Sally Johnson who, with Ben Kildea, is volunteering to provide health care in Maliana in Timor-Leste, describes the challenges and rewards of rural health projects.
The morning fog was so dense along the mountain road to the turn of at Nunutana that we were only able to see two metres in front of the car. After about 15 minutes of 4WDing along the track which winds around the side of the mountain we came to a spot where it was no longer safe to continue by car. It was pouring rain and we were not very prepared for wet weather. The nurse made a phone call and soon after a few villagers from nearby popped out of the bush and said they had come to help with the medicines. We packed what we needed for the SISCa (outreach clinic) as best we could and set of on the 6km hike. It started with a 1 km stretch straight down the hill. We followed the very old lady who was effortlessly managing the route while balancing the largest of the medicine boxes on her head. After a very slippery slope and the discovery that my thongs were not the ideal footwear for hiking – on steep hills, with mud – we reached Raiheu. During the walk the other members of the health team kept suggesting that next time “Senora could just wait in the car”. I’m not quite sure if this was for my benefit or for theirs.
In Raiheu we were joined by about 50 children (just finishing school) who followed us for the second half of the journey. The village which hosted the SISCa was as picturesque as any I have seen so far – thatched huts, ancient trees and panoramic views. I saw 7 pregnant women (with Silda helping to translate when I got stuck) to whom we were able to give nice long consultations – about 30 minutes each – covering as much education as seemed reasonable. They were mostly seeing a midwife for the first time. There were two breeches and a transverse position and one lady who was almost overdue (by her clinical signs and her guess at when she fell pregnant). I was able to discuss the care of these women with the nurse and explain to him what to do if any of them went into early labour or did not go into labour as the case may be (i.e. get them to hospital quickly). The women made lunch for us but we were pretty dehydrated by the time we got back to the car. I really struggled on the 1km assent right at the end. We learnt a few lessons about being prepared for all conditions and immediately stocked the car with water, dry biscuits, umbrellas and hats when we got home at 19:30. Tomorrow’s hike is 2km longer.
Ben is working long hours on site but his progress so far this year has been great. On days when Silda (the other member of our team) and I are not working in the community we plan for future activities – the health promotion radio program we produce each week or the health library we have developed for (and with) the health staff here in Maliana. The Radio Program is way more work than we ever envisaged but a pretty fun project to be involved in. Silda is the talent and it was her idea in the first place. I provide technical and advisory support with editing, logistics and planning. My editorial support is mostly just butchering good songs to provide background music.
The Rotary project we are working on is in its final year this year so there is also a lot of work to be done on responsibly and effectively handing over those elements of the project that the government will hopefully continue on, such as the ambulance and the library. This will be quite a challenge but we continue to have great support from Palms and Rotary. Generally I have been feeling the best I have ever felt about living in Timor and this project. January has been difficult and, as our Palms’ in-country coordinator continues to remind me, we haven’t yet cut down on our ridiculous work hours. I do feel however that we are heading in the right direction. It must seem like not much to people at home but I am constantly amazed that Ben and Silda and I have managed to come up with a program through real consultation with the community with potential to make a small but lasting differences to the attitudes and capacity of the staff and communities.
We have tried to put as much of the Palms philosophy as possible in to a situation which, when we found it this time last year, had not yet been able to achieve the level of relationships and understanding which allow a project to be effective and sustainable. I think my positive feelings have been in part just being more comfortable in my surroundings, in part having Ben around more often and in part because, for the first time, I feel we have a bit of control over what we are doing. Not much, mind you, but that little bit makes a lot of difference.