Arrived in Darwin after midnight on Friday night, woke up early the next day while it was still dark. It was worth it – nothing beats watching the sun rise from a vantage point up in the clouds. 45 minutes later, we were descending into the land called Timor Leste, sometimes known as “East Timor.” Through the window we could see sheets of mist blanketing the tree-covered hills, and a sleepy haze over the lush green land…

The first thing you notice when you step off the plane onto the tarmac is the heat – the stickiness that preludes the sweat that begins to fall off every body surface you never knew existed. The next thing you notice is the smell: the thickness and humidity, the chemical smog, all tempered by a faint, lingering smell of body odour… It was a sensory reminiscence of PNG. So too were the corrugated iron roofs; the stray dogs pottering around the streets; the stalls where bottles of cold water and knick-knacks were peddled; the piles of rubble, signs of shabby half-development here and there…

All these sights and sounds and smells were to me, the thrill of a new place, and reminders of the reality of the people who live in those conditions there day by day.

Some quick stats about Timor Leste:

Bairo Pite Clinic is a community health care centre located in the heart of Dili, the capital of Timor Leste. Run by a small group of passionate volunteers on donations alone , it provides free, quality health care around the clock, 24 hours a day, 7 days a week. On top of treating patients with a wide variety of conditions, they also provide opportunities for volunteering, training and employment for local Timorese; and volunteer positions for doctors and medical students.

It’s not an easy environment to work in. Humid, limited resources, and language or cultural barriers are amongst the challenges faced on a regular basis. But most importantly, they are team who exhibit resilience and are expert at finding innovative solutions to get on the job.

So, we took a tour of the hospital Bairo Pite Clinic for a few hours in the morning: outpatients, general admissions, malnutrition ward (you know you’re in a developing country when malnutrition is even such a problem…), maternity ward, tuberculosis (TB) wards, and HIV centres. It’s the little things that brighten up the compound: the cheerful tropical fish and rainbows are painted onto the sky-blue walls of the malnutrition clinic, and the lilac-coloured shipping containers converted into the HIV/TB Dots clinic centres. At the front of these lilac buildings is a humble garden that was planted together by the initiative of patients and their doctors.

TB is a terrible burden on the Timorese people, even more so than in PNG. The tragic effect it has was made strikingly apparent on one of the patients. Due to TB, his body was wasted away so he was little more than skin and bones. His eyes protruded from a sunken face, and his demeanour emanated suffering and loneliness. 

In the afternoon we had a series of presentations from the hospital team to the supporters. What I found to be most interesting were the talks from local staff, especially of the lay midwives in training. These women had been elected from their own home villages to come to Bairo Pite and undergo a month of midwife training, during which time they may experience around 300 deliveries.

As Sue said, it is inspiring to see when people are motivated to help their own people. Let’s face it – nothing will get done unless health care is modelled around partnership with local communities.

MEET SUE HUNTLEY, Co-founder of Hepatitis B Free!

Sue Huntley has been a passionate and active member of Hepatitis B Free since its very beginnings, and was part of the original team of five who first travelled to Papua New Guinea in 2013. Capable, professional and resilient, she organises a plethora of logistical issues in addition to providing medical aid using her nursing experience. Amongst her favourite things in life are travel, dancing, telling jokes, and her beautiful children and extended family.

How did you get involved with Hepatitis B Free/What made you decide to come on the trip?

Alice and I were talking and I was telling her about the charity “Habit for Humanities Vietnam”, and that it was too physical for me. She asked if I thought that vaccinating in a little village in PNG might be doable, I said yep, and then she told me the story of Kerry and what she wanted to do. I was hooked.

Tell me about your medical background. What experience or skills did you find to be most useful during your time in the clinics?

I was a registered nurse for twenty four years. Nine of those were on night duty…I worked ‘agency’ to fit in with the nights I could work and look after the children. This was a great foundation as I would meet new challenges every day, rarely working in the same environment. After night duty, I worked at Concord Hospital for 14 years, where I worked at research programs and climbed the nursing ladder, which allowed me to finish my nursing career as a clinical nurse consultant (CNC), in gastroenterology and upper GI surgery.

Fourteen years ago, I decided I needed a career change and went into clinical research within the pharmaceutical industry. After a number of years, I decided to start my own independent consulting and contracting in clinical research services within this industry. My initial career change never took me far away from medicine or nursing and allowed me to continually update my medical and nursing knowledge.

Although for the most part it was hands off, I have still taken an active role in regularly conducting education sessions to health care professionals, including doctors and nurses, on clinical research protocol, procedures and then assessing their performance. In more recent years I have extended my services to include project management of Australasian studies, which is now what I am currently involved with. The adaptability of being able to not confine anything that I do, learn quickly and then adapt to any environment allows me to pick up any challenge and step into almost any role that would be required for a trip into remote environments.

What did you find most challenging about the trip?

The physical side (being a couch potato). Getting from point A to point B in a set time frame can be challenging when you are unfit, overweight and not inclined to do training.

What surprised you?

What surprised me the most was my empathy for the women of the remote villages. Here were a group of women who have a hard life every day, and they acceptance it without question and with gratuitousness. They showed such fortitude to their environment and I did not hear one complaint from the local women on either trip.

What made you laugh?

How foolish I felt when I encountered the “First world problem” of how to deal with dirty clothes, shoes…with the lack of washing facilities, no bathroom and flies that were attracted to me for my own aroma.

Cry?

When I left, I felt as though I had only just started, that there is so much to do and so much that I might be able to do. I missed the people before I even left.

What was your most memorable experience on the trip?

