Friday, December 17, 2010

The International Journal of Cuban Studies

Timor Leste health programme

Tim Anderson argues that development cooperation partners and health professionals have a lot to learn from Cuba's health programmes.

This paper considers distinct views of 'capacity building' in health aid, using the example of the largest health aid programme in the Asia-Pacific region, the Cuba-Timor Leste health cooperation. By 2008 there were 300 Cuban health workers in Timor Leste, while 850 Timorese students were studying medicine with Cuban trainers. The paper contrasts 'big money' neoliberal notions of aid with Cuban notions of solidarity amongst peoples and investment in human resources. It makes use of existing literature, health indicators and interviews with doctors, students and families in Timor Leste and Cuba. The Cuban programme poses challenges for Timor Leste, the country's development cooperation partners and other health professionals in the region. For Timor Leste the main challenges seem to be in organisation and retention: how will the hundreds of new graduates be employed and deployed? How will the loss of professionals to emigration (the 'brain drain') be minimised? Other development cooperation partners might use the Cuban programme to measure their own commitment to training (including language training) and the ethos of training. Reflection on the nature of 'capacity building' in health aid seems called for. Finally, other health aid professionals might best consider coordination with, rather than avoidance of and competition with, the Cuban programmes.

Download the pdf version in English with original tables

solidarity aid Cuba-Timor Leste health programme timor_leste

Quietly, just after Timor Leste gained independence in 2002, there began, with Cuban collaboration, one of the largest health aid programmes in the world. Cuba's doctors and its health cooperation programmes were well known in Latin America and Africa, but much less known in the Asia-Pacific. By 2008 there were nearly 300 Cuban health workers in Timor Leste, while around 850 Timorese students were studying medicine in Cuba (700) and in the newly created Faculty of Medicine in Timor Leste (150). The Cuban programme brings with it enormous opportunities but also a number of challenges.
This paper considers distinct views of 'capacity building' in aid and health aid, contrasting the 'big money' approach, project aid and mass training. It explains Cuban health programmes and the development of the Cuba-Timor Leste health programme, before considering some of the challenges posed by the Cuban programme. This discussion makes use of existing literature, health indicators and interviews with doctors, students and families in Timor Leste and Cuba, as well as observations of clinics and colleges.
Health aid and capacity building
'Capacity building' is a concept often referred to in development, aid and poverty reduction discussions; but the expression is used in different ways. These differences relate to the means, as well as the ends, of improving a country's capacity.
Neoliberal approaches to 'capacity building' have focussed on building a narrow group of public sector skills, related to financial and economic management. World Bank discussions of 'capacity building' have referred to "the strengthening of public institutions, with emphasis … on public financial management, decentralization, and governance" (IEG 2008). These emphases have been criticised as presenting 'capacity building' as something technical, even capable of resolution by external direction. The Bretton Woods Project (2003), for example, characterises the World Bank's 'trade-related capacity building' for Least Developed Countries as simply "doing it for them".
In aid discussions, the concept of 'capacity' is often buried in assertions over broad aggregates ('big money') or the need for investment in particular sectors. When discussing health aid and poverty, for example, the OECD argues for "scaling up resources and private investment". It says: "scaling up financial resources for health should be a priority" (OECD 2003: 14). This idea is supported by a committee of World Health Organization on 'Macroeconomics and Health', chaired by former World Bank official Jeffrey Sachs. That committee said:
"The level of health spending in the low income countries is insufficient to address the health challenges ... donor finance will be needed to close the financing gap ... [this will mean] approximately $27 billion per year in donor grants by 2007." (Sachs 2001: 16).
In other words, the overall problem is aggregate resources, expressed in dollar terms. Naturally enough, given its constitutional commitment to private foreign investment, the World Bank almost invariably stresses 'private participation' (e.g. World Bank 2008) in that 'scaling up' process.
AusAID similarly measures aid in dollar aggregates, but introduces notions of procedural fairness and efficacy through the competitive tendering of contracts: "AusAID competitively contracts aid work to Australian and international companies. These companies use their expertise to deliver aid projects and often train local people to continue the projects long after the end of the contracts" (AusAID 2008).
That is, training of 'local people' could be an outcome of this process. In summary, in the case of a particular 'country budget', there is distribution of pre-determined project funds through a sort of quasi-market process, mainly to Australian companies, but also to some university agencies, NGOs and the occasional international company. At the end of these finite projects (usually one to three year contracts) the training of local people could be one outcome.
The Cuban approach to aid is different. First, they regard cooperation as a matter of solidarity between peoples, not of financial flows or financial leverage. Inaugurating a new Latin American School of Medical Sciences (ELAM), in the wake of devastation caused by Hurricanes George and Mitch in 1998, Fidel Castro noted that emergency aid lasted just a few weeks, then people were left to get on with their lives, and deaths. Castro had been strongly influenced by the self-determination ideals of Cuban independence leader José Martí who wrote: "Our own Greece is preferable to the Greece that is not ours; we need it more … Let the world be grafted onto our republics, but we must be the trunk" (Martí 1892). These ideas contributed to the concept of helping other developing countries build their own professional capacity. "This institution," Castro said, "is an attempt at a modest contribution of Cuba to the unity and integration of the peoples" of Latin America (Castro 1999).
Cuba emphasises investment in people, and is flexible about how this is financed. For example, in poorer countries like Timor Leste, the Cuban government pays the salaries of the Cuban doctors. However in wealthier countries like South Africa and Venezuela there is a host government contribution (MEDICC 2008). Cuba itself maintains high levels of education, which for Cubans is free for life. One analyst says:
"In the Cuban strategy of creating … the health system, building human resources has been the most important factor. Human capital development today, in all spheres of the country, is notable; but it is most notable in the health sector" (Rojas Ochoa 2003).
The commitment to high levels of investment in 'human capital' has not been directly related to Cuba's economic performance. The regional branch of the World Health Organisation notes that, despite financial hardships of the 1990s, Cuba expanded its commitments in both domestic health and its international health programs (PAHO 2007). 'Capacity building' here is thus seen as a commitment to investment in people.
Cuban solidarity aid
Cuban health programmes have been based on Cuban medical worker postings in mostly rural-based primary health care services, combined with the training of large numbers of local students to replace the Cuban doctors. The WHO (2006) says there is a worldwide shortage of health workers; Cuba has committed itself to help address this deficit. The country's capacity to do this draws on its achievements at home. By the mid 2000s Cuba had more than 70,000 active doctors, over 28,000 of whom were working abroad. Only from this base can we understand the enormous overseas commitment. Cuba itself has a network of family doctor centres, policlinics and hospitals, a world-class pharmaceuticals industry and a free-access public health system which emphasises health promotion, prevention and education. This capacity has been built up over several decades.
Cuba's achievements in health are well known. It has the best indicators in Latin America and, despite relatively low incomes levels, several of its critical health indicators (infant mortality, life expectancy, HIV infection, low birth weight infants) match or surpass those of the USA (UNDP 2007: Tables 6, 7 & 10). With health indicators more like those of wealthy countries, Cuba demonstrates what can be done with a sustained commitment to public health. By 2007 Cuba had complied with three of the MDGs (for 2015): universal completion of primary school, eliminating gender disparity in school and reducing by 2/3 the mortality of children under 5 (PAHO 2007: 264).
