Ambulance to the Rescue

Olimpia lives with her family in a remote, rural hamlet (aldeia) in Timor-Leste. When Olimpia became pregnant with her fourth child, she planned to give birth at home, just as she had done with her first three children.

However, in the early morning hours of January 5, 2018, Olimpia began to bleed significantly. In a panic, Olimpia’s family went to the home of their aldeia chief, who contacted Olimpia’s midwife and asked her to send the ambulance right away.

The ambulance arrived an hour later, collected Olimpia, and transported her to the referral hospital in Suai, a trip that took an hour-and-a-half. The midwife, who had been put on alert, was ready to provide Olimpia with emergency care as soon as she arrived at the hospital.

Olimpia delivered her healthy newborn via Caeserean section not long after.

“I was so relieved when the aldeia chief helped me arrange emergency transport to the referral hospital,” said Olimpia. “All of my previous children were delivered at home, and everything went fine, so I thought I could deliver this baby at home, too.”

“Now I realize that the health facility is the best place for me to deliver, because it has medicine, equipment, and health workers can help, especially during an emergency,” said Olimpia. “If there had been no ambulance to take me to the hospital, my baby and I might have been in real danger or even dead,” she said as tears welled up in her eyes.

Olimpia was lucky. If she had given birth three months earlier, there would not have been an ambulance to transport her to the referral hospital in Suai. In October 2017, USAID’s Reinforce Project (Reinforce) worked with the village (suco) closest to Olimpia’s aldeia, called Holipat, to develop an emergency transport plan for the suco and surrounding aldeias.

Reinforce is a five-year project (2016-2021) working with Timor-Leste’s Ministry of Health and the National Institute of Health to improve reproductive, maternal, newborn, and child health and the healthy timing and spacing of pregnancies. Reinforce works intensively in one remote municipality, Covalima, to model excellence in health service delivery and improved health.

Most of the aldeias near Holipat are far from the nearest health center, and even farther from the referral hospital in Suai, the municipal capital. Holipat does not have any public transportation options at all, so most people walk everywhere, including to the health center.

To build support for an emergency transport plan, Reinforce began conveying information with community members about the importance of birth planning, danger signs to look for during pregnancy, delivery, post-delivery, and during the newborn phase and in children under five.

Reinforce worked closely with Holipat’s community leaders, including the suco chief, aldeia chiefs, and administrative post officers, who were committed to developing a solid, workable plan. Once developed, the aldeia chiefs introduced the emergency transport plan to the community with support from health facility providers and Reinforce staff. The chiefs reiterated the danger signs and educated the community about how to take action in an emergency situation, including who to call for help.

“I was lucky because the ambulance took me to the hospital in Suai and the health staff were able to take care of me immediately. After the operation, the staff also talked to me about family planning. After hearing about all the methods, I chose the best one for me.”

Olimpia and her newborn are in good health and doing well, thanks to Holipat’s new emergency transport plan.