Overview
Primary health care is the top priority for Bairo Pite Clinic. With an average of 539 patients each day (2009), it is the most visited health clinic in the country.
Patients waiting for consultation. Photo © Basil Rolandsen (bouvetmedia.com)Services provided by BPC include maternity and infant care including delivery and vaccinations; diagnosis and treatment of tuberculosis (TB), malaria, dengue fever and HIV; in-patient services, dental services, health outreach (mobile clinics), and training for local health care workers.
The clinic operates a medical laboratory, pharmacy, kitchen and laundry. It has a water supply system and a power generator to supplement unreliable local supplies.
During 2009 the clinic on average per month received 16,392 patients, a total of 196,707 patients through the year. Of these, each month 83 was diagnosed with TB, and 159 with malaria. The lab performed monthly 300 TB, 757 malaria and 178 HIV tests; a total of 2,058 analysis per month. The midwives received 587 pre-natal visits, attended 96 births and immunised 1,632 children per month. Dental care was given to 305 patients and 206 were seen for emergency services, both monthly. 30 patients received ARV treatment in 2009.
Patients come from all parts of the capital, Dili, as well as from the surrounding sub-districts. The population of Dili was counted to 168,000 inhabitants July 2004, an increase of 40% since the 2001 count, indicating that the need for the services of the clinic will be at the present level or increasing in the years to come. The national hospital in Dili has discontinued their outpatient services in order to be a reference hospital only, a move which has increased the patient load for the city outpatient clinics, including the BPC.
Built and funded entirely by contributions, and aided at times by governmental and non- governmental organizations, BPC is a success story of foreign assistance. But due to the global economic downturn as well as other troubled regions replace East Timor in the media, funding streams for projects like the BPC are drying up, which has the Director, Dr Dan Murphy worried. He runs the clinic on USD 17,000 per month with a staff of 63 East Timorese, including nurses, midwives, lab technicians, administrative staff and 12 volunteers. In order to ensure the operations, it is necessary for the clinic to increase available funding.
The BPC envisages a village-level network of volunteer health workers, where each community has a representative actively working through a national program. The clinic plans to go to the countryside to listen to the people, to learn what they see as their health problems, and to discuss how the people can address these problems using local resources as much as possible. The clinic will be a facilitator of this process, a referral source and training site for the village health worker. Preventative, rather than curative strategies are at the centre. Local involvement and empowerment is the key. A national network of local health advocates could be emerging, village women being the number one health resource, exhibiting concern for health in the community. People would choose and support their own local health representative, who would then learn and become the link to the system. The same principles could apply in the cities. Neighbourhood groups could organize around health care issues, choose a worker, and join the network.
Established to serve the immediate needs of a population affected by a humanitarian crises, the clinic is transitioning from a crises-oriented to a more sustainable and long-term oriented clinic, functioning within the national health care system. Planned strengthening of services requires an expansion of the physical infrastructure. Lack of space for an expansion, combined with problems related to the ownership of the present location of the clinic, requires it to relocate.