Her eyes big and bright, Diana da Costa’s attention flits from the children playing among chickens in the dust outside her home to her father, Domingos, who holds her tightly. She is small in his arms. In May 2005, Diana was almost two years old, yet she weighed only 6.5 kilograms, a typical weight for a six-month-old.

Despite her low weight, Diana was already a success story in the eyes of her family, the health workers at the national hospital and UNICEF. Thanks to the treatment she received at Dili National Hospital, including therapeutic milk provided by UNICEF, Diana’s life was saved. Her weight had stabilized and she had regained the energy and vitality missing a month earlier, when she lay in her hospital bed running a fever, her legs stick-thin and her neck too weak to hold her head upright.

Common problem, multifaceted solution

Diana’s situation, unfortunately, is not unique – not in her country, where around half of all children under five suffer from undernutrition and are underweight or stunted, and not in her family, where three of her fourteen siblings have already died.

In an effort to fight hunger and help the country achieve Millennium Development Goal 1, to halve the proportion of people who suffer from hunger, UNICEF works with partners in Timor-Leste to combat undernutrition from different angles.

Providing therapeutic milk for severely underweight children is only one aspect of this work. Other activities include monitoring the growth of children up to age five, and monitoring and improving the health of pregnant women, including encouraging them to seek antenatal care, and to receive vaccines and micronutrient supplements.

Mothers are also encouraged to exclusively breastfeed newborns for their first six months of life to boost the infants’ immunity and nutritional status. Health staff are trained to explain to mothers how spacing births works to break the cycle of undernutrition.

UNICEF has also helped Timor-Leste’s Ministry of Health establish a growth monitoring system by supplying scales and registration cards across the country, training health staff, and promoting follow-up visits to try to prevent children from reaching chronic undernutrition, which requires hospital treatment.

The struggle to maintain good nutrition at home

Under the strain of hunger and poverty, Diana’s father saw the plight of his children as fate – a view health workers say is all too common. When Diana was discharged from the hospital, she returned to whatever basic food her family could grow or afford to buy.

Diana has gained weight, and she is regaining strength. But the long-term consequences of her severe undernourishment can still be felt. Today, at almost three years old, she still cannot run – or even walk – like other children, a testament to the slowness of the rehabilitation process. Yet her growth to date, her smile and her spirit attest to the positive future that she may have – and that many people and partner groups are working towards.

Note: Some country-specific information was provided by UNICEF country offices or drawn from UNICEF country office annual reports.