East Timor Medical Elective - Week 2 (Part 5 / 5)

HEALTHCARE SHORTAGE IN EAST TIMOR

I started buying the local newspaper (“Timor Post”) and have been amused + appalled at the shortages within their public hospitals (food and medication, will attach photos in the future).

It saddens me that the public hospitals are underfunded even though they have the money to fund it properly (from the oil/gas revenues) due to significant corruption by politicians. I've read that they only have 10-15 years' of oil left, which is extremely scary given that their GDP is supposedly ~90% dependent on oil. An East Timorese person told me that ALL of the oil money is already gone (!!!!!), and that those research papers were just being overly optimistic... : (

 

I also wondered when I get back to Australia, I'll get jaded/absolutely fed up with patient complaints that are relatively minor in comparison. I worry that I might find Clinical Medicine in Australia less fulfilling for various reasons.

Will the Australian patients (esp. in GP setting) seem like “whiny losers” after my East Timor experiences? Will I start resenting the majority of Australian patients for their “lack of perspective”, and their taking for granted of the Australian public health system, which by world standards is very high class and accessible? And what about the stereotypical Australian drug-seeking patients on disability pensions from Centrelink for “questionable” conditions, who demand extra scripts of Morphine / Oxycodone for abuse or diversion (to get extra $$$), even though such drugs are in extremely short supply in East Timor, to the point where Palliative patients in severe pain can only receive Codeine or Tramadol at the best?

I know that my East Timor experiences will forever remain with me (until I die or get memory loss), but I'm not sure if I'll be able to deal with the “Reverse Culture Shock” in the long-term. It may be “heart-breaking” to see the contrast of “feast vs famine” in terms of Medical Resources, but I hope that if this is the case, that it'll push me towards pursuing Pathology Training permanently, 100%, ***LOCKED-IN***. Maybe it might be a blessing in disguise, in helping to clarify career goals and altruistic aspirations?

CUBA HELPS EAST TIMOR MORE THAN PORTUGAL?!

I started watching the main East Timorese TV Channel at night, which apparently only has native programs for ~ 3 hrs / day, the remaining being Portuguese programs direct from RTL International. 

 

The exposure to Portuguese people and lifestyles on TV (soap operas, festivals, talk shows) is blatantly obvious. I wondered if East Timorese people grow resentful of the Portuguese for the relative lack of help in their nation's development, apart from “forcing” students to learn Portuguese instead of Indonesian. Just look at the other ex-Portuguese colonies like Angola and Mozambique.

I was baffled as to why Portugal has barely sent any doctors to help East Timor. My impression was that they needed to rely on Cuban doctors, plus the fact that Cuba (not Portugal) offered medical scholarships to train East Timorese doctors.

Even in spite of Portugal's relative poverty in Europe, it's far wealthier to East Timor by comparison, yet has seemingly done little to help in healthcare apart from establishing a colonial presence.

TETUM LANGUAGE DIFFICULTIES

I thought that the huge lack of vocabulary of Tetum compared to English was one facet of the relative “simple-mindedness” and “purity” of East Timorese people, but have actually found it harder than I initially thought due to the extra reliance on context, to compensate for the greater percentage of words having multiple meanings.

This week, I was looking at the website of a Leprosy Organization in East Timor with a girl and said “Hau hadomi nia.” at a photo of a young man with Leprosy, thinking that I said “I pity him”, but she interpreted it as “I love him” and was very shocked, like I suddenly disclosed my sexual orientation.

I explained myself, and then she then said that although the dictionary says that “hadomi” can mean “pity”, it's more common to use the word “hanoin”, but then that can also mean “think” and “opinion”. 

 

I'm starting to worry that when I say one thing, the East Timorese will misinterpret me, even if I thought the context was clear. I personally like to have 1 word for 1 meaning, and am doing my research for Tetum words (especially the Portuguese loans) that match 1-on-1 with English.

I'm getting humbled by their language, and have been deceived by its superficial simplicity. I'm frustrated that the words I say in Tetum may have less "Ooooomph" (emphasis/power) due to the semantic uncertainty (being dependent on Context), but the East Timorese people have been coping with this for a long time,being able to share with each other their deepest, rawest feelings and thoughts with perfect comprehension when the "time calls for it".

Perhaps it's due to their superior intuition (maybe even more so than a non-East Timorese NT) and context-analyzing abilities, that they're able to communicate adequately with fewer words, even if they don't use the Portuguese loans. Not only do I have to work on the language itself, but my (mechanical) intuition...