Marianos journey: Real life health challenges for Timor Leste 2009

A recent clinical example of a young man's journey through illness to death illustrates the heavy burden of disease in Timor-Leste and the challenges faced by the government in developing accessible, appropriate and efficient services. The Timor-Leste Ministry of Health has made significant advances in rebuilding the health services from near total destruction since independence in 1999. Traditional or religious beliefs delay seeking or continuing with modern care. Although care is free, accessing care and not working is a large financial burden. Human resources, diagnostic and technical resources, drug supply and quality of care are often inadequate so that patients lose faith in the service. What is not acceptable in a developed country is often seen as acceptable in a developing country. With respect to the National TB Program, active casefinding, culturally appropriate health education and promotion, follow-up of defaulters, financial and psychological support for patients may all help avoid the continuing death of young people such as this patient.