Canberra obstetrician Dr David O’Rourke awarded the Medal of the Order of Australia (OAM)

Canberra obstetrician David O’Rourke has for the last eight years sacrificed a portion of the fees from his private practice in Deakin to build and fund a hospital in a poverty-stricken town in West Timor.

In that time, his patients have effectively donated a portion of their expenses to the hospital, rather than to Dr O’Rourke, raising $1.2 million. And 46,000 patients have been through the Mother Ignacia Hospital, since it opened five years ago in the town of Soe.

“I’m very honoured that someone has decided to put me up for that. I’m a sort of an under-the-radar sort of person,” he said.

Dr O’Rourke, and his wife Sue-Ann, decided to build the hospital after he made a life-changing trip to West Timor in 2009 and saw the level of need.

“You can’t change the world, but you can make the world better for some people along the way,” the father-of-four from Garran said.

“We are so privileged where we live and I’m determined to give some of my privilege back to others, and this is the tool I do it by. And it’s an easy fundraising model. You’re just swapping skill you do every day for your charitable project, so anyone could do it.”

Originally from Goulburn, Dr O’Rourke, who turns 52 on Tuesday, was a GP first, moving into obstetrics later. He has delivered 3500 babies in the public and private sectors.

“When you deliver a baby, it’s part of the creation of the family unit and in our world, it’s usually safe, with a good outcome. We’re all very lucky that we take these things for granted,” he said.

“I do the fertility stuff as well so, once again, it’s always a thrill when you’re involved in the fertility side of things and you deliver a baby.”

His parents Paul and Jenny O’Rourke still live in Goulburn and he visits patients there once a month.

The hospital in West Timor is a collaboration with a local order of nuns, The Religious of the Virgin Mary, and the Flinders Overseas Health Group, a collection of volunteer health professionals across Australia including doctors, nurses, pharmacists and laboratory scientists who give their time and expertise in the Eastern Indonesian province of Nusa Tengara Timur, which includes West Timor.

The O’Rourkes are not religious but formed a strong bond with the nuns, who were passionate about getting the hospital built.

“I’d like to acknowledge Sister Yasinta, who is now deceased, and Sister Bernadette from West Timor; Andrew Love, Richard Turnbull and the Flinders Overseas Health Group and Dr Peter Scott from Canberra, who have all contributed to make the Mother Ignacia Hospital a success,” Dr O’Rourke said.

There are plans to expand the hospital, which has recently added a “waiting house” where women from outlying villages can wait until labour, at no cost.

“It will be a long-term thing for me,” Dr O’Rourke said.

And one of his biggest fans is his 16-year-old daughter Lily, who has included a study of the hospital in West Timor as part of her International Baccalaureate at the Canberra Grammar School.

“I’m using the hospital to compare the healthcare in Indonesia and Australia and the disparities between them, even though we live so close to them,” she said.

She was impressed by what had been achieved by her father.

“I am so incredibly proud of him,” she said.

“I think it’s been so important for my little brothers and me because we live a very privileged, sheltered life, we have no troubles and then seeing him help these people who have nothing has been such an amazing thing to see and put our fortunate position into perspective. I’m very proud of what he’s done.”

For more details on the Mother Ignacia Hospital or to make a donation, go to www.muderignacia.com

READ THE ARTICLE  IN THE CANBERRA TIMES HERE

Construction of new Sisters Residence

Despite Covid-19 being present in West Timor, 2020 saw the construction of a new Sisters Residence and a Waiting house for the Mother Ignacia Hospital.

The old residence was demolished and replaced with a new six bedroom house with ensuite rooms, dining room, kitchen, laundry and living spaces.

Six sisters work at the Mother Ignacia Hospital.

The Waiting House consists of four rooms, two bathrooms, kitchen and living rooms.  The waiting facility will allow pregnant women who live long distances from the birthing facility to come and stay until their baby is born.

Transport to health care is one of the largest hurdles that does not allow access to safe medical care.  The Waiting House should make access to the mother Ignacia Hospital easier and contribute to safer outcomes.

