Ending Tuberculosis in Timor-Leste

Australian volunteer Karen Champlin recently returned from three years volunteering in Timor-Leste. She was a Tuberculosis (TB) Program Management Mentor with Klibur Domin, a local NGO that works support those with TB and to enhance social inclusion for people living with chronic illness or disabilities. This is her story:

Since returning home to northeast Victoria at the beginning of April I have been reflecting on my amazing three-year experience supporting the tuberculosis (TB) program at Klibur Domin (KD). I often find myself smiling as a memory pops into my mind. I feel very fortunate to have had the opportunity to work alongside the committed and resilient staff involved with the TB program. 

I have completed two volunteer assignments with KD as part of the Australian Volunteers for International Development (AVID) program, an Australian Government initiative. 
Karen Champlin_1
My TB Program Management Mentor roles involved working alongside the KD staff in various areas such as program planning and proposal writing, activity implementation and financial management, and monitoring and reporting. I also assisted with the development of TB education materials and a four-day TB training module for health volunteers, and supported the lab staff to roll out the GeneXpert TB diagnostic technology. 

The rugged beauty of Timor’s mountains and coastline will remain a highlight, as will the inclusiveness of the TB program staff in involving me in field trips in the remote mountainous areas. However, the commitment and resilience of the TB program staff will remain the fondest memory of all and will provide an ongoing source of inspiration.

The AVID program focuses on capacity development, and sharing of knowledge is a key component of this. I have learnt a lot about TB during the past three years from the KD staff, Ministry of Health staff and World Health Organization (WHO) consultants. I have also learnt a lot about the culture, history and pride of the Timorese people. I have learnt to speak some of the Tetun language and, although basic, it has been enough to communicate every day and this has helped with building relationships, gaining a better understanding of the people and achieving the best results that I could in my roles at KD. On a more personal level, I have learnt a lot through my time at KD about patience, diplomacy, importance of community and adaptability. 

I do have some knowledge of the health challenges facing people in developing countries through my previous roles and in studying for a Masters of Public Health. However, the biggest challenge during my time at KD has been seeing one of Australia’s closest neighbouring countries suffering from an infectious disease like TB and trying to make an impact in reducing the suffering and death from TB. 

I have enjoyed working closely with the TB program staff to try and better understand the multiple reasons that contribute to Timor-Leste having one of the highest rates of TB in South East Asia. There are some common issues that are often discussed such as: people living remotely in mountainous areas with poor road access; limited health knowledge of the community; delayed healthcare-seeking behaviour; traditional healers being first contact for people that are sick; lack of TB related knowledge by health facility staff; and the difficulty getting samples to laboratories for diagnoses. 

TimorLeste_Karen and Carlo

One of the biggest learning experiences has been supporting KD to become a sub-recipient of the Ministry of Health and the Global Fund to Fight AIDS, Tuberculous and Malaria.  This has assisted KD in implementing the TB program. I helped to write the program proposal in 2014 and in April 2016 the program commenced.  As with any new program, there are new requirements from the donor, expanded areas of implementation, different ways of measuring program success and different financial reporting requirements. There has also been recruitment, training and monitoring of new staff. I am happy to have been involved from the early stages of the program with the new donor, from planning to implementation, and have learnt a lot that will be invaluable in future work.

There is still a huge amount of work to be done in Timor-Leste, but I am hopeful that the current international TB motto, “Unite to end TB” will be realised in the coming years. I am excited to see the progress and results that the KD TB team has achieved during the past few years and look forward to follow the progress into the future. There are many TB cases that go undiagnosed and this is the challenge for all involved, but with a united approach it is possible to end TB.

This volunteering assignment is part of the Australian Volunteers for International Development (AVID) program, an Australian Government initiative.  

Banner: Women with umbrellas on World Hand Washing Day, Mauxiga village, Ainaro district, 2012.
Photo supplied by Karen Champlin.

Photo 1:
 L-R: Jacinto da Cruz, Australian volunteer Karen Champlin, Miguel Jorge, Alberto Mascarenhas, Felisberto da Cruz, Lucia Lay at the inauguration of KD lab and GeneXpert machine. 

Photo supplied by Karen Champlin.

Photo 2: Australian volunteer Karen Champlin (R) and KD colleague Carlos da Costa Amaral (L).
Photo supplied by Karen Champlin.