Catherine Graue – June in Timor-Leste would usually mean the end of the wet season and a drop in cases of dengue fever.
But changing weather patterns have seen the rains continue across the country and cases of the mosquito-borne disease are double last year's total.
So far this year Timor-Leste has recorded more than 1000 confirmed cases of dengue fever and eight deaths.
While most cases of dengue are mild, severe cases can require hospitalisation, which puts pressure on a health system already managing the COVID-19 pandemic.
Dr Joshua Francis, who leads Timor-Leste programs at the Menzies School of Health Research in Darwin, said the country was in a strong position to respond to the pandemic due to its expertise in managing dengue.
"There's a public health response to dengue that relies on some of the same principles," he said.
"It's about having the capacity to test and diagnose and to respond to cases, but also to be able to do really good surveillance, so you get a really good understanding of where the hotspots are from one year to the next."
Longer wet season drives mosquito-borne diseases
This year's spike in dengue cases is connected with the longer rainy season, which has increased the number of breeding spots for the mosquito that carries the dengue virus.
The local arm of the Red Cross, Cruz Vermelha de Timor-Leste (CVTL), is funded by the government to fumigate infected houses and travel door-to-door in communities educating households about dengue-prevention behaviours.
It has encouraged locals to remove stagnant pools of water, where mosquitoes can breed, and using mosquito nets and insect repellent to prevent mosquito bites.
CVTL president Madalena Soares said poor water infrastructure and high housing density in villages made it difficult to keep areas clean.
"It's difficult for [people] to manage the sewerage system," she said. "A lot of water not running makes larvae. This becomes the problem of the dengue mosquito."
The organisation supports 5000 volunteers to travel to houses in each of Timor-Leste's 13 municipalities with government advice and behaviour messages.
Visits have continued through Timor-Leste's COVID-19 lockdown, with volunteers physically distancing themselves while delivering advice.
Ms Soares said volunteers' core messages for preventing both COVID-19 and dengue were similar.
"The message that the volunteers come to the community is: wash your hands, clean your environment," she said. "For COVID is wash your hands and social distance. And for dengue, keep your environment clean."
While Timor-Leste's testing and tracing measures in response to COVID-19 have been praised by experts, Dr Francis said there was still a concern a second wave of the virus could affect the country's ability to respond to both diseases simultaneously.
"We're certainly mindful of the fact that if there were to be concurrent epidemics, large outbreaks of dengue and COVID-19, would certainly stretch the capacity of the hospital services in terms of the ability to respond to the clinical need," he said.
With the end of the wet season nearing it's likely the biggest risk has passed.
Dr Francis wants physicians to use the knowledge gained from treating COVID-19 to fight other infectious diseases.
"Some of the challenges that have been raised by COVID-19 have been really a good opportunity actually to refine some of those processes that are going to be relevant in Timor, so not just to COVID-19 but relevant to things like dengue, relevant to other problematic infectious diseases, like tuberculosis," he said.
"To be able to respond to an outbreak over the next couple of months, I'm confident that the health system will be in a stronger position to do that than it was even a couple months ago."