Cornavin, nearby the airport would offer a room for only US$ 90 per night, enough for 3 person to stay in the room. This room equipped with shower, toilet and small TV with at least 3 channels. A bit more expensive is Crystal Hotel, nearby central station Cornavin, USD 150 per night for Deluxe room, Churchill Hotel, Rue de Simplon nearby the Geneva Fountain also USD 150 per night for Deluxe room during its promotion period.

For food, don’t worry, they have Mac Donald or many other restaurants for budget visitors. Traveling in Swiss (Switzerland) is very save, even you are alone. Banks and ATM available in almost every corner of the country, police also are very helpful, but oops, although they adopt 4 languages namely English, Flamish (Dutch), German (Deutch), French is most commonly used by the people here.

Switzerland is a very international country in the world. You can find and bump with people from various nationalities in the world, and this in itself make Swiss most interesting place to visit. Their Young's are very polite, they are not harmful of bad, a bit out of control only if they are drunk, but these are quite a few and most of them usually not a Swiss origin, sorry to say.

Swiss is quite open for foreign workers, especially those under inter corporate transfer, for example if you open and run a restaurant, shops or hotels here, you can bring along your chefs, waitress, bell boys or hired students from your own countries or others as part-time workers. Many foreign students study in Swiss, especially for international law and banking.

Well that is the most I can share, so enjoy your stay whenever you visit this country.

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Oleh: Neneng Tarigan
(berdasarkan pengalaman pribadi sebagai orang awam yang menerima nasehat dokter dan para perawat).

Ini mungkin belum tentu sesuai bagi seluruh pasien diabetes, karena tetap diperlukan nasehat dokter. Akan tetapi berdasarkan pengalaman saya merawat ibu saya atas nasehat dokter semasa ibu saya masih hidup beberapa tahun yang lalu; pembersihan luka diabetes yang benar akan mampu mengeringkan dan menyembuhkan luka.

Langkah yang harus diambil:

1. Sediakan alat-alat berikut:
• Syringe (alat suntik/jarum dan tabung kecilnya ukuran 10 cc).
• Pinset khusus untuk menarik jaringan yang mati (Biasanya besar dan ujungnya lebih runcing.
• Gunting pemotong jaringan yang mati.
• Gunting kecil pemotong kapas dan kasa.
• Kapas yang baik.
• Kasa yang tidak mudah terurai (terlepas benangnya).
• Alkohol 70% untuk merendam dan membersihkan alat-alat sebelum dan sesudah dipakai.
• NHCL (Natrium Hydro Chlorida).
• Betadine atau Rivanol.
• Aquades.
• Racikan Zink salep yang dicampur Metronidazol tablet. Dapat dibeli di RS Siloam, Kebon Jeruk, Jakarta atau diapotik serta RS umumnya.
• Salep Solcoseryl.
• Plester.
• Sarung tangan steril untuk kedua belah tangan.
• Masker.

Catatan penting:
Sebelum tindakan, bersihkan terlebih dahulu alat-alat dengan alcohol 70%. Bila perlu, rendam dengan alcohol beberapa menit apabila alat-alat yang disimpan tersebut kurang bersih dan terkena udara dalam waktu yang cukup lama.
Setelah selesai dipakai, seluruh alat harus dibersihkan kembali dan disimpan pada tempat yang steril. Bisa juga disimpan selalu dalam tapelwer (Tupperware) yang tertutup rapat setelah dibersihkan.
Bila memegang atau mengambil kasa/kapas selalu gunakan pinset, untuk menghindarkan bila tangan tidak sengaja tersentuh benda kotor walaupun sudah dengan sarung tangan steril.
Gunakan selalu masker bila merawat pasien agar mereka tidak tertular penyakit kita.