 

A Waste Water Facility was also installed into the site of the Mother Ignacia Hospital, an essential government requirement to future proof the site and replacing the original septic waste system.

 

The laundry for the site is currently under construction.

Remembering Sister Yasinta Hoar

 



11/12/1963 – 18/02/20


One of the main supporters of the Muder Ignacia Hospital, Sr Yas as she was fondly known, passed away after a battle with breast cancer, in February 2020. She was the driving force behind the hospital project in SoE. She will be deeply missed by everyone in SoE, and by all the FOHG members in Australia.

In the words of Sr Bernadette Leton

‘Yes the funeral activity was so solemn. So many people came – many we do not know them but for sure many poor people from the places where S Yasinta served were there. She is at peace in Heaven. She continues praying for our mission’.

 

The History of the Mother Ignacia Clinic

The Mother Ignacia Clinic is a joint venture between Dr David O’Rourke and his wife Sue-Ann O’Rourke, The Flinders Overseas Health Group (FOHG)  and an order of Catholic Sisters, The Religious of the Virgin Mary (RVM).

The Mother Ignacia Clinic was officially opened on the 11th June 2016 in Soe, West Timor, Nusa Tengara Timur (NTT) , Indonesia.

The opening was conducted by the Bishop of Kupang, representatives of the government and  local health ministry, dignitaries, representatives of FOHG, clinic staff and over one thousand local residents of Soe.  (See www.fohg.com.au)

The Religious of the Virgin Mary (RVM) is a Catholic order of nuns, founded in 1684 in Manilla, Phillipines, by a lay woman called Mother Ignacia del Espiritu Santo.  The name of the clinic being the Mother Ignacia Clinic, a reference to their founder.

The RVM sisters are involved in educational, retreat, dormitory, and social ministries  and are  present in Italy, Taiwan, Pakistan, USA, Canada, Ghana West Africa and in Indonesia since 1988 beginning in Kupang, West Timor NTT.  Helping poor and disadvantaged people is their mission.

(See www.rvmonline.com)

The Flinders Overseas Health Group (FOHG) was founded in 2007, in Adelaide, Australia by a group of people who wish to essentially remain anonymous.  Drawing upon their collective professional, personal and community experiences they were able to form a group to help better the health of disadvantaged through education.

FOHG’s mission statement is to aim for Sustainable Health Through Education,  providing health education to  health stakeholders,  transfer of knowledge and skills to improve health outcomes.

FOHG’s educational activities occur in  the Eastern Indonesian province of Nusa Tengara Timur (NTT) which includes West Timor.  The status normal in this region  is poverty, malnutrition, limited education and a very under resourced health system.

FOHG conducts education visits across the following health disciplines:  Maternal and neonatal health, accident and emergency, oncology, dermatology, infectious diseases, pathology and microbiology.  FOHG works with local partners to deliver educational outcomes, on the basis that health improvements arrive through education.  The health partners range from provincial clinics, local clinics, Indonesian educational facilities through to individuals who provide patient services care directly at the frontline of healthcare provision.

FOHG relies on volunteers and benefactors who self fund the cost of their visits, give their time for free and  receives no government assistance for the programs they have developed

(See  www.fohg.com.au)

Dr David O’Rourke MB BS FRACGP FARGP FRANZCOG MRMed MWomHMed is a specialist Obstetrician and Gynaecologist located in Canberra working in both public and private sectors.  Areas of clinical practice are obstetrics, gynaecology with special interest in keyhole (laparoscopic) surgery and fertility including IVF management.  David was originally a rural general practitioner in NSW Australia with procedural skills in anaesthetics and obstetrics and followed this course for a few years before pursuing specialist training through Canberra (2003 – 2006) and Adelaide (2007-2008).

In 2007, a chance meeting between David and Dr Peter Riddle,  a Plastic and Reconstructive and  General Surgeon occurred.  Dr Riddle, having a long association with clinical work in Keffamenanu (West Timor) as well as being a member of FOHG, convinced David to become involved, on the basis of the desire and need for a Maternal and Neonatal health program  in this area.  David was involved in  clinical and educational trips to Ende (Flores) in 2009 and Keffamenanu (NTT)  in 2010 under the FOHG banner.

