Dr Jim Tulloch, Director of the Child and Adolescent Health Programme at World Health Organization (WHO) headquarters, has been named by the United Nations Transitional Administration in East Timor (UNTAET) to head the new health administration there. The secondment comes following a request from the Special Representative of the UN Secretary General for East Timor, Mr Sergio Vieira de Mello, to WHO's Director-General, Dr Gro Harlem Brundtland.

As head of the Office of Health, Dr Tulloch will oversee the reconstruction and organization of health services in East Timor in the lead-up to independence.

"I am both honoured by the confidence placed in me by the Director-General, and looking forward to the challenge which rebuilding a health system will entail," said Dr Tulloch.

Currently, only around 20 East Timorese doctors remain in the country to serve a population of approximately 800,000 people. Only one of the doctors is a specialist. In Australia (1998 figures), there are an estimated 240 doctors per every 100,000 people; in East Timor, the ratio is currently around 2.5 to 100,000. Two top priorities will be to train more people to work in primary health care and to obtain the services of specialised doctors until local doctors are sufficiently trained.

"WHO has been in East Timor since the arrival of Interfet (the multinational peacekeeping force present in East Timor since 20 September 1999) and has been impressed by the work the East Timorese health professionals have done alongside a number of nongovernmental organizations (NGOs) to keep basic services going in the face of not only the departure of many healthcare professionals from the country, but also the destruction of much of East Timor's healthcare infrastructure. But, obviously, these doctors and nurses are way overstretched and cannot address all of the specialised health needs that exist in the country."

The newly-appointed health authority – in consultation with UN agencies and NGO healthcare providers – has outlined the following as their near-term priorities:

• Re-building and rehabilitation of healthcare facilities
• Re-establishing of basic health services throughout the country
• Ensuring the supply of essential drugs and immunization services
• Training and support for East Timorese health personnel
• Maintaining the communicable disease surveillance system instituted by WHO since September 1999 and improving disease prevention and control

Another area which Dr Tulloch and the interim health authority must address is mental health (with an emphasis on psychological support for those traumatised by the recent crisis).

In addition to the short-term priorities, there is a need to start to develop health policy, to decide on health financing mechanisms and to establish legislation and regulations related to health.

All of the planned health activities will depend on the support of the international community. Dr Tulloch points out that one of the challenges for the interim health authority will be to encourage broad support for health sector development and health-minded measures across the development spectrum while maintaining essential services in the short-term . "Our goal is that, at the end of the UNTAET period, the new Ministry of Health will be managing a well-coordinated health system and not a large number of independently-funded and managed projects."

WHO's work in East Timor is coordinated at WHO headquarters by the Department for Emergency and Humanitarian Action (EHA).