| GVs East Timor - Scenery/Kids playing | Music | 00:00 |
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| MCNEILL: Pretty much everything moves slowly in this languid little place on Australia's doorstep. | 00:10 |
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| Music | 00:16 |
| Morning. People going to work | MCNEILL: As morning unfolds, people gradually make their way into the early light and their day ahead. | 00:31 |
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| Music | 00:36 |
| McNeill on back of motorbike | MCNEILL: It's all very unrushed - unless you're on a motorbike and you're heading into the mayhem of Dili's Bairo Pite Clinic. | 00:46 |
| Inside clinic | Music | 00:55 |
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| MCNEILL: Here it's action stations and American Dr Dan Murphy is off and running on his relentless rounds. | 01:02 |
| Murphy with patients | Music | 01:09 |
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| DR DAN MURPHY: "There is really no access to anything near adequate healthcare. | 01:13 |
| Murphy interview | In every category in health, their numbers are worse than most of South East Asia". | 01:17 |
| Murphy examines child |
| 01:23 |
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| MCNEILL: One man and his small team of volunteers, taking on a case list that would overwhelm many medical professionals. | 01:27 |
| Murphy with child's mother | DR DAN MURPHY: [asking mother of a young girl] "Does she speak to you?" GIRL'S MOTHER: "Only sometimes". DR DAN MURPHY: "Does she play?" GIRL'S MOTHER: "Not really". | 01:34 |
| Sick child | DR DAN MURPHY: "So she only sleeps?" GIRL'S MOTHER: "Yes. Just sleeps". | 01:40 |
| Murphy with child and medical volunteers | DR DAN MURPHY: "The chronic nature of it still makes me lean towards TB". | 01:43 |
| Patients at clinic |
| 01:47 |
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| MCNEILL: To the north of here, the booming bustling nations of South East Asia and their increasingly sophisticated medical systems. | 01:59 |
| Woman at clinic. Murphy examines | DR DAN MURPHY: [in ward] "She's had fever, cough and shaking chills for a week". | 02:07 |
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| MCNEILL: To the south, Australia and its internationally recognised healthcare. | 02:12 |
| Murphy looks at X-rays | Dr Dan is in the thick of arguably the biggest health crisis in our region, but his clinic and Dili's main government run hospital have precious little money, medicine or technology to deal with it. | 02:19 |
| Murphy interview. Super: | DR DAN MURPHY: "There's very few things we can do. We don't have very many meds, we don't have very many diagnostic tools, so mostly | 02:33 |
| Murphy with patients | we're going by smoke and mirrors and trying to make a good lucky guess and hope that people get better. But | 02:40 |
| Murphy interview | you can't do as well as if you had all the right tests". | 02:48 |
| Emaciated patient being carried into ambulance | [in ward] "You can see he's down to almost no weight. I think he's 20 kilos or something. It could be something that were he in a more developed country he could be cured. It's very sad". | 02:51 |
| Ambulance drives away | Music | 03:11 |
| Tomas in classroom with students |
| 03:23 |
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| MCNEILL: Across town, year ten students at Dili's largest high school are settling into class. Out front is teacher Tomas Pinto. | 03:26 |
| Tomas at whiteboard | TOMAS PINTO: [to the class] "I join these lines together. How does that look?" | 03:38 |
| Students in class | MCNEILL: In many ways the challenges facing Tomas in this school are similar to those confronting Dr Dan at his clinic. Scant resources and a massive task, preparing these kids for a challenging world. And if that wasn't difficult enough, Tomas is dangerously ill. | 03:45 |
| Tomas on motorbike | When he was younger he had rheumatic fever, a common illness in East Timor that can lead to life-long heart trouble. | 04:07 |
| Tomas riding alongside ocean | Tomas first started feeling sick about a year and a half go. | 04:24 |
| Tomas arrives home | TOMAS PINTO: "My family noticed it. I hadn't really thought of it myself - but then others noticed, and they started saying "Hey, why are you like this?" | 04:30 |
| Tomas interview | And so I knew I needed to see a doctor. I don't have strength. Sometimes, I can't catch my breath. Sometimes I get dizzy - sometimes I just black out". | 04:44 |
| Murphy interview | DR DAN MURPHY: "Tomas Pinto could die at any moment. His heart is that bad". | 04:57 |
| Pinto family meal | TOMAS PINTO: "What are we eating?" | 05:03 |
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| TOMAS PINTO'S WIFE: "Only vegetables". TOMAS PINTO: "Ok, I'm going to wash my hands". TOMAS PINTO'S WIFE: "Please follow your father to wash your hands". | 05:07 |
| Murphy interview | DR DAN MURPHY: "He has mitral stenosis which is one of the big curses of the tropics and this valve gets smaller and smaller and smaller | 05:13 |
| Pinto family meal | and pretty you soon, you know, you get a stroke or you die".
