UN blamed for E. Timor TB cases

UN blamed for E. Timor TB cases

By Joanne Collins

DILI, East Timor (Reuters): From his ramshackle clinic in one
of Dili's backstreets, Dr. Dan Murphy says the easily preventable
disease tuberculosis is killing too many East Timorese.

And he blames the United Nations administration.

Murphy is the longest-serving Western doctor in the territory
and worked without official permission from Indonesia until East
Timor's de facto independence in September.

"The UN is afraid it doesn't have the perfect program, but it
won't have," he said. "This is a poor country which has just
suffered a major trauma."

Murphy says the bacterial disease has reached epidemic
proportions and is baffled why a UN program will not be in place
until February or March to combat the disease, which has become
East Timor's number one killer.

"I would estimate that it kills one fourth of those who die in
East Timor every day, which is anywhere from 50 to 100. I would
say that almost every Timorese person since September has been
closely exposed to TB.

"When families were forced from their homes into crowded
conditions together with TB sufferers no longer receiving
treatment, they were all sleeping together on the ground. In a
crowded room with no circulation of air, that's great for TB."

An estimated 250,000 East Timorese fled or were forced from
their homes to Indonesian West Timor in the maelstrom of violence
that followed the Aug. 30 vote for independence.

The UN praises Murphy and his tuberculosis treatment program
but maintains it is delaying for good reason.

"I don't think it's UN bureaucracy and I don't think it's lack
of resources," said UN's Director of Social Services in East
Timor, Cecilio Adorna.

"If we want to hand on to East Timor a good, functioning world
class TB program then we need to start it off as well as we can
-- we definitely don't want to hand them drug resistant TB or a
chaotic mixture of different agencies providing different drugs
and different protocol, we want to hand on something that will
keep working," Adorna said.

"We need to have laboratory services, we have to have drugs
available in the country and we have to have people who can
actually manage the program... you can't abandon treatment
because it's very hard to get them back on the treatment and
there is a huge worry about creating drug resistance so we have
to get all these things in place."

The UN disputes Murphy's claim that tuberculosis has reached
epidemic proportions.

At Dili's International Red Cross hospital, Health Co-
ordinator Dr. Kevin Kelly said he has seen more than 260 patients
in the past three-and-a-half weeks who are likely to have
tuberculosis.

"I've been screaming like everyone else, 'Let's start,' but
you do need to have the right program in place, if you don't
follow the treatment through, you risk resistance," Kelly said.

Most independent medical organizations had agreed to delay
treatment where possible until the UN program was in place, he
said.

"If we see people who we think are going to die before the
program starts then we'll start treating them but otherwise we
treat secondary ailments of TB.

"The UN has ordered the drugs, it has the money but TB
programmed are very difficult to run."

Difficult or not, Murphy cannot see why the UN still does not
have a dedicated program in place four months after the violence.

"The UN knew TB would be the worst health problem in East
Timor so they could've been prepared, the first week they came
here it should've been the number one priority. This is the
number one killer here," Murphy said.

"I see people all the time who are not going to last even a
month, they're on their last legs, adults weighing 20 kilograms
(44 pounds) and people coughing up blood, but you give them
treatment and they come right back to life, it's beautiful."