HAI in Post-conflict Timor-Leste: Support and

Solidarity

WRIHC – April 5, 2014

Mary Anne Mercer

Former Portuguese colony Illegal and brutal occupation

1975-1999 by Indonesia Fully independent in 2002 The East Timor Action

Network (ETAN) strong supporter of independence

Background: Timor-Leste

Timorese suffered untold abuses of human rights at the hands of the Indonesian military during 24 years

of illegal occupation

Before leaving, the military and their militias carried out a campaign of violence that left ~75% of the country’s

infrastructure destroyed and 1/3 of the population displaced.

Challenges for post-conflict East Timor: 1999-2002

• Approximately 20 Timorese physicians• A pool of sub-optimally trained midwives, little

management/leadership experience • Small MOH staff (IMF restrictions on total health

staff numbers)• Multiple uncoordinated international agencies in

operation

Health services

• International NGOs were the main resource for health services delivery

• Responded quickly to the emergency situation

• Effective in rapid fund-raising – and in spending donor funds

Health services

• International NGOs were the main resource for health services delivery

• Responded quickly to the emergency situation

• Effective in rapid fund-raising – and in spending donor funds

• BUT:• Costly! $6.2M/year,

heavy use of expat staff• Focused on provision of

services, not capacity building

• Resistant to efforts to standardize district services

2001-2: Preparation for independence

• Careful phase-out of NGO ‘ownership’ of districts

• Resistance by many agencies to the change

• 2002: an independent Timor-Leste Ministry of Health, led by Dr. Rui de Araujo

• HAI began efforts to support the new MOH

- Strengthen quality and improve access to MOH services- Promote improved health practices and care-seeking in communities, linking them with MOH

HAI strategies:

HAI’s role in the new Timor-Leste

• 1999-2004: Small projects, qualitative data gathering in rural areas

• 2004-present: Grants to support MOH priority areas (maternal and newborn health, family planning)

• 2010-present: Developing mHealth activities with MOH midwives

Thank you!