2. Untuk luka baru:
• Bersihkan luka dengan kapas beralkohol, dan tekan-tekan dengan lembut.
• Oleskan betadine atau rivanol secukupnya diatas luka. Biarkan terbuka dan jangan ditutup, karena bila ditutup biasanya, menjadi koreng yang basah.
• Bila bekas luka menjadi hitam, jangan cepat gembira dan menyangka luka sudah sembuh, karena bisa saja dibawah dibawah permukaannya, luka jauh lebih besar dan bernanah; ini berbahaya.

3. Untuk luka yang hitam dan basah atau hitam mencurigakan:
• bersihkan luka dengan alcohol atau aquades. pelan-pelang tarik dan gunting jaringan yang busuk. Tidak perlu sekaligus tetapi bertahap setiap hari.
• Semprot luka yang terbuka dengan cairan NHCL, tekan2 dengan lembut dengan kasa yang sudah direndam aquades untuk menyerap nanah dan menenangkan luka, karena aquades menyejukkan. (Jangan pernah menekan nanah dan mengompres luka dengan alcohol, karena kulit dan luka bisa gosong.)
• Oleskan tipis merata, Racikan Zink salep yang dicampur Metronidazol tablet. Tutup luka dengan kasa (bisa juga denbgan kapas tipis yang dibalut kasa) supaya cukup udara masuk keluar.
• Plester tepi kasa secukupnya..

4. Apabila luka yang seperti nomor 3 diatas, telah bersih dan tidak ada jaringan hitam atau nanah lagi:
• Lakukan (ulang) tindakan yang sama seperti no 3, namun salep diganti dengan solcoceryl. Salep ini memberikan rasa sejuk dan luka cepat sembuh dan menutup sempurna dengan kulit ari biasa.

5. Agar pasien tenang, baringkan dia diatas decubitus bed pad yang berudara sehingga luka tidak tertekan dan pasien akan merasa lebih nyaman. Bagi pasien usia lanjut yang sudah tidak mampu berjalan dan harus dibantu, alaslah decubitus bed pad -nya dengan kain vlanel yang lembut dan taruh perlak dibawah kain vlanel, karena decubitus bed pad tidak boleh terkena/terendam air. Dibawah tubuh pasien terutama yang sering buang air, taruh underpad supaya pasien selalu kering dan hangat.

6. Jaga kamar pasien, seprei, korden, bantal selalu bersih dan steril.

7. Yang terpenting, buatlah pasien gembira dan berpikiran positif. Jangan pernah mengeluh atau marah didepan pasien, apalagi memarahinya.

8. Hidup dan kehidupan yang sehat adalah anugerah Tuhan yang paling berharga. Oleh karena itu kehidupan yang diberikan Tuhan harus dihargai.

9. Sebagai manusia biasa; kita hanya bisa menyaksikan kebahagiaan orang pada saat dia hidup. Oleh karena itu, saling membahagiakanlah selama kita masih hidup.

Jakarta, 22 Februari 2010.

Tulisan ini aku dedikasikan kepada siapa saja yang memerlukan, sebagai amanah dari ayah dan ibu yang sangat aku cintai. I miss you mom and dad, so very much.

Dibawah ini saya sajikan tulisan dari para ahli, yang saya kutip dari website sesuai dengan aslinya. Semoga bermanfaat.

Terimakasih yang sebesar-besarnya kepada dr. Tomy Pancha dan para perawat RS. Siloam, Kebon Jeruk, Jakarta serta kepada Siti, Diah, Sri dll yang telah merawat ibuku tiga tahun yang lalu.


