Kakrui

13/3/2008

I'm pooped. 3-hour climb to the Kakrui hills south of Vatunau this morning. Visiting homes with our volunteer Community Health Educators, five girls and one guy who've attended weekly health workshops for the last two years, and helped me run the clinic for these past five months.
We meet 6 am. Posters, flipcharts, stethoscope, a few meds. As usual, I'm the only dude geared up in boots, backpack and bottle of water. Our CHEs would bounce up Everest in their slippers and pyjamas.

The three-hour trek takes us along the river bed,

through the jungle path



and up the hills

A major adventure for me, but I'm episodically greeted by giggling kids heading the other way, daily walk to school. We arrive at the Kakrui cluster of houses, welcomed with smiles and cassava.

Brunch is followed by the main business of visiting homes. The CHEs teach basic health: nutrition, hygiene, mosquito avoidance, home treatment of children's diarrhea...

The main health problems here are still best addressed through simple education on prevention and improving living conditions. I count the time spent training and supervising our CHEs as my real legacy here in Timor - these guys will remain on the frontlines of the war against disease long after my Panadols are forgotten.

-raj

Penitence

20/3/2008

I've just returned from a 5-day trip to several villages in Los Palos on the eastern tip of Timor, to visit the resident missionaries, conduct community health talks and deworm children.

Gut worms are universal in rural Timor, mainly due to poor sanitation. When one infected child defecates behind a bush, rain and groundwater flow eventually carry the worms to the community’s well – everybody’s drinking water.
The government school health programme includes mass-deworming, but many places have yet to climb on board. So our plan was to carpetbomb our villages’ 2-5-year-olds with deworming meds.

Easier said than done.
Generations of threats from bulging-eyed mothers has left Timorese children with a deep confidence that if you’re naughty, the Evil Foreigners will kidnap you, and – depending on the creativity of your mother – beat/imprison/eat you, feed you vegetables, turn you into a goat or give you injections.
Predictably, being lined up to receive deworming medicine at our hands created much holy terror.
Some children gave wary assent:

Many went ballistic:

And this guy:

survived the ordeal with deworming meds everywhere except down his throat.
Exhausting. For all involved.

But rewarding. I’m told that entire villages are now abuzz about whose kid has passed out the most worms.
Let’s just hope it wasn't behind another bush.

-raj

Deficit

18/3/2008

I'm crunching statistics from the clinic records, in this last leg of my term here in Timor. An alarming 40% of the children I’ve treated are growth retarded.

Due to starvation.
Not the hollow-eyed skin-and-bones frank hunger that's familiar from TV images of '90s Ethiopia; but an insiduous, chronic lack of protein and energy foods that manifests itself in frequent illnesses and poor growth. The resulting physical and mental deficits are significant, and permanent.
Malnutrition here is rare in infants until about a year of age – when they’re abruptly displaced from the breast by a new arrival.

[Vexation]

The staples, cassava and corn, are both mostly fibre and water. So toddlers may fill their stomachs three times a day and still effectively starve.

[Breakfast/lunch/dinner: cassava, salt and chilli]

Concerned mothers stream to the clinic seeking ‘vitamins’ to fix their skinny kids, which I steadfastly refuse to dispense. The solution is upping the energy content of their meals. I’m on a campaign to encourage mothers to include a tablespoon of cooking oil in every meal.
Awkward. It’s exactly what I wouldn’t be advising back in childhood-obesity-smitten Singapore.

-raj

Ainaro district, in 10 photographs

11/3/2008

Timor is gorgeous.
I've just returned from a 5-day foray into villages in the central mountain region, running mobile clinics with a team from Singapore's CEFC.

Sunrise

Girl

Backside

Flowers

Daggers

Routine

Inn

Hut

Precarious

Aftermath

-raj

Steady As She Goes

14/2/2008

Things are better.
We're still wound tight. But Timor has been remarkably - almost supiciously - peaceful.
Regular updates on the radio (they've ditched the "remain calm" guy) and SMSed news clippings from friends in Singapore have made the story clearer.

From CNN.com:
[[DILI, East Timor (AP) -- East Timor declared a state of emergency Tuesday... assassination attempt Monday against President Jose Ramos-Horta and the failed attack on Prime Minister Xanana Gusmao.
The country's top fugitive, Alfredo Reinado, and one of his men were killed in the attack on the president. One of the president's guards also died.
...international soldiers and police patrolled the streets of the capital, Dili, where many shops and businesses were closed. There were no immediate reports of unrest.
Reinado was among 600 mutinous soldiers dismissed by the government in 2006 -- a move that triggered gunbattles between security forces that later spilled over into gang fighting and ethnic unrest.
At least 37 people were killed and more than 150,000 people forced from their homes in the unrest, which also led to the resignation of the country's first post-independence prime minister.
Reinado was arrested but escaped from prison after several months.
He was charged with murder in connection with the 2006 violence, but had remained in hiding and had threatened armed insurrection against the government.
The streets of Dili were calm after the attacks, and Gusmao said an overnight curfew was in place. The United Nations, which controls security in the country, said checkpoints had been set up on main roads.]]

I had to squeak through two checkpoints, getting to Dili today.
Just outside laid-back Liquica, it's all smiles, backslapping and "how-ya'-doin". But Dili's fortified checkpoint greets me with the less-than-neighbourly barrel of an M-60.
The Portuguese UN troops immediately single me out for interrogation - the only foreigner, and a bestubbled one with a fancy laptop computer at that. The furrowed eyebrows, unslung rifles and clipped tones quickly dissipate, however, upon a shameless flourish of my stethoscope. Ah, a medic! I'm merrily planted back on my truck with fresh smiles. And another backslap.

Timor's not out of the deep waters yet, but the crisis appears to be over. We're drifting back toward normality.

- raj

Crisis

11/2/2008

Timor is in crisis. Attempted assassination of the president and the prime minister in the capital Dili this morning.
At least three dead, several wounded. Prime minister has been evacuated to Darwin with bullet wounds. Curfew declared in the late afternoon, we're expecting state of emergency soon.

I found out en route to Dili.
Vehicles being turned away by a new military checkpoint just outside the city. Tension rising among the dozen passengers stuffed into the back of the minivan with me. Ominous snippets filtering to us from shouted warnings of drivers heading the other way: gunfights in the streets, dozens killed, mobs and looting. The women start crying.
Word of violence rapidly puts Timorese on edge - they've been through this too many times. The last outbreak in 2006 saw running gunbattles between the police and mutinous soldiers in Dili's streets, turning into inter-ethnic violence leaving 40 dead and 150,000 in refugee camps.
Our minivan turned back.

Home now.
No electricity, so no TV. The surviving cellphones only do incoming. The radio plays patriotic anthems, punctuated by a grating appeal to 'remain calm'.
Passports, cash and laptops sit in our backpacks, should we need to evacuate (to where?). Yudha gets the golf club, I sleep with the machete. I tell myself that we are fairly safe in Vatunau - agitation rarely reaches this far out into the sticks.

But we legitimately worry for the dozen or so missionaries and friends in Dili.
We worry for Timor. We know maddeningly little about the state of the nation right now, beyond the end of our street. We're sitting on a tinderbox, we don't know if the fuse is alight.
The uncertainty is bewildering.

Back In Timor

5/2/2008

Back after 10 days in Singapore/Batam. Feels like I've returned home.

Top 5 things I've missed in Singapore:
1. Hot showers
2. Cold coffee
3.
4.
5.

Well... can't think of much else, really.

- raj