Bruce Gale – "I just mixed up all the ingredients at random. I don't know if they have any side effects at all or what they were." This chilling admission to the police last November by the operator of an illegal jamu factory in Bogor says it all.

Jamu, a traditional health tonic, is very popular in Indonesia. But consuming it can often carry serious risks, as irresponsible manufacturers add potentially dangerous drugs in an effort to increase sales by adding to the tonic's perceived effectiveness. In August 2010, a herbal drink vendor in South Jakarta was arrested after eight of his customers died and six others were hospitalized.

Jamu is a herbal preparation made from ingredients such as roots, leaves and fruit. It may include animal parts, such as the bile of a goat. Jamu reaches the consumer in the form of powder or pills, or even as a refreshing drink sold by street hawkers, sweetened with honey.

There are various types: general health tonics; tonics for pregnant women or for common ailments. Medically, they are regarded as nutritional supplements rather than drugs. Many poorer Indonesians, however, see them as an affordable alternative to visiting a doctor.

A study by the Health Ministry in 2010 revealed that about 49 per cent of Indonesians aged 15 and above consume jamu, with about 5 per cent taking it every day.

Illegal Bogor factory owner Asep said he mixed herbal ingredients with prescription painkillers piroxicam and mefenamic acid to boost the effect of his drink. He also added allopurinol, another prescription drug. A further ingredient was over-the-counter analgesic paracetamol.

Other drugs used by such producers include potenzhi, a sexual stimulant, and non-steroid anti-inflammation drugs such as fenilbutazon, piroxicam and sodium diclofenac.

Reports of deaths resulting directly from the consumption of adulterated jamu are not common. But the product has been known to damage the kidneys, liver and digestive system.

Recently, a rise in the availability of fake jamu has prompted demands for more stringent regulation. Last October, Charles Saerang, chairman of the Association of Indonesian Jamu Producers (GP Jamu), called for stronger enforcement measures, arguing that the illegal jamu trade threatened the continued operation of legitimate producers.

Companies affiliated with GP Jamu, he said, employ around three million people at 1,300 factories nationwide. The combined annual turnover of GP Jamu members is around 10 trillion rupiah (S$1.4 billion).

Government officials argue that consumers can easily distinguish between the fake and genuine product by looking for the official logo and registration number on the product packaging issued by the Food and Drug Monitoring Agency (BPOM). But some illegal producers have been known to produce fake labels.

Speaking to me in Jakarta late last year, Indonesian Consumers Association (YKLI) spokesman Ida Marlinda said her organization has been urging the government to take a tougher line against errant manufacturers. The BPOM, she argued, should not simply make public statements, issue fines and recall products. Rather, it should use its power to cancel licenses. It was not clear, she added, what happens to the officials of the organizations involved, particularly when they were operating large companies.

More effort is also needed to crack down on the fake jamu sold by street vendors, much of it sourced from small producers such as Asep in unregistered factories. Here, the BPOM's enforcement responsibility is less clear-cut. But the fact that Asep admitted he could get the raw ingredients for all the drugs he used from wholesalers at Central Jakarta's Pramuka Market suggests a promising place for determined enforcement.

The genuine product has wide acceptance in Indonesia, with stocks of well- known and generally reliable brands on sale in supermarkets. The medicinal properties of jamu have recently attracted serious study. Last year, Health Minister Endang Rahayu Sedyaningsih announced that the government was conducting scientific studies on four types of jamu used to treat cholesterol, high blood sugar levels, hypertension and gout, to be followed by the jamu used to treat cancer.

Some good may come out of the widespread Indonesian obsession with the traditional tonic. But without tougher action against unscrupulous producers, millions of consumers remain at risk.