Oleh: Team IGD
Sumber, dikutip sesuai tulisan pada:

Diabetes Melitus atau penyakit kencing manis adalah penyakit menahun (kronis), yang ditandai oleh kadar glukosa (gula) di dalam darah tinggi. Kadar glkosa darah yang normal pada waktu puasa tidak melebihi 100 mg/dl dan 2 jam sesudah makan kurang dari 140 mg/dl. Kadar glukosa darah yang terlalu tinggi dapat menyebabkan timbulya gejala-gejala seperti : sering kencing, rasa haus dan rasa lapar yang berlebihan, sering mengalami infeksi, letih lesu, berat badan menurun, dll.
Namun dapat pula terjadi pada beberapa penderita DM yang tidak merasakan gejala-gejala tersebut diatas dan penyakitnya ditemukan secara kebetulan, misalnya pada waktu pemeriksaan kesehatan rutin.
Apabila pada seseorang penderita kencing manis kadar glukosa darahnya tinggi dalam jangka waktu yang lama, maka akan timbul komplikasi menahun (kronis yang mengenai mata menyebabkan gangguan penglihatan bila mengenai sistem syaraf akan menyebabkan gangguan rasa dan gangguan bila mengenai ginjal menyebabkan gangguan fungsi ginjal).
Adapun gambaran luka padapenderita kencing manis dapat berupa: demopati (kelainan kulit berupa bercak-bercak bitam di daerah tulang kering), selulitis (peradangan dan infeksi kulit), nekrobiosisi lipiodika diabetik (berupa luka oval, kronik, tepi keputihan), osteomielitis (infeksi pada tulang) dan gangren (lika kehitaman dan berbau busuk).
Ada beberapa yang mempengaruhi :
1.Neuropati diabetik.
Adalah kelainan urat saraf akibat DM karena tinggi kadar dalam darah yang bisa merusak urat saraf penderita dan menyebabkan hilang atau menurunnya rasa nyeri pada kaki, sehingga apabila penderita mengalami trauma kadang-kadang tidak terasa.
Gejala-gejala Neuropati : Kesemitan, rasa panas (wedangan : bahasa jawa), rasa tebal ditelapak kaki, kram, badan sakit semua terutama malam hari.
2.Angiopati Diabetik (Penyempitan pembuluh darah)
Pembuluh darah besar atau kecil pada penderita DM mudah menyempit dan tersumbat oleh gumpalan darah. Apabila sumbatan terjadi di pembuluh darah sedang/ besar pada tungkai maka tungkai akan mudah mengalami gangren diabetik yaitu luka pada kaki yang merah kehitaman dan berbau busuk. Adapun angiopati menyebabkan asupan nutrisi, oksigen serta antibiotik terganggu sehingga menyebabkan kulit sulit sembuh.
Infeksi sering merupakan komplikasi akibat berkurangnya aliran listrik (neoropati)

Mengingat segala kemungkinan dapat terjadi pada penderita DM akibat gangguan pembuluh darah maupun syarafnya, maka perlu dilakukan tindakan pencegahan agar tidak terjadi luka, sebagai berikut:
1. Penderita harus mencuci kakinya setiap hari dengan teratur, sesudah dicuci dikeringkan dengan seksama (terutama pada sela-sela jari kaki)
2. Dapat dipakai bedak atau lotion.
3. Pada penderita dengan komplkasi kronis DM, sebaiknya jangan menggunakan air hangat atau air panas untuk merendam kaki, oleh karena kepekaan rasa di kaki untuk panas berkurang sehingga penderita tidak merasakan apa-apa, walaupun kakinya melepuh.
4. Apabila penderita merasa kakinya dingin, sebaiknya memakai kaos kaki, Sebaiknya memilih kaos kaki yang bahannya wol atau katun. Kaos kaki tersebut sebaiknya juga dipakai sewaktu tidur.
5. Apabila memakai sepatu atau sandal, perlu diperiksa apakah alas kakinya licin dan rata.
6. Apabila membeli sepatu baru, sebaiknya diperhatikan : sepatu jangan terlalu sempit, sebaiknya sepatu yang kulitnya lemas, pada awalnya sepatu tersebut dipakai beberapa jam saja, untuk membiasakan diri.
7. Pada penderita DM yang mengalami gangguan syaraf sebaiknya jangan berjalan tanpa alas kaki, karena dapat terkena luka tanpa penderita menyadarinya.
8. Sela-sela jari kaki perlu diperiksa, apakah terdapat luka atau kulit yang pecah-pecah, yang disebabkan oleh jamur kaki. Bila ada, cepat pergi ke dokter untuk diobati.

