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Bare Foot Nurses

Healthy Communities Project – Baucau, Timor Leste

Vision

To improve health of families, particularly infants and children, in Baucau, Timor Leste, and the neighbouring villages through developing community knowledge and capacity in the area of basic health.

Context

At 600 kms from the Australian mainland, Timor Leste is our nearest neighbour, a small country devastated by Indonesian rule and internal civil unrest. Much of the country’s infrastructure was destroyed after the vote for independence from Indonesian rule in 1999. It is a country of approximately 1.1 million people of whom: 41% live below the poverty line of US55 cents per day; 96.5 % are under 64 years, and the median age is 22 years; more than 50% are below 18 years of age; a large percentage is malnourished. A large proportion of the youth are unemployed and disengaged. The infant mortality rate is approximately 40 per 1,000 live births and the life expectancy at birth is only 62 years.

Despite improvement since the independence of Timor Leste, the health system remains inadequate. The major detriments to health are poverty, poor sanitation and poor water supply, both of which contribute to morbidity and mortality from food or waterborne infectious diseases and vectorborne diseases. Distance from and access to adequate health services is a problem (33% of the population lives more than 2 hours walk away from the nearest health facility). In addition, there’s a lack of infrastructure, lack of qualified professionals, poor communication, and low quality of primary health care services. Poor roads and public transport, poor outreach of mobile clinics, and limited human resources compound the problem. Because of these difficulties, Timorese people often do not seek timely health care.
The Marist Brothers, in partnership with Australian Catholic University (ACU), have established a Teachers College in Baucau, approximately 125 kms east of the capital, Dili, although it takes approximately three hours to drive from Dili to Baucau because of the poor conditions of the roads. ACU, through the School of Exercise Science, has also developed a Future in Youth Project with the Salesian community and parish, the community leaders and soccer coaches of Baucau.

Following the 1999 referendum, the education sector became non-functional. When the pro-Indonesian militias began their rampage, they ensured that maximum damage was inflicted by filling the classrooms of Dili’s secondary schools with drums of fuel and torching them. This left Timor Leste without an effective education system since most of the schools were destroyed.  

The destruction of schools and other educational infrastructure was complemented by the mass exodus and displacement of teachers in Timor Leste. Approximately 80% of secondary school and 20% of primary school teachers were from Indonesia. In addition, most of the staff at in the Department of Education as well as the training institutes were Indonesian. These all left Timor Leste during the violence and did not return. Between 1999 and 2002, the United Nations Transitional Administration in East Timor (UNTAET) repaired and re-established the school system.

During this period, the Marist Brothers established the Teachers training college - ICFP in Baucau. In 2004, Br Mark Paul fms, the then Director of ICFP, invited Dr Charles Abercrombie and Sr Helen Peters of St Joseph’s College to establish a clinic to service the needs of the College staff, students and the wider community.

The Parish Priest of Baucau donated a building in the Parish grounds and the O’Neill Foundation in Australia donated the money to renovate and establish the clinic. St Antonio’s Clinic was officially opened in 2006 and is fully registered with the government of Timor Leste.

The visit by Sister Helen Peters to Timor Leste in October 2010 was a key element in working with the Church, health organisations and people of Baucau for the second stage of the Healthy Communities project. She held a number of meetings, the purpose of which was to engage health stakeholders in Timor Leste regarding priorities for developing health communities in Baucau.

Priorities


•    Place an Australian-registered nurse in St Antonio Clinic – a partnership request has been made to Palms Australia;
•    When the nurse is in country, to commence small sessions of education for health workers within the clinic;
•    Develop and present a proposal to the Partnership Committee of the government of Timor Leste to provide education services to all health workers in Baucau and surrounding districts;
•    Sign a Memorandum of Understanding with the Government of Timor Leste to provide education services to health workers.