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46 Speak Out June 2016
Northern
Territory
NT 43
Members
After 400 years of occupation and 25
years of civil war, Timor-Leste (East Timor)
officially became an independent nation in
May 2002. This small country lies 640kms
northwest of Darwin—less than an hour’s
flight away, but the difference in health status,
education opportunities and economic
success compared with Australia’s, could
not be more different. This developing
nation is still recovering from years of militia
occupation and the decimation of lives,
culture and infrastructure was the price paid
for independence. But the Timorese are
resilient, and over the past 17 years, with the
help of the international community they are
slowly rebuilding.
Mr Mark Moore is a cleft surgeon who is part
of the Royal Darwin Hospital Cleft Lip and
Palate Team. He has been travelling to East
Timor and other Asian countries for over
15 years, providing plastic surgery, with the
support from the Overseas Specialist Surgical
Association of Australia, an NGO dedicated
to providing surgical services around Asia.
In East Timor, Mark has conducted and
supervised over 800 cleft surgeries and
trained local surgeons in cleft surgery and
management.
Mark invited me to go to East Timor in 2013
on one of his surgical missions and I have
since participated in two more missions.
The team (plastic surgeon, theatre nurse
and anaesthetist) works from the Hospital
Nacional Guido Valadares, located in the
capital, Dili. Timorese travel from all parts of
the country for their consult with the visiting
cleft team. Many children, and the occasional
adult, present with a variety of unrepaired
clefts. Those that can have surgery are
offered an appointment and I am in awe of
the hope these teams give to the patient and
their families.
Alotu is the first and only practising speech
pathologist in Timor who graduated in 2012
from Akademi Terapi Wicara-YBW Jarkarta,
Indonesia. With the assistance of Rotary,
Alotu has visited Australia to observe speech
pathologists in a number of clinical settings,
including Darwin.
Alongside Alotu, I have conducted feeding
and speech assessments for children pre and
post-surgery. Breast feeding is the norm in
Timor and trying to explain the mechanics of
sucking and suction and the impact of
clefting can be a hurdle. The availability
of appropriate feeding equipment is also
problematic. I have seen teats with tops
chewed off to increase flow and mothers
expressing into spoons to feed the baby.
Another challenge is convincing families to
return after cleft repair for speech follow up.
One of the major barriers is distance, as Alotu
is located in Dili and the travel from districts
to the capital can be tough. Helping families
understand the purpose of therapy is another
challenge—many do not comprehend that
one session with the therapist (and no home
practice) is not going to change a speech
problem.
There is much work to be done to raise the
awareness of communication problems and
the impact upon the individual and their
families in East Timor. Alotu is very keen to
build up the speech pathology services in
East Timor. If anyone has an interest in East
Timor or is heading there, please let me know
and I can put you in touch with Alotu.
Celina Lai - Speech Pathologist
Speech Pathology in Timor-Leste
Speech Pathologist Alotu
Branch News
as at April 2016