David returned from these trips, with a staggering view of the disparity between the world he worked and lived in compared to life where he had just  briefly visited.   David met Sr Yasinata Hoar (RVM) who was the Mother Superior of RVM in Indonesia at this time and she discussed with him the  long term desire to build a maternity clinic in a town called Soe, West Timor.  The theme of disparity and the birthing clinic stayed in his mind.

Sr Yasinta RVM and Sister Rosalind RVM had previously, over many years raised the issue of high mortality rate for mothers and infants in West Timor as a result poor family structure, poverty, poor transport and inadequate facilities.

As a result the majority of women giving birth had to rely upon traditional birth attendants (not qualified and unusual beliefs) or no care, and  deliver in their own home in villages often without any antenatal care, intrapartum supervision or postnatal care.  The survival of mothers and babies was reliant on nature and statistics, call it luck, very different to the interventions and technology present in our first world society.  Sr Yasinta and Sr Rosalind thought  that a birthing clinic for  antenatal care and delivery and postnatal care  would be the way to go.

David and his wife, Sue-Ann discussed these issues many times over, and in the preceeding 12 months (2013) had  just had their 3rd and 4th children, identical twin boys.  Their  twin pregnancy was uncomplicated but still plentiful of antenatal care visits , multiple ultrasounds, spinal anaesthesia, elective  caesarean section and  special care nursery for ten days for the new babies.  All provided under the supervision of  obstetrician, anaesthetist, paediatrician and midwifery and nursing staff.  All this is routine and taken for granted in Australia, and the disparity of this and maternity care in West Timor (and many other parts of the world) is strikingly obvious.  Building and running a clinic or health facility would require money, contacts in the target area and expertise.  Money goes a long way in West Timor compared to Australia.

David and Sue-Ann finally made the decision to help out  and in 2014 visited Adelaide to speak to the then Chair of FOHG, Mr Andrew Love who was also  a foundation member of the organisation and very cognisant of the issues and desires over time.  David and Sue-Ann’s offer was to provide the money to build the project, if FOHG would help out with the organisational side of things given their contacts and history in the area and the links with the RVM sisters.  Before this meeting David had contacted Sr Yasinta  (Mother Superior) and she gave her approval to begin the process

The offer was discussed accepted by the  FOHG committee.  From this point David and Sue Ann O’Rourke, FOHG ( in particular FOHG members Mr Andrew Love and Mr Richard Turnbull), RVM sisters,  (especially Sr Yasinta),  set about the long journey involved.  The O’Rourke’s provided the funds, RVM  provided the land and FOHG along with  everyone was involved with plans, politics, and dealing with authorities over what was a long and tenuous process, with the boundaries constantly changeing.  Eventually, an advisory Board was formed,  a project manager, Mr Ted Burke (based in Kupang, West Timor) was employed, a designer and builder engaged and eventually the construction of the  25 bed clinic started.  A foundation stone ceremony (May 2015) was held in Soe to recognise the start of the project and the clinic was opened 11th June 2016.  The facility is owned and operated by RVM, all aspects having been donated to RVM

During the initial construction phase, the advisory board of the clinic, raised the concept of building a Class D Clinic, which if fully operational would mean that the Indonesian Government would support the clinic financially, through its BPJS scheme.  (Similar to Medicare in Australia)

A class D clinic would allow the facility in the future to become self sustaining, self funding and rely less on donations which it now does.  A class D facility means certain government requirements, now have to be met, more building, more procedures, more requirements.

At the moment the Mother Ignacia Clinic is operational, receiving inpatient and maternity admission, dental clinic as well as outpatients.

A dedicated antenatal clinic and birth sponsor program (“One Birth at a Time”) is  now operational.

FOHG recently donated an ultrasound machine to the Muder Ignacia Clinic.

An ambulance has been donated and much local support is present in this facility.

Staff are currently working at less than award wage in order to support and develop the facility.

