Dr Jim Tulloch, Director of the Child and Adolescent
Health Programme at World Health Organization (WHO) headquarters, has been named by the
United Nations Transitional Administration in East Timor (UNTAET) to head the new health
administration there. The secondment comes following a request from the Special
Representative of the UN Secretary General for East Timor, Mr Sergio Vieira de Mello, to
WHO's Director-General, Dr Gro Harlem Brundtland.
As head of the Office of Health, Dr Tulloch will oversee the reconstruction and
organization of health services in East Timor in the lead-up to independence.
"I am both honoured by the confidence placed in me by the Director-General, and
looking forward to the challenge which rebuilding a health system will entail," said
Currently, only around 20 East Timorese doctors remain in the country to serve a
population of approximately 800,000 people. Only one of the doctors is a specialist. In
Australia (1998 figures), there are an estimated 240 doctors per every 100,000 people; in
East Timor, the ratio is currently around 2.5 to 100,000. Two top priorities will be to
train more people to work in primary health care and to obtain the services of specialised
doctors until local doctors are sufficiently trained.
"WHO has been in East Timor since the arrival of Interfet (the multinational
peacekeeping force present in East Timor since 20 September 1999) and has been impressed
by the work the East Timorese health professionals have done alongside a number of
nongovernmental organizations (NGOs) to keep basic services going in the face of not only
the departure of many healthcare professionals from the country, but also the destruction
of much of East Timor's healthcare infrastructure. But, obviously, these doctors and
nurses are way overstretched and cannot address all of the specialised health needs that
exist in the country."
The newly-appointed health authority in consultation with UN agencies and NGO
healthcare providers has outlined the following as their near-term priorities:
- Re-building and rehabilitation of healthcare facilities
- Re-establishing of basic health services throughout the country
- Ensuring the supply of essential drugs and immunization services
- Training and support for East Timorese health personnel
- Maintaining the communicable disease surveillance system instituted by WHO since
September 1999 and improving disease prevention and control
Another area which Dr Tulloch and the interim health authority must address is mental
health (with an emphasis on psychological support for those traumatised by the recent
In addition to the short-term priorities, there is a need to start to develop health
policy, to decide on health financing mechanisms and to establish legislation and
regulations related to health.
All of the planned health activities will depend on the support of the international
community. Dr Tulloch points out that one of the challenges for the interim health
authority will be to encourage broad support for health sector development and
health-minded measures across the development spectrum while maintaining essential
services in the short-term . "Our goal is that, at the end of the UNTAET period, the
new Ministry of Health will be managing a well-coordinated health system and not a large
number of independently-funded and managed projects."
WHO's work in East Timor is coordinated at WHO headquarters by the Department for
Emergency and Humanitarian Action (EHA).