| 05:21 |
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| MCNEILL: There's quite a simple procedure that would fix Tomas's heart, but specialist cardiac surgery is just one of the many kinds of operations not available in East Timor. | 05:30 |
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| TOMAS PINTO: "There are many parts so far underdeveloped - resources and government areas of specialisation | 05:40 |
| Tomas | such as heart operations, for example. We don't yet have our own heart specialists". | 05:50 |
| Pinto family/Pinto home | MCNEILL: Tomas's best chances lie overseas but a modest teacher's salary in Dili doesn't get you to a foreign hospital and his hope of moving up the long government waiting list for international care isn't great. All he can do is wait and pray. | 05:58 |
| Fast motion Murphy in clinic with patients | Music | 06:17 |
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| MCNEILL: This isn't the only place to get treated in town but it's certainly the busiest. Among the hundreds of people seeking diagnosis and treatment every day at Dan Murphy's clinic, there'll be those like Tomas Pinto who can't be helped - and then there'll be those whose illness would shock and confound a big city casualty department. That's when this doctor and his team come into their own.
| 06:22 |
| Murphy examines child | DR DAN MURPHY: [asking a young child whilst touching his face] "Do you feel anything here or there?" CHILD'S MOTHER: "It's sore". MCNEILL: Five year old Paulo is a suspected case of leprosy. A terrible disease in days gone by where people lost limbs and were banished to isolated colonies. | 0653 |
| [continues] | DR DAN MURPHY: "Is there any numbness in the hands or feet?" CHILD'S MOTHER: "No". DR DAN MURPHY: "They're OK?" CHILD'S MOTHER: "Yes". DR DAN MURPHY: "Hold up your top, let me see your skin. | 07:08 |
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| (to assistant) Test for leprosy. | 07:19 |
| Nurse with child | NURSE: [to young child] "Come inside". | 07:29 |
| Nurse tests child | MCNEILL: Paulo's dad has leprosy and there's concern he's passed it onto his son. | 07:37 |
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| NURSE: "So when you feel the pen press, show me where it is. Straight away, OK? And if you feel it somewhere else, show me but keep your eyes closed. Understand?" | 07:45 |
| Nurse touches child with pen |
| 07:59 |
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| MCNEILL: East Timor has the highest rate of leprosy in South East Asia. It's a disease that's completely treatable and utterly preventable. | 08:08 |
| Murphy interview | DR DAN MURPHY: "We still see it and in fact in the last month I think I've seen seven cases, though the district of Oecusse has over 500 registered cases". | 08:17 |
| Murphy playing basketball | Music | 08:27 |
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| MCNEILL: About the only things Dr Dan holds onto from his past as a GP in America's mid-west is his accent and his love of basketball. | 08:39 |
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| Music | 08:46 |
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| MCNEILL: He'd worked in other disadvantaged parts of the world when East Timor caught his eye. He saw a need, packed his bags and left Iowa. That was 16 years ago. | 08:56 |
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| Music | 09:06 |
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| DR DAN MURPHY: "I mean it's not just the practice in Iowa, it's also how does one go about extricating themselves from the middle class. | 09:14 |
| Murphy interview | So I found ways of just slash and burn, get rid of everything". MCNEILL: "You literally just sold everything and moved to Timor?" DR DAN MURPHY: "Came with one little bag. Yeah". | 09:26 |
| GVs East Timor | Music | 09:37 |
| Mining/Oil shots | MCNEILL: After Indonesia relinquished its control, substantial aid began to roll in here. In recent years, proceeds from oil and gas mean there's more money in East Timor than there's ever been. Yet according to the UN, two thirds still live in poverty - a third in severe poverty. There's still billions of dollar's worth of unexploited resources sitting in the Timor Sea, but as Australia and East Timor continue to wrangle over who owns the oil fields, | 09:44 |
| Clinic | these extra billions remain in the seabed. DR DAN MURPHY: "East Timor has never had a chance to develop like the rim of Asia. | 10:18 |
| Murphy interview | East Timor has never been given an opportunity. They were a colonial, part of the colonial empire of Portugal for 500 years and then a brutal military occupation by Indonesia for 24 years that knocked everything else out". | 10:28 |
