Multidisciplinary visit to Timor in August 2017

Programme development continues apace with remarkable progress in oncology services. The inpatient and outpatient chemotherapy infusion centres are fully functioning and the multi-disciplinary teams are active, involving surgeons, gynaecologists, physicians, nurses, allied health and pathology services. Histopathology and cytology is generally available for anatomical specimens in-house now although further testing is required for immunohistochemistry and tumour phenotyping. Acquisition of diagnostic lab panels for these will greatly enhance management options in the future.

Provision of radiotherapy was discussed with both the Governor, Parliamentary commission V and the local health administrations. There is support for development of this in NTT based in Kupang to augment cancer services in the region. Planning will get under way shortly.

GM met with a number of stakeholders in this and other programme areas including:

Obstetrics and neonatal care in Kupang has benefitted from the building of a new emergency maternal and neonatal department with inpatient beds, NICU and post-natal care available. There are some issues of identifying at risk pregnancies in the community and rapid transfer to Kupang. Post-partum haemorrhage, infection and neonatal asphyxia remain targets of intervention and resourcing.

The surgical department presented a number of challenging skin cancer problems requiring extensive reconstructive procedures. There is a problem with skin cancer in NTT especially, as with many cancers, with late presentations and thus more difficult surgical operations required to treat. In the future, we hope to be able to assist with up skilling in the area of reconstructive surgery in this context.

The medical school continues to go from strength to strength with their first 2 years of graduates in the hospital or community now.

Dr Nicholas (med school faculty) is undertaking a PhD programme through UGM in Jakarta and FUSA conjointly. He spent 3 months at Flinders recently and will return next year. Further collaboration with the Medical school is scheduled with 5 students allocated for our next visit to accompany the various teams during their time in Kupang. We also look forward to a PhD candidate from FUSA undertaking some research in Undana med school as an exemplar of establishing medical education in low resource settings.

Dermatology is now well served with several dermatologists working in the region.

The clinic in PJH is for tertiary referral cases and the district hospital services supply “front line” diagnostic and management expertise.

We congratulate Dr Ratna on the birth of her baby girl and look forward to welcoming her back to PJH in the near future.

PJH will appoint a new Director shortly. FOHG wishes to thank Dr Domminicus for his support, foresight and hard work in the public hospital setting. He will be missed.