When, in 2003, Cuban infant mortality rates fell below those of the USA, the World Bank was forced to respond. Posing the question 'how has Cuba done it?', the Bank suggested important elements may have been: "the sustained focus of the political leadership on health for more than 40 years", "universal and equitable health care", concentration on rural areas, emphasis on a sole provider public sector, the policlinics, mass immunisations, health monitoring, community health programmes and highly motivated staff. The World Bank questioned, though, how such a high level of doctors "can be sustained during economic hardship?" (World Bank 2004: 157-8; see also Anderson 2007). Cuba's consistent commitment to health combined with its more recent strong economic growth makes that question redundant.
In developing health aid programmes, Cuba is able to draw on an experience that closely resembles that of many other developing countries. In the early 1960s, most doctors left the country and there were few resources. In the 1990s with the collapse of its main trading partners, the country suffered serious economic depression. With the US economic blockade since the early 1960s (1), shortages and higher prices for many imports remain a problem. This is a country that 'makes do' when there are fewer resources, relying more on trained human resources, their dedicated professionals. This capacity is probably important in mutual understandings, when addressing the health needs of other developing countries.
In its health cooperation programmes Cuba follows a common pattern, with some adaptations. First, there is a bilateral agreement between governments, including agreement on the number of Cuban doctors to be deployed in, and the numbers of medical scholarships offered to students from, the recipient country. This is a longer-term plan with the aim of replacing the Cubans doctors, by graduate students from the host country, within ten years. The individual Cuban doctors, however, work on two-year contracts (they are flown home for a holiday in the middle) from their own government. Generally the host country provides accommodation, food, workplace and a monthly allowance (generally US$150-200) while the Cuban government maintains the doctors' regular salaries (Jiménez 2006; MEDICC 2008). In the case of wealthier countries, such as Argentina and South Africa, there is a contribution from those governments to the doctors' salaries (MEDICC 2008). In the case of Venezuela, there is a commercial agreement between the two governments for exchange of various goods and services (including health services). In the case of Timor Leste, some aid money was at first used to contribute to the costs of the doctors, but as of 2006 "the Cuban Government pays the wages of all its doctors and charges our medical students nothing" (PMC 2006).
Cuban doctors in a host country work under the direction of the local Department of Health, effectively as public servants. This is different to other 'project aid', which often operates outside the public sector. While the Cuban Health Department's preference is for their doctors to go straight to rural areas, generally working in pairs, this depends on local government policy. The Solomon Islands Government, for example, requested and received an initial three specialist doctors and a surgeon for the capital's hospital (Mamu 2008) (2). In Timor Leste the Cuban doctors are more widely distributed (see Table 3). The general approach is to go to areas where primary care services are absent, and to focus on preventive health, supplemented by clinical medicine (MEDICC 2088).
In the case of countries without strong medical colleges, the local government transports their students to Cuba's colleges, and brings them home for holidays if they can afford it. In some cases the Cuban doctors will help build up the capacity of local medical colleges. All medical students in Cuba are on full scholarships, which includes tuition, board, food, other services and a small allowance of 4 or 5 US dollars a month (within the context of Cuban salaries this is a relatively generous allowance). Non-Latin-American students study Spanish and science in their first year, in a 'pre-medical' course. In some countries, including Timor Leste, the health programme is supplemented by a literacy programme, in the local language (3).
Apart from the health programme in Venezuela, which is a commercial arrangement, Cuba's biggest aid programme is with Bolivia. Around one thousand Cuban doctors work in Bolivia, and there are more than 5,000 young Bolivians studying medicine in Cuba. Apart from those two countries, as at May 2006, large groups of Cuban doctors were working in several countries including: Guatemala (448), Haiti (426), Honduras (347), Timor Leste (278), Ghana (188), Namibia (143), The Gambia (134), Belize (113), Mali (109) and Botswana (93) (MEDICC 2008). The numbers of medical students trained to replace these doctors, averages about 2 to 3 times the numbers of doctors (Jiménez 2006). A large number of countries have smaller numbers of students, including around a hundred US students on medical scholarships, arranged through the US-based solidarity group 'Pastors for Peace' (IFCO 2008).
During the current decade, Cuba has expanded its medical training network, making use of Venezuelan facilities and helping develop the training capacity of medical colleges in several countries. The newer approaches make use of small group learning, led by resident Cuban doctors, local facilities and IT. Dr Yiliam Jimenez, Vice-Minister of Health and Director of Cuba's health cooperation programs says:
"We are returning to the tutorial method, supplemented by information technologies and other teaching aids, so that students from low-income families can go be educated in classrooms and clinics in their own communities, where their services are so sorely needed" (Reed 2008).
More recent initiatives in Cuban health cooperation include: HIV-AIDS projects in Africa; the large scale 'Barrio Adentro' project for mass health services in Venezuela; the 'Operation Miracle' programme, which provides hundreds of thousands of free eye operations across Latin America; and the Henry Reeve Disaster Response Contingent, to send personnel and mobile hospitals to areas hit by natural phenomena such as earthquakes and hurricanes (MEDICC 2008). For example, Cuba sent 2,500 doctors to Pakistan for six months after the large earthquake in 2005 (Akhtar 2006).
The Cuban approach has distinct priorities, and thus sees distinct challenges. Cuban officials calculate very seriously the numbers of professionals from developing countries that are lost through migration to wealthier countries (e.g. Balaguer 2006). This 'brain drain' is a constant challenge for human capacity building. The World Bank has calculated that developing countries lose substantial quantities of their skilled workers. In the entire Sub-Saharan Africa region, 20% of skilled workers have migrated. In Nicaragua and El Salvador the skilled worker migration rate is 29-31%; in Ghana and Mozambique it is 45-47%; in Jamaica and Haiti 83-85% (Schiff and Ozden 2005). Rates for doctors are higher than those for other professionals. One South African doctor said his country was losing 80% of its doctors, first to the private profession, then to migration (MEDICC 2007).
However the World Bank says, despite its scale, this 'brain drain' is not necessarily a problem, as it is compensated for by family remittances; the situation is "complex". Remittances, it is said, reduce poverty and increase spending on education, health and other investment (Schiff and Ozden 2005). The Cubans see the problem differently. Remittances are most often directed into consumption. A critical mass of human capital remains the foundation of a wide range of social and productive capacities. Some emigration is inevitable - Cuban doctors themselves, for example, leave the country at a rate of about 2% (Jiménez 2007) (4).
This rate of emigration can be slowed by the nature and ethos of training. Former Timor Leste Health Minister Dr Rui Araujo notes that Cuban medical training (including the training within Timor) maintains an ethos distinct from that of much other 'elite' notions in medical schools. It appeals to the students' community spirit, and formally briefs students that they are being trained "to serve the public and not trade the services" (Araujo 2008).
Development of the programme in Timor Leste
The Cuban programme grew from a meeting between the then Cuban President Fidel Castro and the then Timor Leste President Xanana Gusmao, at the Non Aligned Nations Summit in Kuala Lumpur, in February 2003. A group of students were sent to Cuba for training at the end of that year, and a small group of Cuban doctors arrived in Timor in April 2004 (Medina 2006). However in mid 2005 the numbers of doctors and students were increased, following a visit to Havana by the then Foreign Minister Jose Ramos Horta. A further visit to Havana in December 2005 by Prime Minister Mari Alkatiri, accompanied by Health Minister Rui Araujo, led to an increased offer of one thousand scholarships to Timor Leste, and a brigade of 300 Cuban health workers. Fidel Castro's rationale for the increased offer was to generate a doctor to population ration of one to one thousand, taking into account expected population growth (Araujo 2007 & 2008). This scaling up of the programme made Timor Leste the largest health aid programme outside Latin America; it also seems to have been a vote of confidence, by Cuba, in Timor Leste's first post-independence government.
