77 Cases of HIV / AIDS In East Timor

from 2005 until 2010 the population of Timor Leste who suffer from HIV / AIDS reached 77 people and 16 people have died, Among which there are two children die at the age of carry.

on the other hand VCT chairman HNGV (Timor Leste National Hospital), Maria de Fatima Ximenes do Rego among people with HIV / AIDS there are already married and some are derived from the youth.

of all cases have been found comes from VCT HNGV and also from non Govermental organizations working in the humanitarian field.
total patients found there are still patients who are still actively running intensive care and also there have been vague because it does not receive clear and accurate description of the hospital.

drugs used by people with HIV / AIDS in Timor Leste is profilatif and futritutif these drugs obtained from the Institutional SAMES. These drugs are not for healing HIV / AIDS but only to kill some viruses that can cause dry and thin until death.

relating to HIV / AIDS health minister Dr. Nelson Martins, MD, MHM, PhD says in its intervention to combat the virus HIV / AIDS in Timor Leste government through the ministry of health has had strategy which can be used as the best advice that is.
 government through the ministry of health in collaboration with associate doctor to further strengthen East Timor VISITIL program for people with HIV / AIDS can join the program.

the umpteenth cases there is stout case of the mother.
therefore the health ministry has recommended to the mother who suffered from HIV / AIDS with the help of medicines for children in the womb are not infected with HIV / AIDS.

HIV / AIDS is the most deadly diseases including tuberculosis.
diseases such as HIV / AIDS found in many Timor Leste in 1999 after peace mission troops arrived. But after the government of Timor Leste stand alone initiate cooperation with the development partnership to control the disease.
Dr. Martins also said that at this time in Timor Leste has a laboratory to control the disease of HIV / AIDS on purpose. There is also a doctor of timor leste specialist dealing with HIV / AIDS. MS01

