| TITLE : Meeting with Sr Carmen, Superior, Sisters of St Paul, Dili.Regarding hospital in Suai |
TEXT : 23 June 2003
Meeting with Sr Carmen, Superior, Sisters of St Paul, Dili.
Regarding hospital in Suai
Evacuated in 1999 during war; sisters were refugees in Darwin.
Taken over by UN – used by NZ troops for about 3 yrs, commander changes about 6 monthly. Initially, roof that was damaged during war was covered by taupalin but eventually repaired by NZ troops because of water leakage. Heavy equipment moved in by troops that damaged parts of the building, including the flooring and walls. Last year, building was taken over by Thai and Singaporean troops. Thais did some minor repair works. Plan is to hand over building to Sisters of St Paul in July 2003. However, Sr Carmen is not satisfied with the current state of the building wrt the damages by the NZ troops; she had expected the UN/NZ troops to have offered some form of compensation or assistance in the repair work. There had been two inspections by UN personnel but thus far no action has been taken. In fact, they wanted to “condemn” the building as unsafe although it has been used to house UN troops for the past 3 years. Sr Carmen had previously written a complaint to the UN administrator in Timor but has also not received any response.
She is interested in our offer of assistance in Suai and agrees that there is a real need for a maternal & child health facility there, but suggests that we speak directly to the current administrator who will be back in July. She also recommended that we speak to the director of the Health department of Caritas Dili, Dr Jaime, before proceeding.
24 June 2003
Meeting with Dr Jaime Da Costa Sarmento, Director National TB Programme, Caritas Dili.
Background Information
42 Timorese doctors, 41 as general practictioners, 1 surgical. 11 are pursuing studies in foreign countries (Indonesia, Portugal, some under Bishop Belo Scholarship),10 with NGOs, the rest with governmental hospitals.
Life expectancy 50 – 58yrs
No. of live births 78 – 149/1000
Maternal mortality 350 – 800/100 000
Births assisted by midwives 30%
Marasmus (6/12 to 5 yr) 3 – 4%
Malnutrition (>5yr) 4 – 5%
(source: Rencana Pembangunan Nasional Mei 2002)
Governmental Referral System (source: Dr Jaime Da Costa Sarmento)
1. Mobile clinic
2. Health post
3. Sub-district – Community Health Centre (CHC) Level I & II *
4. District – CHC Level III (equipped with laboratory)
5. Hospital
* CHC Level II without laboratory services may have staff to prepare fixation slides which are subsequently sent to the laboratories of the local Catholic clinics.
Other clinics include the Catholic clinics (run by religious orders together with Caritas Dili), Café Timor Clinics (sponsored by NCB, an American firm, in 4 districts), 3 protestant clinics as well as Bairo Pite Clinic (Dr Dan Murphy).
3 major health issues: TB, malaria and maternal mortality
Worsened by poor communication infrastructure and transport. Many still resort to traditional midwives as they physically stay with the community cf government midwives who are located usually in the district/sub-district centres. They are also more in-tuned with the local culture. Together with UNICEF and WHO, there is currently a training programme for midwives (1/12 theory, 2/12 practical). However, only a limited number of staff from the Catholic clinics get into each programme intake.
National plan is for 5 district hospitals: Dili, Baucau, Maubisse, Maliana, Ambeno (Oecussi). Caritas is keen for an additional one in Suai. These mostly cover the central and western regions geographically as the areas in the west/southwest are more inaccessible.
(source: Rencana Pembangunan Nasional Mei 2002)
Programmes by Caritas Dili
Caritas Dili – Health, Agriculture, Women Protection, Education/Training, Microfinance.
National TB Programme – joint effort by Caritas Dili and Caritas Norway (with support of the Norwegian government).
3 areas of potential cooperation identified:
Training of dental nurses
Training of doctors and midwives (end Dec or early Jan 2004)
Development of maternity hospital in Suai
Meeting with Dr Julius Daniel Tanasale, Internalist, Dili National Hospital.
Background Information
About 20 – 30 Timorese doctors. One dentist.
Recently in May 2003, a MOU signed with Udaya Universiti (Bali) – reduced fees for Timorese students (undergraduates).
Training costs for post-graduates in Indonesia:
Entrance fee: US$12 000 (for Indonesians)
US$24 000 (for foreigners)
Semestral fee: US$ 6 000 – 8 000
Currently, 7 Timorese on post-graduate training; 3 in Philippines (Int Med, Paeds and O&G), 4 in Bandung (Int Med, Paeds, O&G and Surg).
Government is planning to bring in 20 doctors (?traditional medicine) from China next year (to work near Dili National Hospital) as well as 30 Cuban GPs (to work in one of the district hospitals).
Needs
Medical supplies for governmental health system procured via tender system by a central pharmacy. Results in delay in obtaining supplies. There is a severe shortage, particularly of antibiotics (anti-malarial, anti-bacterial and topical anti-fungal drugs), anti-histamines and vitamin supplements. Has specific request for laboratory machines and reagents (blood counts, renal panel, liver function tests), basic pulse oximeters, sphyngomanometers, stethoscopes and blood gas analyzers.
Agreed that more critical medical attention needed at Oecussi and Suai because of difficult access.
Training suggested to health staff include family planning.
General Discussion with Salesian Community
Other non-medical areas of needs: training in the English language and technical skills: automobile and air-conditioning repair as well as engineering/industrial safety (helpful in obtaining jobs in oilfields).
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