‘I have a huge number of oxygen cylinders but I don’t have any other equipment to go with them. That means the cylinders are unusable.’ This is how Scottish anaesthesiologist Dr Alan Thomson diagnoses his working conditions at the Oecussi hospital, a 12-hour boat ride west of East Timor’s capital, Dili.
The problem is caused by ‘dumping’ – donors who send inappropriate aid. East Timor’s underfunded healthcare system continues to rely heavily on international aid. But donors often give machinery that is inappropriate to the population, too expensive to operate, and requires either specially trained staff or additional technology not available.
Australian eye surgeon John Kearney – like his colleague Dr Thomson – is one of many overseas medical specialists who flies in two or three times a year to assist the East Timorese. ‘A lot of people think: “This is out of date, we’ll send it up to East Timor,”’ Dr Kearney says. As a consequence Dili National Hospital (just one of the hospitals he visits) receives products to treat cardiovascular disease and cancer: conditions that rarely affect the Timorese, who generally die of other things first.
In other cases, the donated equipment can be too modern. Years of oppressive rule has left much of the population uneducated and untrained for healthcare. This is one of the reasons why Dr Kearney has a storage closet filled with ‘beautiful’ equipment that cannot be used.
While unusable donations are likely to continue, so too is East Timor’s dependence on foreign aid. As the country celebrated its second birthday on 20 May, the UN drastically scaled down its presence, leaving the Government with a need to pour its limited resources into improving security and police, not healthcare.Lynnette Hoffman