MDG Six in Timor-Leste

Goal Six: Combat HIV/AIDS, Malaria & Other Diseases

Target 1: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Scorecard for Timor-Leste: Insufficient data/information
Target 2: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Scorecard for Timor-Leste: Insufficient data/information
Timor-Leste is currently experiencing a low level HIV epidemic. Prevalence was less than one per cent in both the 2004 and 2007 studies conducted by WHO. There is also evidence of a low level epidemic in that the total number of HIV case detections so far in the country is less than two hundred. Health workers and community workers in Dili have noted that there are a few women widowed by AIDS and children orphaned by AIDS. Mother to child transmission of the virus has also been noted and children have died of HIV disease. These findings indicate that HIV has been present in the country for up to ten years. However, low HIV prevalence at present does not indicate that there is low HIV vulnerability. There are clear indications that Timor-Leste has many of the factors that increase vulnerability to HIV. Poverty and limited opportunities for income from employment, especially for women, push people into high-risk behaviour. This includes both commercial sex and transactional sex. Low levels of literacy make social mobilization and HIV prevention education more challenging. Although it has other impacts on the epidemic, gender inequality increases both the supply and demand for commercial sex. Timorese women are driven to sex work by poverty and Timorese men have disposable income to purchase sex. Timor-Leste is reported to have extremely high levels of gender based violence. Sexual violence and gender-based violence undermine women’s ability to negotiated safe sex. There are anecdotal reports that trafficking of women into exploitative sexual situations occurs within Timor-Leste. There have also been unconfirmed reports of women trafficked to and from the country.
Prevalence of malaria in the country as well as the number of deaths associated with the disease was 10.7% in 2007. Urban dwellers are better equipped to prevent malaria than their rural counterparts where there is high risk of malaria incidence. Nevertheless, the proportion of people sleeping in insecticide-treated bed nets is still a matter of concern. Only about one fifth of urban population use treated mosquito nets. This situation had not improved much since 2001. Unless new malaria treatment strategies are effective and the population is fully covered, the target of 45% by 2010 and 60% in 2015 could be difficult to achieve.
Global Tuberculosis Control as the provider of such indicator estimated an increasing trend during 2005-2006. The prevalence rate was 713 cases per 100,000 people in 2005 and increased to 789 cases in 2006. Reports also indicate the number of deaths associated with tuberculosis up to 88 per 100,000 people in 2005 and hiked up to 98 cases in 2006. The government has targeted that this figure should be reduced to 874 in 2010 and, further, decreased to 644 in 2015. Aside from number of cases detected, decreasing trend was occurred in the proportion cured cases as well.
Timor-Leste has 56 reported cases of HIV/AIDS. The Government of Timor-Leste has adopted international procedures on HIV/AIDS such as international precautions, PEP, Mother to child transmission, GIPA etc. Given its global mandate of mainstreaming HIV/AIDS in development work, UNDP Timor-Leste has supported setting up of the National AIDS Commission (NAC) in 2006 and continues to assist strengthening NAC secretariat. NAC is composed of 22 members including National NGOs, National Parliament, Ministry of Health, Ministry of Justice, Ministry of Social Solidarity, Faith Based Organizations, clinical services, National Hospital, UNTG and CCM.
Malaria: Timor Leste developed a comprehensive response to reduce the burden of malaria through mobilizing resources, development and implementation of effective strategies. Malaria diagnosis and treatment has been improved and ITN distributed targeted for children under 5 and pregnant women in very high risk areas. Timor Leste is moving towards a wide scale and comprehensive malaria control programme to reduce the morbidity and mortality of malaria. The support of funding from GFATM (Global Fund for AIDS, Malaria and TB) will enable Ministry of Health to further enhance and accelerate the implementation of HIV/AIDS, malaria and TB programme in Timor Leste.
Tuberculosis: Timor-Leste has adopted the DOTS strategy for the control of TB in line with the global recommendations. Presently, the entire population of the country in the 13 districts have access to DOTS services. Sputum microscopy services are provided through a network of laboratories in the 18 DOTS centers. Treatment services have been integrated within the general health system and decentralized to Community Health Centers and other peripheral health facilities. The National TB Programme has been consistently achieving treatment success rates of about 80% among new sputum positive cases. The case detection rates based on earlier estimates of incidence of TB estimates have been low compared to the global targets. However, the proportion of case detection will be closer to the global targets following the revision of estimates of incidence of NSP cases by international experts and agencies. To mitigate constraints in implementation of TB control activities the NTP is mobilizing additional resources through Global Fund and other partners.
HIV/AIDS: The prevalence of HIV/AIDS in Timor-Leste is presently low. However, presence of risk factors like high levels of STIs, low community awareness, social dislocation and rapid social change have the potential to rapidly change the scenario. HIV has been accorded priority in the Health Sector Strategic Plan 2008 – 2012 developed by the Ministry of Health. The National HIV/AIDS and STI Strategic Plan for 2006 – 2010 focuses on prevention and education; voluntary counseling and testing; multi-sectoral response; and clinical services. The National Programme has initiated interventions on community awareness generation, role out of VCT services, targeted interventions among the most at risk groups in collaboration with civil society partners and STI services with fund support from Global Fund. KADALAK0003

HIV/AIDS in East Timor

Timor-Leste is a low HIV-prevalence country with less than 0.2 percent of the adult population estimated to be HIV-positive. However, social factors such as massive social dislocation, cross-border migration, high unemployment, and a weak and limited health system could dramatically increase the spread of HIV infection. Many young people are not well-equipped with the knowledge and life skills to manage HIV risk in an increasingly challenging environment.^[1]

The first HIV/AIDS case in Timor-Leste was detected in 2001. Forty-three cases of the disease were confirmed in 2007 and are now under treatment, according to the Ministry of Health. However, limited surveillance capabilities and inadequate testing could mean that more people are infected.^[1]

Although HIV prevalence among the general population appears to be quite low, there are signs of a low-level epidemic among Timor-Leste’s sex workers and men who have sex with men (MSM). According to data collected in mid-2003 by Family Health International (FHI), HIV-prevalence rates among sex workers and MSM were 3 percent and 1 percent, respectively. According to the same study, among female sex workers (FSWs), 14 percent tested positive for gonorrhea, 15 percent for chlamydia, 16 percent for trichomonas and 60 percent for herpes simplex virus-2. No comparable data have been collected since, and consequently, the current situation is unknown. Timor-Leste is also vulnerable due to its close proximity to nearby countries that are experiencing localized epidemics such as Indonesia and Papua New Guinea.^[1]

