1 00:00:05,200 --> 00:00:09,559 S1: More than 25 years ago, photojournalist Kate Garrity traveled to 2 00:00:09,600 --> 00:00:13,440 S1: Timor-Leste to document the struggles of the Timorese people as 3 00:00:13,440 --> 00:00:17,040 S1: they wrestled back their independence from a decades long and 4 00:00:17,079 --> 00:00:24,200 S1: often brutal Indonesian occupation. One devastating legacy of this struggle 5 00:00:24,200 --> 00:00:28,760 S1: is a deep cultural tradition of withstanding pain, coupled with 6 00:00:28,760 --> 00:00:32,240 S1: a shame about cancer and a lack of resources. A 7 00:00:32,240 --> 00:00:37,000 S1: diagnosis of cervical cancer often equals a death sentence in Timor-Leste. 8 00:00:38,360 --> 00:00:41,920 S1: I'm Samantha Selinger Morris, and you're listening to Morning Edition 9 00:00:41,920 --> 00:00:46,400 S1: from The Age and the Sydney Morning Herald. Today, photojournalist 10 00:00:46,400 --> 00:00:50,160 S1: Kate Geraghty and health editor Kate Aubusson on the Australian 11 00:00:50,159 --> 00:00:53,680 S1: medicos who are helping the women of Timor-Leste fight this 12 00:00:53,720 --> 00:01:04,130 S1: entirely preventable cancer. Well. Morning. Kate Geraghty and Kate Aubusson. 13 00:01:04,170 --> 00:01:06,490 S1: Obviously it's the two Kate's. I've got to distinguish you somehow. 14 00:01:06,490 --> 00:01:08,050 S1: So thanks for coming on. 15 00:01:08,330 --> 00:01:10,650 S2: Thanks for having us. Thank you. Okay. 16 00:01:10,690 --> 00:01:13,210 S1: Kate Geraghty, I'm going to start with you because you 17 00:01:13,209 --> 00:01:17,450 S1: first visited Timor-Leste 25 years ago, and this was obviously 18 00:01:17,450 --> 00:01:20,130 S1: a very pivotal time for the country. This was documenting 19 00:01:20,130 --> 00:01:24,410 S1: the aftermath of a 24 year war between the Timorese 20 00:01:24,410 --> 00:01:28,610 S1: people and the Indonesian military and the Pro-indonesian militia. You know, 21 00:01:28,650 --> 00:01:31,810 S1: they wanted to stop Timor-Leste from gaining independence. This was a, 22 00:01:31,850 --> 00:01:35,010 S1: you know, a hugely traumatic time. So why did you 23 00:01:35,010 --> 00:01:37,370 S1: want to return to the country again? 24 00:01:38,010 --> 00:01:42,850 S2: Well, I think, uh, any opportunity to, to revisit somewhere that, 25 00:01:43,330 --> 00:01:46,890 S2: you know, was I mean, Timor-Leste was it was the 26 00:01:46,890 --> 00:01:51,210 S2: first place where I had gone to document the aftermath of, 27 00:01:51,210 --> 00:01:56,650 S2: of conflict. And. Yeah. So basically to go 25 years 28 00:01:56,890 --> 00:02:03,140 S2: later and see the changes. Um. To see the people again, uh, 29 00:02:03,140 --> 00:02:06,780 S2: was really important and and a huge privilege. Really. 30 00:02:07,260 --> 00:02:09,780 S3: And, Kate Abelson, let's go to you. I mean, what made. 31 00:02:09,780 --> 00:02:11,540 S1: You want to go? Like, what made you want to 32 00:02:11,540 --> 00:02:15,060 S1: travel there and document, you know, some pretty horrific scenes 33 00:02:15,060 --> 00:02:16,180 S1: you're seeing. Really? 34 00:02:16,980 --> 00:02:19,540 S4: Well, I just wanted to say first that it was 35 00:02:19,820 --> 00:02:24,180 S4: pretty incredible getting to travel around Dili with Geraghty because 36 00:02:24,180 --> 00:02:26,340 S4: we drive down these streets and Kate would be like, 37 00:02:26,340 --> 00:02:28,180 S4: oh yeah, I spent a night in there. It was 38 00:02:28,220 --> 00:02:31,220 S4: a it had no roof. It was completely burnt out. Or, 39 00:02:31,260 --> 00:02:34,900 S4: you know, that's where the siege was on, on the US, uh, compound. 40 00:02:34,940 --> 00:02:37,700 S4: And to look at it, the place now, it's it's 41 00:02:37,700 --> 00:02:42,940 S4: incredible what they have accomplished in 24 years, 25 years 42 00:02:42,940 --> 00:02:48,540 S4: of independence after such a brutal and bloody several decades of, 43 00:02:48,900 --> 00:02:53,220 S4: of violence, occupation and before that colonization. So if any 44 00:02:53,220 --> 00:02:56,380 S4: country is going to achieve some truly remarkable things, it's 45 00:02:56,380 --> 00:02:57,760 S4: going to be Timor-Leste. 46 00:02:58,280 --> 00:03:01,040 S1: And it's true. Of course, what you've reported on is 47 00:03:01,040 --> 00:03:04,040 S1: a massive change in in the health there, and there 48 00:03:04,080 --> 00:03:07,800 S1: is a massive health problem there, in particular with the 49 00:03:08,320 --> 00:03:12,320 S1: numbers of women suffering from horrible late stage, in particular 50 00:03:12,320 --> 00:03:15,440 S1: cervical cancer. So, Kate, we're going to get into it 51 00:03:15,440 --> 00:03:18,040 S1: a moment to the women that you met, because in 52 00:03:18,040 --> 00:03:20,160 S1: Australia it's often quite treatable, right? 