If our time in Timor was to be conceptualised as a long-distance race then this final lap would be one in which the seemingly triumphant runner was unexpectedly mauled by a bear. Bruised and bloodied, we are staggering to the line.
Perhaps that’s a little melodramatic. It certainly hasn’t been all bad. Two days ago Bethany and I officially passed the baton of Maluk Timor’s leadership over to our successors, Drs Raj and Lois. They’ve already been with us a full six months and couldn’t be better prepared for the task at hand. It’s hard to describe how wonderfully miraculous it feels to have two such capable and genuine servants ready to take over. Succession planning has always been a troubling question mark: having built up an NGO that punches above its weight, finding someone who would faithfully continue punching was no sure thing particularly when the meagre salary was taken into consideration. The arrival of Raj and Lois has been an extraordinary provision that allowed us to plan our departure with few regrets.
But little else has gone to plan these past four months.
I note that my last entry was back in December – has it been so long? December seems like an age ago, and looking back over photos it looks like we had a lot of fun. I can scarcely remember it.
It was our first Christmas in Dili and we did everything we could to soften the hard reality that our children would not be seeing the family, and that their presents had been held up by the interruption to freight services. It would be a different kind of Christmas.
But we turned that narrative on its head, trying to combine some classic Christmas traditions with some Timorese points of difference. We hosted a Carols Karaoke Night with mulled wine, we made gingerbread houses with friends, and the kids joined the church Nativity Play.
But we also adopted a Timorese teenage student from a disadvantaged home for three weeks as part of a cultural exchange: she lived with us, holidayed with us, and most assuredly now thinks that malae (foreigners) live a completely alien existence. The kids were momentarily downcast when they heard we would be sharing Christmas with a relative stranger. We weren’t entirely sure how well it would work out ourselves: some friends of ours also participated and their guest spent most the three weeks holed up in a bedroom refusing to speak to anyone. There was no guarantee it was going to go well. But when we shared a little of her backstory with our children they immediately responded and welcomed her wholeheartedly into the family. The tears flowed freely when the three weeks was up, with our children perhaps having learned something different this year about the spirit of Christmas.
So we made the best of the Christmas break, with a trip west to Balibo and then all the way to the farthest eastern tip of the country to Lakumorre, near Jaco Island.
We stopped in with friends in Parlamentu (Lautem) again and explored a little more of the surrounds, including a local football semi-final between neighbouring towns and the ruins of a World War II Japanese bunker.
The adventures were definitely distinctive, though it’s easy to forget now (months later) the many irritations along the way. As highlighted in an earlier post, holidaying in Timor-Leste (particularly with children in tow) is still largely an exercise in endurance and I had the distinct sense this time that some of the idiosyncrasies have definitely lost whatever charm they once held for us. We’re ready for a holiday with running water and bath towels.
Returning to work in early January we were focussed on the mission at hand: we had projects to progress, and a succession plan to execute. It didn’t take long before our equilibrium was disturbed by a series of shocks within our organisation: fault-lines opened, trust was broken, old friendships were tested, and what ensued was deeply painful to us all. There is little of it that can be published on the open internet but we are pleased now to be re-emerging with our organisation intact, and hopefully the stronger for having endured it.
But as one apparent disaster began to recede into history another quickly followed to take its place. The miracle of Timor-Leste’s COVID-19 resistance was about to crumble.
It began in January and February with increasingly high numbers of positives among quarantined Timorese returning from West Timor. It was clear that the virus had taken hold of the Indonesian side of the border, and with so much traffic across that long and scarcely-defended line it felt that the dam would surely break soon. The first positive cases in communities in East Timor were found in a remote cross-border area of Covalima, far from Dili. Then in early March there were cases found in neighbourhoods on Dili’s western fringe, and within a few weeks this had spread to almost fifty clusters in the densely populated capital. COVID-19 had finally arrived.
I don’t mean to paint a picture of Timor-Leste having been sitting naively and impotently like a disabled warship waiting for its final torpedo. From the very beginning the Timorese government has been on the front foot, with support from the Australian Government, WHO and many health partners (including Maluk Timor), and they’ve adjusted their strategy accordingly at every point. The 12-month delay between the first case and the onset of these clusters was not a matter of good fortune. Even now the government continues to execute a clear and sensible strategy: it’s been impressive to watch. Just as impressive has been the tireless work of the Ministry of Health – particularly their laboratory and their surveillance teams – which have served as the major bulwark preventing disaster. A year ago Timor-Leste didn’t have capacity to test for COVID-19, and was sending samples to Australia. That was quickly remedied, and the lab have sustained their testing uninterrupted ever since. Timor-Leste was as prepared for the arrival of cases as any of us could have hoped.
Lockdown was declared. We’d been through lockdown before – at this time last year – but it hadn’t felt very scary then as we were confident that COVID-19 hadn’t yet penetrated the communities of Dili. This time we knew it was different. Colleagues in the National Hospital had tested positive. Our own neighbourhood, Bebonuk quickly became the largest and most threatening cluster. The Bebonuk Plague was all around us. The government advice was home confinement which was achievable for us, but home confinement was always going to be a challenge in a country where ten people commonly share a two-roomed shack… which backs immediately on to another equally congested hut… how do you stop the spread of disease amidst that?
