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At a glance: Timor-Leste

Hungry for change: the fight against malnutrition in Timor-Leste

© UNICEF Timor-Leste/2005/ Atkinson
Diana da Costa, 2, spent three weeks in Dili National Hospital recovering from malnutrition. About half of all Timorese children under five years old suffer from malnutrition and are underweight or stunted.

By Simon Atkinson

DILI, Timor-Leste, 25 January 2006 – Her eyes big and bright, Diana da Costa’s attention flits between the children playing among chickens in the dust outside her home, and her father who holds her tightly. Now approaching her second birthday, little Diana weighs only 6.5kgs – the weight you might expect for a six-month old baby.

Yet for her family, the health workers in the national hospital and UNICEF, she is a success story. Even though she is just skin and bones, Diana has regained the energy and vitality she was missing a month ago when she lay in bed at the Dili National Hospital. When her parents brought her to the hospital with a fever, her legs were stick-thin, her neck so weak she had difficulty keeping her head upright.

Diana, a textbook case of malnutrition, spent three weeks in the hospital before gradually gaining strength. She was fed therapeutic milk - a high-calorie drink supplied by UNICEF to hospitals around the country as well as a food substitute that helped her stabilize and then gain weight.

Malnutrition rampant

About half of all Timorese children under five years old suffer from malnutrition and are underweight or stunted.

As her condition improved, Diana was discharged, but because the milk formula can only be given in the hospital, she has now returned to whatever basic food her family can grow or afford to buy.

“Her appetite is better and we try to make her eat,” says her father Domingos da Costa, “but she can only eat what we have and she doesn’t always like it.”

Diana comes from a large family and is one of fifteen children. Five of them have already died. Their father sees it as fate – a story that health workers say is all too common.

“In such large families, it is often the youngest who suffer most,” says Jennifer Lin Barak, Project Officer of UNICEF’s Integrated Early Childhood programme in Timor-Leste. “Like Diana, their voice is weak. Their cries easily lost in parents’ daily struggle to survive. ”

UNICEF promoting breastfeeding

UNICEF is now working with other partners to encourage mothers to exclusively breastfeed their newborns for the first six months to boost their immunity and nutrition. This practice also promotes child spacing, which is not common in Timor-Leste. UNICEF is also training health staff to explain to mothers that if they don’t give their bodies time to recover from pregnancy, the next child will likely be small and underweight - perpetuating the cycle of malnutrition.

Lacking nutrients and energy, a malnourished child is more susceptible to illnesses – making it more complicated for treatment and recovery.

UNICEF has helped the Ministry of Health establish a growth monitoring system supplying weighing scales and registration cards across the country, training health staff and promoting follow-up visits to try and prevent children from reaching the chronic stage and needing hospital treatment.

It is a long and difficult road for the health workers, the Ministry of Health, and agencies such as UNICEF who are trying hard to improve the quality of life of Diana and other children like her across Timor-Leste.



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