Categories
FEATURE HEALTH TIMOR-LESTE

Mobile clinic narrows healthcare gap in Timor-Leste

Jesuit priest travels to hamlets on hillocks, serves as a band-aid for state’s medical woes

Jesuit Father Antonio Martins Abad-Santos, a Filipino most villagers know as Father Bong, celebrates Mass before performing medical check-ups on his patients in Gmanhati hamlet, Ermera district on Jan. 22. (Photo by Michael Coyne)

Mountainous terrain, inadequate modes of transportation and shortages of medical personnel and facilities have all combined to hamper efforts in Timor-Leste to provide local people with adequate healthcare.

As a result many people, particularly children, women and the elderly in rural areas often struggle to access hospitals or clinics when they fall sick or are in need of a check-up. Even access to clean water is a key concern.

However, mobile clinics such as the one organized by a local Jesuit mission is bringing healthcare closer to home — even into people’s living rooms.

Izabel Soares, 21, is among the residents of Gmanhati hamlet in Ermera district who are benefiting from the new service.

She recently took her 3-month-old baby to meet Jesuit Father Antonio Martins Abad-Santos, a Filipino doctor known here as Father Bong.

A certified medical practitioner, he runs the clinic and makes regular visits to a nearby village made even more remote by its hillside location.

Chronic back pain makes it difficult for Soares to stray far from home so the mobile clinic was a godsend on this occasion as her daughter was showing signs of malaria, running a fever and coughing.

“I don’t have to go to the hospital now to collect the medicine and vitamins for me and my baby because Father Bong brings them here for us,” she said.

Before the priest started the clinic, people had to walk to the nearest facility in Railaco about eight kilometers away.

“For young people that’s not such a problem. But for senior citizens like me, or for women, it’s a real challenge to cover such a distance by foot,” said 75-year-old Alderiano Goncalves, who lives in the same hamlet.

Goncalves has been afflicted with rheumatism for years and has to contend with seasonal migraines, fever and a recurring cough.

He met the priest for the first time eight years ago. Before the advent of the clinic he used to rely on traditional medicine supplied by local practitioners because the nearest hospital was too far from home. 

Father Bong’s visits serve as a beacon of hope for hundreds of villagers. Not only does he minister to their physical needs and ailments but also provides spiritual nourishment by celebrating Mass with them before providing treatment.

“We get both — physical and spiritual nurture,” said Goncalves, who lives with his biological child and three adopted kids. One is preparing to work in South Korea, in hope of serving as a new breadwinner for the struggling family. The Northeast Asian powerhouse is a prime destination for overseas workers from Timor-Leste.

Plazida dos Santos, 22, from nearby Naisuta hamlet, also in Ermera district, said the Jesuit priest is now working on her second child’s skin problems after treatments sought elsewhere proved ineffective.

“I’ve taken my baby to Gleno [the capital of Ermera] several times but the doctor just prescribed paracetamol and she’s still sick,” she said.

Now the wounds on her daughter’s feet have rendered her immobile, she added.

And she is not alone. Many of the children suffer from skin problems and parents are at a loss when it comes to dealing with them.

A plague of infections

Father Bong’s mobile medical clinic covers 11 areas in the two districts of Ermera and Liquica. He launched the service in 2004 as part of his pastoral duties at the Jesuit Railaco Mission.

Helped by two assistants, he heads out to local villages every Monday, Tuesday and Thursday, traversing treacherous trails that require a strong sense of adventure.

“We run a mobile clinic because we don’t want to compete with the government clinic in Railaco,”Father Bong said.

“We target those people living in the mountains who cannot be reached by government clinics or medical workers,” said the Filipino priest.

“Every year I see more than 5,000 patients,” he said, adding that most cases involve an infection of some kind. He blamed malnutrition as this weakens the immune system and opens the door for infection.

“I meet lots of people with this kind of problem, such as respiratory infections, intestinal infections or upset stomachs,” he said.

The villagers often fail to prepare their meals in a sanitary way while the elderly chew betel nuts. Smoking is commonplace.

According to the World Health Organization (WHO), lower respiratory infections were the second-biggest cause of death in 2012 among the Timorese people after tuberculosis.

