Timor-Leste Training Program
Background
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Timor-Leste, a developing nation with a population of 1.2 million, is located 450km north-west of Darwin. Despite being so close to Australia, its health outcomes are relatively poor. Infant mortality, while improving, remains at high levels: 57 children per 1000 live-births die by the age of 5 years, 5 times the World Health Organisation (WHO) European Region rate of 11 per 1000 live-births, and well above the global average of 43 per 1000 live births.
Malaria rates have declined by over 90% in the past decade, due to a concerted effort by the Ministry of Health in conjunction with the WHO. Hepatitis B is common in Timor-Leste. A recent study revealed a HepBSAg positivity rate of 2.8% of 755 women who attended the Bairo Pite Clinic in Dili for antenatal and post-natal care. Hepatitis B treatment and vaccination programs are being developed. |
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Partnership with Hospital Nacional Guido Valadares
Ms Megan Brewer (Australian Embassy), Dr Chris Kiely, Dr Zeto (Director General HNGV), Dr Celia Santos (HNGV) at the MoU signing
Hospital Nacional Guido Valadares (HNGV) is the largest hospital in the country, located within the nation's capital, Dili. It consists of 250 beds, with inpatient services across general medicine (80 beds), general surgery (80 beds), paediatrics, obstetrics and emergency. The busy emergency department sees approximately 150 patients daily. 21 patients presented with gastrointestinal bleeding in April 2016. Patients are also admitted for elective procedures through outpatient clinics, and are referred to tertiary level health-care facilities from the districts of Timor-Leste.
Following the arrival of Australian-trained gastroenterologist Chris Kiely in Dili in early 2016, and HNGV's agreement to establish a gastroenterology unit, ANZGITA Director Di Jones visited in August 2016 to train nurses and assess the unit’s capabilities and potential for assistance in moving towards a self-sustaining endoscopy unit over the coming years.
After a plan of engagement was approved by the ANZGITA Board and HNGV, two training programs were held in 2017. Chris took on the additional responsibility of program leader on behalf of ANZGITA. A Memorandum of Understanding (MoU), approved by the Ministry of Health, was signed with HNGV in 2017, cementing a continuing partnership between our organisations. In 2017, 950 gastroscopies and 200 colonoscopies were performed.
Following the arrival of Australian-trained gastroenterologist Chris Kiely in Dili in early 2016, and HNGV's agreement to establish a gastroenterology unit, ANZGITA Director Di Jones visited in August 2016 to train nurses and assess the unit’s capabilities and potential for assistance in moving towards a self-sustaining endoscopy unit over the coming years.
After a plan of engagement was approved by the ANZGITA Board and HNGV, two training programs were held in 2017. Chris took on the additional responsibility of program leader on behalf of ANZGITA. A Memorandum of Understanding (MoU), approved by the Ministry of Health, was signed with HNGV in 2017, cementing a continuing partnership between our organisations. In 2017, 950 gastroscopies and 200 colonoscopies were performed.
Australia Awards Fellowship awarded to Dr Celia Santos, Timor-Leste
Hosted by Canberra Hospital, Dr Celia Santos completed her three month Australia Awards Fellowship of intensive training in endoscopy. She is pictured below (centre picture) with GE Unit Director Vipul Aggarwal and GEU Nurse Manager Sharon Chambers. The Awards are Australian Government (DFAT) funded and are competitively sought, so we were pleased to be able to build a strong case for her fellowship. Celia is the Head of Department of Internal Medicine at Hospital Nacional Guido Valadares (HNGV) in Dili, the Timor-Leste capital.
Celia also worked at Calvary Hospital in Canberra and attended AGW2018 in Brisbane before returning to Canberra to finish her fellowship in late September. The Australia Awards grant also funded a visit by an ANZGITA doctor and nurse to Dili to help her implement her learnings in her home unit. We are very thankful to Canberra and Calvary Hospitals for agreeing to engage Celia over the three months of her fellowship and to ACT Health for their assistance. Tony Clarke and Chris Kiely (Timor-Leste Program Leader) are providing ANZGITA support. The picture on the right is the HNGV endoscopy team in 2017 with Chris on the far right.
Celia also worked at Calvary Hospital in Canberra and attended AGW2018 in Brisbane before returning to Canberra to finish her fellowship in late September. The Australia Awards grant also funded a visit by an ANZGITA doctor and nurse to Dili to help her implement her learnings in her home unit. We are very thankful to Canberra and Calvary Hospitals for agreeing to engage Celia over the three months of her fellowship and to ACT Health for their assistance. Tony Clarke and Chris Kiely (Timor-Leste Program Leader) are providing ANZGITA support. The picture on the right is the HNGV endoscopy team in 2017 with Chris on the far right.
Two training programs were held in 2018 - one in April and another in October.
In September 2018, the semi-automatic endoscope reprocessing system (pictured below) was installed at Hospital Nacional Guido Valadares (HNGV) in Dili, the capital of Timor-Leste. It was the culmination of over two year’s work by Dianne Jones, supported by others, to specify and source a system best suited to a developing country's conditions. The system enables the learning of best-practice skills and procedures for reprocessing during intensive training sessions by visiting ANZGITA teams and, most importantly, supports endoscopy practice which is free from equipment cross infection. Cantel Australia supplied and installed the system using equipment from a Chinese supplier, and committed to a multi-year support arrangement. The project was funded through a generous donation by the Ainsworth Foundation.
In September 2018, the semi-automatic endoscope reprocessing system (pictured below) was installed at Hospital Nacional Guido Valadares (HNGV) in Dili, the capital of Timor-Leste. It was the culmination of over two year’s work by Dianne Jones, supported by others, to specify and source a system best suited to a developing country's conditions. The system enables the learning of best-practice skills and procedures for reprocessing during intensive training sessions by visiting ANZGITA teams and, most importantly, supports endoscopy practice which is free from equipment cross infection. Cantel Australia supplied and installed the system using equipment from a Chinese supplier, and committed to a multi-year support arrangement. The project was funded through a generous donation by the Ainsworth Foundation.
In October, another system will be installed in Honiara at the National Referral Hospital.
The system is a fit-for-purpose training facility at NRH that enables the learning of best-practice skills and procedures for reprocessing during intensive training sessions by visiting ANZGITA teams and throughout the year from senior NRH medical staff.
It will enable endoscopy procedural practice free from equipment cross infection at all times.
The system is a fit-for-purpose training facility at NRH that enables the learning of best-practice skills and procedures for reprocessing during intensive training sessions by visiting ANZGITA teams and throughout the year from senior NRH medical staff.
It will enable endoscopy procedural practice free from equipment cross infection at all times.
Whiteley Medical kindly donated a further pallet of cleaning products to be used with the system. The company also sponsored the attendance of HNGV's lead GI nurse, Mrs Augusta Menezes, to AGW2018 and to Logan Hospital to observe the operations of an Australian endoscopy unit.
Initially Drs Sydney Chung (Hong Kong) and Stephen Pianko (Melbourne) donated Olympus scopes and equipment. Olympus Australia have subsequently supplied further endoscopes and are providing on-going maintenance and support. They also plan to visit HNGV in 2019 to provide training on the care and support of their products.
Information relevant to training programs is available below to download.
Initially Drs Sydney Chung (Hong Kong) and Stephen Pianko (Melbourne) donated Olympus scopes and equipment. Olympus Australia have subsequently supplied further endoscopes and are providing on-going maintenance and support. They also plan to visit HNGV in 2019 to provide training on the care and support of their products.
Information relevant to training programs is available below to download.
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