I have been waiting to post to tell you about the good work that I have been doing: how many patients at the clinic, re-starting prenatal care and nutrition programs, and so on. I was worried that just describing our life in East Timor would not be enough, as we have been sent here on behalf of Global Ministries to work alongside our partners in IPTL.
In the four years that we have been gone from Lospalos, and since I have worked at Imanuel Clinic, the same staff have been carrying on, seeing patients every day, checking for malaria and TB. When I arrived in Lospalos in late July, patient numbers were about half of what they were in 2012, when we left, and the prenatal care and nutrition programs had ceased. There were only a couple TB patients being treated here. We had 27 in 2012. On top of this, the Uniting Church of Australia, who completely funds the clinic, was suggesting to reduce support for the clinic unless the work changed from providing direct patient care to a community health promotion model.
So the past three months have been a discernment period: discerning the role of the clinic for the church and for the local community; discerning the work of the clinic staff, discerning my work. Now, we have secured funding for another year, and are implementing some new programs. We have connected with a somewhat remote village where we are providing mobile clinic care, and hopefully will help them to improve sanitation in their area by providing funding for some new toilets. Only 9 of the 24 local families use a toilet, while the others still do their daily business in the nearby trees. This is commonplace in Timor, right along with diarrhea and intestinal worms, so we hope to have some lasting impact by helping in the sanitation department.
We have started documenting our clinical teaching moments during patient care visits at the clinic this month. We want to demonstrate that our clinical work is not simply doling out vitamins or antibiotics. We do provide these, yes. But we also spend substantial time teaching patients about nutrition, from breastfed babies to adults with anemia. We are teaching patients daily how to decrease the spread of infections through hand hygiene. Imagine your doctor telling you to wash your hands often when your child has diarrhea or a runny nose, when you don’t have running water in your house. Nor do you have a toilet. Hmm.
Paul Farmer and Dan Murphy would certainly agree that as far as health care in the still-developing world goes, prevention without basic health care services and treatment, or vice versa, is not enough: you need both. We are diving in to do our best here in Lospalos.