One thing I didn’t know about the Timorese is some of them really like to party, they party hard and they party long. They party to celebrate anniversaries of dead ancestors, religious milestones, school events, anniversaries of freedom from oppressors (they have a couple of those), and you know, New Years Eve and Christmas. What some don’t seem to be great at celebrating, is the living. The living child, the living person, the living animal. This is a bit harsh because these are the friendliest nicest, gentlest people I have known, and they are desperately poor, but the day I had today unveiled a side to these people that makes me feel like, that in telling it, I will become a traitor to the hospitality they have shown me.
The day began early not because of choice. You see they have these festivals here and despite having no power to the village they manage to pump out music at a volume a stadium would be envious of. Not everyone attends the festivals but everyone knows about it. The first night it happened the village were having a school festival and they kindly came and invited us, but we were too tired, we could hear the music quite loudly and Lucinda warned it could go all night, and it did. But that night, it was, in Australian terms, about the space of ten houses away, so I slept OK. But last night the festival was rather closer by and the music was so loud we were even having trouble hearing each other talk, and it was hot, so sleep was almost impossible. The music went from about 4pm until 7am, and through the night revellers were going past the house making a point of screaming and cheering. The music actually seemed to get louder, and it was awfulI. I got little sleep, Lucinda got less.
But still, life goes on, I got out of bed and finally gave up the attempt to sleep about 4:30 am and Lucinda and I commiserated over the lack of sleep. I made breakfast, we ate and I had a shower. We had planned to go and see the clinic early, but by 9am Lucinda can see that can see it is not open. When I came out of the shower I could hear a baby crying and Lucinda and Alina were busy making phone calls. It was the same baby from a few days ago, about 20 months old, so really a toddler but he is very small. He is running a temperature of 38 degrees, clearly listless, you can hear an infection in his cough, his swollen belly poking out from his shirt is making him look like a World Vision add, Lucinda also notes his swollen ankles and he has been up in the mountains. She thought there was a possibility he may have malaria.
This child should be at the clinic because it is suppose to open 9-5 Monday-Friday. This doesn’t always happen, and the mother of the sick child even went to the government nurses house to try to raise her but was unable to. The mother told us the nurse had been at the festival. Accountability processes for these nurses are almost non existent and I can see it is making my sweet natured calm friend hot under the collar. Lucinda and Alina are trying to get hold of the clinic doctor (Dr Nicho) by phone. Dr Nicho of course would not have been at the festival, but may be off on calls or at a conference. There are currently many good programs underway to asses and improve the healthcare in East Timor, and doctors are expected to attend various meetings and conferences. Dr Nicho is a young Dili trained man, who is very professional and comes to live in the village Monday to Friday. This morning, we find, he is in Same attempting to collect his monthly wages. Wages in this part of the country can’t go into bank accounts because there are no banks here to get the money out of. So people line up to collect their wages on a particular day. It’s not as if doctors earn enough in East Timor not to worry about it either, they and their family very much depend on their monthly wage. Nicho relies on the staff to open the clinic when he is not there, but there doesn’t seem be the same kind of accountability systems here. I am sure everyday in Australia there are people who don’t turn up to work after a rough night. But if lives depend on a clinic being open and it doesn’t open because responsible people are at a party, and a dying child is unable to access care, then that is considered gross misconduct. But here, no questions are asked, no accountability processes are triggered, people just accept after a night of partying the clinic may not open unless the doctor is there, and then you go to the foreign Nurse’s house because she doesn’t attend the festivals. Lucinda doesn’t have a hero complex, she is working toward a time when she won’t be needed in the village and the people can take over her work here, but that day is not today. This child is at her door because the government, the economy and his community have failed to provide him access to medical care. This happens less frequently now with the Government clinic in Weberek and our focus as an organisation is more toward the wider work in Timor but there is a way to go.
