After 7 weeks in the capitol, Dili, we moved out to our village, Lospalos.  It is 180 km (@120miles) from Dili, and takes 5 hours to drive, plus whatever stops you want to make.  LP is cooler, with less mosquitoes, few cars, virtually no internet access, and much more limited produce and packaged food available.  I would say, the season dictates the fruit availability out here, and bananas are pretty much it.  Also, eggs, tomatos, potatos, greens, of course, some carrots, peanuts, garlic onions chilis, rice, dried corn, beans.  In another month, it will be mango season, and perhaps others will come: papaya, pineapple, I hope.  

We are the only Malay (foreigners) in Lospalos, other than the UN police stationed out here, who are from all over: Africa, Bangladesh, Portugal.  They don’t speak the language, and do not interact with the locals, according to a conversation Tom had with one of them.  Our Tetum continues to improve (Tom is better than I am at speaking), and we have every intention of participating in the Timorese community as fully as we can, which means learning at least Tetum, probably more.

Hannah is learning Tetum quickly; it takes her about 5 minutes to make new friends. She has a new best friend in LP, Asiu, who is maybe 10, (I asked her how old she is, and she said she didn’t know, but agreed with me that she is around 10).  She is very smart, and very happy, and she and Hannah play dolls, play house, run around, and generally do what kids do.  Here in Timor, your neighbors’ kids come around about 8 in the morning, saying, “Hannah! Hannah!” Then Hannah is done eating her bread and jelly, and gets on shoes and races out the door to play. ……Sounds like the old days, doesn’t it?  No phone calls needed, you just show up, and see what’s up.  

The clinic is good.  Despite the fact that water may not be running to wash your hands, or that the electricity may not be on, patients are receiveing good care…..and ths is not my doing; I am here to participate, but the staff here are dedicated, committed, and do great work.  I started last Monday morning.  Patients start showing up around 7am, clinic opens a bit after 8am, when the staff are all arrived and ready.  Before seeeing patients, the staff stand in a circle, read ( in Bahasa Indonesia) a scripture passage, then share a prayer for the days’ work.  The clinic sees about 90 patients a day. The clinic director/sole trained nurse, Senhor Delfin, consults, and I consult with the assistance of Esther, who is a nurse with no schooling but years of clinical experience.  She is in charge of the DOTS TB program, so patients come in daily for their TB meds which she administers, and she also consulted along with Delfin before I arrived.  A lab technician collects malaria and TB samples.  The electricity last week was only on from 6pm till around midnite, so the staff would actually come back in the evening to process the labs.  Lots of malaria, even though it is the dry season, still.  Anyway, over the weekend, someone brought the part to fix the broken generator, so maybe the generator will be running during clinic hours now.  What are clinic hours? About 8am till the work is done, which is maybe 1 or 2 or 3.  That is when the patients are all seen, and the paperwork is done, the charting complete, meds restocked.  As I am new, I expect that, like Delfin, my work won’t really ever be all the way done in a few months, once I am more integrated, and more fluent.  There is just too much to be done.  I have yet to meet the Lospalos hospital Cuban doctors and Timorese staff.  Also, there are lots of NGOs in LP doing health related work, and I have not yet met them, either.  

There is not currently a maternity program at the clinic.  Few pregnant woe=men come in, but for other reasons than pregnancy: a sick child, back pain.  I am checking Blood pressures and speaking with them about follow up care, and they seem receptive, so I will continue to slowly , or quickly, begin the process of getting a system going again here. I believe the only option for care is thru the local hospital.  Most women stay home, unattended, because midwives from the hospital don’t go to peoples’ homes, I am told.  Thus, there needs to be care for women not in teh hospital system.  If the clinic could become another birth center in town, that would be great.  The closest C section is a 2+ hour drive down a bumpy, curvy road.  Makes the drive between Grand Marais and Duluth in an ambulance seem reasonable.  This is in Baucau, the 2nd biggest city in Timor, and a Kenyan surgeon with a good reputation is always there.  Of course, communication between LP and Baucau hospital is a big question mark, so how quickly an emergency could be addressed is another question.  

In Timor, there is a relatively new system with air transport, Mission Aviation Timor, or somethnng like that.  A missionary from Australia will fly rescue flights from whereever there is a prepared runway (LP has one, in the last year), to Dili National Hospital, or Baucau Hospital, the only 2 hospitals in the country with major trauma or surgical services (except for the military, and UN, of course, but those are essentially unavailable for common people).  LP is not using the service much, but I will find out the situation, as I know this will be essential for some maternity and other situations.  In the developing world, there is so much more to health care than just having a nurse or a doctor nearby.  Issues of transportation, of water, sanitation and nutrition, of language barrriers, of trust in the system, and of competency in every singly area are so critical.  Things one takes for granted in USA, Europe Australia, seem like luxury here.  Makes a world of difference.  And, Makes my work interesting, challenging, and requires grassroots investment to make lasting impacts.   

Lovin’ every minute of it, Mon