As we headed out for a health-focused field trip in Timor-Leste’s central highlands, we were treated to almost all the geographical delights of the country. Along the coast road, the dry season winds were whipping up the sea into the biggest waves I’d seen since I arrived in Timor-Leste. As we turned inland, the brown fields among the rising hills attested to the end of the harvest. Driving ever higher—along narrower and narrower roads—the altitude brought back the green of forests.
We were headed through the district of Ermera to the “sub-village” of Hatugeo, tucked just below the peak of Timor-Leste’s highest mountain. This district has some of the country’s worst health indictors:
- Infant mortality is 70 babies per 1,000 births, far higher than the national average of 45/1,000, and higher than in neighboring Indonesia (34/1,000).
- Only 3 percent of mothers deliver their babies in a health care facility, compared with 22 percent across the country.
- A higher percentage of children show signs of malnourishment and illness than in the rest of Timor-Leste.
Why is that? I’ve been told there are four main reasons (and I suppose that there are more). First, the district is very mountainous; second, there are few roads; third, there is a shortage of professional health staff; and fourth, this district is known for its festivals and parties—people spend what little money they have on these, not on nutrition and health, so says the Deputy Director of the District Health Service Florindo De Araujo. This is a big problem, and Mr. De Araujo and his staff are wracking their brains to figure out what to do about it.