While a large component of Cuban doctors were attached (with other foreign doctors) to the National Hospital, the majority were sent to the Districts, and to small clinics at sub-district level, thus starting the core of a rural doctor-centred health service (Rigñak 2007). Here they provide most of the personnel for immunisations, TB treatment and skilled assistance at childbirth. Timor Leste had never before had resident doctors at the sub-district level (Medina 2006). Despite the large commitment in Dili, the presence of twice as many doctors outside the capital (CMB 2008) introduced a new pattern of health services to the country, including the practice of house visits, at village level. The maintenance of such rural health services, apart from the substantial extension of primary health services, could have important implications both for rural development and rates of urbanisation.
Human resource inputs were thus substantial. The health outcomes from these inputs is difficult to measure at this stage, given the limited state of Timor Leste's records (Araujo 2008). However, Cuba places high priority to generating a robust statistical databas for its work in public health (see Corteguera and Henriguez 2001) and some preliminary data has been recorded by the Cuban Brigade themselves. Between April 2003 and mid 2008 the Cuban Medical Brigade had carried out more than 2.7 million consultations. It was estimated that they had saved more than 11,400 lives and had helped reduce infant mortality (CMB 2008).
One important documented contribution of the Cuban doctors was their maintenance of health services during the 2006 political crisis. The displacement of tens of thousands of people into camps in and around the capital posed a major challenge for health services. A number of foreigners left the country; the Cubans did not. This difference in dedication was noted by the then Prime Minister José Ramos-Horta, who said: "During the worst of the crisis in May, June and July [2006] our Cuban doctors stayed unconditionally in the villages and hospitals with the patients and the people, providing the much-needed moral, medical and psychological support" (PMC 2006). The point was repeated by Foreign Minister Zacarías Albano da Costa, when he visited Cuba, and the students there, in May 2008 (Granma 2008).
An Australian study of health services during the crisis also noted this contribution. The National Hospital "was able to remain open throughout all periods of the crisis; and for a period at the height of the violence in late May and early June the hospital drew heavily on the Cuban Medical Brigade (CMB) to maintain its activities (Zwi et al 2007: 17). The CMB also regularly attended the IDPs, during the crisis (Rigñak 2007). They provided the only 24-hour services and were the major source of mobile services. The CMB "contributed crucial "surge capacity" when mainstream services were stretched" (Zwi et al 2007: 21, 33).
The longer-term element in the programme is represented by the Timorese medical students, whom their Cuban trainers call 'the doctors of tomorrow' (Infante Sanchez 2007). Students departed for Cuba in waves from 2003 to 2006, the largest groups leaving throughout the crisis of 2006. However in December 2005 a Faculty of Medicine was inaugurated at the National University, so that training could take place in Timor (CMB 2008). This university really operated through groups of students attached to the small groups of doctors posted at each of the hospitals and district heath centres (Rigñak 2007 & 2008). In 2007-08 they gained access to three classrooms within the National University, with computer facilities. As at early 2008 there were almost 700 students studying in Cuba, and another 150 in Timor. There will be some small new intakes in 2009, within the Timorese faculty, as the Cuban offer of one thousand scholarships remains (Rigñak 2008).
I visited two groups of medical students in November 2007 and, while groups in their first year struggled with the Spanish language, the facilities and teachers were well regarded (Guimaraes 2007; Marques Sarmento 2007). Promotion rates had been 100% and reports from the medical trainers were all good (Betancourt Gonzalez 2007; Infante Sanchez 2007). The Timor Leste Government has had similar good reports:
"Timor-Leste's 498 students in Cuba are considered to be the best among thousands of overseas people studying medicine in terms of results and discipline, according to Vice-Minister of Health Luis Lobato" (PMC 2006).
Cuban training is widely acknowledged as being of a high standard. Fourteen Cuban medical colleges are recognised in the US (ECFMG 2008) while US graduates from Cuba medical colleges are now registered and practising back at home (Edwards 2008). The first group of Timorese students are due to arrive back in Timor either in mid 2009 or early 2010, to begin their one-year internship within their country's health system (Rigñak 2007 & 2008).
Following Timor Leste, Cuban health programmes have grown within the region. Twenty students from Kiribati were studying alongside the Timorese students, when I visited them in late 2007; they were to be joined by another 20 in 2008. In early 2008 a group of 25 Solomon Islands students travelled to Cuba to begin their studies; they will be joined by another 25 (Mamu 2008). The Papua New Guinea Government had an offer of health cooperation in 2006 (Jiménez 2006; Balaguer 2006) but at the time of writing this program had not yet begun. A summit with South Pacific nations in September 2008 emphasised the Cuban commitment. Cuban Foreign Minister Felipe Pérez Roque said Cuba and the South Pacific nations "confront common challenges in their efforts for development, building human resources, the risks of climate change and increases in the price of fuel and food" (CubaMinrex 2008). Cuban Vice President Esteban Lazo, meeting with the President of Kiribati, the Prime Minister of Tuvalu and several foreign ministers and ambassadors, said the encounter would "lay the foundations for our relations" (ACN 2008). Despite the political tensions in Timor, this programme has maintained bipartisan support. One symbol of this has been the willingness of former Health Minister Rui Araujo to act as special adviser to his successor, current Health Minister Nelson Martins. The current Minister says Cuba has provided a collaboration in health and education that was "irreplaceable" (Nusa Peñalver 2008).
Challenges from the Cuban programme
Several challenges are posed by Cuban health cooperation programme in Timor Leste: challenges for Timor Leste; for other development cooperation partners; and for other health professionals and collaborators in the region.
For Timor Leste the main challenges seem to be in organisation and retention. The Health Department has to plan for the incorporation of several times more health professionals than currently exist in the country. How will they employ and place eight or nine hundred new doctors? Can they be encouraged not to leave the country, taking their skills with them to wealthier countries, thus adding to the developing world's 'brain drain'? Although it arises from additional assets, this is nevertheless a major political and administrative challenge. Current Health Minister Nelson Martins proposes a five year plan with new doctors being located, at first, at sub-district level, and maintaining the popular Cuban practice of house visits (Martins 2008). Former Health Minister Rui Araujo suggests the service ethos of Cuban medical education will be important in combating the brain drain, and in encouraging the new doctors to keep working at village level (Araujo 2008).
The challenge for other development cooperation partners is to compare their own programs against the Cuban programme, especially as regards the commitment to training and the ethos of training. Some reflection on the nature of 'capacity building' seems called for. In addition, the Cuban practice of linking language instruction to medical training deserves attention. All Timor Leste students have to learn a world or large regional language to study abroad, but there is often little help with this. Some Australian expectations, for example, that Timorese students will simply learn English by themselves, seem quite unrealistic.
Finally, the challenge for other health professionals and collaborators is to choose to coordinate with - rather than seek to avoid - the Cuban programmes. The international community remains largely ignorant or sceptical of Cuban health professionals. The fear of status and work conditions being undermined has also led to negative reactions in many countries, including Bolivia (BBC 2006), Venezuela, and Honduras (MEDICC 2007; MEDICC 2008).
On the other hand, there seems to be ample room for coordination between health aid professionals, through some goodwill and reflection. One Christian health aid worker put it this way:
"It is the friendship of the poor and not the rich, the weak and not the strong. It is strange that the best example of Christian behaviour and good deeds comes from a secular country. This is an intriguing mystery; one that deserves pondering by those of us who profess to be Christian" (Anon 2008).
In summary, then, the challenge is to reflect on and find new opportunities to work with both the Cubans and with those students who have been given a unique opportunity to study medicine and help their own people. These remarkable health programmes deserve serious study.

