Mentorship of future Timor Leste health leaders

AAF Timor Leste Group

Mentors and members of Timor Leste Health Leaders

Members of the Marie Bashir Institute have spent the last 3 months mentoring rising stars in health from Timor Leste to develop their leadership potential and guide them in developing a Project for Change. The scheme was coordinated by Sydney Medical School’s Office for Global Health (OGH) and was supported from the Australian Government’s aid programme.

The Australian Government funds the Australia Award Fellowships, which aim to develop leadership, address priority regional development issues, and build partnerships and links between Australian organisations and their partner organisations in developing countries in the Asia-Pacific region, Latin America, the Caribbean, Africa and the Middle East. Fourteen future health leaders were identified and interviewed by the OGH and those with an interest in infectious diseases, inflammation or immunity were provided with mentorship by seven members of MBI. As well as attending courses, lectures and visiting healthcare facilities, each fellow had to complete a Project for Change where a need was identified in their country and an implementable plan developed. The mentors will continue to work with the Fellows now that they have returned to Timor Leste to ensure that their Projects for Change are implemented and audited.

Improving infection prevention and control in Timor Leste

Paulina Pinto, Quality Control and Infection Control Manager - Hospital National Guido Valadares
Mentor: Professor Merrilyn Walton

Timor Leste has one major 340-bed National Hospital that receives patient referrals from all of the district hospitals as well as caring for the residents of Dili. Despite all staff receiving training in infection control in 2005 there has been continuing poor compliance with infection control guidelines and protocols with the associated transmission of healthcare-associated infections and antimicrobial resistance. Paulina developed a programme to improve the knowledge, skills and awareness of staff, patients and relatives, leading to better hand hygiene within the National Hospital. When she gets back to Timor Leste she will create an infection control committee, develop posters for promoting hand hygiene and preventing the transmission of infectious organisms, develop an education and training programme and start active surveillance for nosocomial infections. With increased knowledge, skills and awareness of infection prevention and control Paulina hopes to improve the care given to patients at the National Hospital.

Meeting core capacities at Points of Entry

Ofelia MO do Carmo, Port of Entry Coordinator, Communicable Disease Department
National Public Health Directorate, Ministry of Health
Mentor: Dr Siobhan Mor

The International Health Regulations (2005) were adopted by the World Health Assembly in 2005 and entered into legal force in 2007. A number of the requirements pertain to international Points of Entry (PoE) and include providing access to appropriate medical services, assessing and quarantining patients with suspected infectious diseases and decontaminating baggage from insects. Timor Leste was supposed to have fulfilled its minimum core capacity obligations by the end of 2012 but in light of a lack of resources has been granted an extension until 2014. Ofelia’s Project for Change was to develop national standard operation procedures for each PoE and to strengthen the multisectoral collaboration between the relevant ministries, stakeholders and agencies. Whilst in Australia she met with the Commonwealth Departments of Health and Agriculture who were able to provide here with the equivalent documents used in Australia and provide guidance on how to proceed with her project.

Intravenous line infections in Hospital National Guido Valadares

Mateus Pinheiro, General Practitioner, Medicine Department
Hospital National Guido Valadares
Mentor: Dr Grant Hill-Cawthorne

Peripheral, central and renal dialysis catheters are frequently used in the National Hospital and in outpatients receiving home intravenous therapy. However, they are associated with a high incidence of sepsis. Patients are usually treated empirically with antibiotics, with very limited culturing or antimicrobial sensitivities performed. Mateus developed care bundles for use in the hospital based on the UK Department of Health’s High Impact Intervention schemes. The aim of these schemes was to save lives by reducing infection and delivering clean and safe care. The care bundles focus on areas such as hand hygiene, use of personal protective equipment, skin preparation, documentation and clinical observation. Upon returning to Timor Leste Mateus will meet with the board of the hospital to begin implementing the bundles over the next 6 months.

Nutrition education for people living for HIV/AIDS

Ines Lopes, Executive Director
Estrela+ Timor Leste
Mentors: Dr Shailendra Sawleshwarkar, Dr Anthony Santella and A/Prof Richard Hillman

People with HIV/AIDS in Timor Leste are often nutritionally deficient due to reduced food intake, impaired nutrient absorption or changes in metabolism. Ines identified that there is a lack of knowledge among healthcare providers about the existence and impacts of nutritional deficiencies and a lack of human resource to deliver education to people with HIV/AIDS. When Ines gets back to Timor Leste he will work on improving the awareness of these needs among healthcare providers and develop manuals and materials on nutrition, antiretroviral therapies and adherence.

Establishing both a community and facility based tracking system in order to “reduce dropout” and reach unreached children for vaccinations

Carlos Sarmento, Field Coordinator
Immunizasaun Proteje Labarik
Mentors: Dr Nicholas Wood and Telphia Joseph

The expanded immunisation programme in Timor Leste has made significant progress since 2000 but it continues to have some of the lowest coverage figures in the WHO Southeast Asia region. Immunisation coverage in 2009–10 for a 1-year-old child was 66.7% for completion of the third dose of diphtheria, tetanus and pertussis and 68.2% for measles. Community centres lack a mechanism to track children dropping out of vaccination schemes and there continues to be children in rural communities with whom contact has not been made. Carlos will implement a tool and tracking system by training villagers and volunteer community health workers. He will also develop a quality data plan to ensure that missing children are vaccinated.