Acute shortage of doctors, medicine

Subject: Acute shortage of doctors, medicine

Oakleigh Monash/Spingvale Dandenong Leader (Australia)

November 19, 2003 Wednesday

DR IAN Woolley gently inquires after the health of female inpatients on the morning ward round.

Through translator and fellow doctor Milena Dos Santos he gives directions about medication, care and treatment.

Despite the familiar ward round routine, you could never mistake this scene for a morning shift in a Melbourne hospital.

For a start, the ward's stark emptiness stands out, bereft of anything except beds and stuffy heat.

Then there is the relative by each patient's bed, a cultural tradition where they unroll a mat and sleep on the ward floor next to the patient.

But the difference that jumps out most shockingly is the condition of some of the patients.

This is where East Timor's status as one of the world's poorest nations falls most sharply into focus.

Domingas Maia is in her 20s and has been in hospital for two weeks with tuberculosis.

The disease had spread from her lungs to her abdomen by the time she arrived at Dili National Hospital.

She weighs only 32kg and looks thinner than anyone I have ever seen.

But the doctors are happy with her progress and say she has put on six kilograms since she was admitted.

Meanwhile, 36-year-old Jacinta Soares has ovarian cancer.

Because of a late diagnosis and lack of treatment the disease has spread to her lymph nodes and she has a huge visible tumour in her neck.

Her condition is irreversible and the best doctors can do for her is give her a painkilling cocktail.

Between 20 and 25 per cent of inpatients are TB sufferers and 12 to 15 per cent have Hepatitis B.

Malaria and complications caused by malnutrition are the other major health scourges.

Dr Woolley, from East Melbourne, is on a two-month placement at the hospital, which has 236 beds.

The physician took unpaid leave from his job at Monash Medical Centre to take up the position.

He said limited medical tests and treatments meant the work could be extremely frustrating.

There is practically no chemotherapy and there is no cardiac surgery.

"It is confronting to see the number of young people with irreversible conditions who will die," he said.

In an interview with the Leader, hospital administrator Antonio Caleres Junior said East Timor's biggest health crisis was a doctor shortage.

There are only 12 East Timorese doctors at the national hospital, with no specialists and the country has no medical school.

The 12 are supplemented by five general physicians and 11 specialists from overseas.

He also appealed for help to send doctors from East Timor to Australia to train.