Challenges using Telehealth in East Timor

Daniel Manahan1

1 Director of Medical Services, DDHHS Rural Division


East Timor is a new nation, a mere 75 minutes flight from Darwin. Following the United Nations independence referendum of 1999 and subsequent formal independence in 2002, East Timor became a sovereign state. The civil unrest and violence around the time of independence led to significant death and internal displacement. The country has undertaken to rebuild since independence. This includes healthcare.

The challenge of healthcare in a developing country is significant. Warfare heightens the impact of poverty and disease. East Timor’s 1.1 Million population spread across 13 districts are primarily rural based. Transportation, health infrastructure, supply continuity, and communication are a challenge. Weather and terrain are problematic for this tropical near equatorial nation. Maternal, perinatal, and infant mortality rates are amongst the highest in the world. Tuberculosis, parasitic disease, and malnutrition rates are amongst the highest in the Asia Pacific region.

East Timor had very few medical practitioners at the time of independence. Over time medical staff were trained in Cuba and subsequently by UNTL (University National Timor L’est). Support for new graduates and clinical services in East Timor from senior colleagues was sparse with many foreign doctors in the country around independence gradually leaving as the newly trained East Timorese doctors graduated. This has left a large number of enthusiastic but unsupervised minimally trained medical graduates with lack of career structure or progress opportunity within the country.

Telehealth opportunities could assist the new nation of East Timor in delivering health care and education to patients and clinicians across the country. The opportunities for engaging expertise in areas such as dermatitis and tropical skin disease, infectious disease diagnosis and management, paediatrics, and mental health provide significant potential benefit to patients. The problems with connectivity, affordable hardware, and user engagement are similar to experiences in other places.

In this paper, we look at some use of Telehealth in East Timor including what has worked and what some of the challenges are.
Daniel Manahan
FACRRM, FRACGP, DRANZCOG, Graduate Diploma Medical Sonography
Orcid Number 0000-0003-4752-7352
Orcid email

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