General public health knowledge on primary health care, including reproductive health, sexually transmitted infections (STIs), and HIV/AIDS, is very limited especially in remote areas. Only 50.7 percent of the population 15 years old and over ever heard about HIV/AIDS; and among those in that same population group who think it can be avoided, only 41.8 percent know that it can be avoided by use of condoms, according to the 2007 Timor-Leste Living Standards Measurement Study. There are others factors that contribute to the risk and impact of HIV/AIDS among women; they include domestic violence, lower literacy and education levels, and cultural constraints in discussing issues of sex. Providing the general population with information to combat HIV/AIDS is complicated due to low prevalence and limited access to the communities. According to the National Statistic Directorate Census 2004, most people live in the rural areas, mainly around the northern coastal regions in small, dispersed villages. According to the Demographic and Health Surveys conducted in 2003, more than 60 percent of women and 70 percent of men do not recognize any method of family planning, and only 10 percent of women are using any contraceptive method.^[1]

Timor-Leste can still be classified as a conflict country. The civil unrest that erupted in April/May 2006 continues to be unsettled and constitutes a risk for high rates of domestic violence and sexual assault, thereby leaving women more vulnerable to infection since they are unable to negotiate condom use. The country has a high tuberculosis (TB) burden, with 250 new cases per 100,000 people in 2005, according to the World Health Organization.^[1]

From the 43 cases under treatment, data from the Ministry of Health due to be released in early 2008, shows that at least three people have HIV-TB co-infections; two children under five received the infection from their mothers; and two pregnant women are under prevention of mother-to-child transmission (PMTCT) HIV treatment.^[1]

National response

HIV/AIDS has had a devastating impact on other countries in comparable circumstances to Timor-Leste. Among Timor-Leste’s nearest neighbors, Papua New Guinea appears to be in the early stages of a generalized HIV epidemic that threatens to not only halt, but also reverse the development achievements the nation has made in its relatively short history. Many of the circumstances that have led to the current HIV situation in Papua New Guinea are also present in Timor-Leste, including large-scale social dislocation and high levels of HIV-related risk.^[1]

In 2002 a National HIV/AIDS/STI Strategic Plan (2002–2005) was adopted. In the period since, Timor-Leste has adopted and implemented strategies, policies, programs, and projects to address HIV/AIDS. However, among key stakeholders, it is generally accepted that while many effective activities have been implemented, overall coordination is weak, and important gaps exist. Knowledge about HIV/AIDS across the general population remains low, the level of unsafe sex practices is high, and STI rates are also high.^[1]

In mid-2005, the Ministry of Health, with support from UN Agencies and key civil society organizations, initiated a process to review the National HIV/AIDS/STI Strategic Plan (2002–2005) and develop a new national strategic plan to cover the period 2006–2010. The new National Strategic Plan for HIV/AIDS/STIs 2006–2010 was approved by the Council of Ministers in August 2006. The goal is “to maintain Timor-Leste as a low prevalence HIV nation and minimize the adverse consequences for those infected with HIV.” Four program components were identified:

• Prevention and education targeting the population in general and more specifically most-at-risk groups (MARGs), which include MSM, FSW, clients of sex workers, people in uniform, and young people;
• Voluntary counseling and testing targeting MARGs and PMTCT; and
• Clinical services: ensure availability of antiretroviral treatment to all diagnosed people; develop policies, protocols, and procedures to all aspect of patient management; STI treatment services; procurement and supply of drugs and other commodities; and blood safety.^[1]

A key part of the national strategy is the establishment of the National AIDS Commission, to provide independent advice to the Government of Timor-Leste on all matters related to HIV/AIDS and to monitor and advise on the progress in implementation of the National Strategic Program.^[1]

In 2006, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved a fifth-round grant for Timor-Leste to scale up the national response to HIV/AIDS through the delivery of services and information to at-risk populations and people living with HIV/AIDS. The grant was signed in December 2006 and now is on quarter three implementation. Assessment reports show good performance in relation to targets settled for quarter 1 and quarter 2.^{[1] Kadalakpress001}

ATAURO

An hour and a half by speed boat (or a 2+ hour ferry ride) north of Dili brings you to Atauro Island. The island can literally be seen from the shores of Dili, yet the island is miles away in terms of activities and development. If the hustle and bustle of Dili is like a rabbit, Atauro Island is like a slug. People on the island take life a day at a time… adults fish and kids play.

A group of 16 of us went to Atauro for the weekend and it was definitely a nice break. Some of us took the speed boat which was chartered from Jim’s Island Charter Tours (USD$65 rtn per person) while the others took the slower ferry and fishing boat (USD$15 rtn). We stayed at the Tua Koin Eco Lodge. The eco lodge is a great idea whether for Atauro Island or for other places that are more developed. It tries to stay in harmony with nature and minimize its impact on the local environment.