53 00:03:20,480 --> 00:03:24,320 S4: Yes, it's very treatable in Australia, in fact, we are 54 00:03:24,360 --> 00:03:28,840 S4: on track to completely eliminate this cancer by 2035. So yeah, 55 00:03:28,840 --> 00:03:31,359 S4: I was really keen to go to Timor-Leste to see 56 00:03:31,360 --> 00:03:35,640 S4: the work of a particular group of experts there, called 57 00:03:35,640 --> 00:03:40,080 S4: the Elimination Partnership in the Indo-Pacific for cervical cancer. And 58 00:03:40,320 --> 00:03:44,040 S4: Professor Deborah Bateson, who is someone I have known for years. 59 00:03:44,040 --> 00:03:47,840 S4: She is a wonderful advocate for women's health. She used 60 00:03:47,840 --> 00:03:50,880 S4: to work for Family Planning, New South Wales, and now 61 00:03:50,880 --> 00:03:53,920 S4: she is the lead in the program in Timor-Leste. And 62 00:03:54,200 --> 00:03:57,010 S4: I was interviewing her about something else several months ago, 63 00:03:57,250 --> 00:03:59,450 S4: and she mentioned that she was off to Timor-Leste er 64 00:03:59,450 --> 00:04:01,570 S4: for this program. And I just said, can I come? 65 00:04:02,010 --> 00:04:04,650 S4: And essentially she said yes. I mean, it took a 66 00:04:04,650 --> 00:04:07,090 S4: few months of back and forth and get everyone to 67 00:04:07,130 --> 00:04:11,410 S4: sign off, but that's essentially why I mean, I was 68 00:04:11,410 --> 00:04:21,450 S4: just really taken by this group of brilliant researchers, doctors, scientists, 69 00:04:21,450 --> 00:04:26,970 S4: health care workers who were essentially harnessing all the groundbreaking, 70 00:04:26,970 --> 00:04:31,250 S4: world leading work Australia has done in cervical cancer elimination 71 00:04:31,610 --> 00:04:34,130 S4: and taking it to where it was needed most because 72 00:04:34,410 --> 00:04:39,810 S4: it's frankly deplorable that in Australia, we're on track to 73 00:04:39,850 --> 00:04:44,130 S4: eliminating this deadly disease by 2035. And some of our 74 00:04:44,130 --> 00:04:48,850 S4: closest neighbours, they still have young women, women in their 20s, 75 00:04:48,890 --> 00:04:53,090 S4: their 30s and 40s dying of this cancer who are 76 00:04:53,089 --> 00:04:57,100 S4: not seeking medical treatment for this cancer until it's far 77 00:04:57,100 --> 00:05:00,380 S4: too late to do anything about it. And that, to me, 78 00:05:00,380 --> 00:05:05,580 S4: is just so perverse when this is a almost entirely 79 00:05:05,580 --> 00:05:06,820 S4: treatable disease. 80 00:05:07,180 --> 00:05:08,420 S3: Well, yeah, I was so struck. 81 00:05:08,420 --> 00:05:11,219 S1: By something that Deborah Bateson, you just mentioned her before. 82 00:05:11,260 --> 00:05:14,260 S1: She is the deputy lead of this program there that 83 00:05:14,260 --> 00:05:16,820 S1: you just mentioned. And she said to you, everyone you 84 00:05:16,820 --> 00:05:20,060 S1: meet in Timor knows someone with cervical cancer or someone 85 00:05:20,060 --> 00:05:23,300 S1: who has died of this terrible disease, often horrible deaths, 86 00:05:23,380 --> 00:05:27,339 S1: stigmatized and isolated. So I guess tell us about some 87 00:05:27,339 --> 00:05:29,700 S1: of the women or the families you met that really 88 00:05:29,940 --> 00:05:33,740 S1: unfortunately illustrate this, because there was one woman in particular, Philomena, 89 00:05:33,980 --> 00:05:37,340 S1: who spoke about her mother, who had died. Maybe. Tell 90 00:05:37,339 --> 00:05:38,419 S1: me about their story. 91 00:05:39,020 --> 00:05:42,060 S4: Yeah. I mean, she's really a testament to there is 92 00:05:42,060 --> 00:05:45,299 S4: no one in Timor-Leste who has not had some experience 93 00:05:45,300 --> 00:05:47,900 S4: with this cancer, whether it's a mother or sister or 94 00:05:48,140 --> 00:05:52,580 S4: a friend. We happen to be talking to Philomena's aunt 95 00:05:52,950 --> 00:05:57,390 S4: about her breast cancer diagnosis, and she mentioned that her 96 00:05:57,390 --> 00:06:01,510 S4: relative Maria had died of cervical cancer. And, you know, 97 00:06:01,589 --> 00:06:05,029 S4: within a few minutes, Philomena came riding up on her 98 00:06:05,029 --> 00:06:08,270 S4: scooter to Maria's front porch with her four year old 99 00:06:08,270 --> 00:06:12,270 S4: daughter Grace, in her lap. And she was kind enough 100 00:06:12,270 --> 00:06:16,150 S4: to take us to her mother Maria's gravesite, which was 101 00:06:16,150 --> 00:06:20,109 S4: beautifully tended and and she cared for it with just 102 00:06:20,150 --> 00:06:24,549 S4: this really, really lovingly. And what was really heartbreaking about 103 00:06:24,550 --> 00:06:27,910 S4: that was