Tim Anderson
is Senior Lecturer in Political Economy at the University of Sydney, New South Wales, Australia and has written widely on health systems, globalisation, criminal justice and human rights.
A version of this paper was presented to the 17th Biennial Conference of the Asian Studies Association of Australia in Melbourne 1-3 July 2008.

(1) The USA has imposed a commercial, legal and diplomatic blockade on Cuba since the early 1960s. Special US Government licenses are need by US citizens to travel to or sell any items to Cuba.
(2) The Solomon Islands will eventually receive 40 Cuban doctors, and 50 scholarships (Mamu 2008).
(3) Since 2008, the Cuban literacy method 'I Can Do It' (Yo Si Puedo) has audio-visual facilities in every Suco in Timor Leste. Classes began in Portuguese, but since 2008 Tetun materials have been in use.
(4) In the case of Cuba it is not simple emigration, as the US has specific laws to encourage Cuban professionals to 'defect'. Unlike emigrants from other countries, Cubans get an instant 'green card' on arrival in the US. Fidel Castro (2007) estimates total 'brain theft' of all professionals from Cuba to the US between 1959 and 2004 has been 5.16%.

Monday, December 13, 2010

Saida Mak Prezidente Horta Koalia Ba Estudantes Medicina Iha Havana, Kuba?

Horta Iha Kuba, Foto CJITL
Kuba Flash, Tuir mai ne’e deskripsaun kompletu, Sorumutu estudante Timor oan ho Presidenti Republika, Jose Ramos horta iha Habana, Domingo dader, loron 5 Dezembro 2010, iha eskola da medecina faculdade de presidente de Salvador Allende Havana, Kuba, Participa iha ekontro ho prezidenten ne’e, estudante Timor oan iha havana, estudante timor oan iha provincia matanzas no estudante timor oan iha provincia de ciego de avila, hamutuk nain 250 resin.
Tuir mai ne’e intervensaun kompletu husi Prezidenti nian ba Estudantes sira iha Kuba:

Invitados estudanes Hau senti konteti tebes bele fila fali mai Kuba, país ida ne’ebe durante ne’e tulun ona Timor leste - TL, países Latino Americanos, países asiáticos hanesan iha area saude no edukasaun e mos tulun Países Africanos hanesan Angola liu husi combatentis cubanos hodi luta ba libertasaun angola nian, nune’e mos iha Argelia no Vietnam, ida ne’e hanesan konribuisaun ida nebe Kuba halo ho espíritu solidaridade no humunidade nebe makas tebes.

Relasaun TL ho Kuba hahu kedas wainhira TL sai nudar estado soberano liu husi restaurasaun independensia Timor Leste iha 20 de Maio de 2002, iha tinan 2003 mosu primeiro enkontru entre Presidente Xanana Gusmao no Komandante Em Xefe, Fidel Castro Cruz iha reuniaun ida nebe halao iha Kuala Lumpur Malaysia, sira koalia konaba posibilidades atu haruka médicos kubanos nain 13 ou 15 ba Timor.

Iha konversasaun entre líderes nain rua ne’e Fidel mos sublina katak lalos deit atu haruka médicos Kubanos ba Timor maibe hanoin mos katak atu hari mos eskola ou faculdade medicina ida iha TL.

Plano ne’e ikus mai realiza duni iha tinan 2005 programa ida nebe importantes tebes liu husi esforso no sakrificio bo’ot ne’ebe Kuba halo iha area saude inklui mos ho programa analfabetizasaun.

Ohin ita bele konsidera katak ne’e sukseso bo’ot ida nebe Kuba no Timor hetan, contribui duni ba prudusaun pobreza no mortalidade infantil, iha tinan 2004 governo institusional de Timor Leste apresenta ninia programa katakbTL lanca duni desenvolvimento ba objetivo mileneo nian.

Ho dificuldade ne’ebe TL enfrenta liu husi apoiu no esforso governo Kuba nian, TL bele alkansa duni objetivos balun nebe iha ne importante tebes.

Apelo ba estudante sira presidente dehan:

Imi un’udar pioneiros medicina nian iha ita nia país nebe libre no soberano nebe oras nee estuda iha Kuba, imi belun balun kompleta ona sira nia kursu no simu ona sira nia diploma iha fulan hirak liuba iha GMT dili.

Tuir programa ne’ebe governo 2 ne’e estabelece ona imi sei halao estudo iha cuba durante tinan 4 nia laran deit no sei kontinua imi nia kursu quinto no sesto ano iha Timor Leste.

Objetivos principal nebe haruka imi fila atu kulmina imi nia estudo iha timor, ne’e katak atu imi bele konhese diak liu tan ita nia moras fundamental nebe povu Timor hetan.

Ejemplo ne’ebe hau hakarak hato’o ba imi katak estudantes barak, sientíficos husi estados unidos ou nortevamericano nian ba Timor tinan ida dala 2 ou 3 nune’e hodi halo investigasaun, tamba iha Kalifornia laiha moras nebe ema Timor hetan.

