Timor Leste: Health in Isolated Communities
Isolation is caused by many things in Timor-Leste! Some people here are isolated by jungley forests where no clear road has been made. Other people live perched high on the sides and ridges of mountains, with roads that often are impassable due to landslides, mud or generally poor condition.
For the people of Atauro Island, their isolation comes from a lack of passable roads, a rocky mountainous terrain and then a secondary level of isolation that comes from living on an island, removed from the rest of Timor-Leste. An island that when the westerly winds are blowing strong is left inaccessible by boat or plane. The mainland of Timor-Leste is visible to from Atauro island, only twenty five kilometres away, yet how great that distance must seem when all methods of transportation are stopped due to bad weather.
The remoteness and isolation of the people of Atauro has led several organisations to work with the local people to develop their knowledge and skills in health, nutrition and medical issues, so that they are not so helpless in their times of isolation. In June, SHARE, (Services for Health in Asian and African Regions), a Japanese Non Government Organisation used both of our MAF Timor-Leste aircraft to transport their staff to Atauro island. SHARE uses healthcare programs to develop human resources and assist communities in protecting their health. They have been working in Timor-Leste for twenty years, especially supporting school health and community health.
It was an early start to the day on the 18th of June as MAF pilots, Jason Job and Timothy Southcott loaded up their thirteen passengers on VH-MFM and VH-MQO to make the fifteen minute flight to Atauro island. The passengers included SHARE staff, both Japanese and Timorese, staff from the Ministry of Health in Dili who oversee the health services on the island, as well as a supply of vaccinations, medical tools for assessing and evaluating people’s health and personal belongings for their stay on the island.
The SHARE project on Atauro Island started in February 2019, after carrying out survey work the previous year, which revealed the great difficulty that local people on the island have in accessing health facilities. Many areas on the island lack reliable transportation due to the undeveloped roads. Local people have to walk along steep paths or cliffs for two or three hours to reach the nearest health facility. Another significant issue is the fact that many local people have poor health knowledge which leads them to not to go to the health facility to receive care when they need to. A combination of these factors lead to late diagnosis and treatment, low immunization coverage, low rates of maternal health checkups, difficulty of ongoing follow up, and eventually cause greater health problems within the community.
The SHARE project on the island hopes to improve the quality of care provided by the health facilities by training local medical staff to improve their communication skills and give more training to develop their medical skills. SHARE will work in partnership with the local medical staff to conduct mobile medical clinics in the more remote areas, which will aim to teach local people about their health.
Aya Kakimoto, a Japanese nurse, recently based on Atauro island explains, “Atauro island is located 25km offshore from Dili. It is not very far from Dili, but there is no public transport operating every day between two islands. Therefore, it is difficult to visit and carry out our plan with a limited time schedule. We only had three available days including a traveling day to conduct our research and other activities. With the support of the MAF planes, we were able to carry out our field research, supervision of health facilities, mobile clinic and meet with local people. … It was an absolutely great opportunity for all the staff members to observe the health situation and difficulties that local people are facing on Atauro island. We listened to the local people’s voices about their health situations. We discovered that many children were not receiving immunization as scheduled, many pregnant women were malnourished, and health records were not completed properly. Now all the staff members have a common understanding of what must be done to improve health status of communities in Atauro. And we are ready to cooperate with each other to implement plans.”
During the time the staff from SHARE were working on the island they spent many hours walking and travelling by small local style boat to reach the communities where their mobile clinics were run.
MAF Timor-Leste loves partnering with organisations like SHARE who bring health and education to some of the most difficult to reach places in our world, like tiny communities on an island where a plane, boat and a long walk is needed to visit them.