here we have three generations of women. We 104 00:06:27,910 --> 00:06:32,229 S4: have Maria, who has died of cervical cancer only the 105 00:06:32,230 --> 00:06:36,589 S4: year before she was a nurse. She had more health 106 00:06:36,589 --> 00:06:41,150 S4: literacy than almost most people in Timor-Leste, and she still 107 00:06:41,150 --> 00:06:45,310 S4: delayed for years getting her symptoms seen to. There's this 108 00:06:45,310 --> 00:06:48,789 S4: real culture in Timor-Leste and and also in other countries 109 00:06:48,790 --> 00:06:53,890 S4: across the Indo-Pacific of seeing traditional healers first who have 110 00:06:53,890 --> 00:06:58,890 S4: their pastes and tinctures and, um. And so people often 111 00:06:58,890 --> 00:07:02,969 S4: don't go and see a medical doctor until sort of 112 00:07:03,010 --> 00:07:06,250 S4: all other pathways are lost to them. And even then, 113 00:07:06,450 --> 00:07:10,570 S4: cancer is such a terrifying prospect in countries where there 114 00:07:10,570 --> 00:07:14,410 S4: aren't a lot of treatments. So when Maria did finally 115 00:07:14,410 --> 00:07:18,130 S4: get a diagnosis, she was sent overseas for treatment and 116 00:07:18,290 --> 00:07:21,410 S4: she was essentially given the all clear. But when she 117 00:07:21,410 --> 00:07:24,050 S4: came back, she was far weaker than she was when 118 00:07:24,050 --> 00:07:27,250 S4: she left and something still wasn't right. And so her 119 00:07:27,250 --> 00:07:29,730 S4: family went in search for answers. And no one could 120 00:07:29,730 --> 00:07:33,290 S4: really help until there was a Chinese medical ship, which 121 00:07:33,290 --> 00:07:36,970 S4: they called it a Chinese ferry that was docked in 122 00:07:36,970 --> 00:07:38,690 S4: the port of Dili. So they took her there and 123 00:07:38,690 --> 00:07:40,890 S4: she had an MRI. And it turned out that, no, 124 00:07:40,930 --> 00:07:44,730 S4: absolutely not. Her cervical cancer was now advanced. And despite 125 00:07:44,730 --> 00:07:48,489 S4: going back overseas for treatment, Maria was sent home and 126 00:07:48,490 --> 00:07:52,700 S4: told to to prepare for her death. And this was 127 00:07:52,900 --> 00:07:56,100 S4: I mean, it goes without saying, heartbreaking for Philomena, but 128 00:07:56,100 --> 00:08:01,780 S4: it really galvanized Philomena's resolve that she would be screened 129 00:08:01,780 --> 00:08:07,140 S4: for cervical cancer when she was 30 and her daughter Grace, 130 00:08:07,140 --> 00:08:11,380 S4: who is only four now, would be vaccinated as soon 131 00:08:11,380 --> 00:08:15,340 S4: as she was 11. And this would not be possible 132 00:08:15,340 --> 00:08:19,540 S4: without epic, because epic is doing the three things that 133 00:08:19,540 --> 00:08:24,380 S4: the World Health Organization say is necessary to eliminate cancer. 134 00:08:24,740 --> 00:08:30,540 S4: They want 90% of all girls vaccinated. They want 70% 135 00:08:30,540 --> 00:08:34,030 S4: of all eligible women. So women from age 30 to 136 00:08:34,030 --> 00:08:37,940 S4: 49 screened twice for HPV and 90% of women who 137 00:08:37,940 --> 00:08:41,980 S4: have precancerous cells or invasive cancer treated. And this is 138 00:08:41,980 --> 00:08:44,579 S4: the way that the world is going to eliminate this cancer. 139 00:08:44,820 --> 00:08:48,420 S4: And epic is the only program that is operating across 140 00:08:48,510 --> 00:08:49,550 S4: all three pillars. 141 00:08:50,030 --> 00:08:51,110 S3: And so I'm just. 142 00:08:51,110 --> 00:08:53,030 S1: Going to turn to you for a moment, because this 143 00:08:53,070 --> 00:08:55,670 S1: incredible feature over the weekend that you both have produced, 144 00:08:55,670 --> 00:08:59,350 S1: it features really some heart wrenching photographs that you have taken, 145 00:08:59,350 --> 00:09:03,270 S1: in particular those two women. Maya Dominguez is one woman 146 00:09:03,270 --> 00:09:06,829 S1: who's being treated in a clinic in Dili, and Olga Gutierrez. 147 00:09:07,030 --> 00:09:09,830 S1: She is also being treated, both of them for advanced 148 00:09:09,830 --> 00:09:13,469 S1: cervical cancer. So what struck you about these two women 149 00:09:13,470 --> 00:09:15,590 S1: and what was it like to meet them? 150 00:09:16,270 --> 00:09:20,710 S2: Yeah, the, uh, the two ladies were were wonderful to meet. Uh, 151 00:09:20,710 --> 00:09:25,829 S2: and especially in such a circumstance where they're obviously in pain, uh, 152 00:09:25,830 --> 00:09:29,390 S2: and they're in hospital. So they're sitting on their beds 153 00:09:29,670 --> 00:09:34,590 S2: in a ward surrounded by other women. There is, you know, 154 00:09:34,630 --> 00:09:38,910 S2: afternoon light filtering through the window kind of touches their 155 00:09:38,910 --> 00:09:43,110 S2: the sides of their faces. And they sat there and 156 00:09:43,470 --> 00:09:48,920 S2: quite humbly spoke to both Kate and I about their experiences. 