First, electricity was only used when it was needed (i.e. when the sun went down), then there was no air-con. This surprisingly was refreshing – not only did nature provide natural A/C, it also felt cooler here than in Dili, probably because of the lack of cars, A/Cs and other machines generating heat and warming up the air. Then there was the natural shower that consisted of a simple yet very effective way to shower – a bucket and some plants around to soak up the waste water. Its shocking how little water we actually need to shower. Finally, there is the eco-toilet. Similar to the shower, the bathroom was simply but nicely decorated and had a sturdy seat which sat above a large and deep hole. Even though the toilet was constantly being used, it didn’t smell. I didn’t get a chance to read why this was so, but from what I heard, it is because of the depth of the hole, and the dried leaves and tree bark that are added to the waste. Because of this system, the waste eventually gets composted and becomes natural fertilizer.

And then there was the bungalows that we stayed in… they were clean, well-kept, and made of local natural materials (i.e. bamboo). We took a bungalow in the corner that was literally steps away from the beach. This weekend on Atauro Island at the Tua Koin Eco Lodge was close to being ‘heaven on Earth’. Kadalak001

Jaco – and it's not about Michael

Just got back from Jaco Island… at the eastern end of Timor-Leste.  It’s a long ride to get out to the point (about 6 hours on some very questionable roads), but well worth the effort. The scenery changes (i.e. it’s really dry since it’s the dry season) and there is a definite shortage of civilization/people… The east is where you’ll also find the traditional Timorese spirit house (above photo).

Imagine the tropical paradise that advertising companies do so well and you’ll only get a slice of what Jaco is.  The water is crystal clear with the most vivid turquoise imaginable, and the sand is as find as sand can be. I’ll let the photos speak for itself – I haven’t retouched any of these photos!

I’m not sure if development is good or not… yes, it’ll help the country, but then again, places like this won’t be kept untouched kadalak001

Day 2 (#GISDay) – Kids, military, uni students come for a visit

With maps, we build the future of Timor-Leste keeps going strong at Casa Europa. Day 2 was as popular as the first day. This time around there was a class field trip from the Dili International School who came for a visit – as you can see they were very interested in the 1:50000 floor map. Also, the military came to look around since they contributed a couple of 2+ meter long maps to the event. It’s great to see that the event is drawing people from all over.

One of the highlights was the presentations in the afternoon which was mainly attended by Timorese… the first was given by a staff member at the Ministry of Agriculture. The surprising thing was that it was a women who really knew what she was talking about – collecting climate data from weather stations setup around the country. Given that Timor-Leste has its issues with Education, and the challenges for women to have a higher education, the sight of a very pregnant staff member presenting was a pleasant surprise.

The second half of the presentation was given by our good friend Osorio, who is probably one of the only experts in remote sensing in the country – he knew his stuff! One idea that came up was to have more presentations like these in the academic setting to encourage Timorese to learn more about how GIS and maps can help their country develop – maybe a special lecture once a month at the university could be a good start! Kadalak001

Going for a stroll

For some reason taking photos in Timor-Leste isn’t as relaxed as other places – well that’s what it seems for some of us amateur photographers. After spending over a year in Timor, I’ve chalked up approximately 5 rolls of film and probably a total of 500 photos from friends. To get out and take more photos, we decided to setup a small photo club so that we could get together to take some photos and get some criticism on what works and what doesn’t… it helps us take back memories of Timor and, hopefully, helps to improve our photographic skills. Last weekend was our first outing and here are a few photos I took with my camera, including this boy who was with a bunch of kids running around like crazy when they saw us taking photos… i think some of them didn’t realize I wasn’t shooting digital so when they came to ask to see their photos and realized I couldn’t show them, they said “no good”… hmmm… even kids from one of the poorest countries in  the world are hinting that maybe I should switch to digital! Just behind a market in Taibessi where the streets are lined with huge what looks like banyan streets.
Inside the market, this is a typical scene of how people buy fruits and veggies in Dili. You have two choices, either off of a stick or on the ground… it’s interesting that most of the times, it’s guys who go around with the stick and women who sell veggies in one place.
Public transit in Timor-Leste – called “microlets” these small little vans carry people across Dili and the districts. Usually the conductor is a teenage boy hanging off the side of the van looking for customers. All the vans have their own personal style (which would actually be a good photo project). Kadalak001