Perlu diperhatikan.
Setiap hari kaki harus diperiksa dengan seksama minimal 1 kali. Ini sangat penting untuk menemukan luka secara dini atau perubahan warna kulit seperti kemerahan, jangan sungkan untuk pergi ke dokter walaupun hanya luka-luka kecil sekalipun.

Pengalaman merawat luka pada penderita DM.

Berikut adalah kasus perawatan ulkus DM terinfeksi dengan abses besar di sisi lateral metakarpal dextra (kanan). Perawatan ulkus ini mengenai pasien wanita berusia 40 tahun yang dirujuk ke klinik rawat jalan dengan kasus gawat darurat label kuning 2 (gawat tidak darurat) kondisi saat ini terdapat luka terbuka, diatas metakarpal dextra sudah berlangsung 2 minggu, pasien mulai murung dan stres karena tidak dapat melakukan aktifitas sehari-hari serta bekerja sebagai pedagang kain dengan alam terbuka.

Dari pemeriksaan diketahui terdapat luka terbuka berukuran 10 x 7 cm pada sisi lateral metakapral dextra, dibawah luka terdapat luka yang berfluktuasi, dan seluruh daerah kemerahan serta sudah mulai terdapat nekrose (jaringan mati) pada permukaan kulit. Parawatan luka ini tidak terlalu rumit apabila ada kerjasama antara pasien dengan petugas kesehatan, pasien bersedia dilakukan perawatan secara rutin dengan keyakinan luka akan sembuh. Perawat melakukan perawatan dengan sabar dan teliti serta profesional.
Sebelum kita melakukan perawatan luka periksa GDS (Gula Darah Sewaktu) kemudian baru kita lakukan tindakan incisi abses serta nekrotomi sebelumnya kita berikan cairan antiseptik dengan betadin cair dan anestesi untuk menghilangkan rasa sakit, kaluarkan semua pus (nanah), gunting jaringan yang mati atau yang berwarna hitam, cuci dengan perhidrol kemudian bilas dengan cairan Na Cl 0,9 %, pasang tampon dengan betadin yang diencerkan dengan Na Cl 1:1 selama masih ada pus dan diganti setiap hari, apabila luka sudah menjadi gangren atau busuk, untuk perawatannya setelah digunting jaringan yang mati dan dikeluarkannya nanah kita lakukan kompres revanol dicampur norit dengan perbandingan 2 : 100 CC berfungsi untuk menyerap pus (nanah) agar bau busuk hilang, dilakukan tiap hari dan rutin hingga luka membaik. Setelah luka bersih dan tidak ada pus baru kita lakukan rawat luka dengan terapi gentamicin salep dan bioplacenton (untuk menumbuhkan jaringan). Demikian hasil dari perawatan luka dengan perawatan sederhana dapat dijangkau dan dapat dilakukan tanpa rawat inap.-IGD-