157 00:09:49,240 --> 00:09:55,200 S2: They're a little bit about their daily life. They're both mothers. And, uh, 158 00:09:55,360 --> 00:09:59,720 S2: always when you meet people like, uh, Olga and Maya 159 00:10:00,000 --> 00:10:03,160 S2: in situations like this, it it breaks your heart, like 160 00:10:03,200 --> 00:10:07,880 S2: you've you can't photograph or meet people, uh, like these 161 00:10:07,880 --> 00:10:12,600 S2: ladies without walking away and feeling, you know, something could 162 00:10:12,640 --> 00:10:17,280 S2: have been done earlier or or it's preventable and you 163 00:10:17,280 --> 00:10:20,520 S2: wish them all the best. And you hope that. Yeah, 164 00:10:20,559 --> 00:10:21,679 S2: they have some peace. 165 00:10:21,920 --> 00:10:24,319 S1: And and, Kate, I wanted to turn to you as 166 00:10:24,320 --> 00:10:27,280 S1: well because there was one quote in your story, um, 167 00:10:27,320 --> 00:10:30,760 S1: this was a doctor who was either treating Olga or 168 00:10:30,760 --> 00:10:33,320 S1: was there with her. This was Doctor Zito, a man 169 00:10:33,320 --> 00:10:37,160 S1: that you, uh, interviewed there, and he seemed to be 170 00:10:37,200 --> 00:10:40,160 S1: sort of frustrated and at one point said he couldn't 171 00:10:40,160 --> 00:10:43,320 S1: interpret what Olga was saying anymore because Olga has said, 172 00:10:43,320 --> 00:10:46,219 S1: my doctors have said good things to me, encouraging me 173 00:10:46,220 --> 00:10:48,780 S1: to continue to follow the Bible and pray hard to 174 00:10:48,820 --> 00:10:51,420 S1: my Jesus so that I can return to good health. 175 00:10:51,700 --> 00:10:54,339 S1: So is that anecdote, I guess. Is that just a 176 00:10:54,340 --> 00:10:58,220 S1: testament to, I don't know, I guess the desperation, the 177 00:10:58,220 --> 00:11:02,220 S1: frustration of doctors there dealing with a crisis that perhaps 178 00:11:02,220 --> 00:11:03,660 S1: they feel like they shouldn't be in. 179 00:11:04,300 --> 00:11:06,620 S4: Doctor Zito is someone who is going to stay with 180 00:11:06,620 --> 00:11:10,860 S4: me for a while. He's a gynecologist and he works 181 00:11:10,860 --> 00:11:14,300 S4: really closely with epic. They brought him to Sydney for 182 00:11:14,500 --> 00:11:17,780 S4: On a Fellowship to see what it's like here, to 183 00:11:17,820 --> 00:11:23,380 S4: treat cervical cancer, which just must have been such a 184 00:11:23,380 --> 00:11:27,220 S4: confronting thing to see in a country that has the 185 00:11:27,220 --> 00:11:30,660 S4: health care system. We have the hospital care, we have 186 00:11:30,940 --> 00:11:35,660 S4: the surgical capabilities. Chemo, radiation, like this is just worlds 187 00:11:35,660 --> 00:11:40,380 S4: away from where he works in Dili and Timor-Leste. And 188 00:11:40,380 --> 00:11:44,550 S4: he has been treating women with cervical cancer for years, 189 00:11:44,590 --> 00:11:48,310 S4: years and years. And he broke down at one point 190 00:11:48,309 --> 00:11:52,830 S4: and just said to us, I cannot keep seeing women die. 191 00:11:52,870 --> 00:11:56,550 S4: I just can't keep experiencing this. And he was very 192 00:11:56,550 --> 00:12:01,189 S4: kind to translate for Olga when we were speaking to her. 193 00:12:01,590 --> 00:12:07,270 S4: And Olga was describing to us that she had a cancer, 194 00:12:07,350 --> 00:12:10,830 S4: a sickness, and she kept sort of holding her abdomen. 195 00:12:11,270 --> 00:12:16,510 S4: And Zito was translating, but also saying she she doesn't 196 00:12:16,510 --> 00:12:19,470 S4: comprehend what a cervix is. There is not that knowledge. 197 00:12:19,470 --> 00:12:22,550 S4: So she's talking about having a cancer in her womb. 198 00:12:22,950 --> 00:12:26,550 S4: And she was talking about the fact that her doctors 199 00:12:26,550 --> 00:12:29,310 S4: were telling her to pray, and that they hoped that 200 00:12:29,309 --> 00:12:33,150 S4: they could send her overseas for treatment because they do 201 00:12:33,150 --> 00:12:37,110 S4: not have the treatment options in Timor-Leste to treat the 202 00:12:37,110 --> 00:12:41,030 S4: later stage cervical cancers, the kind that Olga has. And 203 00:12:41,030 --> 00:12:44,280 S4: this is this is what Epic is hoping to avoid 204 00:12:44,280 --> 00:12:48,839 S4: by picking it up earlier. But, um, Olga doesn't have 205 00:12:48,840 --> 00:12:53,559 S4: a passport. She doesn't have a birth certificate. And, uh, 206 00:12:53,559 --> 00:12:57,480 S4: what's called a junta médica, a medical council