Australia’s near neighbour, and former Portuguese colony with a population of 1.2 million, Timor-Leste has remained relatively untouched by COVID-19 for over a year. But its porous border with Indonesia and recent floods have raised concern the virus could spread and wreak havoc on Timor-Leste’s poorly equipped health care system.
Over the past 12 months, all COVID-19 cases in Timor-Leste were diagnosed in quarantine. But in the middle of February, cases started to rise across the border with Indonesia, then gradually spread to the capital Dili, prompting the government to impose its first lockdown.
Meanwhile, heavy rain caused severe floods and landslides over the Easter weekend, killing at least 41 people and displacing more than 14,000.
The floods prompted the government to lift COVID-19 restrictions temporarily. Evacuees gathered in crowded evacuation hubs, increasing the risk of spread of the disease. Some COVID-19 treatment centres lost power, putting extra pressure on the precarious health system.
“That has lowered our guard,” says Nevio Sarmento, a Timorese microbiologist and member of the Timor-Leste National Immunisation Technical Advisory Group. “Now, two, three weeks later, the number of cases is rising.”
Record days for cases in Timor-Leste have all come in late April and early May; the country recorded its first COVID death on 9 April and there have been another three since.
Timor-Leste is a young country still recovering from a prolonged conflict for independence that left the nation’s infrastructure destroyed. Nonetheless, the government has heavily invested in its primary health care capacity to ensure health services to all communities, many of whom live in remote areas. Recent census data indicate that 84% of Timorese children have been immunised with all vaccines in the national immunisation schedule.
In the past 12 months, the Timorese COVID-19 response has been remarkable. “Our hats go off to all the frontline workers, the surveillance workers and the public health response team,” says Sarmento.
Very early in the pandemic, the Timorese government banned international flights and closed borders except for essential travels. “This has bought us time,” Sarmento says. “We did very well in delaying that first wave. I could not imagine if this had happened last year when we had no insurance of having a vaccine.”
In Timor-Leste, the vaccine rollout started at the beginning of April, when the first AstraZeneca doses of the 100,800 allocated to the country were delivered through the COVAX initiative. Sarmento says that barely covers frontline workers.
But a country with a high level of malnutrition, several other infectious diseases, a shaky health care system and now devastating floods to recover from cannot afford to let its population be exposed to SARS-CoV-2. Urgent international help is crucial to avert yet another COVID-19 disaster.
“We hope that with the COVAX initiative, international vaccine donations, we can start vaccinating the rest of the Timorese population,” says Sarmento.