| Malnutrition ward | Music | 10:42 |
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| MCNEILL: East Timor has some of the worst malnutrition rates outside of Africa. Nearly 45% of children under 5 are classified as underweight. The clinic runs a busy inpatient ward, dedicated to treating undernourished kids. | 10:50 |
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| Music
| 11:08 |
| Ozmenia | MCNEILL: Four year old Ozmenia arrived weighing just 6.7 kilos. She just keeps getting diarrhoea and being readmitted. "Ozmenia is actually four years old". NURSE: "Yeah she's four years old". | 11:18 |
| McNeill with nurse | MCNEILL: "And why is she so malnourished?" | 11:30 |
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| NURSE: "Okay, she's malnourished because the mum has lots of children and they are really poor. They live in the mountains and it's really hard for them to get the water - they have to go down and get the water. It means they don't really have like good hygiene". |
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| Nurse feeds Ozmenia | MCNEILL: "Lydia and Sylvia, the carers in charge of this ward, do everything they can to make eating enjoyable. | 11:52 |
| Malnourished twins | Their efforts pay off. These five month old twins arrived weighing only 2 kilos each. SYLVIA: "They came, very skinny, about | 12:12 |
| Sylvia with baby | two kilos and sister about 2.6 kilos. Ah now she's four kilos". MCNEILL: "So the babies have more than doubled | 12:24 |
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| their weight in the past six weeks". SYLVIA: "Yes". MCNEILL: "It's a success story here in the malnutrition room". SYLVIA: "Yes of course - and I'm very happy". | 12:36 |
| Sunset/People walking to church | [singing] | 12:45 |
| Tomas in church | MCNEILL: For schoolteacher Tomas Pinto, faith and prayer have finally paid off. An Australian charity called "East Timor Heart Fund" will pay for him to fly to Melbourne and undergo life-saving surgery. | 12:55 |
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| TOMAS PINTO: "I am so very grateful. When I go to have the operation, I will be offering myself to God | 13:18 |
| Tomas interview | and to my doctors, and trusting they will look after me". | 13:27 |
| Murphy interview. Super: | DR DAN MURPHY: "We are so fortunate to have a group in Australia who have found ways to give state of the art care to poor Timorese people, free. It's amazing. And actually, to tell you the truth, Australians in general I have found to be most generous people". | 13:24 |
| Tomas to Melbourne sequence | Music | 13:53 |
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| MCNEILL: Tomas Pinto had never flown before and certainly never experienced the sort of cold Melbourne's turned on for his arrival. Members of the local East Timorese community are there to meet him. | 14.03 |
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| TOMAS PINTO: "It is the first time that I have travelled outside my country... so yes I feel happy!" | 14:23 |
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| MCNEILL: Tomas is on his way to the cardiac unit at Monash Medical Centre and while the patient heads to the expertise here, | 14:36 |
| Medicos visit villages | in East Timor, the expertise is heading out to the patients. | 14:45 |
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| Music | 14:51 |
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| MCNEILL: Most of East Timor's population live outside the capital, in regional towns and tiny villages scattered across the island. | 15:02 |
| Village GVs | Music | 15:10 |
| McNeill in car | MCNEILL: "Now we're out of Dili, we're on some really remote and rough roads here in the mountains of East Timor and we're going to one of the Bairo Pite Clinic's remote visits. Now where we're heading the people there might only get to see a nurse or a midwife once a month if they're lucky so there could be dozens of people waiting for us when we get there". | 15:24 |
| Rural scenery | Music | 15:40 |
| Goncalves in car | MCNEILL: We're following Aida Goncalves who's based out of Bairo Pite Clinic. She's a piece of paper away from her medical degree and is one of the country's most experienced obstetric specialists. | 15:49 |
| Goncalves | DR AIDA GONCALVES: "I've been doing this for six years and every time I come out here I always get inspired because you know you never know what you.... you know, you might find out in the villages". | 16:01 |
| Village | Music | 16:09 |
| Car crossing bridge | MCNEILL: On these roads you never know if you're going to get there safely.