Tamba ne’e imi sei fila ba Timor no halo kompleta imi nia estudo quinto no sesto ano akompanha husi profesores ou médicos Kubanos sira, akordu ida ne’ebe halo entre ambos países laiha ona mudanza iha politika ida ne’e, katak tenki kumpri no halo tuir duni.

Kuba halo ona sacrificio bo’ot tebes hodi simu ita iha ne’e, liu husi dificuldade nebe imi hotu hatene, maibe imi nia belun sira nebe estuda iha Timor desde primero ano to agora, sira hasoru obstáculo oin-oin deit iha proceso estudo nian liu fali imi iha ne’e(Kuba), imi hotu hatene didiak kondisaun ita nia rain nian, liu husi dificuldade iha posibilidade ba ita atu halo estudo, hatene mos katak futuru TL pertenece juventude sira hotu no jerasaun foun sira, maibe pertence tebes ba hirak nebe servico no hakarak estuda katak aproveita duni opurtunidade nebe sira hetan hodi estuda, estuda no estuda.

Sai nu’udar juventude la significa katak automatikamente iha futuru, ohin ita nudar joven maibe aban oin seluk ona, karik ita la estuda no la aproveita diak tempo ida ne’e tinan 5 ou sanulu mai ne’e ita sei la manan no lahetan buat diak ida iha ita nia vida tomak.

Hau koalia mos ho estudante balun iha Timor iha tempo hirak liu ba, imi hotu hatene katak mayoría maluk sira iha Timor iha hau nia numero telefone, hanesan vendedores iha dalan, tiga roda, estudante seluk-seluktan, deves em kuando iha problema kona ba elitricidade no funciona hau simu sms ou telefone katak prezidente tanba sa maka elitricidade mate, ami atu estuda mos ladiak, maibe hau la presta atensaun ba preokupsaun hirak ne’e.

Atu konta ba imi katak wainhira hau sei ki’ik estuda iha soibada, laiha elitricidade, internet no laiha mos komputadora e lor-loron han deit aifarina, tamba ne’e hau hatene saida maka terus no kiak saida maka difikuldade.

Nune’e maka wainhira imi koalia konaba dificuldade hau sei la rona, tama husi tilun sorin no sai fali husi sorin.

Hau nia hanoin katak imi nia terus no susar ne’ebe imi hasoru dadauk ohin loron la to’o hanesan ami iha tempo uluk hanesan xanana, Mari Alkatiri no ema hotu nebe estuda iha tinan 1960 liuba ne’e.

Ohin imi hetan opurtunidade nebe diak tebes estuda iha Kuba, país ida nebe ho ninia reputasaun iha area saude no formasaun médicos nebe konhecido tebes iha mundo.

Laiha experencia seluk iha mundo tomak kompara ho Kuba, relaciona ho formasaun de medicos no programa analfabetizasaun.

Atu hato’o dala ida tan katak depende ba akordu entre nasaun 2 ne’e atu termina imi nia kursu quinto no sesto ano iha Timor, ita sei hare mos ba aproveitamento académicamente cada estudante, notas diak, disciplinario dalaruma sei iha tan opurtunidade atu hasai especializasaun iha Filipina, Indonesia, Australia ou bele mos fila fali mai Kuba.

Ho akordu ida ne’ebe oin seluk fali ona. Maibe tenki halo hotu lai kursu sesto ano iha Timor, depues ba hirak nebe maka iha interese atu hasai tan especilidade ruma bele rekomenda ba governo, ministerio da educasaun no ministerio da saude ou bele mos halo fali akordu foun ida entre Timor ho Kuba atu loke rasik especilizasaun iha Timor Leste.

Hakarak atu hato’o ba imi katak hau un’udar presidenti sempre defende, koalia no hato’o ba governo liu husi primero ministro atu tau matan especifico ba salarios médicos nian iha Timor, ita hotu hatene katak servico médicos nian sempre estado alerta durante 24 horas nia laran ne sakrificio nebe bo’ot tebes ba médicos atu salva vida, por tanto salarios ba médicos sira sei la hanesan ho salario ba funcionarios sira seluk.

Apartir husi tinan 2011 medicos iha Timor sei hetan salario nebe diak minimo maka 700 dolares, aleinde ida ne’e depende mos ba servico cada médicos ida-idak nian, sira ne’ebe servico iha programa tuberculosio no SIDA nian sei hetan por cento salario nebe as liu, nune’e mos ba hirak nebe servico iha area rurais ho distancia nebe dok husi kapital Dili. (Hery/CJITL CUBA)

Sunday, December 12, 2010

Horta konsola Estudante Medicina Cuba atu Fila

S.E Dr. Jose Ramos Horta Prezidente da Republica
Presidente Republika Jose ramos Horta afirma katak nia parte konsegue konsola estudante medicina Cuba nain 80 ne’ebé rejeita atu fila mai Timor-Leste.
“sira  lakohi fila imediatemante , sira nia pozisaun mos balun la interpreta didiak , la komunika didiak ,sira hakarak kontinua remata sira nia kursu depois maka sira fila, ”hateten Horta iha kurta ne’e (08/12) durante konferensia imprensa iha Aero Portu Internasional Nicolau Lobato, hafoin fila husi ninia vizita iha Cuba foin lalais ne’e.
Dili-Horta hatutan razaun estudantes ne’ebé lakohi fila ne’e la esplika klaru,” maibe depois hau esplika didiak prosesu ne’e ba sira, sira parezenta sria nia kazu normal,ho maturidade sira nai preokupasaun, no hau mos esplika klaramenta ba sira no sira simu no laiha problema no sira prepara an atu mai mos”,esplika Horta.
“hau hateten ba sira programa ida ne’e todan  teb-tebes ba Cuba ,tamba se ita halo curso ne’e karik iha rai seluk hanesan iha Australia,Portugal no Amerika , kada estudante ida tinan tinan iha Amerika bele kusta mais ou menus 100 mil Dolares”,afirma Horta.
PR haktuir Cuba fo suporta to’o fulan dezembru tinan ida ne’e.” maibe iha fulan Janeiru 2011 responsabilidade total kustus mai husi estadu TL, tamba Cuba augenta ona tinan 4 nia laran”,dehan Nia.(*TE)

Karta husi Estudante Medisina

Husi        : Colectivo estudante 5º  ano da Medicina Cuba
Ba        : Inan ho aman estudantes sira nian                 
Assunto    : Preocupasaun husi Estudantes relaciona ho fila ba Timor iha     próximo Mes do Dezembro