Other major threats to their mortality include ischemic heart disease, strokes, birth asphyxia or trauma during conception, diarrheal diseases, neonatal sepsis and infections or cancer of the trachea, bronchus or lungs.

The clinic cannot deal with all of these complaints and illnesses because it is part of an outreach program and not that well-equipped.

The doctor-priest is restricted to providing first aid or primary healthcare and trying to prevent people from getting more sick.

He refers serious cases to government hospitals or clinics with better facilities.

Father Bong, who was ordained as a priest in 1998 back in the Philippines, said the St. Canice Parish in Sydney, Australia has been providing financial support for the clinic’s operations for years.

“In the beginning they only offered their help for five years. But when they saw the need was there, they continued,” he said.

Healthcare challenges

Timor-Leste is struggling with a fractious young government but has achieved significant improvements in terms of its healthcare, according to a report by the World Bank in 2017.

For example, when the fledgling state gained independence from Indonesia in 2002 its healthcare infrastructure was decimated with only 20 doctors to tend to a population in excess of 1 million.

Fortunately that number has since multiplied significantly, with the government employing nearly 900 doctors as of last year.

People’s life expectancy soared from a dismal 48.5 years in 1990 to 67 years in 2014.

Meanwhile, antenatal coverage has improved and the general population are now much more aware of infectious and non-communicable diseases, officials say.

This has been helped by a health budget that has curved upward since 2008. The government allocated $67.2 million for the Ministry of Health in 2014 to build 39 clinics, among other projects.

But Bolormaa Amgaabazar, the World Bank’s country representative for Timor-Leste, has warned “the growth outlook for the Timorese economy during the next few years is subdued.”

“As such, the government is attempting to put a curb on rising public spending,” he added.

Father Bong said the nation’s woes are widespread and even the National Hospital in Dili suffers from a lack of medicine.

“The current government focuses more on bureaucracy than the quality of healthcare that’s provided,” he said.

The country has sent nearly 1,000 young people to study as doctors in Cuba in recent years, and now many have returned to plant new seeds.

“But for them to perform their duties effectively and efficiently, the government needs to upgrade its healthcare equipment,” Father Bong said.

“If the healthcare system was more efficient and the country had world-class facilities, people wouldn’t need my help,” he said.

“Then I could focus on my duties as a priest.”

This article was republished in UCA News on January 2 2019

Categories
FEATURE TIMOR-LESTE

Prison brings Timor-Leste inmates closer to God

Convicted rapists, murderers rejoice in being shown the path to righteousness as Easter approaches

Prisoners join a regular prayer service at the Ermera District Court in Gleno, Timor-Leste, in January 2018. (Photo by Michael Coyne/uncanews.com)

Julio was a physics teacher at a high school in Timor-Leste before he made a series of wrong decisions that finally landed him in jail.

He worked in Oecusse district, close to border with Indonesia. Everything was going fine, he said, until he made the mistake of falling in love with a 14-year-old student.

Their feelings became so strong that the father of six, who declined to give his real name, said their affair soon blossomed into a sexual relationship.

“I was in love with her, so of course we became intimate,” he told ucanews.com, adding the relationship lasted four months.

However, in 2011 the news reached the girl’s family. They accused Julio of raping the young student. Top of Form

Bottom of Form

“I was attacked and beaten by several members of her family. They also reported me to the police,” he said. “The case went to court and in June 2013 I was sentenced to 12 years in prison for rape.”

During those early days, he said he spent most of his time feeling sorry for himself and wondering how he would cope.

But after several encounters with priests and other members of the church while behind bars, he began trying to follow the teachings of the Bible.

Sensing God’s presence

This coming June will mark Julio’s fifth year at Ermera District Jail in Gleno, about 40 kilometers west of the Timor-Leste capital of Dili, where another prison is located.

Instead of counting down his days in prison, he said he reflects on the harm he has inflicted on his family, the girl and her family, the school he worked for, society and God.

“I really regret what I did. I always ask for God’s forgiveness for that,” he said.

As he devotes more time to religious studies and his inner conversion to Christianity, he said he can feel God mapping out a path for him to walk down.