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| DR AIDA GONCALVES: "Oh Jesus... Oh Saint Anthony... Oh Saint God's Mother.. Yes I think we should get out of the car. Wait! Get out! Okay get, get out of the car". MCNEILL: This bridge is missing a few wooden planks | 16:22 |
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| and the back wheel is nearly hanging off the side. DR AIDA GONCALVES: "Sabino, you have to get out of the car. Come and have a look. Stop. Stop! Don't drive! | 16:38 |
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| You could come and see from the front, here! See how fun this is? This is what we do. [Sabino gets car across the bridge] Yeah, yeah!!! Hallelujah!! [laughing] All right. So you almost died! That's why I told everyone to get out of the car!" | 16:52 |
| Arriving at village | MCNEILL: After four hours, we arrive in the remote village of Hatu-lia and the crowds have gathered for Dr Aida. | 17:18 |
| Goncalves weighs baby | DR AIDA GONCALVES: "How old is the baby?... 7.2 kilos." MCNEILL: She understands these women and the difficulties they face living out here. | 17:35 |
| Goncalves with patients | Dr Aida grew up just a few villages away. | 17:49 |
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| DR DAN MURPHY: "Those are her people. She's going to try to do something for them and she was lucky enough to be able to go
| 17:58 |
| Murphy | for five years to get medical education in the US and come back and not lose sight of where she came from, and go back to those villages". | 18:04 |
| Goncalves with villagers | MCNEILL: If there was a doctor like Aida around when she was young, her family might not have lost three sons to preventable illness. DR AIDA GONCALVES: "Two of my brothers they died when one was a year and a half, the other one was two. Both of them died of diarrhoea - | 18:13 |
| Goncalves interview | something in your country it's... diarrhoea don't, don't kill - yeah, doesn't kill people. But here in Timor it kills a lot of people especially babies and you know we live so far away from the hospital and you know, they had diarrhoea and my mother did not know what to do, so you know, they died of dehydration". | 18:32 |
| Goncalves with villagers | MCNEILL: Aida's other brother died of an asthma attack at 17. | 18:51 |
| Goncalves with woman and baby | DR AIDA GONCALVES: [to a village woman] "Did you deliver the baby at your house?" VILLAGE MOTHER: "Yes". DR AIDA GONCALVES: "Okay. Who was helping you?" VILLAGE MOTHER: "My husband". DR AIDA GONCALVES: "Only your husband? Why didn't you go to hospital?"