From the first trip: the generosity of the locals in preparing all our meal and going without themselves (unbeknown to us at the time), accepting the differences of our culture and sanitation requirements and wanting to assist in any way they could. For example, carrying supplies, translation, shelter construction.

From the second trip: my most vivid memory is the stark difference that health care makes to those that are able to access it. At the remote village region we had been in for 4 days, there were locals bringing their families to the clinics with basic medical issues such as worms, skin condition, sanitation (cleanliness and clean cloths) and many unknown ailments including ulcers and unclean open wounds. In comparison, at the clinics in the town Popondetta we visited, the general health of the population appeared to be better looked after. The children had clean faces and by comparison there were minimal skin conditions and ulcers.

Weirdest thing you ate/did?

Still mulling this one over (still unable to face yams)… the time we spent in the remote highlands during both trips was surreal. The weirdest thing was more of a thought process. When the penny dropped and I realised that women were held in such low esteem, I just laughed and thought, “Do they really believe that?”

How has it impacted the way you see the world?

I have seen the world differently for many years, although my trips to all of the countries I have visited have never failed to reinforce how very lucky I am to live in the ‘lucky country’ of Australia. This was not planned or a choice I could have made, as I was born in Australia, but it does give me the opportunity to have a great education, choose where and how I want to live, eat well, and access health care or other government services very easily. I feel humbled that I am able to assist/help others who are living through their country’s development or struggle, and to realize its full potential through the people and the health of those people.

Sunday March 2, Federation Square, Melbourne

Amongst the striking architecture of Melbourne’s Federation square, hundreds gathered to support and spread awareness about Hepatitis B in the community. It was a joint event run by a few organisations, including the ACMAV (Australian Chinese Medical Association in Victoria), Hepatitis Heroes and Team HBV, an initiative run by a group of passionate medical students in Melbourne. 

These students, mainly post-graduates from Melbourne university and Austin Hospital, have been working on various projects over the last year to further community education of Hepatitis B, and are in the process of becoming a chapter of the Stanford University Team HBV/Jade Ribbon group. As a growing Melbourne Team HBV faction, they aspire to one day link up with other states as a united Australian Jade Ribbon chapter.

The Jade Ribbon campaign, symbolised by a jade-turquoise coloured ribbon artfully designed in the shape of the Chinese character for “person”, represents the movement of people “united against Hepatitis B Virus and liver cancer”. Part of a growing global movement, this campaign aims to raise awareness about the danger and high prevalence of Hepatitis B amongst at-risk demographic groups. This predominantly refers to those people born overseas in areas where Hepatitis B vaccines are not part of the national immunisation program, or where there is little information available about the transmission and consequences of HBV. Asia, Africa, Eastern Europe and South America are amongst the identified risk groups who are strongly urged to be screened for HBV.

Mum was there to give a short talk at the rally as the representative (President) of KAMS (Korean Australian medical society), as well as to support and learn from the volunteer activity in Melbourne. I was essentially there to ghost her, document the movement, and to learn and create a partnership with the student volunteers in Melbourne.

It was inspiring to see the sheer numbers who gathered in federation square that morning. Members of the community who came to support the cause, many of whom had wandered through by chance. The student volunteers were united by their Jade-ribbon shirts, and disseminated into the crowd as if on street patrol: handing out brochures, informing the public about the nature of, vaccination and screening for HBV, and gathering signatures for a petition for government-supported screening of HBV in Victoria.

The medical students were passionate about the cause and willing to get out there and pitch in. In preparation for the event, Team HBV had created shirt and poster designs, created an educational slide-set to project onto the huge screen in Federation square, and gathered volunteers to be around on the day. Last year they had also created a documentary in which they interviewed Hepatitis patients, snippets of this student-made video were also playing on the big screen. 

I pulled a Jade ribbon tee-shirt over my head, and spent some time helping out in what the other volunteers were doing: promoting HBV awareness in the community. The process of talking about HBV with others helped to consolidate my own understanding of the viral infection…proof that teaching is the best form of learning. And seeing the photo slideshow of photos from our PNG trip rolling through on the big screen wasn’t bad either (!!).

I was told by a teacher at the Melbourne Chinese Ethnic School (a multicultural centre for the teaching of Chinese language) that the school received regular visits from a doctor who encouraged and taught parents to do Taichi (Chinese shadowboxing”) for health, and talked to the teachers and students about their health. 

The children, even given a short week’s notice for the event, had created a series of posters about HBV and liver, in both Chinese and English. Even if the young’uns contributed by cutting out a picture of the liver and sticking it on the cardboard, it was an important process of being part of health awareness, and meant that they were aware of issues like HBV from a young age. 

The presence of the volunteers and atmosphere of the event was a testament to a spirit of giving and initiative demonstrated throughout this Melbourne community. The ACMAV (unlike the Sydney group) seemed to be so involved in community education programs. And it seemed like almost every Melbournian I approached was happy to sign the HBV screening petition, or find out a little more about HBV. There were many moments throughout the day that I threw up my hands and questioned why we were lacking this in Sydney?! Or is there a whole movement already existent in Sydney that I'm not even aware of?

The Melbourne launch in Federation square was a collaborative effort that promoted community health education on a grass-roots level: essentially rallying a group of passionate volunteers to disseminate information through a street patrol. It didn’t seem like anything that we couldn’t replicate in Sydney…using street teams of Hepatitis B Free uni students to volunteer at Hepatitis B Free events. 

We’re not looking at miracles here: how much media coverage have we seen for movements like HIV/AIDS, breast cancer, lung cancer, skin cancer etc.? And I believe that when there’s a job to be done, there’ll be good people ready and willing to work together to get it done.

Carrie