East Timor: MSF becomes key player in Baukau district

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The United Nations is now acting as temporary administrator of the country; efforts to rebuild are slowly taking shape, especially in the capital, Dili. During the second half of 2000, MSF signed an agreement to implement a district health plan in the Baukau district in the north. At the hospital and in health posts throughout the district, MSF provides basic health services and tuberculosis treatment, trains staff, rebuilds health facilities, and monitors for disease outbreaks. The Baukau hospital is one of only three health structures in the country with surgical facilities; as such, MSF provides surgery coverage to about a quarter of the entire population of East Timor. Difficulty in hiring permanent East Timorese staff has hampered the full implementation of the district health plan. With only 20 doctors in the whole country, the human resources are just not available. Recruiting has also been slowed by the need to put into place a countrywide health system. A cumbersome tender process that is centrally managed by the interim ministry of health and the World Bank has also slowed things down, and has raised questions about how NGOs can remain independent under such a centralized sub-contracting system. In early 2001, MSF handed over supervision of the Dili Transit Center for returning refugees to another NGO. Some 90,000 East Timorese are still refugees in the Indonesian province of West Timor, cut off from humanitarian aid (see Indonesia, next page). MSF is following this situation closely, and remains ready to respond to an influx of refugees or other emergencies. MSF has been working in East Timor since May 1999. International staff: 11 National staff: 70