In East Timor's national hospital in Dili, an Australian doctor checks the vital signs of an impossibly tiny baby girl, six months old, born prematurely and struggling to breathe through an acute respiratory infection.

An oxygen tube covers most of her face as her miniature lungs pump at double time as she struggles for breath. Across the ward, a boy with stitches in his leg after a nasty fall is examined by a Timorese paediatrician.

An exchange program will send two Timorese paediatric registrars to Darwin for six months to learn about Australian medicine, while next year, four Darwin doctors will travel to Dili to do the same.

In East Timor, half of the one million-strong population are children, and doctors face enormous challenges in treating them.

It is the poorest country outside of Africa and the ninth-poorest country on the poverty index, said Professor David Brewster, head of paediatrics at the national hospital.

He says about 1000 doctors have been trained in Cuba, and the Royal Australasian College of Surgeons is now helping them to specialise in fields such as surgery, obstetrics and paediatrics.

"There really are major challenges because of the low education level," Prof Brewster told reporters on Friday.

"Patients often come late to hospital, there's a great deal of malnutrition, a great deal of infectious disease, tuberculosis, so they're really very major public health and clinical challenges.

"It's also a post-conflict country that's gone through a very difficult time during colonisation and particularly during Indonesia times... We're just getting over that and making progress."

He said a fifth of the country's health budget had been cut by the Timorese government. "We're short of drugs and short of staff, nursing staff, and other supplies; things are a little bit disorganised, so yes, there are frustrations," Professor Brewster said.

"I am particularly disappointed with our inability to deal with severe malnutrition as well as I would have liked, and we need to get our immunisation program going; rheumatic fever and tuberculosis are pretty much out of control."

He said Timor had been successfully reducing the infant and child mortality rate, but that took time.

"Given that there is significant oil in Timor, one would have hoped more money could have been put into health and education because in order to improve the health of the population we need schooling.... There's an enormous amount of unmet needs in Timor that we can't deal with, but progress is being made slowly."

Dr Carla Madeira will soon travel to Australia to begin her exchange, and said she was excited to take up the opportunity.

"If you treat them from when they're born until they're growing... If they're okay they will be a good future for us," she said of her young patients.

She said it was very different compared to western countries, where there was a lot of equipment to support them that Timor did not have. "It's very hard; sometimes we have to let go (of a patient) because we cannot go further in treatment."

Australian paediatrician Joshua Francis said the Northern Territory and East Timor had a lot in common, with malnutrition and rheumatic heart disease affecting indigenous children in remote communities.

Professor Brewster said the Australian doctors would also benefit from being exposed to the poverty of Timor. "It's important for doctors in Australia to see how the other half live, and die," he said.

Source: http://www.sbs.com.au/news/article/2015/09/11/darwin-and-dili-doctors-switch-places