Quoted as published by:
Diabetes and Wound Care
Diabetes and wound care has grown to be a critical subject over the years. Approximately 5 million Americans suffer from some sort of chronic wound or open sore, 15% of these are diabetics. Chronic wounds can become infected, develop gangrene or require amputation.
Diabetics are at a greater risk of developing chronic wounds because of poor circulation, slow healing times, vascular disease and neuropathy (numbness).
Diabetic ulcers are the most common foot injuries leading to lower extremity amputation.
Because of this fact we will focus on diabetic foot ulcers, the most common of all diabetic chronic wounds. We'll discuss how ulcers form, what treatments are available to you and how to prevent ulcers.
Patient education regarding foot hygiene, nail care and proper footwear is crucial. Let's get started.
What is a Foot Ulcer?
Foot ulcers are open wounds that develop on the sides, top or soles of the feet. Diabetics are prone to these wounds because of poor circulation and other problems that arise from having diabetes. Diabetes and wound care should be taken seriously. They are notoriously difficult to treat and the treatment can be lengthy and frustrating.
Lower extremities, particularly foot wounds account for one quarter of all diabetic hospital admissions in the U.S. and Great Britain.
Who Gets a Diabetic Foot Ulcer?
Almost anyone who has diabetes can develop foot ulcers.
Who is more likely to develop foot ulcers? African Americans, Native Americans, Hispanics and older men.
Who is at risk? People who use insulin and those who suffer diabetes related ailments such as heart disease, kidney and eye problems are equally at risk. If you are overweight, smoke and use alcohol you are at a greater risk of developing foot ulcers.
How Do Diabetic Foot Ulcers Form?
There are 4 major causes of diabetic foot ulcers.
• Neuropathy (numbness). Neuropathy is a condition when you lose sensation in your limbs and lower extremities. Prolonged elevated glucose levels over time cause this to happen. This condition has a way of creeping up on you. Often you are not aware of the problem until it's too late.
Because of numbness patients can't feel small cuts on their feet, wounds can go untreated for days even weeks. Also neuropathy can cause a patient not to shift or move their feet when pressure points develop. This can lead to wounds developing.
Your doctor can check your feet using a simple painless test with a tool called a monofilament.
• Foot deformities. Because of neuropathy patients can break bones in their feet and not be aware of it. Foot deformities can put unnatural pressure on certain areas of the foot and cause wounds to develop.
• Vascular Disease. This disease causes narrowing of blood vessels and can lead to wound development. Restricted blood flow and circulation make treating foot ulcers frustrating and lengthy. This condition reduces the body's ability to heal itself--which increases the risk of infection.
• Skin irritation and friction. Patients with neuropathy (numbness) cannot tell when they have skin irritation, problems with friction or pressure points. The only way to know for sure is to check your feet often for redness, peeling skin or blisters.
How Should a Diabetic Foot Ulcer be Treated?
Prevention, prevention prevention. Diabetes and wound care is all about prevention. You know what they say about an ounce of prevention.
Untreated wounds can lead to infection. The quicker you treat the wound the less likely you are to develop a problem.
There are 3 commonly used treatments for foot ulcers.
• Offloading - That's offloading off-roading. It means quite literarily putting your feet up. Reducing pressure on a wound is probably the single most important and most neglected factor in chronic wound treatment.
It could mean anything from using crutches or a wheelchair to complete bed rest. Taking a load off sounds like a nice idea but it could take anywhere from 6-12 weeks for your wound to properly heal. That's a lot of downtime.
This is where doctors have a problem. Their patients rarely ever follow the proper protocol. So, listen to your doctor!
Podiatry Today has a good article about offloading. You can find that here.
It's a little technical, written for doctors by doctors but it's very informative.
• Debridement - The removal of dead skin and tissue. Dead tissue can slow or impede the healing process. The dead skin can appear yellow, tan or black in color. A doctor usually includes debridement as part of a complete diabetes wound care protocol.
There are 4 ways to debride a wound, autolytic, mechanical, enzymatic, and surgical.
• Applying medication or dressings - This is usually used in conjunction with other treatments. Your doctor will advise you what medication or dressings to apply. In most cases you will be responsible for changing the dressing and keeping an eye on the wound. The medication could be a course of antibiotics or simply an antibiotic ointment. With diabetes, wound care can be a big responsibility for the patient.
Recently we discovered a DVD that shows you how to dress and treat a chronic wound. It is called, Taking Care of Your Wound.
