Mark Colvin: One of our nearest neighbours, East Timor, is still so poor that many people lack even the most basic access to health care.
One of the country's largely unsung heroes is an American doctor who's been running a clinic there since 1998.
You might have seen Doctor Dan Murphy and his Bairo Pite clinic on the ABC Foreign Correspondent program last year. He saves lives daily under extremely difficult conditions, but a lot of what's needed is very expensive and requires patients flying to Melbourne for treatment.
Dr Murphy gets financial support from Macquarie Telecom, but he says his patients need a lot more.
Dan Murphy: As you know, East Timor is maybe one of the poorest countries in South-East Asia and health-wise, just starting with things like nutrition, we're number three in the world in malnutrition, tuberculosis – our clinic, to me, is the busiest one I've ever heard of in South-East Asia for treating tuberculosis.
Many other problems – women are the number one in South-East Asia in maternal mortality. Everything must be addressed, and you're talking about a country that has never had a chance to do anything to develop.
They've always been under the control of somebody else that had other interests. Now, finally independent since 1999, and it's time for them to build and become the country that we all dreamed about.
Mark Colvin: Is none of the natural resources money flowing through to the health sector?
Dan Murphy: Some has, but you've got to remember this is a country with absolutely no infrastructure, it's all mountainous terrain, very difficult, and even to get communication – we're so happy now because with a cell phone we can talk to almost any village.
There are still a few isolated ones that we can't get to. Before, we had to go up there somehow and communicate with people.
Roads are still a huge problem, and during the rainy season it's impossible to go many places, so there's still a long way to go just for infrastructure.
Then once you get that done, we need the capacity to do something meaningful when we get a hold of people and they come in.
We don't have any of the things needed and we don't have personnel that are trained to run a good program or to operate in the way western countries are accustomed to.
Mark Colvin: Are you worried about the fall in the oil price, are you worried about what the resources crash will do to East Timor's economy more broadly and flow-on to your health sector?
Dan Murphy: Yes, of course that's a tremendous worry. I mean, we're very limited by a single source for 90 per cent of the income for the country.
And yet recently somebody asked Doctor Rui, who's the new Prime Minister, "what are you doing to develop an economy because we know the price of oil's dropped and it's going to run out, then what?", and he said "well, we have a lot of ideas but we haven't really started that yet", so we don't know. There are individuals and there are NGOs doing some things, but it's on a small scale, and here we have a country that's growing, that is going to have tremendous needs and I'm afraid there's going to be a lot more suffering in the future.
Mark Colvin: And the things that you've talked about, like lack of infrastructure, lack of roads, all of that sort of thing, also I imagine, militate against, say, growing a tourism industry? I know a lot of the southern Indonesian islands are starting to do quite well there.
Dan Murphy: Well, unless you want to do eco-tourism and you want to go hiking or go on these Tour de Timor bike rides that go through the mountain trails and up river beds – that we can do, but as far as a nice sweet drive up to a beautiful resort high in the mountains, it's not going to happen.
Mark Colvin: So tell us about the patients that you're advocating for, tell us about these children who come to Melbourne, give us a couple of case studies.
Dan Murphy: Okay, just last week we had a young man come back from Melbourne from surgery and he had a hole in his heart. He's from a village, he would never have any special attention from government, he's not from a high family or anything, anybody important.
But we had discovered him, and they, Doctor Noel Bayley from Melbourne came over – he's a cardiologist, he brought his sophisticated equipment along to do an echocardiogram and discovered this hole in the heart, and we were lucky enough – he went over to Melbourne thinking that we was going to have open-heart surgery, but they were able to do the whole thing through a catheter.
See, technology's really advancing and so they closed this hole just through inserting a catheter through the groin and getting it up into the heart and doing that. They had problems, they had trouble pushing their way through the right part of the heart but they got it, they took care of it all and he's fine now.
Mark Colvin: But that stuff of course needs real-time imaging, it needs big machines so that the surgeon can see what he or she is doing at the time, and there's nothing like that...
Dan Murphy: Oh, not only that but you have to be ready for every disaster, anything that could potentially happen.
Mark Colvin: But there's nothing like that in Timor.
Dan Murphy: Nothing. You have to realise we are totally under-developed. We do not even have good laboratory or any kind of pathology. No heart surgery whatsoever, half the time the x-ray machine doesn't really even work, so we're pretty primitive.
Mark Colvin: What would you like listeners to do about this?
Dan Murphy: Read about our website, which is Bairo Pite Clinic (https://bairopiteclinic.org), and we're on Facebook, we are also on the internet, and we actually have been there since 1998, we know what we're doing, we have experience. Any resource we get we can put to good use.
Mark Colvin: And can Australian government aid help?
Dan Murphy: Well, the trouble is most time Australian aid is government to government. We have had some help from Australia, it's not nearly enough and now it's harder than ever to get.
We mostly depend on individuals as donors and I've found Australians to be very generous. We get money from people and even if it comes in small amounts it builds up and we're able to do a lot with it because we don't have any overhead – all we do is work.
Mark Colvin: Doctor Dan Murphy from the Bairo Pite Clinic in East Timor.