Outreach

The recent Health Care Seeking Behaviour Study concludes that the “health status in East Timor is poor”. Furthermore that “long distances to health facilities discourage attendance, in particular for non-urgent conditions, but also for severe conditions”.

With three-quarters of the population living in rural areas, access to health care is indeed one of the country's biggest health problems. Bairo Pite Clinic see the solution in popular participation, giving grassroots groups a central role in planning and administration of health services.

Photo © Basil Rolandsen (bouvetmedia.com)Our short-term response to the poor access to health care in isolated villages, is mobile clinics combined with training of community midwives.

Bairo Pite Clinic, supported by the Japanese NGO Frontline, conducts more than 400 mobile clinics per year. 11 villages are visited at least monthly (some places weekly), and clinic staff in co-operation with local health workers (often lay midwives trained at the clinic) perform consultations (15,000 per year), TB follow-up and health promotion. We get requests for more mobile clinics, but are limited by available resources, as most visits include substantial travel in rough conditions.

The community (lay) midwives are chosen from the forgotten regions of this grossly underdeveloped nation. The training is conducted at the clinic, and the programme then equips them and continues to support their work through periodic on-sight visits. Empowering women and reducing the terrible toll of maternal morbidity and child mortality that plagues Timor Loro Sae, is the goal of this ambitious programme, which has been well received.

While we are trying to improve the conditions for rural people through use of mobile clinics, we realise a more holistic approach is needed. To meet this important challenge, we want to develop a village health worker project, inspired by Paulo Freire (“Pedagogy of the Oppressed”) and David Warner (“Where There is No Doctor”). Aiming at the poorest of the poor, we will, in cooperation with lay midwives (trained by us) and other women, organise a process to be lead by elected health monitors. We will facilitate and bring our knowledge and experience, but utilise local resources whenever possible. The goal is empowerment of grassroots populations, eventually enabling them to address their own problems.