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Sunday Herald Sun (Melbourne, Australia)

November 14, 2004 Sunday

Victoria's gift of sight to Timorese

BYLINE: ELLEN WHINNETT

A TEAM of Victorian volunteers has returned from a ground-breaking medical mission in the remote East Timorese enclave of Oecussi.

The team of doctors, optometrists and a nurse was part of a group of Australian volunteers that has been working for four years to give the gift of sight back to the people of poverty-stricken East Timor.

It was the first major surgical outreach program to be held in Oecussi, which is 14 hours journey by ferry from the capital Dili and is encircled by its neighbour West Timor.

David McKnight, of Ballarat and Mark Ellis, of Kew, are ophthalmologists, specialised eye doctors who spent a week in Oecussi after being airlifted into the enclave by the United Nations.

They were joined by nurse Madeleine Whiting, of Balwyn, and optometrists Peter Lewis, of Mt Waverley, and Christopher Dean, of Moe.

Along with three Tasmanian volunteers, they performed 77 surgical procedures, mainly cataract removals.

In the same week, they examined 500 people in a clinic run from a courtyard at the Oecussi Regional Hospital, prescribing 400 pairs of glasses.

The program, sponsored by AusAID and the Royal Australasian College of Surgeons, focuses mainly on providing cataract surgery, removing the protein growths that can rob a person of their sight and take away their ability to cook, farm, fish and live independently.

The hospital is crumbling, but clean, with dogs sleeping in its wide corridors and its dedicated staff working with basic medical equipment.

There is no hot water and only intermittent electricity. Instruments are sterilised in a pressure cooker heated over a flame.

Outside, about 300 people are waiting when the eye team arrives in the back of the UN ute, squatting under the giant banyan trees as water buffaloes meander past.

McKnight has been to East Timor before, but is still shocked by the scenes of poverty and illness he encounters in Oecussi.

"I just saw a pair of twins, blind since birth," he says. "They were boys aged 10 years."

The boys' parents had brought them to the clinic, hoping the Australian doctors could do something for their sons.

"They have six children and there is nothing we can do for these two, they've got a retinal abnormality," McKnight says.

"They're under the care of their parents and they looked healthy enough, but the likelihood of them dying young is high because they can't look after themselves."

McKnight says eye heath in East Timor is in a poor state because of a lack of facilities.

"They have everything we have -- cataracts, glaucoma -- but in a much more developed way because of a lack of regular attention," he says.

'THEY'VE got cataracts that are so developed we're treating blindness rather than vision impairment. We're not treating them to keep them driving, we're treating them so they can see their dinner on a plate."

The optometrists screen the patients, working barefoot in the 30-plus temperatures, dripping with sweat as the humidity hovers in the 90s.

Inside the hospital, Ellis is working on cataract removals in the surgery, where two beds have been jammed into a tiny room.

The IV stand is a rusty pole cemented into a fruit tin. There is no door, as termites have eaten away the frame.

But the portable microscope attached to the bed is working, after the nuns prayed for the one major generator in Oecussi to be operational to help the Australian doctors perform their 20-minute miracles.

Ellis has worked in the Third World before, but is touched by the way the Timorese respond to the Australian volunteers.

"One of the orphans changed into a clean T-shirt to come down to the hospital," he says after a visit to an orphanage in the outskirts of the Oecussi capital, Pante Macassar.

"The optometrists are doing the screening and they are seeing a lot of refractive errors. We had a large number of teachers come and they all needed glasses. The strength they needed showed they couldn't read for nuts, and if they can't read they can't teach."

Ellis said the number of young Timorese residents in Oecussi vastly outnumbered the elderly.

"The old people were either too afraid to come out to us, or they had been killed," he said.

Since its hard-fought independence from Indonesia in 1999, East Timor has had to build its health system from the ground up.

The country's budget is $100 million, and in a population of 850,000, two out of every five people live on less than $1 a day.

In Oecussi, there is no opportunity for the 48,000 residents to receive specialist eye care, and many of those who visited the Australian medical mission had been blind for years from cataracts.

The UN provided a Dash-7 aircraft to take the Australian team and its 850kg of equipment and medical supplies to Oecussi. The first landing point for the Portuguese when they settled East Timor 500 years ago, Oecussi has gradually become marginalised from the capital Dili, and bore the brunt of the militia violence in 1999.

Pante Macassar faces the Ombai Strait, and is home to about 10,000 people, many of whom survived the violence only after fleeing to the mountains and hiding for months, surviving on a bowl of rice a day.

* To make a tax-deductible donation, please send a cheque to the Royal Australasian College of Surgeons, College of Surgeons Gardens, Spring St, Melbourne, 3000, and mark it to the attention of the East Timor Eye Program.