Subject: GLW: Long queues for medical facilities

Green Left Weekly, Issue #400 April 5, 200

EAST TIMOR Long queues for medical facilities

DILI -- To come face to face with public health services in East Timor is a daunting thing.

For expatriate workers, there is access to foreigner clinics and always the possibility of being evacuated to Darwin or some other First World medical facility. However, this is not an option for the population in general, who are suffering from various diseases, many associated with the deplorable living conditions forced upon a majority of the Timorese and hence very much preventable if their living conditions were improved.

There are around six hospitals and clinics in Dili which provide medical care to the population. All seem to be operated by non-government organisations and the United Nations.

As a volunteer worker in East Timor, though I had the option of being evacuated to Darwin, I remained here while suffering from a bout of malaria. The first clinic I visited was small, operated by Accion Medical International opposite Dili Stadium.

On that day there were more than 50 people waiting, sitting on benches and filling the corridors. It was only 9.30am. I was suffering from undiagnosed malaria and my friend, chronic bronchitis. We were refused as there were already too many patients. We were lucky enough to be able to afford a taxi for the 10-minute drive across town to the Medecins Sans Frontieres office, located on the main road into Dili.

Although highly visible from the very large banner hung outside the office, proclaiming their presence in Dili, the office had no doctor in attendance. We were told by a staff member to go to "quarantine" at Taci Tolu, on the outskirts of Dili. I did not consider quarantine to be necessary as yet, so we left slightly perplexed and getting more desperate.

Another volunteer worker suggested the Dili General Hospital in Bidau. This hospital was an Indonesian-run public hospital and is now run by the International Committee of the Red Cross. We hopped into another taxi for another drive across town.

At the hospital there were around 60 people already waiting to see a doctor, a daunting sight for someone who is ill. Our names, ages, addresses and patient numbers were written on slips of recycled paper. There are no patient files. We were numbers 79 and 80.

The waiting room is a series of long, hard wooden benches, painted white, in rows out in the corridor. The discomfort of a young woman who had obviously waited for a long time on those benches was plain to see. Doors were kept open and there might be other patients in the room during a consultation, so privacy is extremely limited.

We waited for an hour before being called and the system was chaotic with those who arrived before us still waiting. My friend and I, male and female, were seen at the same time. I was sent to the laboratorium for a blood test, where the needle that would prick my finger was lying in an open sachet, looking suspiciously like it was being reused. The doctor had refused to answer when we asked whether needles used were sterile or not.

Consultation and medicines at the clinics around hospitals are free at the moment. It is questionable if the majority of the population would be able to afford health care if it was not.

The next day, I waited for two hours to get a prescription after malaria was confirmed. The man next to me had an abscess on his foot and malaria. Other patients showed pity on me for being a foreigner with malaria, but attitudes to this common disease here are positively blase.

The lack of proper drainage systems and rubbish collection means open drains and "impromptu" drains, trails of water seeping out from toilets and kitchens are ubiquitous. In fact, this is my view from my window as I get up every morning. Rubbish, besides being burnt, is also thrown in the drains since there is no organised rubbish collection as such for locals.

Vaccinations for children are hard to get and extremely limited. There are limited surgical and dental services at the hospital and an emergency clinic. To circumvent the queues, some families are relying on personal contact with medical staff to receive injections and medicines at their homes outside work hours. At these types of consultations, syringes are "sterilised" in a glass of hot water and then reused.

The desperate, frustrated, worried and ill faces at the clinics I visited continued to haunt me. They are still waiting for the tangible results of the transitional period.


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