Klibur Domin (KD) has 80 beds for inpatients who are referred from the Dili National Hospital, Community Health Centres and from KD outreach programs.
A doctor and nurses provide medical care for local Tibar villagers in the KD Clinic. Transport is provided for those needing more intensive care in the Dili National Hospital.
At least half of the 80 inpatient beds are dedicated to patients being treated for tuberculosis (TB). The patients receive ongoing support and care, including supervised medication during their time at KD which can stretch into many months.
Two Mobile TB Teams
TB Teams travel to remote villages detecting and treating TB. Hundreds of people have been cured, and TB has been virtually eliminated from many villages. Most people are treated locally with medication taken under the supervision of KD trained local volunteers. Those with more severe symptoms are transferred to the Dili National Hospital, Community Health Centres or KD for inpatient treatment.
KD staff work over a large area of Liquisa and Ermera Districts, Dili and Bacau sub-districts, including Atauro Island. Conditions in the field are difficult being mountainous, with poor roads and basic facilities for examining suspected TB cases and sputum collection.
KD staff provide training for community leaders from village level through to District Administration. The support of these local leaders is essential to encourage TB suspects to come forward, comply with treatment requirements and to recruit local community volunteers to work in their villages. Participants are reimbursed for their expenses and a meal is provided
The TB Program would not be possible without KD’s trained volunteers who work in their own villages. They find suspected cases of TB, encourage them to have sputum tests and then monitor their on-going treatment. The volunteers receive a small reimbursement of their expenses, such as mobile phone cards and money for fuel. Education for TB patients and their family members is provided when the patients are receiving intensive treatment in KD and also when in their villages to encourage families to be tested and to support their family member to continue treatment.
Many young people are exposed to and contract TB. The KD Mobile TB Teams conduct education in schools aimed at reducing the stigma of TB and spreading information into families. People diagnosed with TB are admitted into KD where they receive intensive drug treatment and medical care. They are given extra nutrition, especially protein, as malnutrition is a major problem in Timor-Leste. They and their families also attend health education sessions as crowded housing can mean cross-infection within families.
Multi Drug Resistant TB
Two purpose-built wards provide intensive nursing care for up to 14 patients with MDR-TB. This is the only such facility in Timor-Leste. MDR-TB is the most virulent form of TB and can take 12 months to cure. A GeneXpert machine provides extremely fast diagnosis of MDR-TB and other strains of TB. This allows appropriate treatment to commence in the shortest possible time.
The Korean International Cooperation Agency (KOICA) is funding a KD program to detect and control TB in sub-districts of Baucau and Dili, including Atarau Island. A new office and laboratory have been set up in Bacau with ten staff members employed. The team has its own 4WD vehicles, GeneXpert machine and a digital chest Xray machine.
Community Based Rehabilitation (CBR)
The CBR Team provides therapy and support to hundreds of children and adults with disabilities. The CBR Team has a dedicated 4WD vehicle and travels to remote villages in the Ermera and Liquisa Districts.
These people receive support from the CBR Team in the form of basic water and sanitation, physiotherapy, occupational therapy, and some material support. Wheelchairs, ramps, and other specialised equipment are provided to assist with the adults’ and childrens’ mobility. Many of the children in the program are now able to attend schools, whereas before they had no option but to remain in their homes.
Maria Filipe, KD’s first CBR patient came to KD in 2002 for several months after an operation to address problems with her legs. She returned to KD in 2005 for several months and when she returned to her home near Gleno, KD recognised that she would need ongoing support if she was ever to receive an education. Maria became the first of many hundreds of children and adults helped by KD under the (CBR) Program.
A 12 bed home provides respite accommodation, rehabilitation and support for people with disabilities who would benefit from some rest and recuperation for several weeks or months. They receive good meals, intensive physiotherapy and occupational therapy during that time. A carer, who is normally a close family member, is also able to stay with them to assist with the rehabilitation process.
The Barbara Cottage was constructed in 2011 in memory of Barbara Lewis. It initially accommodated six long-term elderly residents with disabilities who had been at KD since Indonesian times, but now it accommodates six homeless females with disabilities and mental health issues. There are six bedrooms, four bathrooms, a lounge/dining area and one small storage room.
John Garton Cottage
John Garton Cottage was completed and dedicated in 2019. It is now occupied by students with disabilities living at KD and attending the Franciscan Secondary College across the road. It has five twin bedrooms and can accommodate up to10 students. Some students have now graduated from the College and moved on to universities and others have jobs. Without the opportunity to stay at KD, these people would have had little prospect of an education.
A Dental Care Program was set up in 2017 in a purpose-built dental clinic at KD. The program is based on educating people, particularly children, in dental hygiene, undertaking examinations and corrective treatment. Regular visits are made to local and remote schools and communities. A Timorese dentist and two assistants are the core staff in the dental surgery.
Garden and Livestock Program
Gardens have been developed at KD since 2000 but the projects have met with limited success. In 2020 KD won a grant from the New Zealand Embassy in Dili to implement a Garden and Livestock Project. Existing vegetable gardens and fruit trees will be expanded and livestock added to provide eggs and meat.
Solar Panels Project
The cost of electricity in Timor-Leste is very high and the service is most unreliable with power outages for days at a time. A generator provides power to KD during these outages. The cost of electricity and diesel to run the generator often exceeds A$18,000 pa. In 2019 it was decided to provide a solar system with 132 solar panels and nine Tesla batteries, making KD independent of the electricity grid. A 40 foot container has been sent to KD with the solar panels, Tesla batteries and other essential components. It will remain at KD as the electrical hub.