When East Timor won its independence from Indonesia in 1999, the country's medical infrastructure in rural areas was almost non-existent.
When then-Cuban President Fidel Castro heard about the problem at a regional summit, he offered to send Cuban doctors free of charge — as many as were needed.
So began the largest Cuban medical assistance program outside Latin America.
In 2010, after a six year program of study in Cuba, the first of nearly 500 East Timorese medical students graduated and took up their posts in East Timorese villages and towns.
Together together with up to 300 Cuban health professionals on two-year missions, these doctors form the backbone of East Timor's fledgling public health system.
Dr Merita Monteiro is a 2011 graduate of the Cuban scholarship program. After working as a general practitioner in a provincial East Timorese hospital, she was recently appointed head of the Department for Control of Contagious Diseases at East Timor's health ministry.
Monteiro is also president of the Timor Leste-Cuba Friendship Association. During a visit to Australia to share experiences and foster collaboration with Australian doctors and medical experts, she took part in the April 12-13 Australia-Cuba Friendship Society (ACFS) national consultation in Brisbane.
Monteiro told an April 18 public meeting in Sydney hosted by the ACFS that her new job was challenging: “I'm responsible for five disease control units that deal with conditions such as malaria, tuberculosis, HIV-AIDS and neglected diseases such as intestinal parasites.”
She said the focus is necessarily on prevention rather than treatment: “There's a lot of ignorance in rural areas. People don't know about hygiene, about clean water, about hand washing and wearing shoes.
“It's a tropical, underdeveloped country. We can't just sit there in the hospital waiting for patients to come to us. We have to go to where the people live.
“And the doctors who go to the rural districts are the ones who were trained in Cuba — because we have made this commitment to our government [as a condition of entry into the Cuban scholarship program].”
In other nations, Monteiro said, a doctor's social status may create be an empathetic barrier between them and their patients. “In Cuba, it's not like that. Even the specialists ride their bikes to work and say hi, you can go to their house if you want to have something explained.
“It's about human values, not 'if you have money to pay me I'll serve you better'.”
Illiteracy is one of many challenges that confront East Timor's public health system. Thanks to Cuba's internationally recognised Yo Si Puedo (“Yes I Can”) literacy program, “we have eradicated illiteracy in some provinces”.
The literacy program is carried out by Timorese, who have been trained by Cuban specialists, under Cuban supervision. The Cuban doctors also learn and communicate in Tetum, one of East Timor's two official languages.
Cuban support for these programs in ongoing. Cuban scholarships for East Timorese youth are ongoing in such diverse fields as pharmacology, sports and music.
Cuba's extensive and selfless collaboration has sparked keen interest among many Timorese youth to learn more about the Caribbean archipelago.
“Our Friendship Association has 400 members, 300 of whom are Cuban-trained doctors. Many young people wear Che Guevara tee-shirts but they don't know much about Cuba. We organise workshops, including on the campuses.”
The eventual goal is for the country to sustain its own health system. “We can't depend on Cuban doctors [forever], someday they'll return to Cuba.”
For this reason, Cuban expertise is a vital pillar of East Timor's sole medical faculty in the capital, Dili.