Above: Maria gives volunteer Kelly Warner a knitting demonstration
With support from volunteers, Timor-Leste's mental health services can reach the people who need them most.
She's knitting, deftly turning pink wool into intricate roses. She's trying to teach the volunteer beside her, breaking into laughter at the foreigner's attempt and holding her close.
Maria de Jesus Alvaro* is a regular visitor to the psychosocial support centre at Dili's National Hospital, as are young men Paolo, Alfredo and Joao. They participate in weekly psychiatric counselling sessions and recreational activities such as tai chi, knitting or table tennis, to support their ongoing recovery from depression and psychotic episodes.
Mental illness is an area of emerging need in Timor-Leste. Ongoing internal conflict, family violence and high rates of unemployment and poverty all contribute to the problem, and many Timorese still carry the psychological scars of the country's brutal struggle for independence from 1975-1999.
The Australian Volunteers for International Development (AVID) program works to help survivors of trauma and violence find support and justice, by strengthening local mental health, counselling and legal aid services. A key partner is Psychosocial Recovery and Development in East Timor (PRADET), an organisation that has provided psychosocial support to Timorese since 2002. PRADET offers community education, training and rehabilitation services, and advocates for policy development in the health sector.
"If we're talking about human rights, we need to talk about the rights of people with a mental illness," says director Manuel dos Santos. "They have the right to get healthy and recover from their condition."
PRADET's biggest challenge is to find the resources to cope with demand. With 674 clients in the last year alone, there is immense scope for its services - from supporting young prisoners to emergency response and counselling for survivors of sexual violence and trafficking. International donors, including Australia, are a key source of funding but have stringent management and reporting requirements.
AVID volunteers are supporting PRADET to continually improve its services and meet donor requirements. Kelly Warner is working with staff to make monitoring and evaluation a part of all activities. "M&E is a very donor-driven concept," she explains. "If it's just associated with writing a report, then people don't see the point; but if it's tied into program development and listening to our clients, it becomes more meaningful."
Manuel recognises the need for data-driven programming and is appreciative of Kelly's contribution. "She accompanies our field staff to meet clients, monitors activities in the districts and helped develop the program for this psychosocial centre, which provides therapy for clients recovering from severe mental illnesses."
Manuel has moved rapidly up the PRADET hierarchy. "First I worked as the car driver … but now PRADET trusts me to drive the whole organisation!" he laughs. Constantly seeking to improve his skills and those of his team, he requested a second AVID volunteer to work in finance and governance.
Kerry Nicholls is now supporting PRADET's finance team to create meaningful monthly reports using financial software. As she explains, this is critical to the organisation's sustainability. "To achieve their vision, all non-government organisations have to be financially accountable to their donors; they have to be viable. If they are not, they inevitably fail."
This behind-the-scenes support enables PRADET to remain a sustainable organisation that can give clients like Maria and Joao a chance at long-term rehabilitation.
"I like it here," Joao says quietly. "I can do tai chi here. A doctor comes to talk with me. I can use a computer to share my experiences. This is a learning experience and I want it to continue."
*Clients' names changed to protect privacy. All photos published with permission.
Photo: Australian Red Cross/Conor Ashleigh