Produced by a company in British Columbia it's designed to inform the patient on proper diabetes wound care, how to dress a wound, what problems to look for, how to check your feet, etc.
We really like it, it's reasonably priced and very informative.
How to Keep a Foot Ulcer from Becoming Infected
If you want to keep a foot ulcer from becoming infected, there are a few things you need to do.
• Control your blood sugar levels - It is vitally important that you control your blood sugar level. It's especially important during the time you are receiving treatment for diabetic foot ulcers.
Try to avoid and reduce the risk of infection while undergoing treatment--consult your doctor about the steps you should take to control your blood sugar. Eat right, exercise and check your levels daily.
• Keep the wound clean and bandaged - We've discovered that the old way of thinking about wounds, "let it breathe", is not correct it can impede the healing process. Keep a wound clean, covered and moist is the way to go.
Clean the wound daily. Cover it with a medical bandage. Keep the wound or ulcer moist--with creams or antibiotic ointments.
Not moist as in; whirlpools, peroxide, soaking or full strength Betadine. These things are not recommended for healing a wound or ulcer. They can in fact make things worse.
• Do not walk barefoot - Diabetics often suffer from neuropathy (numbness). As a result, they won't feel it if they accidentally step on a tack or a piece of glass.
The subsequent wound could be difficult to heal, or worse, become infected and lead to serious consequences. So, keep your feet covered.
• Never reuse a syringe - As a rule our skin acts as a good barrier to most infections. But if you are on insulin, you routinely have to breach the surface of the skin and puncture the underlying tissue.
From the minute you uncap the syringe it is exposed to the atmosphere of the room.
After drawing in the insulin, the needle is moist. So you are administering a shot with a moist needle exposed to the room temperature and atmosphere.
It would be unwise to recapped a moist syringe after puncturing the skin.
Make sure you always have a healthy supply of syringes on hand and that you never run out.
If the price of syringes is a factor. There are now programs that can help you with the cost of medicines and supplies.
How Can a Foot Ulcer be Prevented?
The best and by far the easiest way to prevent a foot ulcer is....never get a foot ulcer! Other than the obvious, you can follow the steps recommended above.
Wear shoes, keep your feet covered with heavy or thick socks. They should fit snuggly but not too tight, you should avoid constriction.
Every time you buy shoes you should have your foot measured and sized correctly. Clean and inspect your feet daily. Try to correct any foot deformities such as bunions, corns or hammer toes.
Take care to reduce all risk factors such as; drinking alcohol, smoking tobacco and uncontrolled blood sugar levels.
Self-Care Products and Diabetic Wounds
There are many products available on the market today, so called “beauty aids” for the feet. It can be a treat on occasion to have a home pedicure. However, if you are a diabetic these products can lead to open wounds.
For example, there is the “pumice stone”, a hard abrasive stone used to scrape away “dead” skin from the foot. If you're a diabetic this can leave cuts and abrasions on your feet that won't heal.
There is something called a “corn plane”, this device operates exactly like a wood plane. Instead of shaving away wood pieces, you are shaving away skin.
In the category of corn and callus removal, there is salicylic acid. The way this acid works is to slowly erode skin that makes up warts, corn and calluses.
All of these products come with a strict warning for diabetics to refrain from use, as their sole (get it "sole", foot "sole") purpose is to abrade the skin.
The most common of these self-care products is the nail clippers. Most people cut their nails too close to the cuticle. If you are diabetic you should cut your nails straight across. The object is to avoid getting a hang nail.
See a podiatrist regularly and let your doctor advise you on the best way to care for your feet.

Return to Wound Care from Diabetes and Wound Care
Disclaimer: All information on is for educational purposes only. This information is not intended as a substitute for professional medical advice, emergency treatment or formal first-aid training. If you're in a life-threatening or emergency medical situation, seek medical assistance immediately.

Catatan: Publikasi diatas tampak mempunyai kemiripan. Namun, karena kedua publikasi bertujuan untuk menyediakan informasi gratis bagi orang yang sangat memerlukan, dan tanpa niatan untuk melakukan perbuatan tidak benar seperti mengambil keuntungan, maka keduanya saya publikasikan melalui situs saya, untuk kemanfaatan orang banyak.
Notes: The above publications, seems to have similarity. However, since both publications aiming at providing free information for people in needs, and there is no intention of any wrong doing such as taking profit, therefore I publish the two publications through my website for the benefit of people in general.

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