3rd December 2015
I couldn’t write about my short time in Timor-Leste and in particular Dili without mentioning the Taxi’s. At times I have relied on them for transport e.g. when the car was at the mechanics or getting to and from the airport. They are apparently all old taxis from Singapore and the degree of ‘bling’ in them is truly inspirational! Often they have an extremely dark tint all over the front windscreen with a small clear sliver at the bottom requiring the driver to be slumped down in the seat to be able to see anything (eg the road!). The dashboard is inevitably covered with soft toys or bright shiny ‘things’. Unfortunately there is a degree of variability in roadworthiness but on the whole the drivers are helpful and accommodating and I always got to my destination in one piece.
In my last few weeks I have seen two terrible cases, of women in the post partum period, who have what I assume is choroidal infarction from pre-eclampsia and eclampsia respectively (very high blood pressure in pregnancy). Unfortunately the burden of perinatal morbidity and mortality is still very high in Timor-Leste. Access to antenatal services is limited in the districts and for a variety of reasons many women receive no antenatal care. I have never seen this condition in Australia, although it is well described photographed in text books. Given both patients’ very poor visual acuity e.g. Count Fingers or worse in both eyes, it really is a tragedy. Visual recovery in uncertain however in the two weeks I was able to follow these women, neither showed any visual improvement despite having delivered and their blood pressure returning to relative normal levels.
On a brighter note, a fairly momentous occasion is occurring at the National Eye Centre in Dili this week. Fred Hollows NZ, which was instrumental in setting up and maintaining the National Eye Service, have formally handed over the running of the centre to the National hospital and ultimately the ministry of health. While there have been many speed bumps in the transition process it is ultimately a necessary evolution into a self-managed National Eye Service for Timor-Leste. Their was an official ‘handing over’ ceremony from Fred Hollows NZ to the ministry of health which was then followed by a big Timorese BBQ (as we say in Australia). Delicious!
The dashboard of a Dili taxi
Presumed Choroidal Infarction secondary to pregnancy induced Hypertension
Handover from Fred Hollows NZ to Ministry of Health
BBQ time (Timor style)