Ho respeito, liu husi carta ida ne´e ami um grupo do estudantes da Medicina 5to ano, hakarak hato´o ami nian questoes da preocupasaun  nian relacionado ho fila ba Timor Leste iha fulan Dezembro oin mai nebe tuir aviso husi Adido da Saude i Educaçao Sr.Leonildo Da Costa mai   ami iha día 16 do Fevereiro de 2010 lokraik  iha Teatro da Faculdade ELAM 14 nian, Sandino Pinar del Rio  iha momento neba ami levanta tiha ona questao hirak nebe ami sei temi iha kraik,  katak ami ho principio ida  LA ACEITA ATU  FILA BA TIMOR iha data nebe maka Governo rua  Cuba ho Timor Leste decide tiha ona maibe ami HAKARAK CONTINUA NO REMATA AMI NIA ESTUDO 5º ANO NIAN IHA CUBA  ho razaun maka hanesan tuir mai ne´e:

1.    Problema Económico ho Condisaun familiar ami ida – idak nian nebe sei hanesan todan boot ida mai ami no ami nia familia cuando ami fila ho momento ida hanesan ne´e.
2.    Problema Docencia ou Rotasaun hospitalaria nebe ami sei hasoru iha 5º ano oin mai ne sei realiza iha Hospital nebe iha condisaun ho especialidades maka hanesan:
Ø    Cirugia
Ø    Ortopedia
Ø    Urologia
Ø    Psiquiatria
Ø    Oftamologia
Ø    Dermatologia
Ø    Otorinolaringologia
Ø    Pediatri
Ø    Ginecobstetricia e seluk-seluk tan
Nebe ba ohin loron iha ita nia rain seidauk iha condisaun e disponible iha hospital no clínica sira nebe agora radica iha Timor laran nebe sei coloca ami ba, por tanto ami sente sei lakon no la aprende lisaun  hirak ne´e se wainhira ami fila ba agora.

3.    Ami iha interese teb-tebes atu halo ajudantia ba especialidades sira nebe iha leten, tuir ami gosta hodi nune´e bele aumenta mos ami nia conhecemento ho capacidade diak liu tan. Se ami fila entaun tal vez ami sei lahalo buat nebe maka ami hakarak, tamba iha neba seidauk disponible.

4.    Problema socioambiental ou situasaun ita nian rai laran nian nebe as vez laiha estabilidade fixo e iha provocasaun oi - oin nebe sempre mosu iha ita nia ema nia mente, nebe que ami sente sei obstaculiza no desconcentra ami nia hanoin ba ami nia estudo ho razaun katak ami sei ba ho estatus estudantes laos médico ona.

5.    Ami iha principio ida katak ami hakarak conserva cualidade médica Cuba nian iha Futuro oin mai e sai médico ida que diak no capacitado, por tanto ho conhecemento mínimo nebe maka ami iha agora seidauk suficiente atu fo base diak ida mai ami hodi hasoru ami nia povu, i em baze de ida ne´e maka ami husu ba Governo Cuba atu forma didiak tan ami iha ne´e no iha área hospital (práctica) para ami bele adquiere tan conhecemento ida que diak liu tan e nune´e aban bain rua ami bele implementa ba ami nia povu.

Ami hanoin maka ne´e deit puntos importantes  hirak nebe maka ami atu hato´o ba sua excelencia  para bele hatene mos, no fo ideas ruma atu soluciona ami nia questaun hirak ne´e. E ikus mai, ami ho respeito tomak taka ami nia carta, obrigado wain ba atensaun ho considerasaun.
CC :1.    Sr. Ministerio da Saude RDTL
2.    Sr. Secretario Geral do Ministerio da Saude RDTL
3.    Sr. Direitor do Recurso Humano do Ministerio da Saude RDTL
4.    Sr. Embaixador de Cuba para  Timor Leste
5.    Sr. Primeiro Secretario da Embaixada RDTL em Cuba
6.    Sr. Adido de Saude i Educaçao de Timor Leste em Cuba

Tuir mai ami adjunta colegas estudantes sira nia naran nebe maka ami hamutuk hodi levanta questao sira ne´e
Anexos: Lista de los estudiantes

1.    Sidonio João Da Silva Pereira    F. C. M. José María Aguirre    82022036621         
2.    Gracieth Tomas C. D. Ximenes    Idem    86061630010         
3.    Manuel Francisco Da Costa    Idem    84030529385         
4.    João Eleuterio Freitas    Idem    82020136629         
5.    José Osorio Ximenes    F. C. M. José Maceo, actualmente en la Enrique Cabrera    82072036621         
6.    Honorio Ribeiro Neves    F.C.M. José María Aguirre    83100101141         
7.    Boaventura Sarmento    Idem    83072001146         
8.    Nilton S. Da Costa S. Cruz    Idem    84052629402         
9.    Salvador Soares Da Silva    Idem    85010530983         
10.    Felipe Fátima Martins    Idem    86020930029         
11.    Teófilo Ximenes Ornai    Idem    84072499408         
12.    Jaimito Lopez    Idem    83080101162         
13.    Teodoso Da Conceição    Idem    83102101163         
14.    Aurelio Boavida Gusmão    Idem    82082936629         
15.    Vicente Carvalho Dos Santos    Idem    84032629385         
16.    Jonatas María D. R. Madeira    Idem    84052729406         
17.    Fernando João A. Gomes    Idem    86093030042         
18.    Rosalina Da C. A. Cardoso    Idem    85021900117         
19.    João Bosco Dos S. Sarmento    Idem    86110100102         
20.    Aljaksono Soares Maia    Idem    82101336627         
21.    María Cidalia S. Guterres    Idem    86012030035         
22.    Tito Januario De C. Gusmão    Idem    84101729381         
23.    Mauricio Sequiera Fraga    Idem    86042030049         
24.    Andre Soares Claver    Idem    86060700104         
25.    Eni Lili Dila    Idem    83032036490         
26.    Caetano Gaspar    Idem    84042029383         
27.    Silvino Da Silva Barros    Idem    79072130242         
28.    Julito Dos Santos        80110429764         
29.    José Antonio De Deus Cabral    Idem    84121329389         
30.    Simplicio Amaral De Deus    Idem    82050536621         
31.    Tomas A. C. F. G. Ribeiro    Idem    85062830981         
32.    João Menezes Pinto    Idem    85032831004         
33.    Antonio Do Rosario    Idem    82092036625         
34.    Horacio De Araujo Maia    Idem    85101400106         
35.    Arcanjo De Jesús S. Nunes    Idem    85101630989         
36.    Carlos José Lay Gutterres    Idem    84122029398         
37.    Lilia Julieta Da C. A. Borges    Idem    85010730999         
38.    Luis De Carvalho    Idem    85021500103         
39.    Joanico Gusmão Soares    Idem    84100100102         
40.    María Das Dores Correia    Idem    84011129316         
41.    Edson Baptista Matoso    Idem    85051030984         
42.    Leandro F. Do Rego Soares    Idem    86082730029         
43.    Salvador Amaral Soares    Idem    87091000202         
44.    Domingos Gaspar Brito    Idem    82111100206         
45.    José Moniz Ferreira    Idem    84091400104         
46.    Cornelius Coli    Idem    84010800101         
47.    Zinia Mascarenhas    Idem    84100529372         
48.    Joaquim De Jesus Mendonça    Idem    83121600100         
49.    Acidalia L. D. C. R. Araujo    Idem    86072300115         
50.    Anacleto Godinho Caeiro    Idem    81030125883         
51.    Frederico Bosco A. Dos Santos    F. C. M. José María Aguirre    87030336501         
52.    Pedro Pereirra    Idem    86072100109         
53.    Nelson José G. Vong Da Silva    Idem    84052300202         
54.    Julia Rodrigues Quintao    Idem    87042736490         
55.    Estefania Ximenes    Idem    84100129376         
56.    Francisco Amaral  Da Costa    Idem    84100129407         
57.    Egio Francisco Da C. de Jesus    Idem    84061929380         
58.    Floriana Joana Ximenes    Idem    86012130055         
59.    Evacene María Gonçalves    Idem    82050836615         
60.    Tomas Belo Baptista    Idem    83060900100         
61.    Mónica María    Idem    85082730973         
62.    Ana Severina S. Da Costa    Idem    84091429394         
63.    Odete Anita da costa    Idem    84080129371         
64.    Julio Freitas    Idem    80091200207         
65.    Narciso Soares    Idem    84112200104         
66.    Luis Soares    Idem    82060136627         
67.    Alexandre Lopes Cabral    Idem    83052301144         
68.    Merita Marques Lafu    Idem    84031129374         
69.    Zemena Maria A. J. Roteiro    Idem    84060500117         
70.    Augusto Pereirra Guterres    Idem    83080600205         
71.    Mariana da Silva     Idem    84031000211         
72.    Sonia María Exposto Gusmão    Idem    85080631018         
73.    Sonia Soares De Deus     Idem    85092630971         
74.    Adilson Abelito T. Freitas    Idem    77082331321         
75.    José Alves    Idem    83031200202         
76.    Helder Sousa Xavier    Idem    84062000105         
77.    Aniceto D Jesus Pereira    Idem    84091300105         
78.    Ubaldo Ximenes    Idem    83012100207         
79.    Cesaltino Da Silva Belo    F.C.M José Maceo, actualmente en la Enrique Cabrera    82051539949         
 80.    Nelson Januario    Idem    83123000210         
81.    José Amaral Ximenes    Idem     84020430306         
82.    Eldegar Lopes Martins    Idem    84080830281         
83.    Mariano Soares Xavier    Idem    83090700049         
84    Humberto Yohanes    Idem    83121200023      