“I’m sad because I left my family to struggle by themselves. But I’m also happy because [I realize] prison is God’s way of telling me to return to Him. I believe God has plans for me in the future,” he said.

He said the loneliness he feels, and the pain of living so far removed from his family, pales in comparison to the suffering of Jesus, who died on the cross.

“Jesus was crucified for me. His suffering was far bigger than mine,” he said.

For Julio, the crucifix and Easter are now a central part of his life. To help sustain his conviction he stays active in the prison ministry — singing in the choir, praying with other inmates, and attending Mass.

Maubere — also not his real name — was a catechist before he was jailed. The 47-year-old said he never imagined he would one day be locked up.

His problems began after he contested a local election to serve as the leader of his village. He won and served successfully for four years before he was undone when news of his affair with a 17-year-old girl came to light, he said.

“I was accused of raping the girl. I was reported to the police and finally in 2014 the court sentenced me to six years in prison,” said Maubere, who still believes he was the victim of a politically motivated attack by village rivals.

Instead of fighting back, he said he had no choice but to accept the court’s ruling.

“I didn’t have enough money to pay lawyers to fight on my behalf. I just accepted their decision. This is God’s way of telling me to follow His path,” he said.

He continues his work as a catechist in prison, helping his fellow inmates grow closer to God with community prayers, religious classes, Bible sharing and Mass, held once a week in a chapel inside the prison.

Maubere assists prison chaplains such as Jesuits from Our Lady of Fatima Church in Railaco and priests in Gleno, who regularly deliver Mass there and hear confessions at the prison.

“I also help my friends to recollect their past deeds, something we do ahead of religious festivals like Christmas and Easter, ” he said.

‘Not here to judge’

Anibal Da Luz, 42, has been a guard at the prison for 18 years. He said the facility was renovated around the time he started working there and it now has around 90 prisoners, including 17 women.

Inmates’ sentences range from four to 24 years, he said. The man with the longest jail term was imprisoned for raping and killing a woman. The youngest inmate is 18, and is also there for raping a minor. The oldest inmate is 60.

“Most of them have been convicted of murder, followed by cases of rape or those involving narcotics,” he said.

Agustino de Fatima Salsinha, 43, serves as the deputy head of Ermera Prison. He said inmates are encouraged to see prison as an opportunity to change their lives and work toward a brighter future while forgetting their dark pasts.

They receive training to arm them with a range of skills including carpentry, welding, brick making and more.

As many of the inmates are illiterate, the prison teaches them how to read and write as well as providing other forms of academic education.

“We also offer them spiritual guidance, such as by inviting chaplains to come in,” Salsinha said.

He said preaching alone is not enough: The inmates must be shown how they can transform their lives and prepare to re-enter society as better people.

“So when they leave prison, they’ll already have the skills they need to start new a life,” he said.

He said it was important to treat inmates like people who are capable of converting to a better life.

“We’re not here to judge them, but to make them realize they are humans, people who have faith,” said Salsinha.

“It’s our job to make them realize their wrongdoing and help them look forward to a better life in the future,” he added.

As of now, Timor-Leste has two prisons. The biggest one is in Dili, which has over 560 inmates. A third is scheduled to be built soon in the western part of Timor-Leste, near the Indonesian border.

Salsinha said that while the number of prisoners nationwide is relatively small compared to Timor-Leste’s population of 1.2 million, state resources are being stretched.

Dili prison is suffering more than Ermera as it has more prisoners, he said, adding it needs more staff to bolster security and ensure the programs designed to improve inmates’ lives are carried out properly.

“Like I said, we’re preparing people for the next stage in their lives. We just need a few more personnel to help us carry that out,” Salsinha said.

Published in UCA News on March 28, 2018

Categories
FEATURE TIMOR-LESTE

Timor-Leste’s ticking time bomb

Economy grows yet unemployment is worsening rapidly

Christovao Freitas Almeida finally managed to find work at the Education Ministry. (Photo by Siktus Harson)

When Christovao Freitas Almeida graduated from high school in 2007, work was thin on the ground. Too poor to go to university, the 26-year-old found himself stuck in his village in Timor-Leste’s northwestern district of Aileu, close to the capital Dili. Young and jobless, the future looked bleak.

