September 1, 2000
Dili, East Timor — Doctors Without Borders/Médecins Sans Frontières (MSF) continues its work in East Timor, mainly in Baucau district, and also in a transit center for returning refugees in Dili.
MSF teams are working in all levels of the health care system in Baucau, providing services and medicines free of charge. A volunteer doctor and anesthesiologist carry out surgery in Baucau District Hospital, one of only two hospitals in the country that offer surgical services. There is also one volunteer MSF doctor who works together with a Timorese doctor to provide general consultations and treatment for the hospital patients. The 120 bed hospital has a shortage of medical staff, so MSF is also assisting with covering the night shift. As part of its work in rehabilitating existing health structures, the teams have also installed a blood transfusion facility in the hospital, which already has the capacity for surgery, X-rays, and laboratory work. There is also a volunteer midwife who assists with complicated deliveries. Finally, MSF is supplying all the medicines for the hospital and for the 6 health centers of Baucau district where it works.
In the health centers, many of which were completely looted during the fighting last fall, MSF is working to rehabilitate structures and re-supply necessary equipment. Teams are working to install radios in some of the centers to improve the referral system to the hospitals. MSF volunteers also provide on the job training to the nurses who staff the centers, as there are no remaining doctors.
Much of the population in Baucau lives in outlying areas, and many have not had easy access to the health centers. Therefore, MSF is also operating mobile clinics to remote areas to provide basic services, including consultations for children and adults, immunizations, pre- and antenatal consultations, family planning, and health education. Much of the health education involves informing the population about the availability of health services, since they did not use those services often in the past.
The teams also conduct epidemiological surveillance in the district, and monitor the nutritional status of the population. Currently, the nutritional situation is stable. The most common diseases in the area are malaria, diarrheal diseases, tuberculosis, and upper/lower respiratory tract infections. Although there have been no reported outbreaks or epidemics recently, the teams maintain an emergency preparedness program in case of a cholera or malaria outbreak.
In Dili, MSF nurses carry out consultations at a transit center for returning refugees. Returnees who arrive in Baucau are provided similar services, including vaccinations for children and current information on the availability of services in the public health system.
MSF works with a team of 13 international and 80 national staff.