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Meeting the daunting health challenge in Timor-Leste, 23
June 2006
The big killers in Timor-Leste are post-natal illness and disease,
and the many infectious diseases related to poverty, and malaria,
tuberculosis, intestinal parasites, disease related to malnutrition
and poor water and sanitation. This health profile, characteristic
of very poor countries, has started to shift as the incidence
of degenerative diseases of the heart and kidneys starts to increase.
"We had our last epidemic of diarrhea in 2002, and an epidemic
of dengue fever in 2005," said Health Minister Dr Rui Maria
de Araújo. "Our highest priority in preventive health
is to reduce the death and illness rate in mothers and new-born
children. Our surveys indicate that only 40% of women giving birth
are attended by a midwife, but some surveys indicate it could
be as low as 25%. Even 40% is a very poor figure and we have a
major program to provide more midwives, a reproductive healthcare
program for a woman's entire child-bearing years, ante-natal and
post-natal care, and breastfeeding programs, more family planning
counseling, immunization, and integrated management of child illnesses,"
said the Minister.
HIV / Aids is a serious and growing problem in Timor-Leste, and
is being addressed by a national program developed under UNTAET
in 2002. This program focuses on education about the nature of
this disease and measures to prevent its spread, and this is strongly
supported by the church. "The risk factors for Aids exist
in Timor-Leste," said Minister Araújo. "There
are 30 identified cases of Aids, and already some people have
died from Aids-related diseases".
Anti-retroviral drugs are supplied free, like all medicines in
the public sector, and Timor-Leste receives these drugs through
a support program from Brazil and from USAID. Most of the HIV
/ Aids cases are treated by Dr Dan Murphy's clinic in Bairro Pité,
Dili, which is integrated into the public sector.
The public sector provides 80% of health services in Timor-Leste,
and the Catholic Church and the Clinic Café Timor program
provide most of the other 20%. The Ministry of Health provides
medicines and consumables to the church clinics, and in return
these clinics integrate with the District Health Management Teams
and account for the medicines they distribute.
Clinic Café Timor is a health program of the coffee cooperatives
which operate in Ermera, Aileu, Same and Ainaro. These cooperatives
receive support from USAID. As well there are some private General
Practice doctors in Dili and Baucau, as well as some private pharmacies.
While there have been some proposals for private hospitals, so
far none have been established.
The current National Health Policy Framework concludes in 2007,
and work is now underway to develop a new National Strategic Health
Plan for 2007-11. This includes sectoral strategic plans and associated
human resources plans. "Right now there is one doctor for
every 4,000 people in Timor-Leste, and we want to achieve one
doctor for every 1,000 people by 2015," said Minister Araújo.
"You do the calculations". The current population is
986,000 and with a population growth rate at 3.5% per year, Timor-Leste
will need 1,352 doctors in the year 2015 to meet the target. Today
Timor-Leste has 275 doctors.
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