For six years Christovao was among a worryingly large proportion of Timorese without a job. The country, which for 24 of the past 40 years was engulfed in war, has Southeast Asia’s highest unemployment rates, at 11 percent according to the country’s Labor Ministry. The youth has taken the brunt of the crisis, and even a university degree no longer provides anything close to a guarantee of work.

By dint of his geographical location, however, Christovao became one of the lucky ones. Staff from the NGO Plan International arrived at his village one day in 2013, offering free skills training for unemployed villagers. He spent six months honing his computer and communication skills, and this year landed a job at the Education Ministry in Dili. He now earns a monthly salary of $160, above the $115 minimum wage set by the government, but he remembers well the hard years.

“Most of my time was spent playing, drinking, and sometimes getting drunk. That’s what jobless people often do, drinking and get drunk, and can easily get provoked [to fight],” he told ucanews.com.

This came to the fore in 2006 when, triggered by upheaval within the Timorese military, the country became embroiled in a major crisis, with soldiers and police taking over the streets of Dili, forcing 150,000 people to flee. In the aftermath of the crisis, the UN warned that underlying problems that had contributed to the spread of violence among civilians were not being addressed, one of them being mass unemployment.

Top of Form

Bottom of Form

On paper, things don’t look bad for the Timorese economy. The country’s GDP grew by eight percent last year, according to the Asian Development Bank, and this is set to continue into 2015. But, warns Paulo Alves, director of employment at the Secretary of State for Vocational Training and Employment, that doesn’t always translate into job creation in Timor, the region’s poorest country.

The proof is in the figures. Timor has accumulated more than $10 billion since independence in 2002 from offshore oil and gas reserves, yet it remains a low-income country, with extreme levels of poverty and complex social problems.

“The problem here is that the labor force grows rapidly, while employment opportunities are growing at slow phase,” Paulo told ucanews.com.

Every year, he said, about 15,000 to 20,000 people graduate from high school. Only about 2,000 to 3,000 of them can afford to continue to university, while those from poor families seek immediate work to improve their families’ financial wellbeing. According to a World Bank report last year, by 2030, 470,000 individuals will have attempted to enter employment, a consequence of the fact that Timor-Leste has one of the world’s highest birth rates, with more than 40 percent of Timor Leste people below 15.

At present, the country does not have labor-intensive sectors such as a garment industry, which in many other countries – such as Bangladesh or Indonesia – draws a huge amount of even unskilled labor. Agriculture, which employs more than 60 percent of Timorese, is only seasonal, and therefore not considered a fix. “When crop seasons [rice, corn, and coffee] end, people will again be jobless,” said Paulo.

One government response to the problem has been to create a “three dollar program” in which it pays people $3 a day to work in government-sponsored projects such as road construction.

“One of most important things is to encourage more private companies to invest in sectors that can recruit many local people, such as in tourism and commercial sectors,” said Alves. He cited Dili’s first and only shopping mall, Timor Plaza, as an example. The business center inaugurated last year has employed hundreds of local Timorese.

While the energy sector is presently not a solution to the problem, the government’s ambitious $1.3 billion Tasi Mane oil and gas project will focus on recruiting locals, and become the backbone of the country’s petroleum industry.

“We estimate that the project will cut unemployment by 95 percent, as it will need more than 100,000 local people,” said Paulo, adding that the Labor Ministry has established a subdivision that will be in charge of training oil and gas workers.

Another strategy to curb domestic unemployment has been a deal struck in 2008 with Korea and Australia, in which young Timorese are sent to work in both countries, focusing mainly on the fisheries, agricultural, and industrial sectors. More than 1,400 people have been sent to both countries, with total remittances of $2.9 million.

Etha Mota, head of Plan International’s youth empowerment for sustainable development program, said in the last two years the group has been involved in training more than a hundred young people like Christovao aged 15 to 24 with different skills depending on their needs.

Yet this training will only be more effective when employment opportunities are made available nationwide.

“On the one hand the huge labor force is an opportunity for the country,” Etha said. “On the other it is a threat because not everybody has the chance to work, even though they want to.”

Published in UCA News, May 12, 2014