Every now and then I have a guest bloggers on Development Horizons. Jessica Fanzo is someone who is always in the middle of interesting things and takes the time to reflect on them. Here she writes about her recent work in Timor-Leste.
By Jessica Fanzo, Assistant Professor of Nutrition, Dept of Pediatrics, Columbia University.
I recently had the opportunity to travel to Timor-Leste to work with a local organization, , a program within the Timor-Leste Ministry of Agriculture and Fisheries, supported by AusAID and the Australian Centre for International Agricultural Research (ACIAR). The work is focused on integrating nutrition into its food security efforts at a national scale.
Timor Leste is a country steeped in a history of conflict and conquests, which have resulted in stalled development and progress on all fronts. Healthcare, food security, infrastructure, and capacity are all lacking in a serious way, with the exception of political will. This small island of 1 million has been independent for only one decade, and now with UN Peacekeeping forces pulling out as of December 31, 2012, Timor-Leste is beginning to mark its own path on what will likely be a long road towards development.
One of the biggest development challenges Timor-Leste faces is its state of nutrition. Timor-Leste is in a crisis situation with 58% of children under five being moderately to severely stunted, one of the highest prevalence rates in the world. In some districts of Timor Leste, the number is as high as 75%. Furthermore, 38% of people in Timor-Leste suffer from anaemia. Why is this? I think the reasons are complex which are clouded with its long-term political instability, however some big determinants stand out:
1. Poverty: The country is a brand new country, and they have a long way to go to rebuild their nation after 70% of its infrastructure had been destroyed. They are now building the political architecture moving forward. Timor-Leste has dedicated significant efforts towards improving the country’s financial and human resources, which remain limited. The country sits on massive amounts of oil in the Timorese Sea, which is worth billions. It will be interesting to see how they spend these funds on their citizens beyond just pensions for veterans who fought in the resistance. But with the absolute poverty line at US$0.88 per day, and with major issues of high youth unemployment and increased poverty rates in rural areas, investments will need to be made in areas such as agriculture and rural infrastructure and technology.
2. Dietary Diversity: The Timorese eat a lot of starch – potatoes, cassava, and rice. Rice rules in Timor-Leste but comes from Vietnam. They don’t eat much meat, and are low consumers of fish, although they are surrounded by water. Most Timorese are subsistence farmers working on marginal lands with nutrient-poor, shallow soils, so food insecurity in general is high and the dry season takes its toll.
3. Primary Health Care and Culture Links: Sanitation and hygiene is a huge issue and health care services are sparse. Dengue and malaria are no joke. Knowledge on childcare practices and traditional cultural taboos and rituals tend to dictate decision making, the way limited funds are spent, and what is purchased at the household level. Cockfighting is a huge business, often at the expense, and this is just a hypothesis, of spending money instead on necessary childcare.
4. Capacity Development: Capacity to deliver interventions, to govern the country and scale up development efforts remains a huge issue. Now that the Peacekeeping Forces have pulled out, it is time for donors to start thinking about how to invest in capacity development for Timor-Leste as a part of the country’s overarching development plans.
5. Access: Access to markets, to healthcare or healthworker, and technology remains scant at best, particularly in rural areas. Timor-Leste is very mountainous – and the roads are god awful. The north to the south of the island is only 120 kilometers but it takes 5 hours by car to make the trek. Lucky for me, I was in a car.
There are only 1 million people on the island, and they are squeezed in between Indonesia and Australia, countries of growth and prosperity respectively. What a great place for donors to come to the table and make some investments with high impact. Investments in rural agriculture (from rice production to coffee to vegetable and fruit production), community health and extension workforces, and improving the capacity in the government are doable, in a short time period. There is only one nutritionist in the Ministry of Health for the country! On the nutrition front, I hope Timor-Leste joins the SUN movement to demonstrate their commitment to improving nutrition in their country. Tourism could be huge in Timor-Leste. Investments in ecotourism along with some help on how to keep beaches clean and how to build a tourism industry is desperately needed.
By working with the Seeds of Life team, we are trying to improve the nutrition within the varieties selected for their national seed system, and providing nutrition education and knowledge to cooperatives of farmers working in the formal and informal seeds systems in the country. We are starting at the basics of food security, the seed. I think it is a good place to start.
As we enter 2013, I hope we will see a Timor-Leste on its own, independent, and beginning to prosper. A country where the cycle of stunting is broken and children grow, learn and become prosperous citizens. The time is now to pull for Timor-Leste. They deserve the chance.