After speaking to Nicho and the doctor in Wedauberek (the next closest clinic), it is clear we needed to go to Wedauberek, here there are several doctors and better facilities, an ambulance, and they can do an official assessment and provide a referral. We decide to take our car because it is air conditioned and Lucindas car is not, it is at least 40 degrees and the child is feverish. Wedauberek is about 20 km and with the state of the roads here, that takes about 45 minutes. As we leave the house there is a large group of people gathering outside the gate. Some of them are the family of the boy and they want Lucinda to know that although she can take the child and the parents to the doctor, they do not give permission for the child to be admitted to hospital because they can’t afford for the family to be away from home. The hospital will only feed the child and one parent, not the other. So they need cash to feed themselves while away. But the child is dying and Lucinda is in no mood to negotiate with a community, some of whom, have kept her up all night. She doesn’t bother explaining this to them, she tells them simply that these matters are up to the doctor. If the child does die of course, animals will have to be sold to pay for an elaborate funeral, involving, you guessed it, a festival. Selling an animal to save the child is clearly not being discussed. I am not here to judge just observing contradictions in another culture, as my own also has many.
We drive to the Wedauberek clinic which is a modern facility over about four buildings with about five underpaid doctors on staff at any one time, but with virtually no facilities. The doctors are however all on lunch when we arrive and we are instructed to sit down and wait. Lucinda is not having it, she marches over to the doctors quarters where some live and have lunch and finds a doctor. The doctor is a lovely man, and very keen to help. As I walk through I start to feel angry. Angry at a country who can build all these buildings and fail to connect services to them (The maternity ward at Wedauberek didn’t even have water until we received a donation from Rotary). Just angry that nothing worked, that things just went so slowly here and that nothing seemed to go to plan. That some people party all night without restraint or consideration for the wider needs of the community. Just angry. So then I sit outside while the child is examined and IV fluids drip are put in. And the baby really starts to object, he is really distressed and howling with his tired and infected lungs. Saying some word over and over that I don’t understand and in my tired exhaustion I imagine him objecting to the country that gave birth to him, crying that he is malnourished, crying that he has an infected chest, crying that some big scary bloke was sticking a pin in him, and I think that the dam of tears that have been welling up in me, may just burst any minute. I really want a good cry. Then I see his mother and I know I will not cry in front of her.
So the child is now on IV fluids but needs antibiotics and needs whatever treatment you need for malnutrition and possibly worms, but that can’t happen here, he needs to go to Same Hospital (about two hours away). However the ambulance is in Dili having its seats repaired, and of course there is no replacement. When you drive around Dili you see dozens of brand new Prado’s with “government car” (in Portuguese) written on them but they can’t provide a replacement ambulance for a community stretching hundreds of kilometres. One of those nice shiny Prados would even do the trick because there are no paramedics out here, the guys that drive the ambulances are no different from bus drivers, they have no medical training. So we become the ambulance for the two hour drive. The doctor hangs the IV to the handle on the roof and off we go again. On the way I nod off to sleep, I am exhausted and glad I am not driving. Lucinda will use this example to approach the chief about some noise restrictions for the village.
Same hospital is not really what we would term a hospital. It looks unkept and worn out from western eyes but I concentrate on the staff, who are friendly and professional. While the child is being admitted Lucinda encourages me to take photos. We are taking pictures for the website and Facebook to raise awareness. But I fell like I am making a spectacle of these people’s pain and poverty. I can’t bear to take another picture. I flashback to an emergency medical situation with my own baby many years ago, and I remember a team of doctors, nurses, bright examination lights, a private paediatrician, blood tests, urine tests, faeces tests, talk of cultures and results and labs and a colourful room with a cot and a bed for me and I remember worried faces and tears and a heavy, heavy painful burden in my chest, a lump in my throat and a sick pain in my stomach that I would wish on no one. And I look at this child and know God values him the same as my precious girl, but the contrast in care is becoming too much for me. So I go and sit in the wait area and listen to someone vomit. When Lucinda comes out I am ready to run, not walk, out of the hospital. She has given the family $40 from the church offerings from Australia so they can get some food while the child is in hospital and pay for transport home. An offering from the living to celebrate the living. Thank you for your donations, they matter to these people.