US navy ship brings health services to East Timorese
Updated
East Timor's fledgling health services are still in great need of support from outside nations; now a United States navy hospital ship has offered to lend a hand.
Presenter: Sen Lam
Speaker: Dr James Rice, USNS Mercy Commanding officer; Barbara Moravec, USNS Mercy nurse; Maria Baptista Gomez, patient family member; Arun Thapa, Head of the World Health Organization in East Timor.
MARCH: At 270 metres long, the USNS Mercy is a stark contrast to the humble fishing boats usually seen in Dili's harbour. The US navy hospital ship is visiting the island nation for two weeks to provide medical treatment for Timorese civilians.
Dr James Rice is the hospital ship's commanding officer.
RICE: We do the full range of surgery: everything form simple dermatology, skin lesions excisions, all the way up to complex paediatrics and other surgery as well as laparoscopic and general surgery.
MARCH: Before they leave port they hope to operate on at least 200 patients. Aside from surgery on the ship, the doctors are holding remote medical clinics in five locations across the country where patients are treated for simple health problems, or referred to the ship for further surgery. One of the remote patients referred to the ship is Angelita Amaral.
Nurse Barbara Moravec first saw Angelita in her home town of Viqueque, a 6 hour drive from the capital Dili.
MORAVEC: She was a 15-year old girl who had a cleft-lip, a congenital anomaly and her front teeth were also twisted a bit so she might be a little bit more complicated. But because of the severity of her illness and her age we thought that it would be really beneficial to have surgery and that would hugely impact the rest of her life.
MARCH: Only hours after being seen by Nurse Moravec, Angelita was flown by helicopter to the ship. If it wasn't for the USNS Mercy, it's unlikely Angelita would have the opportunity to receive that type of surgery in East Timor. According to government statistics, almost 50 per cent of Timorese who report a health complaint say they don't access medical treatment because facilities are too far away. It takes on average one hour and twenty minutes for a person living in a rural area to access a hospital and that is provided they have access to transport, and are able to afford it.
Angelita's sister Maria Baptista Gomez agrees this operation could be life changing.
GOMEZ: She is shy when she watches her other friends who are normal, she doesn't want to speak them.
MARCH: While the USNS Mercy provides a temporary solution for people like Angelita, the Ministry of Health is trying to focus on improving access for people in remote areas by increasing the service provided by outreach and mobile clinics. The Head of the World Health Organisation in East Timor, Arun Thapa, says the outreach model used is unlike those in other countries, and that land issues and unique cultural factors need to be taken into account.
THAPA: You know when you design an outreach clinic, and let's say there is one area that used to belong to one tribe and here is another area that used to belong to one tribe, and both are far away and remote and you happen to place a clinic that is close to this one and not that one, and people start asking questions like "why are you favoring that tribe?" you know?
MARCH: He says the recently launched government initiative is helping allow communities play a role in the way their health services are delivered.
THAPA: There is a common forum where they meet the health care providers and then they agree, this day this month, this time here, this day this month, this time here, and that helps.
MARCH: And Arun Thapa says as health services improve, there is a clear perception that the Ministry of Health is performing better than other government departments when it comes to executing its budget.
THAPA: Particularly at being able to getting better services out the communities as well as services that communities trust. And I think that perception is well founded. In terms of budget implementation, the Ministry of Health has struggled initially although a lot of work has been put in now to try to streamline procedures, and you know it's going to take time, but they seem to be doing better.
