Time at Klibur Domin

RCA Volunteer Martin with Klibur Domin staff in July 2018

I recently returned from six months volunteering at Klibur Domin, from February to July 2018. It was a very rewarding and enjoyable experience and I would strongly encourage anyone with even a short amount of time to make the journey to Timor-Leste to see Klibur Domin (KD). I spent most of my time supporting the administration, although every day was a little bit different and over my time there I ended up with great variety of activities both in and out of the office.

I have been thinking about what really grasps me the most about Timor-Leste and KD. The solidarity and teamwork of KD’s staff and the passionate efforts of supporters have been inspirational, and the beauty of the country, its mountains, its coastlines and its oceans have all had a great impact.

Klibur Domin’s Community Based Rehabilitation program manager Gregorio and physical therapist Manato walk along a mountain trail to reach a house which is inaccessible to vehicles.

Going out into the community with KD’s Tuberculosis (TB) and Community Based Rehabilitation (CBR) teams made clear the scale of the work KD is undertaking to address healthcare needs in Timor-Leste. It is easy to underestimate the distances and the time needed to reach patients in Timor-Leste.

A large proportion of the communities impacted by KD are in the mountains and as a result there is a tremendous logistical component to KD’s community work. To illustrate the vertical scale of Timor-Leste’s mountainous terrain, the ocean trench off the coast is 3,000 meters deep, and the narrow island rises to 3,000 meters above sea level at its peak. This makes it both a beautiful and challenging country.

The local area around KD is flat and hot during the day but driving inland with tremendous gains in elevation in the first few kms, the temperature drops rapidly. It is too simplistic to think of Timor-Leste as a small country in the context of delivering healthcare to those in need, as well as in the ability for the sick to reach medical attention when they need to. In reality the overwhelming expanse of mountains and valleys make the country vast.

Issues around transportation weigh heavily in the minds of program staff, with regard to reaching those patients already identified, as well as the knowledge that there are other areas which are in need of contact; issues made even more challenging during the wet season when roads become increasingly difficult. Facing these challenges, the perseverance of KD’s TB and CBR outreach programs to reach these villages by 4WD, on motorcycles, and by foot, are truly praiseworthy.

KD is making significant contributions towards the global effort to identify and treat TB. This disease is a very serious issue in Timor-Leste, having one of the highest rates of infection worldwide. The reasons are manifold, with living conditions and access to appropriate healthcare leading the list of many stresses. What really sets KD apart is the active case finding strategy to seek out those who have TB in remote communities combined with an in-house directly observed treatment program; the best of its kind in Timor-Leste.

A weekend excursion to the beach with Klibur Domin staff and patients

There is a vital link between the work that KD does in community outreach and the inpatients program that will help free Timor-Leste of this high burden of TB in coming years. The recent completion of additional facilities at KD to treat more TB and Multi Drug Resistant-TB patients has been a necessary investment towards this global objective.

Every day at KD ensures that patients complete their treatments and have activities to keep them physically active and prepared to regain their livelihoods when they return home. A family I met in the community said that they could never thank KD enough for treatment which cured them of TB, and that it was their hope that KD’s presence will continue for many years to come.

As KD expands beyond TB and CBR it has been very exciting to see the Dental Clinic up and running. It is a program that is bound to have lasting impact. There are so many people who have had little to no dental treatment in their lives, and the amazing contributions of the volunteer dental teams are making serious inroads into dental health in Timor.

The efforts of the Dental Clinic both in treatment and education is truly magnificent. Through the efforts of KD in partnership with Maluk Timor, many people come through the Dental Clinic for treatment. With this helping hand, they can focus on achieving their ambitions without the burdens associated with dental complications.

It was great to have so many visits from Ryder-Cheshire and Rotary volunteers while I was there, catching up on news from back home and feeling the brightness and motivation of everyone who made it to KD. We had many memorable evenings in the volunteer cottages. Amazed by the common connections I found with many of the volunteers, I was reminded of what a small and interconnected world it is that we live in.

Broni and Snr Joaquim Soares discuss the use of water and fertilizer to care for new plants at KD

Hearing about the worsening drought facing Australian farmers was concerning. It is an experience shared with the Timorese.

By the time I was preparing to return to Australia, it was well into the dry season and the fields around KD that were so productive earlier in the year were becoming very dusty and bare. A large proportion of Timorese are involved in small scale agriculture but even in the more built up areas around KD, people generally make full use of their land with crops, fruit trees, and livestock.

KD is right on the edge of the rural and urban environments and while there is still a strong sense of biodiversity in the area, increasingly there are the flow-on effects of the rapid urban development of Dili. KD is working to ensure positive environmental outcomes, paying close attention to our own waste, water and energy use. A recently completed incinerator has given us an effective method of medical waste disposal, we have installed our first solar hot water system, and the Garden Program will help to address food security at KD in coming years, providing leadership for staff and patients to improve horticultural practices, and further reducing our carbon footprint.

Carmelita leads the way at Tybesi Market, which is Dili’s largest fresh produce market, where we collect KD’s food for the Inpatients program. KD is making progress to supplement purchases with on-site food production.

And it says something about KD’s success that through the years the tireless efforts of volunteers working hand in hand with staff have helped maintain the vision and momentum. We are achieving so much every day for the relief of suffering and it really feels like there is a prosperous future ahead for KD because of these unwavering commitments.

Coming back to that initial question of what really captured me in my time at KD, I would have to say it is the resilience of the Timorese people and their long history of struggle and determination that is truly inspiring. The strength and positivity of the Timorese people is a testament to the spirit of human endeavor and it has been incredibly rewarding to be part of this amazing team that is contributing to their future.

Martin Moignard