Impressions of Timor Leste
- Colin Tuft – medical student from Sydney Medical School, undertook an ILA with the Ministry of Health, Timor Leste in 201112
"Few things in my life beat the four weeks spent in Timor-Leste in hospitals, clinics, rural villages and hanging out a 4WD's sunroof. The medical experience was unique, set in a country only a decade old with a fledgling health system staffed by people from all over the world. The culture is fascinating and charming; the people are open and friendly yet still personally impacted by the decades of brutal Indonesian occupation. And the country is stunningly beautiful, with Australian, Caribbean, South-East Asian and German landscapes all within a tiny 200 by 40km nation.
Something that should be known before applying for Timor is that everything in the country works on a very relaxed organisational system known affectionately as 'Timor time'. Despite insistent and later desperate attempts at communication very little was organised by the time we landed in Dili. Thankfully this proved to be no problem, as the hospital was very welcoming and the expat community helpful and generous. We spent most of our time at the National hospital in Dili, under the wing of the generous and lovely nurses of St John of God. Our time was divided between assisting the nurses and doctors in the paediatric and emergency wards. On several occasions Australian surgeons from RACS arrived to do an intense week of surgery, so we saw a number of interesting operations and enough cataract surgeries to last a lifetime. The resources in the wards and theatres are limited (the surgeons found it surprisingly easy to adapt to regular power failures), and the patients often present in advanced stages of disease. The majority of cases would not be seen here, with much TB, malaria, dengue and countless malnourished children. The work there was confronting, but infinitely valuable from a clinical point of view, with a vastly different pattern of diseases to what is seen in Australia.
In order to gain a comprehensive perspective of health in Timor-Leste we visited one of the district hospitals in Oecusse, and spent time in a free, charity-run clinic in Dili. We also managed to tag along on an outreach clinic to a rural area which provided education, registration of births and medical services to people far from any health facility. Apart from the clinical experience accrued from our time there, the most valuable understanding I gained was of public health in developing nations. I found it fascinating observing how the hospital system worked with so few resources despite the fact that patient notes were written in 4 different languages. Equally fascinating was learning about Timor's development from the ashes of 1999 from the welcoming and friendly expat community of NGO volunteers, UN workers and military personnel (I wish there were pubs like the Dili Beach Hotel in Sydney).
Lastly, in order to gain a truly comprehensive perspective of life in Timor-Leste we travelled the entire length of the island with some vital med students we met in Dili, dived spectacular coral gardens and taught orphans in a mountain village how to play the didgeridoo. How can you expect to understand the intricacies of medicine in another country if you don't understand the culture and environment.
I would recommend Timor-Leste highly to anyone interested in a career in developing world medicine, and would be more than happy to answer questions about the charming fledgling nation."