Joint Standing Committee on Foreign Affairs, Defence and Trade's Inquiry into Australia's Relationship with Timor Leste

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29 March 2013

Despite notable improvements in the health system in Timor Leste since 2001, there remains a critical need for Australia to demonstrate an ongoing commitment to the development of a sustainable workforce at all levels of the health system - primary, secondary and tertiary. The Australian Government's focus on primary health care and on the need to improve maternal, newborn and child health indicators is noted and welcomed. However it must be recognised that in line with a focus on primary and preventive health, tertiary health care through surgical and medical services must also be developed and maintained in tandem in a broad range of clinical specialities.

With the significant influx of Timorese medical graduates from the Cuban medical system over the next two years, Timor Leste will have an increased pool of doctors from which to deliver basic medical services throughout the districts - again this is welcomed as a mechanism for ensuring increased access to basic medical services, particularly for people living in rural and remote areas. However, it is critical that the skills and expertise of these doctors are further developed beyond the basic level of medical training received through the Cuban system. ATLASS II's primary focus is on training through a Post Graduate (PG) Diploma Program which has five modules: surgery (including orthopaedics), anaesthesia, obstetrics, paediatrics and internal medicine. The diploma modules will increase the PG trainees' skills in basic clinical procedures however high performing Timorese candidates must be identified, recognised and nurtured, with opportunity to undertake overseas specialist training funded and supported.

At the same time as strengthening the capacity of the health workforce to deliver emergency and essential surgical and medical services and the wider health workforce (nurses, allied health professionals, mid-level workers, community based workers), the health system in Timor Leste needs institutional strengthening. The national hospital in Dili and the MoH need to be supported in strengthening capacity in policy and program planning, procurement, HR and financial management, monitoring, evaluation and quality improvement systems, and regulation.