HAI in Post-conflict Timor-Leste: Support and Solidarity WRIHC – April 5, 2014 Mary Anne Mercer.

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HAI in Post-conflict Timor-Leste: Support and Solidarity WRIHC – April 5, 2014 Mary Anne Mercer

 Former Portuguese colony  Illegal and brutal occupation 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: 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 : 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!