of doctors 207 00:12:57,480 --> 00:13:01,600 S4: will determine whether she can go overseas. And then the 208 00:13:01,679 --> 00:13:04,160 S4: the health ministry have to determine whether there's enough in 209 00:13:04,160 --> 00:13:07,080 S4: the healthcare budget to send her. Like, these are these 210 00:13:07,240 --> 00:13:09,960 S4: are obstacles that should not exist, and they certainly don't 211 00:13:09,960 --> 00:13:12,920 S4: exist in Australia. And so I cannot imagine what it's 212 00:13:12,920 --> 00:13:16,000 S4: like for someone like Doctor Zito, who is trained to 213 00:13:16,040 --> 00:13:20,240 S4: treat women, to not be able to do that, and 214 00:13:20,240 --> 00:13:23,959 S4: to to stand there with me and with Kate Geraghty 215 00:13:23,960 --> 00:13:28,640 S4: and to translate for Olga, like, I can't imagine the 216 00:13:28,640 --> 00:13:32,760 S4: helplessness he would have felt and to hear him talk 217 00:13:32,800 --> 00:13:35,760 S4: about what Epic's achieving. I think like that really gets 218 00:13:35,760 --> 00:13:38,280 S4: to the heart of it. He's just so grateful. He's 219 00:13:38,280 --> 00:13:40,719 S4: just so grateful for the help and the assistance that 220 00:13:40,720 --> 00:13:43,929 S4: epic is offering doctors like him and the Health Ministry 221 00:13:43,929 --> 00:13:48,010 S4: to to eradicate this. And that's that's really at the 222 00:13:48,010 --> 00:13:50,770 S4: heart of this. Like this is entirely possible to do, 223 00:13:51,170 --> 00:13:54,810 S4: entirely possible to do like it. It's going to happen. 224 00:13:55,090 --> 00:14:00,330 S4: And it just means that women who could be in 225 00:14:00,330 --> 00:14:03,770 S4: Olga and Maya's position in the future perhaps won't exist 226 00:14:03,770 --> 00:14:05,650 S4: because they would have been picked up so early, or 227 00:14:05,650 --> 00:14:07,170 S4: they would have been vaccinated. 228 00:14:11,250 --> 00:14:12,210 S1: After the break. 229 00:14:13,330 --> 00:14:16,250 S4: It comes down to the people. It really does. There 230 00:14:16,250 --> 00:14:20,050 S4: is such a will, such a will to save these 231 00:14:20,050 --> 00:14:25,330 S4: women's lives and they will stop at nothing. It's really remarkable. 232 00:14:28,010 --> 00:14:28,490 S1: We'll be right. 233 00:14:28,490 --> 00:14:28,890 S5: Back. 234 00:14:38,370 --> 00:14:41,380 S1: Well, let's get into this because this is so exciting. 235 00:14:41,420 --> 00:14:45,620 S1: Amidst the heartbreak, there is this incredible new project that 236 00:14:45,620 --> 00:14:49,500 S1: you've referred to. It's a $35 million program. It's funded 237 00:14:49,500 --> 00:14:53,900 S1: by the Australian government and also prominent business executives and philanthropists, 238 00:14:53,900 --> 00:14:58,140 S1: Andrew and Nicola Forrest. So tell us, what is this 239 00:14:58,140 --> 00:15:00,420 S1: program exactly like? Can you break it down for us? 240 00:15:00,420 --> 00:15:02,780 S1: What are they going to provide? Because it seems like 241 00:15:02,780 --> 00:15:05,980 S1: in this country the challenges are just multifold, right? Like 242 00:15:05,980 --> 00:15:09,180 S1: they don't have much equipment. They don't have the equipment 243 00:15:09,180 --> 00:15:12,300 S1: to handle late stage cancers. It sounds like there's all 244 00:15:12,300 --> 00:15:14,860 S1: kinds of other challenges as well. So what are they 245 00:15:14,860 --> 00:15:15,740 S1: actually going to do? 246 00:15:16,300 --> 00:15:19,380 S4: Yeah. So epic works across the Indo-Pacific. It works in 247 00:15:19,380 --> 00:15:23,900 S4: places like PNG, in Fiji, in Vanuatu, in Tuvalu, like 248 00:15:24,100 --> 00:15:28,460 S4: they are everywhere. And if you speak to Professor Karen Canfell, 249 00:15:28,500 --> 00:15:32,460 S4: who heads this entire program, she says, we meet countries 250 00:15:32,460 --> 00:15:37,020 S4: where they're at, which means we offer countries whatever they 251 00:15:37,020 --> 00:15:39,680 S4: need at whatever stage of development they're at when it 252 00:15:39,680 --> 00:15:43,400 S4: comes to cervical cancer elimination. So for somewhere like Timor, 253 00:15:43,560 --> 00:15:48,120 S4: it's helping them set up and run a HPV cervical 254 00:15:48,120 --> 00:15:53,000 S4: cancer screening clinic, which means women come in, they self-collect 255 00:15:53,000 --> 00:15:56,600 S4: a sample. It's tested in clinic in this sort of 256 00:15:56,640 --> 00:15:59,720 S4: little portable, um, testing machine about the size of my 257 00:15:59,720 --> 00:16:03,360 S4: home air fryer, and it spits out a result within 258 00:16:03,360 --> 00:16:06,280 S4: 1 or 2 hours. And about 13% of women will 259 00:16:06,280 --> 00:16:10,320 S4: test