Sistema Nasionál Saúde nian


Roo Ambulansia Multifunsaun Ministeriu Saude Nian

Sistema Nasionál Saúde nian iha Timor-Leste fahe ona ba servisu Ospitalár no servisu saúde Komunitária.
Iha servisu ospitalár iha ospitál rekursu rua no ospitál rejionál tolu – ospitál hirak ne’e bele halo ona operasaun hirak simples, hanesan apendisite ka sezariana, iha distritu sira. Ospitál Sentrál Rekursu mak Ospitál Nasionál Guido Valadares, iha Dili.
Iha Sentru Saúde Komunitária 65 no Postu Saúde liu 200, sira ne’e liga diretamente ho SISCa, ne’ebé mak hamutuk 600.
Sistema sentrál ambulánsia nian servisu ba populasaun iha distritu sira no ambulánsia sira kordena ho kareta hirak ho funsaun-barak, ne’ebé mak halai iha Sub-distritu sira. Kareta hirak ne’e lori ema moras sira ba iha Distritu sira, no hosi ne’e ambulánsia mak lori mai Dili. Iha Distritu sira ne’ebé hasoru problema barak tande’it infra-estrutura, ne’ebé ambulánsia sira la konsege to’o iha ne’ebá, sira uza aviaun, “ami kontrata avioneta Australia nian ida atu lori ema moras sira husi Suai no Oe-Cusse mai iha Dili, ami mós husu Helikópteru ida hosi Nasoens Unidas, no ami mós iha ró-ahi ida atu liga Ataúro ho Dili. Alende ne’e, ami mós iha kuda 50 iha teritóriu tomak, hodi lori ema moras liu hosi mota-dalan” Vice-Ministra esplika.
Timor-Leste iha ona akordu atu transfere moras ba Singapura, Austrália no Indonésia. Iha Indonésia iha kolaborasaun ho ospitál tolu, ida mak veteran sira mak ka’er no rua seluk atu halo tratamentu ba populsaun sira.
Kona-ba rekursu umanu nasionál sira, Timor-Leste oras ne’e iha tékniku profisionál liu rihun tolu, maibé timór-oan médiku espesialista formadu to’o de’it 50. Estudante timór-oan ba medisina ne’ebé estuda iha Kuba hamutuk besik 450, ne’ebé mak sei fila tui-tuir malun hahú hosi Agostu, to’o Fevereiru 2011. Sira ne’e nu’udar estudante medisina jerál ne’ebé mak frekuenta 4o no 50 anu. Sira sei mai hakotu sira nia kursu iha Universidade Nasionál Timor Lorosa’e, hodi hetan espesializasaun ba tinan ida ka rua.
“Ha’u optimista, la’os deit ho estudante sira husi Cuba, mos husi estudante medisina hirak oras ne’e sei iha Indonésia no iha Filipina, nebé sira nia familia rasik mak seluk. Estudante hirak ne’e hamutuk husi 100 to’o 200. Karik sira fila mak sira sei integra ba iha rekursu umanu ministeriu nian”, vice Ministra ne’e garante.

Thursday, December 02, 2010

“TL na’in 202 Pozitivu Virus HIV & SIDA. 49 hala’o hela tratamentu ARV no 22 mate”


Saude-Semanal, Loron  Mundial  HIV & SIDA hanesan  loron ida importante  tebes  ba mundo  tomak.  Tamba  ne’e 1 Desembro tinan-tinan  Ministériu da Saúde  ho nia  parseiro hotu  husi  Internasional  no Nasional  hamutuk  ho  povu  Timor  Leste  tomak  Selebra loron   espesial ida ne’e iha distritu  hotu – hotu. Tinan 2010 Ministériu Saúde Selebra loron Mundial HIV/AIDS ho Thema  Maluk  ne’ebé  iha  ona  HIV & SIDA , nia  mos  ita  nia  Kolega “
Hodi fo hanoin tan no fanu  hikas  no konvida  povu Timor  Leste  tomak,   mai  hakas aan ho konsiensia  tomak hodi   buka  hatene  rasik  informasun  ne’ebé loos   konaba problema  transmisaun  no  prevensaun  HIV & SIDA hodi nune’e  bele  proteze ita  nia aan, Ita nia  familia, Ita nia  Povu no  ita  nia  Rai  doben Timor  Leste   husi virus  HIV  & SIDA.
Ita  hotu hatene  katak  virus  HIV sai  amiasa  bo’ot  tebes  ba dezenvolvementu  Nasaun  iha Mundu  hotu nune’e  mos  ba ema  nia vida   tamba  ne’e, Ita  ida – idak  tenki  prepara aan  hodi  responsabeliza no kuidadu  ba ita nia  Saúde  rasik  hanesan liufuan   diak ne’ebé  Ministériu da  Saúde  sempre fo sai  ba  publiku  katak :  

