Primary health care is the top priority for Bairo Pite Clinic (BPC), the most visited health clinic in East Timor (Timor-Leste). Established after the civil disturbance in 1999, they are situated in the Bairo Pite part of the capital, Dili, patients coming from all parts of city, as well as from the surrounding sub-districts.
Services include maternity and infant care (with delivery and vaccinations); diagnosis and treatment of tuberculosis (TB), malaria, dengue fever and HIV; in-patient services, dental services, health outreach (mobile clinics), and training for local health care workers. They operate a medical laboratory, pharmacy, kitchen and laundry, and have a water supply system and a power generator to supplement unreliable local supplies.
During 2009 the clinic received more than 16,000 patients per month, almost 200,000 patients through the year, many with TB, malaria or HIV. The lab performed monthly almost 2000 tests. The midwives received about 600 pre-natal visits, attended 100 births and immunised 1600 children per month. Dental care was given to 300 patients and 200 were seen for emergency services, both monthly. 30 patients received ARV treatment.
Built and funded entirely by contributions, and aided at times by governmental and non-governmental organisations, BPC is a success story of foreign assistance. However, due to the global economic downturn, as well as other troubled regions replacing East Timor in the media, funding streams for projects like BPC have been drying up, which has the Director, Dr Dan Murphy worried. He runs the clinic on a shoestring budget, with a staff including nurses, midwives, lab technicians, administrative staff, and volunteers. In order to ensure the operations, the clinic works hard to increase available funding. BPC provide community health care for the poorest of the poor, and to do that, services and treatment need to be free…
Established to serve the immediate needs of a population affected by a humanitarian crises, the clinic is transitioning from a crises-oriented to a more sustainable and long-term oriented clinic, functioning within the national health care system.
Dr Dan and Bairo Pite Clinic envisage a better future: a village-level network of volunteer health workers, where each community has a representative actively working through a national programme. BPC want to go to the countryside to listen to the people, to learn what they see as their health problems, and to discuss how the people can address these problems using local resources as much as possible. The clinic will be a facilitator of this process, a referral source and training site for the village health worker. Preventative, rather than curative strategies are at the centre. Local involvement and empowerment is the key. A national network of local health advocates emerging, village women the number one health resource, exhibiting concern for health in the community. People choose and support their own local health representative, who would then learn and become the link to the system. The same principles apply in the cities. Neighbourhood groups organise around health care issues, choose a worker, and join the network.
This future already started, based on a cooperation with the Japanese organisation Frontline. Dr Aida Goncalves manages a project training and following up village health workers and community midwives, as well as through mobile clinics to project areas. This initiative is the most promising I’ve seen within the health sector, and has a significant impact for the poor.
In my opinion, Dr Dan and Dr Aida are heroes, no less.
Basil Rolandsen of Bouvet Foundation assisted Bairo Pite Clinic between 2010–12 with developing and maintaining a new web site (later replaced), social media presence, documentary photo and video, and podcasts. He also supported the Director providing advice regarding management, project development, and more.