Frontline Timor troops fighting disease war

By GREG ANSLEY

TIMOR - Roberto do Rosario arrived at the New Zealand field hospital as night fell across the East Timorese border town of Suai.

By morning, doctors knew, the 5-year-old's life would be over unless he received urgent treatment.

Roberto had contracted cerebral malaria, a virulent form of the mosquito-borne illness that, if untreated, inevitably kills its victims.

His parents had delayed taking him to the town's Medicins du Monde clinic, which treats the minor wounds and ailments of a population left with nothing after pro-Indonesian militiamen ransacked the territory in the wake of last year's pro-independence referendum.

By the time Medicins du Monde had called in New Zealand Army doctors, Roberto was being racked by seizures.

The team saved the boy, stabilising his condition and evacuating him by helicopter to the big Red Cross hospital in Dili, across the mountains to the northeast.

It was an emergency that has become almost routine for the Field Surgical Team attached to 2/1 Battalion Royal New Zealand Infantry Regiment.

Flown in by Air Force Hercules when the first New Zealand troops arrived last October to care for peacekeeping and United Nations personnel, 75 per cent of the hospital's surgical work has been performed on East Timorese.

In an effort that has both deepened local affection for New Zealand soldiers and given deep satisfaction to the team led by Major Andy Dunn, more than 120 operations have been performed on Timorese.

A further 400 locals have been admitted as medical patients and more than 500 blood tests have been taken.

In effect, Major Dunn says, the field unit has become Suai's emergency hospital, and the x-ray and diagnostic centre for the region.

Timor has been a rigorous trial for the hospital, a compact unit that fits into a single C-130 Hercules flight and which had been tested only once before on exercise.

With compact high-tech equipment, the entire hospital squeezes its x-ray, laboratory, operating theatre, resuscitation bays and intensive care and general wards on to three pallets.

Its 24 medical and support staff can set it up and operate it for 48 hours without help or new supplies.

In Suai, even without war, the hospital has been a lifesaver, processing 2500 people through its outpatients department, dealing with emergencies and tackling some of the plagues that infest the area.

Earlier this year, 11 locals scavenging the town's rubbish dump were caught in an explosion that caused burns covering up to 45 per cent of their bodies.

All but two - a boy of 14 and a man in his mid-50s - were saved.

Doctors have performed four successful emergency caesareans, saved the legs of a man who was badly gored by a bull, broken the fever of cerebral malaria in a man and a 3-year-old girl, and repaired the hernias of a hero of the Falantil resistance army and a high school teacher.

A 5-year-old boy, weighing only 15kg, was admitted with typhoid fever - he lived.

"It's absolutely rewarding," Major Dunn says.

"Even when people have died we've done follow-up visits, and when we've pulled up, their relatives have kissed our hands because of what we've tried to do."

Death, when it happens, is accepted philosophically.

When Major Dunn told the father of twins born in an emergency caesarean section that one of the children would die, he replied: "It's God's will."

And there is the tragedy of endemic tuberculosis, curable if treated in time and now the target of a national campaign inching its way out of Dili.

"The other day a woman came in weighing 27kg and I discovered why TB is called consumption," Major Dunn says.

For the moment there is nothing the New Zealanders can do for the victims, other than refer them to Medicins du Monde to be listed for the national programme when it gets as far as Suai.

"The local people are pretty resigned to it," Major Dunn says.

But there are lessons the New Zealanders will leave behind when peacekeeping ends and East Timor fends for itself.

Francisco Dearauto and Ernesto do Nascimento, both with medical experience, are being trained as nurses at the hospital.

In the new nation, Major Dunn says, they are the kind of people who will become district nurses.

The success of the New Zealanders in beating malaria and dengue fever has demonstrated the importance of destroying mosquito breeding grounds and of other control measures.

The 1st Battalion had only half the rate of malaria of the UN peacekeeping force as a whole.

A Philippine battalion of 497 men recorded 67 cases of malaria in just six weeks.

In six months, the much larger New Zealand battalion suffered 20 cases of malaria and 15 of dengue fever.