Oecussi, Timor-Leste

24th August 2015

We are in Oecussi this week for an outreach surgical visit through the Royal Australasian College of Surgery (RACS).  The Oecussi enclave is a small area of land officially surrounded by Indonesia in West Timor.  It home to the local Dawan people but was settled by Dominican brothers in the 16th century, and later the Portuguese, for which it was the first permanent settlement in TImor.  It’s current border is a legacy from division between the Dutch and Portuguese colonies very early in the 1900’s.  In the past it has been notoriously difficult to reach, either with an overnight ferry from Dili or a pretty bumpy 12+ hour drive from Dili.  Thankfully we are going on a chartered Mission Aviation Fellowship (MAF) flight leaving from Dili airport.  With all the team and equipment we are on 4 separate flights.  Its a stunning flight West along the coast with the blue and greens of the waters and reefs contrasting with the browns and khaki of the coastline.  It also gives me a chance to appreciate some of the remoteness of the hilltop villages in Timor-Leste and Indonesia which are literally perched along the ridge line of some very precipitous mountain ranges.

The scenery changes quite significantly once we reach Oecussi, steep brown mountains arising almost straight from the coast.  The major town town in Oecussi is called Pantemakassar and is a small settlement between the coast the the mountains.  The landing strip is a gravel stip and I notice some goats up the far Western end.  The landing was surprisingly smooth and is didn’t take long to unpack the remainder of the gear and get settled in the ‘qantas club” - a tin shed to await the pick-up.  No drinks here.  

The outreach team is a well oiled machine with very regular outreach visits all through the year.  Generally a 4WD goes ahead with the larger equipment such as the portable microscope, operating tables and chairs and sets up the OT and commences screening of patients.  This is in conjunction with the local eye technician, who has been trained with he National Eye Centre, who is permanently based at a particularly hospital in the districts.  This person provides a very important link with the other local health staff, hospital administration and of course patients and surrounding communities.   I think that they do a phenomenal job with limited resources and I am always very impressed by their referrals and communication to and with the National Eye Centre.

The Oecussi hospital is a relatively new hospital and I was told it was based on a similar design to Broome Hospital in Western Australia.  It certainly feels like some of the regional hospital in Australia with the low set design, wide verandahs and corrugated iron roof.   We have to be mindful of local theatre limitations as well as their need to continue to provide their regular surgical and anaesthetic service.  The eye team needs to take over a whole theatre for the entire week as well as utilising local staff and equipment.  We hope to do approximately 60-80 cataracts in the week and it looks as though the screening team have done an excellent job in reviewing and advising patients for surgery.  

Flying into Pantemakassar, Oecussi

The landing strip and MAF plane

Oecussi Hospital