Our Volunteers: Ben and Sally volunteering in Timor-Leste

Maliana Hospital, Timor-Leste

Former Palms volunteer Annette Joyce conducts a check-up in Railako
Timor-Leste’s Health Policy Framework identifies maternal and child heath as a national priority. In 2005, it was estimated that Timor-Leste had an infant mortality rate of 61 and a maternal mortality rate of 4 in every 1,000 live births. Australia’s statistics stand at 6 and 0.04 respectively.

These dramatic figures, represent progress from the levels prior to independence. It is apparent though, that rural women and infants are still at a higher risk of mortality than those in the cities. These are statistics which are easily improved with training in maternal health and midwifery.

Maliana is the capital of Bobonaro district and is 4-5 hours drive South-West of Dili. Its hospital is responsible for providing care and health education for one of Timor-Leste’s poorest districts.

Palms Australia received a request from the Rotary Club of Morialta, in partnership with the Timor-Leste Ministry of Health, for two volunteers to work in partnership with Rotary and the Ministry of Health to improve the health services available to the people of Maliana.

Ben and Sally

ben & sally Palms Australia recruited Sally Johnson and Ben Kildea to meet this request.

Sally will supervise and implement activities at community health centres (CHC), health posts (HP) and community settings, in the training of local midwifes and other staff in involved in the provision of safe motherhood services. She will also assist in upgrading CHCs and HPs for maternal health and develop capacity for health education and health promotion initiatives.

Ben will assist and support Sally with her duties including coordinating training activities and will manage project infrastructure development, including the building of delivery suites. This project will serve to both employ and train local labourers as well as ensure safe delivery is available to the women of Bobonaro. Ben will also assist in many other areas such as managing assets and relationships between Rotary, the Ministry of Health, hospital staff and the local community.

Ben and Sally ‘s CommUNITY News no. 1

March 12, 2010

Sally on her way to a rural clinic
The morning fog was so dense along the mountain road to the turn of at Nunutana that we were only able to see two metres in front of the car. After about 15 minutes of 4WDing along the track which winds around the side of the mountain we came to a spot where it was no longer safe to continue by car. It was pouring rain and we were not very prepared for wet weather. The nurse made a phone call and soon after a few villagers from nearby popped out of the bush and said they had come to help with the medicines. We packed what we needed for the SISCa (outreach clinic) as best we could and set of on the 6km hike. It started with a 1 km stretch straight down the hill. We followed the very old lady who was effortlessly managing the route while balancing the largest of the medicine boxes on her head. After a very slippery slope and the discovery that my thongs were not the ideal footwear for hiking – on steep hills, with mud – we reached Raiheu. During the walk the other members of the health team kept suggesting that next time “Senora could just wait in the car”.  I’m not quite sure if this was for my benefit or for theirs.

I was able to discuss the care of these women with the nurse and explain to him what to do if any of them went into early labour.

In Raiheu we were joined by about 50 children (just finishing school) who followed us for the second half of the journey. The village which hosted the SISCa was as picturesque as any I have seen so far – thatched huts, ancient trees and panoramic views.  I saw 7 pregnant women (with Silda helping to translate when I got stuck) to whom we were able to give nice long consultations – about 30 minutes each – covering as much education as seemed reasonable. They were mostly seeing a midwife for the first time. There were two breeches and a transverse position and one lady who was almost overdue (by her clinical signs and her guess at when she fell pregnant). I was able to discuss the care of these women with the nurse and explain to him what to do if any of them went into early labour or did not go into labour as the case may be (i.e. get them to hospital quickly). The women made lunch for us but we were pretty dehydrated by the time we got back to the car. I really struggled on the 1km assent right at the end. We learnt a few lessons about being prepared for all conditions and immediately stocked the car with water, dry biscuits, umbrellas and hats when we got home at 19:30.  Tomorrow’s hike is 2km longer.

Ben and Ricky at Christmas
Ben is working long hours on site but his progress so far this year has been great.  On days when Silda (the other member of our team) and I are not working in the community we plan for future activities – the health promotion radio program we produce each week or the health library we have developed for (and with) the health staff here in Maliana.  The Radio Program is way more work than we ever envisaged but a pretty fun project to be involved in.  Silda is the talent and it was her idea in the first place.  I provide technical and advisory support with editing, logistics and planning.  My editorial support is mostly just butchering good songs to provide background music.

There is also a lot of work to be done on responsibly and effectively handing over those elements of the project that the government will hopefully continue on, such as the ambulance and the library.

The Rotary project we are working on is in its final year this year so there is also a lot of work to be done on responsibly and effectively handing over those elements of the project that the government will hopefully continue on, such as the ambulance and the library.  This will be quite a challenge but we continue to have great support from Palms and Rotary.  Generally I have been feeling the best I have ever felt about living in Timor and this project.  January has been difficult and, as our Palms’ in-country coordinator continues to remind me, we haven’t yet cut down on our ridiculous work hours.  I do feel however that we are heading in the right direction.  It must seem like not much to people at home but I am constantly amazed that Ben and Silda and I have managed to come up with a program through real consultation with the community with potential to make a small but lasting differences to the attitudes and capacity of the staff and communities.

We have tried to put as much of the Palms philosophy as possible in to a situation which, when we found it this time last year, had not yet been able to achieve the level of relationships and understanding which allow a project to be effective and sustainable.  I think my positive feelings have been in part just being more comfortable in my surroundings, in part having Ben around more often and in part because, for the first time, I feel we have a bit of control over what we are doing. Not much, mind you, but that little bit makes a lot of difference.

Food for thought

  • "They were mostly seeing a midwife for the first time". What other challenges might rural women face in East Timor? Do you think there might be advantages to a rural lifestyle over an urban one?
  • Sally talks about "handing over" the project and trying to be sustainable.  How important should this be in international development projects?
  • Consider projects you are aware of; was sustainability or local ownership truly sought, mentioned only cursorily or completely forgotten?

Letter from Maliana, Timor-Leste

March 11, 2010

Sally Johnson who, with Ben Kildea, is volunteering to provide health care in Maliana in Timor-Leste, describes the challenges and rewards of rural health projects. The morning fog was so dense along the mountain road to the turn of at Nunutana that we were only able to see two metres in front of the car. […]

Click here to read the full article

Letter from the field (5 months)

October 23, 2009

Now that we are getting our bearings a bit more and the end of the building project is in sight, we would like to start looking at what activities we should be focusing on over the next eighteen months.

Click here to read the full article

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Timor-Leste

Population: 1,292,755

Area: 15,007 sq. km.

Median Age: 21.5

Literacy: 58.6 %

Languages: Tetum, Portuguese, Indonesian, about 16 indigenous languages

A brief history of independence. mid 1500s – Timor colonised by Portugal 1859 – Portugal cedes West Timor to the Dutch 1942-1945 – Japan occupies East Timor 28 November 1975 – East Timor declared independent from Portugal 7 December 1975 – invaded and occupied by Indonesia. It is estimated that 100,000 to 250,000 were killed […]

More on Timor-Leste

If you have come to help me, you are wasting your time. But, if you have come
because your liberation is bound up with mine, then let us work together. - Lilla Watson