| 18:57 |
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| MCNEILL: Every second day a woman in East Timor dies in childbirth - one of the highest maternal death rates in Asia. DR AIDA GONCALVES: "They live so far away from the hospital | 19:06 |
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| and, you know, imagine you have to walk, you know you have contractions, you know you're in labour pain and you have to walk all the way from where you live, to the hospital. From here to the hospital it's about 45 kilometres so yeah a lot of women they choose to have the baby at home because of that - | 19:20 |
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| the distance from their homes to the hospital". | 19:37 |
| Monash Medical Centre exterior |
| 19:42 |
| Tomas in hospital |
| 19:46 |
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| MCNEILL: In Melbourne, preparations are under way for the operation to repair Tomas Pinto's rapidly narrowing heart valve. | 19:49 |
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| MELBOURNE DOCTOR: "We're hopeful that we will get a good result so that you'll be a lot better and you'll be able to go back | 19:57 |
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| to teaching with a lot more energy". TOMAS PINTO: "I trust you". | 20:02 |
| Tomas is wheeled in to surgery | MCNEILL: Tomas's rheumatic heart valve disease is rarely seen in Australia so this procedure isn't so common. | 20:10 |
| Operating theatre |
| 20:23 |
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| Tomas's surgeon inserts a tiny balloon that will inflate and widen the valve that's been restricting blood flow. | 20:33 |
| Tomas on operating table | He should be able to breathe much easier and look forward to a longer life. | 20:57 |
| Tomas in recovery room | Of course Tomas Pinto is just one example of a terrible illness that could be simply solved by expertise and resources. DOCTOR: "Feel much better? Happy?" TOMAS PINTO: "Happy. Very happy". [Tomas gives the thumbs up] | 21:07 |
| Murphy at clinic examining Sergio | MCNEILL: But not everyone is so lucky. DR DAN MURPHY: "He's got a cough. I think it's mostly likely a nasopharyngeal carcinoma". | 21:19 |
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| MCNEILL: "Does that mean cancer?" DR DAN MURPHY: "Yeah. Which has pretty good treatment, but it would include radiation and chemotherapy. We don't have either one. | 21:31 |
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| In a developed country he'd have a pretty decent chance. It's another tragedy right here of a young kid". | 21:41 |
| Murphy interview | "We cannot deal with almost any kind of cancer very well at all". | 21:50 |
| Malnutrition ward | MCNEILL: Sergio's baby sister is a patient in the malnutrition ward. He's the second oldest of five kids. | 21:54 |
| Sergio with mother | SERGIO'S MOTHER: "He's very cheeky. He and his friends come home from school and play and eat together. He really is cheeky. And then, one day, he came home with a bleeding nose". | 22:10 |
| Sergio | MCNEILL: Sergio is in year three but he's stopped going to school. SERGIO: "I used to be good at soccer, but now I'm too sick. All I can do is sit or lie down as I get sicker and sicker". | 22:33 |
| Sergio lying on bed | DR DAN MURPHY: "The surgery is not good enough, we don't have the chemotherapy, we don't have the laboratory back up that you would need to run chemotherapy programs. We don't have radiation. So | 22:57 |
| Murphy interview | when you have cancer, it's very serious. You're going to probably succumb to that problem". | 23:09 |
| Candle | MCNEILL: East Timor doesn't have a dedicated palliative care program. Morphine is in short supply and rarely used. | 23:17 |
| Murphy sits with Jekka | DR DAN MURPHY: [to Jekka, a young boy] "How are you? Are you a little better?" MCNEILL: In a ward on the other side of the clinic, 11 year old heart patient Jekka Pereira has just received good news. | 23:27 |
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| An Australian cardiologist is coming to Dili in a few weeks to do an ECHO on his heart, a diagnostic test not normally available here. "What kind of quality of life does Jekka have at the moment?" | 23:41 |
| Murphy | DR DAN MURPHY: "He's limited in what he can do because he gets out of breath and you can see he's frail. He can't climb up and get a coconut. He can't play like other kids do". | 23:53 |
| Jekka | MCNEILL: Once his exact condition is known, he's eligible to be the next patient heading overseas for lifesaving surgery. | 24:02 |
| Jekka has passport photo taken | Jekka and his mum are even getting passport photos in the hope it will happen soon. | 24:10 |
| Melbourne. Marathon event |
| 24:24 |
| Tomas at marathon | Tomas is providing plenty of inspiration for patients like Jekka. Just days after his surgery, he's the East Timor Heart Fund's guest of honour at the city's half marathon. He won't be running, but his presence will put a spring in the step of many of the participants here. | 24:28 |
| Tomas | TOMAS PINTO: "I came here today to see how I'd go - and I felt the difference. I went up the stairs and it was fine - not like before". | 24:53 |
| Sunset/Kids on beach | Music | 25:03 |
| Stills. Clinic patients | DR DAN MURPHY: "I still feel like healthcare should be equally provided for everyone. I do not think we should accept in any way that rich people get one standard and poor people get another standard - and if you're born here you don't get it, if you're born there you get everything". | 25:19 |
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| Music | 25:39 |
| Sunset |
| 25:44 |
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| Further Information/How to Donate | 25:49 |
| Credits: | Reporter: Sophie McNeill Editor: Garth Thomas Producer: Ian Altschwager |
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