Moreover, I can’t even begin to guess at how local Timorese perceive their risk. They’re used to living with worse in their recent history: tuberculosis, malaria, dengue and the ravages of malnutrition, to say nothing of violent conflict. Some people believe the virus is a political invention to advance the interests of the elite. Others believe that Timorese people cannot be harmed by it. Their mighty wartime hero Xanana Gusmao shows no sign of being cowed by the threat of contagion. In any case, if SARS-CoV-2 is a virus that mostly leaves the young unscathed does this country of young people have much to be afraid of? One can certainly imagine why a young Timorese person might ask exactly that.
While some live in denial, fatalism or complacency, others are wracked by anxiety. Fear and superstition abound and these manifest themselves in a thousand different ways. Any collective understanding of germ theory is tenuous at best, so talking about microbes and infection control is as foreign as any language we can speak here. Facebook is among the leading sources of health information, and the conspiracy theories and scaremongering that spread faster than truth are having their own impact. Even among health workers many are expressing doubts as to whether they’ll accept a COVID-19 vaccine. So how will people respond to the arrival of the pandemic? There is clearly no single answer.
We’ve tried to play our part by following government advice. We closed down as much of Maluk Timor as we could, limiting access to the office, and posting people to ‘work-from-home’ duties. At the same time we deployed our COVID Team to support the government in the national roll out of COVID vaccine training.
Disastrously the Family Medicine Program (FMP), which has been Bethany’s major project for the past three years, was again suspended.
To put this in context, we had planned our departure from Dili around the scheduled conclusion of this diploma. The 24 registrars are more than two years into their course, and have five weeks of rotations remaining before their final exam. That was all scheduled to happen in April, so we planned to leave in May. Suddenly it was all on hold – so near the finish line – with no certainty whatsoever about when it could recommence. Our team of FMP international clinical supervisors weren’t going to be able to sit and wait for an unscheduled restart, and the registrars themselves were told they were being recalled to the workforce. We were going to be denied our finish.
Bethany pulled out all stops in negotiations, and thankfully found willing allies on all sides. I put this down to the quality of relationships she’s built here over these past years, because when she went knocking she found the doors opening almost everywhere. Our counterpart at the Royal Australasian College of Surgeons was equally adaptable, and the new program was launched with less than two weeks lost to the lockdown interruption. Almost overnight the FMP training was reprogrammed as an online course, to be delivered over Zoom videoconferencing. I’ll never be able to articulate how complex a transition this was, moving from 16 unique clinical placements to an online teaching platform in a country with appallingly unreliable internet. Timorese clinical educators who had never used Zoom before were suddenly hosting their own videoconferences. It was extraordinary, and has propelled the medical education sector here into the digital era in an unexpected but potentially profound way.
So the exams are still scheduled for April, and we still expect to leave in May.
Lockdown meant closure of schools, so our four kids were back to online learning in our kitchen. At least this time we were at home with them, which was better… and worse. Trying to get our own work done (including the transition to this new FMP model) whilst undertaking craft projects and teaching handwriting skills was not a balance anyone would want to keep up for long. To break up the monotony of being confined to home, we invented all kinds of new games and sports. Old gym mats were deployed on the back lawn for cartwheels, forward somersaults and Ninja Warrior sessions.
A litter of five new bunnies came at just the right time too.
Just as we were finding our rhythm we hit the next bump in the road, just a week before our expected handover of leadership: positive COVID-19 cases among Maluk Timor staff. With almost a hundred staff, some of whom lived among the fifty clusters in Dili, this was not totally unexpected. However, it did trigger a new level of fear and anxiety among our staff, and interrupted our already curtailed activities even further. Many of us had to be tested as contacts, and to auto-isolate.
The scheduled handover – planned for almost nine months – was beginning to look suspiciously like rats deserting a sinking ship. Our organisation had been through the wringer in January and February, and we were still finalising a major management restructure and a full salary review. We now had COVID-19 cases, our activities partially suspended, and our staff feeling terrorised. The COVID-19 vaccine, the first doses of which are arriving on Monday, would surely help dampen people’s anxieties (if they agreed to have it), but that could still be months away for our staff. How does one pass the baton confidently in such circumstances?
We did it the only way that anything gets done in Timor – using Whats App.
We sent messages to notify staff, and introduced the new Executive Director and Clinical Director as best we could. The new management structure was socialised the same way. It lacked any of the pomp and ceremony, nor even the simple warmth and practicality, of a face-to-face event. There would be no farewell speeches, no parties, possibly no further meeting with anyone at all.
This is our inglorious ending. If we had hopes of a victory lap they have been soundly laid to rest. We still have a last surge in front of us to complete our work in April and early May, and then a scramble to pack up five years of our life and head on home, via quarantine in Darwin.
Sometimes you do your best and things just don’t quite work out how you expect. On our holiday we went fishing a few times, without much success. My designated job was to dive in with the mask and snorkel to free our hooks from the many rocky snags, sometimes up to a dozen times in a single trip. Levi got snagged when fishing off the beach at Lakumorre and the locals laughed as the foolish white man swam back in again to fetch it. I held my breath and followed the line down to the bottom, finding that it tracked back under a coral ledge. There was a degree of resistance but I eventually pulled it free only to find a sea-snake on the end of it. Levi reeled it in… it wasn’t the catch we were after, but it was memorable.
I don’t like to suggest that our finish will be akin to catching a sea-snake but however this story ends, we can be confident it won’t be quickly forgotten.