What is a woman worth?


Dr Alexis Shub has one  especially prized photo from her time teaching obstetrics in Timor Leste. It shows a stack of innocuous, brightly coloured plastic chairs standing in a gloomy room in Dili�s Hospital Nacional Guido Valdares.

�Those plastic chairs, which cost  $60 in total, were one of the truly lifesaving gifts I was able to contribute to the hospital,� says Dr Shub, obstetrician at Mercy  Hospital for Women. �They gave  the patients somewhere to sit  while waiting to be examined  and their families somewhere  comfortable to wait for them to  give birth. It made them think  �Well, they�ll be nice to me and  my family here � I might stay�.  That small reassurance could  literally save women�s and  babies� lives�. 

There can be few symbols more  powerful of the catastrophic gulf  between women�s reproductive  health in the developing and  developed worlds. Women fear  poor treatment in Timor Leste�s  under-resourced facilities, including that their values, beliefs  and inherent worth won�t be  respected. �That can make them  reluctant to come into hospital,  or to stay if they do come,�  Dr Shub explains. 

Speaking at the joint Mercy  Hospital for Women and Austin  Health International Women�s  Day celebration on 7 March, Dr  Shub made a compelling case for  the responsibility � and potential  � Australia has for driving  change that improves the lives of  women and babies in one of our  closest neighbouring countries. 

�Timor Leste is just an hour from  Australia and there�s more reason  to help out in our region�, said  Dr Shub. �I�d always wanted  to go out and do some good  somewhere in the world, and you  spend more time in customs than  on a plane to get there.� 

The contrast between the outlook  for mothers and babies in Timor  Leste and Australia could not be  more stark or more heartbreaking.  Timor Leste has the highest  maternal and neonatal mortality  in our region and among the  highest in the world. 

�The maternal mortality rate  in Timor Leste is around 557  per 100,000 women compared  with 10 in 100,000 in Australia,�  confirms Dr Shub �and the rate  of stillbirth is a very high 3%�. 

It was this crushing inequity that  spurred Dr Shub to relocate �  with her young family in tow  and the full support of Mercy  Hospital for Women � to the  Timorese capital�s hospital to  run a postgraduate diploma  of obstetrics. 


 Alexis Shub 

Dr Alexis Shub, Championing maternal and child health in Timor Leste. 



Like many other Mercy Health  clinicians and nurses who  offer their time and expertise  internationally, Dr Shub was on  a steep learning curve from day  one. Conditions in the hospital  mirrored the nation�s struggle to  rebuild a healthy society after  decades of conflict. 

�On my first day I was just  astonished. There was a women  dying in a room with no one  attending to her. One of the  Timorese staff said �Right, I�m  going to give some blood� and  off he went, brought back a unit  of blood and put it straight into  the patient, who miraculously  recovered. It was just so different.� 

�We routinely ran out of   basic supplies like antibiotics,  ultrasound gel, blood, sterilising  equipment. And while the  hospital staff were great, many  didn�t speak any language common to another staff  member so there were significant  communication issues. 

�Then there were cultural issues:  women with severe preeclampsia  were taken home for �spiritual  business� and never seen again.� 

Many people would feel  paralysed in the face of such  daunting obstacles, but Dr  Shub�s commitment to reversing  them was not just unshaken, but  strengthened, by her encounters  with Timor�s resilient women. 

�Although there were many  frustrations, I was endlessly  inspired by the women  themselves. They face pain  and suffering with bravery and  dignity, and even when outcomes a re poor, they are always  polite and grateful for the help  they have received. In Timor, I  regularly felt that I had made a  real difference to women and  their families.� 





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