In Timor-Leste, the awareness and integration of physiotherapy into the local healthcare system has been growing thanks to the efforts of professionals like Lourdes Lay, Head of Department for Physical Medicine and Rehabilitation and Manager of Physiotherapy at Guido Valadares National Hospital (HNGV). Over the years, Lourdes has worked to increase the number of trained physiotherapists at HNGV, enhance public awareness, and integrate advanced practices and technologies into the healthcare system.
Growing up in Timor-Leste’s Aileu municipality, Lourdes was inspired to pursue a career in healthcare not through textbooks but through the compassionate actions of those around her. In a place where medical resources were limited, Catholic sisters operated a small clinic in the municipality that not only treated the patients but also fostered a community-centric approach to health and wellness. Lourdes became an assistant at the clinic, dispensing medications and helping organise special education and physiotherapy for children with cerebral palsy (CP) - a first-hand education in patient care and community service. Witnessing the struggles and small victories of these children planted a seed in Lourdes to one day start a career in physical therapy.
These formative years shaped Lourdes’ understanding of healthcare as a multifaceted service that extends beyond immediate treatments to encompass community engagement and empowerment. Motivated by her early experiences and driven by a passion for helping others, Lourdes applied for an Australia Awards Scholarship and study physiotherapy in Australia, laying the groundwork for her future leadership role at HNGV.
While studying in Australia, Lourdes overcame language barriers and adapted to new healthcare methodologies, she remained committed to learning new skills that would one day benefit her home country. After graduation in 2015 Lourdes returned to Timor-Leste and began applying her skills at HNGV. Working alongside two other physiotherapists Lourdes said, “It was challenging to put everything I had learned into practice, people assumed I must know more because I graduated in Australia, but I didn’t.” Overtime, Lourdes’ confidence grew as she gained hands on experience and developed a strong interest in neurological conditions, particularly stroke cases.
I saw a lot of stroke patients and became fascinated in neurological cases and musculoskeletal issues. It’s like a puzzle for you to solve.
Working closely with her colleagues, she helped stroke patients regain independence and improve their quality of life. "As their health improved, my confidence improved too," Lourdes said.
Through her work, Lourdes provides education to her community about the broader benefits of physiotherapy, focusing on preventative measures and empowering patients and their families to manage care at home. In turn, she hopes they will become advocates for stroke prevention, spreading awareness and ultimately reducing the incidence of stroke cases.
Implementing modern medical practices can be challenging due to prevailing cultural beliefs and values that still favour traditional healing methods. "Some people still seek traditional medicine for fractures, which might not be effective," Lourdes said. "It can cause delayed treatment, and often leads to complications, affecting the outcome." She emphasises that patients should seek medical advice at the hospital instead, as modern technology like X-rays can provide a clearer picture than traditional methods which rely on manual assessments.
During the COVID-19 pandemic, Timor-Leste faced unprecedented healthcare challenges, further exacerbated by severe flash flooding that damaged key infrastructure including arterial roads, bridges and government facilities. Coupled with the surge of COVID-19 cases in the aftermath of the floods, AUSMAT members including Occupational Therapist Erica Bleakley and Physiotherapist Hanna Quayle were deployed to support the local medical teams. It was then that Lourdes first connected with NCCTRC and AUSMAT staff. “At the time, our department wasn’t involved in the hospital’s COVID-19 response. Hanna and Erica immediately recognised how our skills could be utilised. They taught us advanced rehabilitation techniques to support patient recovery. It was a tremendous learning opportunity for us," recalled Lourdes. The AUSMAT team integrated themselves with the existing hospital environment, utilising available equipment and resources, ensuring that the new practices could be sustained long after their departure.
Since then, the NCCTRC’s Regional Engagement Program (REP) has continued to play a role in the professional development of Timorese health professionals. In 2022, following a request from the Timor-Leste government, NCCTRC returned to deliver the Rehabilitation in Disasters and Emergencies (RIDE) course as a pilot program. This initiative provided Lourdes and her team with essential training to integrate rehabilitation into patient care during health emergencies. Following the success of the pilot, the REP returned to Timor-Leste earlier this year to deliver the RIDE course at the Centro Nacional de Reabilitação (National Rehabilitation Centre), and again at HNGV, this time expanding it to allied health professionals across the municipalities as well.
"We are immensely grateful for the continued support from the NCCTRC," Lourdes expressed. "The skills and knowledge imparted through their programs have not only enabled us to respond effectively to immediate health challenges but have also equipped us with tools for long-term resilience and improvement in patient care."
Carla Yeung
Communications and Digital Engagement Officer
