Black Rock, Liquica, Timor-Leste

3rd October 2015

Our month of ‘touring’ continues with a trip to the Caimeo Beach at Black Rock at Liquica, approximately 30km West of Dili.  It is a ‘glamping resort’ with permanent tents and camp beds built on the waters edge.  It has a nice little restaurant and is generally a great place for relaxing, enjoying the ocean views and breeze.  On a calm day the ocean is like bathtub but often there is a reasonable shore break which makes it a little tricky for the little kids to enjoy.  Crocodiles are also in the back of my mind although i’m not sure if there have been any recent attacks (but given the recent and regular crocodile sitings on the beaches in Dili - it doesn’t seem an unreasonable anxiety given that Dili is really not that far away by coastline).

Liquica itself it also an interesting place to walk around.  Unfortunately it was one of the towns that was hardest hit by the scorched earth policy of the retreating Indonesian military and ‘militia’ but the town has been largely rebuilt.  There are also some old, but rather dilapilated,  Portuguese administrative buildings which still remain and have been developed into a small heritage trail.   The road to Liquica is currently being re done and as such it is a very slow trip out there at the moment but I imagine it will be a pretty speedy trip in the future.  I certainly felt for one of the registrars who had a period of time doing the daily commute from Liquicia to Dili on a motorbike to get too and from work every day.  

It was world sight day on October 8 2015.  This was an initiative of the Lions Club International Foundation and is now incorporated into VISION 2020 and managed by the IAPB (International Association for the Prevention of Blindness) and the WHO (World Health Organisation).  In Dili, a large tent has been set up in a park down near the waterfront.  There has been speeches by officials as well as skits by a local performing group regarding the prevention of ocular trauma.  The main event of the day is a large screening program by the eye health workers.  Patients have their vision tested, their refraction tested (need for glasses) and then if needed a referral to the National Eye Centre for treatment - usually for cataracts or pterygium.  It is of course a free service to the community and we have a busy upcoming 2 weeks to get through all the extra surgical load.

One of our favourite things to do in Dili, particularly on a Friday night is head down to Areia Branca, the beach down the Eastern end of the harbour, just before Cristo Rei.  There are some great restaurants where you can sit right on the beach and eat dinner as the sun goes down.  Lots of Dili families do the same an often the kids have an instant playdate - climbing trees, running along the beach and playing on the makeshift swings slung up in the nearby trees.  The pizza and pasta from Caz bar are clear favourites with everyone but also the homemade curries and sate are equally nice.  Our ‘go to’ dessert comes in the form of crepes with a variety of toppings such as maple syrup or chocolate sauce.  All in all a fun and social night and the kids sleep of the dead on that particular night. 

World Sight Day (Loron Mundial Matan), National Eye Centre

Screening in Dili, World Sight Day (Loron Mundial Matan)

Black Rock Restaurant, Caimeo Beach

Caimeo Beach

Aipelo Prison, on the way to Liquica

Friday Evening, Areia Branca - awesome tree climbing!

Sunset at Caz Bar Areia Branca

Atauro Island, Timor-Leste

26th September 2015

I am always amazed at the scope of clinical cases that walk into our Eye clinic on a daily basis.  Even relatively routine things like pterygium, which is a growth over the cornea normally caused by exposure to UV light, often take on extra significance in Timor-Leste.  This week a gentleman came down from the districts with both eyes affected by very large pterygia, on both sides of the cornea.  On one eye he only had a very small window of clear cornea from which to see.  As such his visual acuity was worse than 6/60 (20/200) and he had considerable astigmatism (distortion or warping of the shape of the cornea from the pterygia).  I have never seen such extensive pterygia in Australia and I booked him for surgery the next day to at least try and improve his vision in one eye.  As expected the surgery took considerable time and required a very large autoconjunctival graft however thankfully his vision even one day after surgery had considerably improved. 

I have also seen a patient this week with presumed chloroquine induced maculopathy.  Malaria is quite widespread in Timor-Leste outside of Dili, and I was informed by the registrars that many patients self treat themselves with Chloroquine whenever they have a temperature or feel unwell.  This patient was in in their 60’s and had been taking large doses of self prescribed chloroquine, up to 2g/day for many many years.  They had reported that their visual acuity had started to decline in both eyes over the previous 2 years.  Normally in Australia I would confirm diagnosis with electrophysiology testing however this is of course unavailable in Timor-Leste.  While we can never prove definitely that Chloroquine was the cause, we felt that the clinical history of significant longitudinal exposure to chloroquine, in conjunction with the changes seen at the macula, was likely consistent with chlorine toxicity

We are now currently on Atauro Island for the weekend.  Atauro is a small island to the north of Dili, accessible by an hour long fast boat ride or 4 hours on the old ferry (or 2 hours in an outrigger as the last time I did it 10 years ago).  It is a wonderful tourist drawcard for Timor-Leste with world class diving, hiking and a unique cultural experiences and as someone mentioned to me ‘jurassic park’ like - obviously minus the dinosaurs.

While on the Island we stayed at Barry’s - a Timor institution, near the main jetty of Beloi.  Barry runs an eco-resort on the Island with beach bungalows and a central dining room serving 3 local meals a day.  The kids love running around the resort with the other kids and Barry’s kids are very gracious in letting the visiting children play with toys, trampoline and swings.  As my daughter says “we love it here because we can run around without the adults” .

For the adults, there is wonderful snorkelling just off the beach as well as fantastic diving, particularly around the other side of the Island.  Fishing is also a predominant activity on the Island for both locals and tourists, although my husband had no luck on his early morning fishing trip.  The small nearby town of Vila, has some lovely Portuguese style buildings and currently a big draw card is the local NGO called Bonecas de Atauro, which handmake dolls, bags and soft toys and provide employment for local women.  If nothing else, Vila has lovely wide, shady streets on which to walk around and just enjoy the atmosphere.  Again, a lovely relaxing weekend away to escape the heat of Dili.

A very big Pterygium!

Presumed Chloroquine Maculopathy (appearance identical in the other eye)

Dili Harbour, early morning - leaving for Atauro Island

Arriving Beloi, Atauro Island, Timor-Leste

Late afternoon run, Atauro Island.  Looking south back towards Barry's and Beloi village

Hammock love, Barry's Eco Resort, Atauro Island

Bonecas de Atauro - a great gift from Timor-Leste

Inside the Bonecas de Atauro showroom