positive for cervical cancer causing HPV strains. And most 260 00:16:10,320 --> 00:16:13,040 S4: of them can also be treated in the clinic on 261 00:16:13,040 --> 00:16:16,120 S4: the spot, which is exactly what a country like this 262 00:16:16,120 --> 00:16:17,640 S4: needs to be able to just do it all then 263 00:16:17,640 --> 00:16:20,160 S4: and there while the woman's in front of them, and 264 00:16:20,160 --> 00:16:23,240 S4: then in other countries. Epic might do things like help 265 00:16:23,240 --> 00:16:26,960 S4: them do modelling or more technical assistance if they're sort 266 00:16:26,960 --> 00:16:29,760 S4: of further along. But in Timor-Leste, we could really see 267 00:16:30,080 --> 00:16:34,040 S4: what epic could help the Health Ministry do on the ground. 268 00:16:34,040 --> 00:16:37,200 S4: Whether it is the screen and treat clinic, the thermal 269 00:16:37,290 --> 00:16:42,290 S4: ablation treatment. They're also setting up a pre-invasive clinic for 270 00:16:42,290 --> 00:16:45,130 S4: women whose precancerous cells are too advanced to be treated 271 00:16:45,130 --> 00:16:49,050 S4: by thermal ablation. And they're also supporting them improve their 272 00:16:49,050 --> 00:16:52,050 S4: lab because that's really needed as well. Something that really 273 00:16:52,050 --> 00:16:55,730 S4: struck me when we met. Maya and Olga is in 274 00:16:55,770 --> 00:16:58,890 S4: their medical files. It doesn't say that they have confirmed 275 00:16:58,890 --> 00:17:02,890 S4: cervical cancer. It says that they have suspected cervical cancer, 276 00:17:03,170 --> 00:17:05,810 S4: even though it's so advanced. Their cancer can be seen 277 00:17:05,810 --> 00:17:09,169 S4: by the naked eye of a trained medical professional. There's 278 00:17:09,170 --> 00:17:13,209 S4: so much waiting that goes on and delays in the 279 00:17:13,210 --> 00:17:16,810 S4: lab that the histopathology results, which is the gold standard 280 00:17:16,810 --> 00:17:19,530 S4: to diagnose cervical cancer, will take too long and they 281 00:17:19,530 --> 00:17:21,770 S4: don't have months to wait for treatment. They need to 282 00:17:21,770 --> 00:17:25,610 S4: be treated now. So Epic's helping equip the lab. It's 283 00:17:25,609 --> 00:17:30,050 S4: helping train Timorese healthcare professionals to do what they do, 284 00:17:30,090 --> 00:17:33,770 S4: only better in order to help these women, and also 285 00:17:33,770 --> 00:17:38,780 S4: to improve palliative care and hopefully access to pain relief medications. 286 00:17:38,780 --> 00:17:42,180 S4: Because frankly, when you run a screen and treat programme, 287 00:17:42,180 --> 00:17:44,220 S4: you're going to pick up more women with cervical cancer, 288 00:17:44,220 --> 00:17:46,660 S4: so you better help treat them as well. 289 00:17:47,300 --> 00:17:49,500 S1: Well, that's another quote that sort of stopped me in 290 00:17:49,500 --> 00:17:54,100 S1: my tracks. You spoke to Sydney PhD student Julia de Costa, 291 00:17:54,420 --> 00:17:59,100 S1: who's researching opioid access for pain management in Timor-Leste, and 292 00:17:59,100 --> 00:18:01,020 S1: she said there's a lot of resilience in Timor. We've 293 00:18:01,020 --> 00:18:03,260 S1: been through a lot and there's this culture around pain 294 00:18:03,260 --> 00:18:06,580 S1: that we should tough out. No one complains, but no 295 00:18:06,580 --> 00:18:09,180 S1: one should suffer. I mean, that's devastating to think that 296 00:18:09,180 --> 00:18:13,179 S1: there's this sort of confluence of horrible things here happening. 297 00:18:13,180 --> 00:18:15,580 S1: There's lack of treatment, there's lack of pain medication, and 298 00:18:15,580 --> 00:18:17,260 S1: then there's that culture where people feel like they have 299 00:18:17,260 --> 00:18:20,300 S1: to toughen it out. So it really is almost a 300 00:18:20,300 --> 00:18:22,820 S1: perfect storm, isn't it? In terms of what's leaving so 301 00:18:22,820 --> 00:18:23,900 S1: many people to suffer. 302 00:18:24,460 --> 00:18:27,140 S2: So usually what we see straight after a conflict or 303 00:18:27,140 --> 00:18:31,220 S2: in the aftermath of a conflict is individuals who have 304 00:18:31,220 --> 00:18:35,590 S2: been injured or have an illness or a disease will 305 00:18:35,710 --> 00:18:39,910 S2: endure the pain because there's bigger things at play. Uh, 306 00:18:40,030 --> 00:18:42,870 S2: that's the kind of sense that I get from from 307 00:18:42,910 --> 00:18:46,910 S2: meeting people. There's the creation of a government. There is 308 00:18:46,910 --> 00:18:50,830 S2: the security of, you know, the community or the population. 