WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
DEPARTMENT OF EMERGENCY AND HUMANITARIAN ACTION
PROJECT PROGRESS REPORT TO
THE COMMONWEALTH OF AUSTRALIA
June 2000
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Project Title:
Roll Back Malaria in East Timor
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Country:
East Timor
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Beneficiary Population: 750,000 – 800,000
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Amount (A$): 850,000
5.
Date Contributions Received: 16 February 2000
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Initial Project Duration: 6 months
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Actual Starting Date: January, 2000Completion Date: Ongoing
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Project Objectives:
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Amount (US $): 540,260
Extension: 3 months
To reduce the morbidity and mortality for malaria in East Timor by using and implementing the
Roll Back Malaria (RBM) strategy in collaboration with the national health staff
To conduct assessment of the malaria situation using experts based in the region and from RBM
Complex Emergencies Network
To conduct surveys to measure parasite prevalence and drug resistance
To assess the efficacy of appropriate insecticide spraying programs
To support distribution of permethrin-impregnated bed nets in collaboration with NGO partners,
the major partners, Merlin and the International Rescue Committee
To ensure accurate diagnosis and effective treatment of malaria in order to reduce morbidity,
mortality from malaria
To train health workers on the correct use of the antimalarial drugs and introduce the new WHO
treatment protocol
Project Achievements:
Malaria management in the province is being intensified through efforts of the department of
Emergency Humanitarian Action and the Roll Back Malaria Program. Malaria specialists identified
a target of 40,000 bed-nets for distribution to high-risk families by district health authorities. Over
10,000 bed-nets have been provided by WHO with UNHCR and UNICEF expecting to contribute
the remainder of the targeted amount over the next month. Epidemic malaria management for
epidemic foci consists of mass treatment of fever cases. Standardized non-epidemic case
management remains consistent with national guidelines and is reviewed at health centers by four
Indonesian project consultants. Pesticide spraying of enclosed domiciles started in May. The overall
activities of the Roll Back Malaria project were publicized during a visit to Kupang of the Minister
of Health accompanied by the WHO Country Representative.
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Diagnostic and treatment capacity:
 Laboratory capacity: Training of laboratory technicians for each of the 13 districts of East
Timor in the microscopic diagnosis of malaria (Laboratory safety, sample taking, staining
techniques, diagnosis by light microscopy, quality control, WHO weekly reporting
requirements) was implemented. Equipment and reagents for functioning of district
laboratories were procured and distributed. Laboratories in 8 out of the 13 districts are
functioning. The Dili Central Laboratory was re-established as central reference laboratory
with supervisory, quality control and centralized reporting role for the diagnosis of malaria
by light microscopy.
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Clinical management: WHO specific protocols for clinicians were developed and
disseminated in seven districts. Workshops on the management of malaria and standard
WHO protocols for clinicians were conducted in seven districts. A series of training
modules on the management of malaria for district level were developed and translated.
Training of trainers sessions of these modules were conducted, (including background,
clinical features of uncomplicated malaria, other causes of fever, assessing the child with
fever, treatment protocols for uncomplicated malaria, complicated and severe malaria,
treatment of cerebral malaria at the sub district level). Contingency anti-malarial drug stock
were maintained and distributed. Technical support on the management of malaria by
international NGOs was provided.
Technical support and coordination
 Task force: The Malaria and Dengue Task force meetings with international and national
agencies were coordinated. The following surveys were conducted: three brief incidence
surveys and two wet season cross-sectional prevalence surveys in different geographical
locations.
As for additional technical support in line with malaria control activities, the following was
achieved:
1) Provision of technical support to and collaboration with other agencies for dengue
haemorrhagic fever outbreak response;
2) Participation in a combined review of health services in East Timor to ensure that vectorborne disease control programmes can be integrated into the system and well coordinated in
the future.
Constraints:
Not all districts have operational health facilities, and therefore activities related to laboratory
services at district level are not fully implemented.
The many partners in place have requested special efforts from WHO to build consensus on
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malaria strategy and treatment.
NGOs have short-term presence and are therefore interested in "short-term acute response" only.
They have no or limited capacity in "long-term sustainable development".
UNTAET has requested WHO to maintain its presence and continue WHO activities and
coordination in many different areas, malaria control being one of them. Additional funds are
needed to continue this project.
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