At the present time, an Architect has been engaged to develop  plans and gain approvals  to expand the clinic to a 50 bed facility with operating theatre, high care unit and other facilities so the  Clinic will be a Class D general clinic and qualify for BPJS funding and allow an expansion in services.

The eventual aim is for the Mother Ignacia Clinic to be a self sustained health facility with 25 beds for general admissions and 25 beds for Maternity admissions.  A centre for clinical activity to benefit the poor people of Soe  as well as a facility for visiting teams from Australia to visit and deliver educational programs that will achieve sustainable health through education.

Thank you letter

Dear Dr. David,

Praised and thank God for His kindness that he sent you to help in sponsoring the birthing program at Muder Ignacia Hospital. Muder Ignacia Hospital family would like to thank you for your attention, support and generosity in helping us bring a better care towards the patients in our hospital, by sponsoring birthing mothers.

Muder Ignacia Hospital is a social hospital that provides healthcare mostly to the unfortunate communities of SOE who came from economically-challenged background and living in rural, remote areas. We are beyond blessed, happy and grateful for sponsoring the birthing mother and we believe that patients of Muder Ignacia hospital along with their families grateful and thanking you for your generous heart to release them from their financial problem. We are hoping that this generous sponsorship is an establishing of a familial relationship between you and the families of Muder Ignacia Hospital that is sustainable in the future.

We can only return your kindness by praying to God to bless you and all your endeavours and provide you with good health so that you can keep being a channel of blessing for those who are in need.

Thank you very much and God bless you and the family.

Greetings in the love of God

Ma. Bernadete Letek Leton, RVM
Hospital In-Charge

History of the Establishment of the Muder Ignacia Hospital RVM Indonesia

History of the establishment Muder Ignacia Hospital

Established as clinic in March 4th, 1998 by our Sisters under Ancilla Domini Foundation in Kupang. Our Service more on helping those patients who are economically poor and cannot afford medical care. We were limited in facilities, in form of clinic rooms and medical equipment but we have many patients who came to our clinic which they came from all parts of SoE and even out site of SoE.  But after the 15 years of service as a clinic, the Sisters have found the calling to improve their service to a more professional care with better quality, in order to help those who are in need but the sisters could not do anything because of financial mater.

Finally, through the grace of God, we were helped to expand our service  into a hospital by the generosity of Dr. David O’rourke and his family that was channeled through Flinders Overseas Health Group (FOHG), an organisation providing assistance in health sector. Considering the fact that Muder Ignacia Clinic has experienced an increase in the number of visits through every part of Kota Soe despite being an outpatient clinic, the Sisters are making an effort to increase their service by becoming a hospital, providing more comprehensive, optimal and professional health care that are better in quality.

On May 2015 the construction was started and The hospital was officially opened on June 11, 2016 and started to serve the patients.  The Muder Ignacia Hospital, equipped with outpatient and inpatient facilities. The Sisters has provided  satisfactory health services towards our patients comprising financially-challenged community in Soe City and its surroundings, including people from remote areas.

Mission, Vision, and Goals of the Muder Ignacia Hospital

Vision

Loving service emanating from the love of Christ

Mission

Devotion to:

  1. Witness toward the love and healing power of the risen Lord
  2. Revive the enthusiasm of mother Marry reflected by Mother Ignacia for the poor, giving hope and strength all people who care about human life and creation
  3. Share with a generous heart the healing gifts of our profession

Goals

  1. To serve the sick with love
  2. To provide good quality healing service
  3. To provide a wide range of services
  4. To contribute to a collaborative network that will work and form partnerships with good quality government and non-government agencies
  5. Development of human resources

As for now, the Muder Ignacia Hospital is equipped with various facilities including inpatient care, 24 hours emergency service, General Practice clinic, Dental clinic, Obstetric clinic, Delivery Room and supporting facilities such as a laboratory, ECG, nutritionist consultation service and pharmacy.