309 00:18:51,190 --> 00:18:56,389 S2: There is the rebuilding of infrastructure. We have to remember 310 00:18:56,390 --> 00:19:02,150 S2: that Dili and Timor-Leste was pretty much devastated at the 311 00:19:02,150 --> 00:19:07,350 S2: end of 99 and the beginning of 2000. So there were, 312 00:19:07,510 --> 00:19:09,510 S2: you know, there were a lot of things that kind 313 00:19:09,510 --> 00:19:14,550 S2: of took a priority over, um, individual suffering. And so 314 00:19:14,550 --> 00:19:18,550 S2: that doesn't surprise me to hear that people endured and, 315 00:19:18,550 --> 00:19:21,190 S2: and just kind of put up with a lot of pain. 316 00:19:21,710 --> 00:19:24,590 S1: And Kate Geraghty, I guess, sticking with you for a moment, 317 00:19:24,590 --> 00:19:26,790 S1: I did want to bring the listeners in on something 318 00:19:26,790 --> 00:19:29,350 S1: that you mentioned right before recording, because you said on 319 00:19:29,350 --> 00:19:32,510 S1: a hopeful side, what was so interesting for you returning 320 00:19:32,550 --> 00:19:35,930 S1: to this country 25 years after you were last there 321 00:19:36,250 --> 00:19:39,010 S1: was actually how impressive it is that for a country 322 00:19:39,010 --> 00:19:42,850 S1: that only gained independence 25 years ago, it's now got 323 00:19:42,850 --> 00:19:47,010 S1: this plan to eradicate cervical cancer. Such a high priority, right? 324 00:19:47,369 --> 00:19:50,410 S2: I think it's incredible. I mean, as we flew in 325 00:19:50,450 --> 00:19:54,689 S2: over Dili, I was looking down and it looked completely different. 326 00:19:54,850 --> 00:19:58,810 S2: And yeah, I did think at the time while we 327 00:19:58,810 --> 00:20:04,730 S2: were there that on a scale of, you know, really 328 00:20:06,010 --> 00:20:10,810 S2: life changing and important policies and, and, you know, to 329 00:20:10,850 --> 00:20:15,250 S2: have the eradication of cervical cancer right up there as 330 00:20:15,250 --> 00:20:18,690 S2: a top priority in a country that is, you know, 331 00:20:18,730 --> 00:20:22,970 S2: had independence for only 25 years is beyond impressive. It's, um, 332 00:20:23,490 --> 00:20:27,610 S2: take a hat off. Take a take a bow. Timor-Leste. Really? 333 00:20:28,410 --> 00:20:31,090 S6: And I guess to what do we attribute this? 334 00:20:31,090 --> 00:20:33,300 S1: The fact that because this is quite amazing to me, 335 00:20:33,300 --> 00:20:36,100 S1: I didn't. I had no idea. I knew that Timor-Leste 336 00:20:36,140 --> 00:20:39,979 S1: had achieved independence only relatively recently, but how has it 337 00:20:39,980 --> 00:20:42,300 S1: come about that a country which sounds like it still 338 00:20:42,300 --> 00:20:46,820 S1: has relatively rudimentary, I guess, medical facilities, certainly in comparison 339 00:20:46,820 --> 00:20:48,540 S1: with a country like ours? How is it that it's 340 00:20:48,540 --> 00:20:50,700 S1: come to have this near the top of its list 341 00:20:50,700 --> 00:20:52,340 S1: of priorities so soon? 342 00:20:53,740 --> 00:20:57,260 S4: It comes down to the people. It really does. When 343 00:20:57,260 --> 00:21:01,260 S4: we visited the clinic and the hospital with the Australian 344 00:21:01,260 --> 00:21:03,820 S4: members of the epic team, you could not shut them up. 345 00:21:03,820 --> 00:21:07,500 S4: When it came to singing the praises of their Timor-Leste colleagues, 346 00:21:07,500 --> 00:21:11,340 S4: the doctors, the healthcare workers, the midwives, the the bureaucrats 347 00:21:11,340 --> 00:21:14,500 S4: in the health Ministry, right up to the Vice Minister 348 00:21:14,500 --> 00:21:16,740 S4: of Health and the Minister of Health. Like there is 349 00:21:16,740 --> 00:21:20,540 S4: such a will, such a will to save these women's 350 00:21:20,540 --> 00:21:25,419 S4: lives and they will stop at nothing. It's really remarkable. 351 00:21:25,859 --> 00:21:31,750 S4: The Australian members of epic would recount stories of having 352 00:21:31,790 --> 00:21:35,990 S4: to have, um, sort of teller meetings with Doctor Andy, 353 00:21:36,030 --> 00:21:38,910 S4: who runs the screen and treat clinic in the middle 354 00:21:38,910 --> 00:21:42,350 S4: of a flood when the building was literally flooding and 355 00:21:42,350 --> 00:21:45,950 S4: the water was creeping up his legs. Or, you know, 356 00:21:45,990 --> 00:21:50,150 S4: right after an earthquake, like the the obstacles these people 357 00:21:50,150 --> 00:21:52,990 S4: face is just insane. I don't know how I would 358 00:21:52,990 --> 00:21:55,550 S4: take a day off, but they don't, you know, because 359 00:21:55,550 --> 00:21:58,710 S4: they know what the stakes are. And again and again 360 00:21:58,710 --> 00:22:01,230 S4: we heard we will leave no woman behind. We will 361 00:22:01,230 --> 00:22:05,949 S4: leave no girl behind. There is just so much resilience 362 00:22:06,230 --> 00:22:09,550 S4: and so much commitment to the cause there. I mean, 363 00:22:09,750 --> 00:22:15,710 S4: for example, this country had no HPV vaccination program. And 364 00:22:15,710 --> 00:22:20,150 S4: then last year, during their first HPV vaccination drive, which 365 00:22:20,150 --> 00:22:25,149 S4: was supported by an Epic partner, they vaccinated 90% of 366 00:22:25,150 --> 00:22:28,949 S4: the cohort of 11 to 14 year old girls, 90%. 