Ita  nia  Saúde   iha  ita nia  liman  rasik
Ne  signifika  katak   ita duni maka primeiru  tenki  fo atensaun bo’ot  ba  ita nia  Saúde  no  hadook  aan  husi  hahalok  ne’ebé  de’it  maka  bele   lori  ita  ba  susar no terus  nia  laran no labele  tau de’it  kulpa  ba mediku  no ema  seluk.
Povu  Timor  Leste  tomak,  Tenki iha  konhesimentu  lolos konaba  transmisaun  no prevensaun  HIV & SIDA para bele  kria  estabilidade no ambiente  ne’ebé  hakmatek,  Ita nia moris rasik  ho Saúde  ne’ebé  saudavel  hodi  bele fo  kontribuisaun  makas    ba  desenvolvimento  iha  parte  hotu – hotu no bele  proteze  Nasaun  husi  amiasa  hotu-hotu liu – liu  husi virus  HIV.

agora  ita  iha  ona maluk  202 maka   moris ona   ho  Virus  HIV  & SIDA. Husi  nomor  ida ne’e nain  49 mak  hala’o hela tratamentu  ARV  no 22  maka   mate ona,   Hodi  soe  hela  kaben feto no mane no oan  ki’ak barak.  Situasaun  ida ne dezafia  tebes sentimentu umana  ita hotu  nian hodi  luta  makas  liutan kontra  transmisaun  HIV no labele husik  tan  ema moras, terus ka mate tamba  HIV  &  AIDS.

Rekomendasaun Husi Ministériu Saúde RDTL Ba  maluk  sira  ne’ebé  moris hela  ho HIV  SIDA ,  lalika  tauk  no  prekupa  ho imi  nia  Saúde tamba  Ministériu  da  Saúde   servico  no  esforsu makas  hela,  Prepara  nafatin  Aimoruk ARV  no nutrisaun  hodi  tau  matan no fo   apoiu  ba imi  nia  Saúde.
husu  ba Povu Timor  Leste  tomak  atu  bele  servico  hamutuk  ho entidade  Ministériu  da Saúde  iha Distritu hotu-hotu  hodi   halokan  tia  hahalok  stigma  no diskriminasaun  ba maluk sira  ne’ebé moris  hela  ho  HIV & SIDA, no  tenki hakbesik  an ba  sira.  Sira  persiza  ita  hotu nia  karidade  no  hadomi   atu  fo  Kaman  no enkoraza  sira  hodi  bele  dezenvolve  moris  hanesan  ema seluk 
Ministériu  da Saúde kumpri nafatin  nia  mandatu hodi  esforsu makas, oinsa  atu  salva  povu no Rai  doben  Timor  Leste  husi  virus  HIV no moras sira  seluk  ne’ebé  amiasa tebes ba ema  nia moris.

Tamba  ne’e Ministériu da  Saúde ho nia  parseiro  hotu  Dezenvolve ona strategia Nasional ida  ho durasaun  husi 2011 to 2016,  hanesan   “ Mata  Dalan Ida “  hodi  fortifika  liu  tan  Programa  Prevensaun  HIV & SIDA   iha   Nasional  to  iha  teritorio  tomak.
Responde ba nesecidade  povu nian   maka Ministériu  da  Saúde  hari tan sentro de  Volontariu akonseilamentu ba koko ran  ( VCT )  iha  Distritu hotu – hotu  atu  bele facilita  diak liu tan  povu  nia  moris  ho informasaun HIV & SIDA  ne’ebé  los  liu.  Tamba ne’e maluk  tomak  atu   lalika moe  ka  tauk, ba  visita   VCT  ne’ebé  hari  ona  iha imi nia  Distritu tamba  iha  neba  imi sei  hetan  informasaun ne’ebé  los liu hodi hadok  an  no salva  imi nia moris husi  amiasa  virus  HIV.

Responde  mos  perkupasaun   inan no  oan mak  Ministériu  da  Saúde  dezenvolve  tan  programa  foun  ida ho naran  “ PMTCT “.   Hanesan  metode  ida  ke diak  tebes   atu halo Tratamento hodi  Prevene   transmisaun  HIV  husi  inan  ba oan.

Edukasaun Sexual  Importante tebes atu  eduka  ba  joven  sira.
Tamba  iha joven sira  nia moris  dala  ruma  hetan  dezafius bo’ot  atu  foti  desizaun  relasiona  ho  sira  nia moris  sexualidade no Saúde  reproduktiva  ne’ebé  bele  fo  impaktu  ba  sira  nia  Saúde no moris  iha  sociadade  nia leet.
Edukasaun  Sexual  sei   hanorin  ba   joven sira ho  informasaun ne’ebé klaru konaba  sexualidade  no Saúde reproduktiva  hanesan  parte  bo’ot   ida   husi prosesu dezenvolvimentu  ba joven sira  nia  moris.
Eduakasaun  Sexual  sei  fornese  informasaun  ne’ebé bele  fasilita  moris  ho  kualidade moral   ba joven sira hanesan  tuir mai ne
Joven sei  kumpriende sira  nia dezemvolvementu  fisiku  no Psikologia
Joven sei kumpriende  karakteristik  sexual  sekundaria durante  progresu dezemvolvementu hormonal iha  sira  nia  isin
Joven  sira  sei  kumprinde konflitu  ne’ebé  sempre  mosu  entre  sira  nia  emosaun iha  prosesu Sosial
Joven  sira sei kompriende katak  ema hotu iha  direitu  no dever  atu hala’o  relasaun sexual  maibe  tenki  halo ho se  no sei la hala’o relasaun Sexual  arbiru  de’it

Inan  no aman  sei  kumpriende  no akompanha  prosesu  dezemvolvementu  sira  nia  oan  husi  labarik  to adultu no atu  for  suporta wainhira  presiza

Problema  HIV & SIDA  la’os   responsabilidade Ministériu da  Saúde  mesak de’it   maibe   ema  hotu  ne’ebé  agora  dadaun  moris  no  hela  iha   Timor  Leste  nia responsabilidade tomak.
Tamba  ne’e partisipa aktiva iha  Programa Nasional  Prevensaun HIV & SIDA  ne’ebé  prepara no hala’o  hela  husi  Ministériu da Saúde  ho  nia  parseiro  hotu.
Mai  ita fo liman ba malu   no tau  hanoin hamutuk  hodi  defende  no proteze  ita nia  povu no  rai  Doben Timor  Leste husi  problema  transmisaun  HIV.MS01