Foundation stone speech


Speech for laying of first foundation stone for Mother Ignacia Clinic in Nunumeu, City of SOE, TTS District, Indonesia

With the greatest respect for:

The Head of the District, today represented by the District Secretary; the Head of the Sub-District and his staff; Sr. Yasinta Head of the RVM District of Indonesia; Sr. Lani Head of the Mother Ignacia Clinic; the Parish Priest Father Dago; Paul Sianto and his work crews; community leaders and all others in attendance.

Please allow me to read a message from Andrew Love, the head representative of the organization Flinders Overseas Health Group (FOHG) which has generously provided the funding for the construction of new buildings for Mother Ignacia Clinic.

Flinders Overseas Health Group as an  Australian based group of volunteer Doctors, who in conjunction with Dr David O’Rourke and his wife Sue-Ann, are pleased to provide funding for this clinic, as a practical indication of our support for the people of the City of Soe, and the people of the Timor Tengah Selatan (South Central Timor) District.

With the support of the Nuns of the Religious of the Virgin Mary we will assist in supporting the  provision of  a clinical service and birthing clinic for the people of Soe and the wider region.

With the agreement and support of the local authorities and the Department of Health we will offer educational programmes, specialist  and support services for the training and development of personnel in this clinic,  as well   as  other local health organisations,  in the training of their staff. Our overall objective is to assist in the improvement of the health of all people in this region.

We are appreciative of the support of the government, the RVM Nuns, our neighbours and  the people of SOE, the builders, our architect and  all who have been involved in the building of this clinic.

Maternal and Neonatal Health in NUSA TENGARRA TIMUR (NTT), INDONESIA.

Maternal and Neonatal Health in NUSA TENGARRA TIMUR (NTT), INDONESIA.

The area of Indonesia known as NTT is one of the most under resourced in Indonesia. This is partly because of the dry mountainous terrain and remote villages. The roads are winding, have poor surfaces, and many pot holes make slow going, as in our visit to a clinic, below.

The National Census data shows the NTT has amongst the worse health in Indonesia with malaria and tuberculosis having high prevalence. These two conditions alone can be life threatening and cause death in pregnant women or their babies. Poverty and poor nutrition cause much anaemia which is a catalyst for haemorrhage in childbirth.


Housing is poor and facilities almost nonexistent. Water must be carted in containers to the home. Basic hygiene is a major issue because of the lack of water. Sepsis is shown to be 6% of all deaths under 5 years of age.
A small child is seen below, carting 2 containers of water from the local trickling river.

There are a disturbing  number of maternal and neonatal deaths in this area. A major cause of death is haemorrhage and eclampsia. Both which require early follow up. The WHO advises that mothers and children continue to die due to delays in

  • seeking appropriate care,
  • reaching a health facility and
  • receiving appropriate management at the facility.

FOHG is training midwives to arrange potential transport in case of emergency care, and refer women early to facilities instead of trying to manage problems themselves. FOHG also train staff within the larger hospitals to manage such emergencies.  In Australia, all women have ultrasounds early in pregnancy. With gifts of machines from NGO’s, recently volunteer ultra sonographers ‘up skilled’ staff in the use of ultrasound to detect problems earlier, thus saving both mother and babies lives.

Poor access to facilities has been a particular problem in the area around SoE. SoE is towards the central highlands of West Timor and many hours from the capital Kupang. The roads are narrow and few private people have cars. Most people travel on public transport, which means the back of trucks or overfilled busses.  Not the type of vehicle a woman experiencing labour can use. Even the price of such transport can be prohibitive for families.

It is the families that have the last word on whether a woman can be transported to a facility for delivery.  A refusal to allow women to travel may be the cost of travel or cultural reasons.  Over 85% of births are facilitated by midwives in the NTT.[1]  Although the Government of Indonesia discourages it, people are familiar with women delivering at home, not in hospitals.  Hospitals are for sick people. The  use of health facilities by pregnant women is less that those at home. The 2018 census  information (Indonesian Ministry of Health, Health Research and Development [RISKESDAS}) shows that most births are still taking place at home (16%)  which is almost the same rate as the use of health facilities (18%).