367 00:22:29,560 --> 00:22:32,719 S4: That is so impressive. And the Health Ministry is now 368 00:22:32,720 --> 00:22:35,440 S4: going to continue this program. Like, this is a new 369 00:22:35,440 --> 00:22:38,280 S4: generation of girls who are going to grow up with 370 00:22:38,320 --> 00:22:42,200 S4: significantly lower rates of cervical cancer because of that. 371 00:22:42,800 --> 00:22:45,000 S1: And I guess, just to wrap up, Kate, one question 372 00:22:45,000 --> 00:22:48,520 S1: that's left for me is why is Australia putting so 373 00:22:48,520 --> 00:22:51,239 S1: much money into this program, into the Indo Pacific? I mean, 374 00:22:51,280 --> 00:22:53,920 S1: it's incredible to me that it is. But for those 375 00:22:53,920 --> 00:22:57,040 S1: listeners out there, you know, wondering because it is such 376 00:22:57,040 --> 00:22:58,800 S1: a great story, why are we doing this? 377 00:22:59,560 --> 00:23:02,199 S4: I think Australia feels like it has a responsibility to 378 00:23:02,240 --> 00:23:06,119 S4: help their closest neighbours, especially when Australia is such a 379 00:23:06,119 --> 00:23:08,920 S4: pioneer when it comes to cervical cancer. The first cervical 380 00:23:08,920 --> 00:23:14,400 S4: cancer vaccine was invented here. It was co-invented by an 381 00:23:14,400 --> 00:23:19,640 S4: Australian scientist called Ian Frazer. So many of the members 382 00:23:19,640 --> 00:23:24,480 S4: of Epic are pioneers in cervical cancer elimination around the world. 383 00:23:24,720 --> 00:23:26,679 S4: Australia is leading the way when it comes to cervical 384 00:23:26,680 --> 00:23:31,980 S4: cancer elimination. We have screening programs. We have vaccination programs. 385 00:23:32,180 --> 00:23:34,900 S4: We have new data just out in the last few 386 00:23:34,900 --> 00:23:38,380 S4: weeks showing that we have incredibly low rates of cervical 387 00:23:38,380 --> 00:23:44,859 S4: cancer and vanishingly low death rates for cervical cancer. So 388 00:23:44,859 --> 00:23:50,419 S4: I can completely understand a cervical cancer expert looking further 389 00:23:50,420 --> 00:23:53,780 S4: afield than Australia and going, oh my God, we're doing 390 00:23:53,780 --> 00:23:57,820 S4: so well here. And an 85 minute flight away. Young 391 00:23:57,820 --> 00:24:00,060 S4: women are still dying of it. We need to do 392 00:24:00,060 --> 00:24:04,060 S4: something about this. And when the epic team proved that 393 00:24:04,060 --> 00:24:07,260 S4: they could do this with some money that they got 394 00:24:07,260 --> 00:24:11,380 S4: from Minderoo foundation, the Australian government got on board and said, 395 00:24:11,420 --> 00:24:13,940 S4: you're actually going to do this? This is so achievable. 396 00:24:13,940 --> 00:24:16,620 S4: We're going to help you. And so now it has 397 00:24:16,660 --> 00:24:19,340 S4: become a priority for DFAT as well. 398 00:24:20,540 --> 00:24:23,260 S1: Well, it's such a great story and we're so lucky 399 00:24:23,260 --> 00:24:25,580 S1: that you both managed to get on the ground there 400 00:24:25,580 --> 00:24:28,190 S1: to report on this. So thank you so much Kate 401 00:24:28,670 --> 00:24:30,670 S1: and Kate, Alison, for your time. 402 00:24:31,070 --> 00:24:32,110 S2: Thank you so much. 403 00:24:32,230 --> 00:24:32,950 S4: Thanks, Ann. 404 00:24:33,190 --> 00:24:35,629 S2: And thank you to the ladies who are allowed us 405 00:24:35,630 --> 00:24:37,310 S2: to photograph and interview them. 406 00:24:37,350 --> 00:24:52,669 S1: Absolutely. It's such a privilege to share their stories. For 407 00:24:52,670 --> 00:24:55,990 S1: all of today's headlines and in-depth analysis on what's making 408 00:24:55,990 --> 00:25:03,190 S1: news today. Head to our website at the Smh.com.au. Today's 409 00:25:03,190 --> 00:25:07,190 S1: episode was produced by Josh towers. Our executive producer is 410 00:25:07,190 --> 00:25:11,150 S1: Tammy Mills, and our podcasts are overseen by Lisa Muxworthy 411 00:25:11,350 --> 00:25:14,909 S1: and Tom McKendrick. If you like our show, follow the 412 00:25:14,910 --> 00:25:17,510 S1: Morning Edition and leave a review for us on Apple 413 00:25:17,510 --> 00:25:19,910 S1: or Spotify. Thanks for listening.