The IMOG project in Timor-Leste is a collaborative initiative with Timor-Leste's Ministry of Health and aims to support the health system in addressing the high rate of infant and maternal mortality and morbidity. 

In developing countries, women and children suffer from a high burden of disease.  Timor Leste has one of the highest infant, child and maternal mortality rates in the world.  IMOG is working towards improving these conditions by contributing to the efforts of governments and communities for the provision of effective and accessible health care. 

Timor-Leste, formerly a Portuguese colony, is the eastern half of Timor, an island in the Indonesian archipelago.  It is the newest nation on earth, and the poorest.  It has recently emerged from a devastating 24-year struggle for independence and ongoing civil unrest, which has left it desperately short of infrastructure and capacity in almost every area. Its population comprises 850,000 people spread over 13 districts.  The conditions are difficult and the topography is spectacular.  Steep mountain ranges, remote villages, precipitous unsurfaced roads and heavy monsoonal rains create logistical problems for delivery of, and access to, medical services.

The living standards are low and most rural families, where the need is greatest, live in thatched houses with earthen floors.  There is no electricity or running water and the average income for 40% of the population is just 75 cents per day.

The general health of the population is poor and life expectancy is just 54 years of age.  Malnutrition and tropical diseases such as malaria and dengue fever are common.  The average number of children per family is 7 and approximately half the population is under 20 years of age.  Maternal and infant health needs are immense and maternal mortality is a staggering 660 per 100,000 (by contrast, in Australia it is just 4 per 100,000).  Only 7% of births are attended by professional health care workers and more than 40% are not seen at all during pregnancy.  Infant mortality is 88 for every 1,000 births (while in Australia it is just 4 per 1,000). Source - World Health Organisation.

Health care is inaccessible or unavailable for many.  

THE BOBONARO DISTRICT PROJECT

IMOG is working towards strengthening the Bobonaro District Health System for reproductive health and safe motherhood.

Bobonaro District is remote, picturesque, and mountainous and the main town Maliana is approximately five hours drive from Dili.  As such, communications, transport, water and power services are almost non-existent.  The District has 1 hospital in Maliana, 5 Community Health Centres & 16 Health Posts and there are 4 doctors for about 90,000 people.  Health Posts are normally only staffed by one nurse (in a community of 2,000 to 3,000 people).  Many Community Health Centres and Health Posts are in desperate need of upgrading. 

When the IMOG project started, it was very difficult for health care workers to travel to remote villages as community access to health care facilities was limited by terrain, distance and lack of transport.  There was only one ambulance serving the large community.  Further, hospital operating facilities were inadequate for performing caesarean deliveries and general anaesthesia was unavailable.  Management of complicated deliveries was beyond the current experience of the doctors, hospital and community midwives.

GOALS

IMOG's goal is to contribute to the health status of mothers and children in the district by improving availability, accessibility and affordability of reproductive health services in accordance with the Government's health policies and objectives.

This would be achieved by: 

• Increasing the number of trained health care staff
• Establishing an effective referral system
• Equipping Maliana hospital to provide quality emergency obstetric care as well as comprehensive antenatal, intrapartum, postnatal, gynaecological and paediatric care as well as strengthening of laboratory services
• Upgrading health posts and community health centres facilities
• Improving access to care at health posts, community health centres and hospital
• Improving access to a range of affordable and quality reproductive health services at all levels
• Making essential medicines and nutrition supplements available throughout the district
• Empowering community members through health awareness and education

PROJECT DURATION: Five Years (2007-2012)