Their trust in the local midwife, or even the ‘traditional’ midwife (dukan) remains very strong. Sadly, the midwives are often young, often unmarried, and have only a basic education. They have few resources at their disposal, (eg., syntometrine used routinely to prevent bleeding, is not available) and the traditional midwives have only their experience and beliefs to support them.  Regardless, many people trust the local dukan implicitly, often to their detriment.

Maternal and neonatal deaths in the SoE area are very high. Dr. Lorens, the coordinator of ‘Maternal and Neonatal Auditing’ in West Timor, reports that the total number of maternal deaths in SoE for twelve months to August 2018 was 30 (We do not have the total number of live births). The main causes reported were haemorrhage and eclampsia. The maternal deaths in other NTT regions, where FOHG also work are Ende 8 and Nagakeo 2. Neonatal deaths in Nagakeo alone were 30.  Major causes of neonatal death (amongst others not recorded) include asphyxia (11), congenital abnormality (6) and pneumonia (4). A major cause of perinatal death is low birthweight. Much of this is due to poverty and resultant poor nutrition of women in NTT.

To put these figures into some context, Australia has 3.5 maternal deaths for every 100,000 births [2] and 9.7 neonatal deaths per 1000 births. Of these only 2.1 were neonatal deaths, the rest were stillbirths[3] (AIHW 2018).

[1] RISKESDAS Health of Indonesia from National 2018 census information

[2] Australian Government. Australian Institute of Health and Welfare (AIHW): Maternal Deaths in Australia 2012 -2104

Australian perinatal mortality by state.

[3] Australian Institute of Health and Welfare (AIHW) 2017, Perinatal deaths in Australia 2013–2014. (Released 29 May 2018)

Figures for the health of Indonesia nationally can be found on the WHO website. However, according to the Indonesia’s Health Research unit (RISKESDAS)[1], Nusa Tenggara Timur (NTT) as a Province has poorer health than the national figure at 306 maternal deaths per 100,000 live births. Neonatal mortality is 57 neonatal deaths per 1,000 live births.[2]

To try and combat such deaths Flinders Overseas Health Group has supported the opening of the Muder Ignancia Hospital where the staff are being encouraged to upskill and take special care of mothers and babies.

[1] GOI, RISKESDAS Health of Indonesia from National 2018 census information

[2] GOI, RISKESDAS Health of Indonesia from National 2018 census information

[1] Australian Government. Australian Institute of Health and Welfare (AIHW): Maternal Deaths in Australia 2012 -2104

[1] Australian Institute of Health and Welfare (AIHW) 2017, Perinatal deaths in Australia 2013–2014. (Released 29 May 2018)

[1] GOI, RISKESDAS Health of Indonesia from National 2018 census information

[1] GOI, RISKESDAS Health of Indonesia from National 2018 census information

The opening was very traditional. The Heads of the village are seen here dressed traditionally as part of the opening ceremony.

The FOHG maternal and neonatal team volunteers each had a tree planted in the grounds of the new facility, along with their names.


The midwives working in SoE have trained at the Kupang Polytek. FOHG Maternal and neonatal team also provide seminars to upskill the midwifery trainers at this Polytek. These up to date teaching and skills transfer techniques instead of didactic teaching are enjoyed more by the participants. Evaluations reveal they loved ‘hands on’ learning instead of ‘chalk and talk’.  The Head of the nursing Polytek is most appreciative of FOHG’s input and has upgraded the methods accordingly.

Since the opening of the Muder Ignancia Hospital, the MNH team have provided seminars to both the staff and those of the SoE General Hospital.

Reference list:

Australian Government. Australian Institute of Health and Welfare (AIHW): Maternal Deaths in Australia 2012 -2104

Australian Institute of Health and Welfare (AIHW) 2017, Perinatal deaths in Australia 2013–2014. (Released 29 May 2018)

GOI, Indonesian Ministry of Health, Health Research and Development. Health of Indonesia from the 2018 census .

Personal Comment : Dr Lorens, coordinator of ‘Maternal and Neonatal Auditing’ in West Timor.

Personal comment: Ibu Since, Head Midwife, Ende General Hospital and District.

Personal comment: Ibu Onda, Head Midwife, Nagakeo General Hospital and District