Asia has the highest prevalence of methanol poisoning worldwide, according to MSF’s database.
It is a problem that often affects poorer countries – outbreaks are common in Indonesia, India, Cambodia, Vietnam and the Philippines.
Indonesia is regarded as a hotspot – it has reported the highest number of incidents in the past two decades, according to MSF, external, largely down to the widespread production and consumption of bootleg liquor.
Towns like Vang Vieng in Laos, where the fatal poisonings took place, are known stops on the backpacking trail through South East Asia. The town’s economy is built on tourism, with streets of bars, restaurants and hostels that cater to visitors.
But in Laos, law enforcement is under-resourced and there are few regulations around food and alcohol standards. There is also an industry of home-brewed alcohol, which can lead to accidental poisonings.
Producers also make counterfeit drinks by making products with methanol instead of ethanol because it is cheaper, say local observers.
“You have the unscrupulous producer adding methanol to their drinks because it’s cheaper – it’s used to create a stronger-seeming drink or make lower-quality alcohol drinks seem more potent,” one Western diplomat in the region told the BBC. They also said methanol poisonings are reported to consulates across the region.
However, a lack of data means it is hard to quantify the scale of the contamination, and where tainted drinks enter the supply chain.
“I don’t think it’s nefarious bar owners going out of their way to poison tourists – that’s not good for them or their industry either,” the diplomat said.
“It’s more about the production side – there being being low education, low regulation, people cutting corners.”