Timor-Leste

Help Stop TB in Their Lifetime

By Meg Carter, ChildFund Sponsorship Communications Specialist

Tuberculosis is rare today in the United States and other developed countries, but in developing nations, it is a killer. Globally, TB has created 10 million orphans and is one of the top-three causes of death in women ages 15 to 44.

Today, March 24, we mark World TB Day by joining with the World Health Organization (WHO), the Centers for Disease Control and other international organizations to raise awareness and mobilize political and social commitment toward progress in the care and control of tuberculosis.

children in Sierra Leone

Sierra Leone has the world’s highest tuberculosis incidence and mortality rates by far.

Caused by an airborne bacteria, TB often attacks lungs and has developed strains that are resistant to multiple drug treatments. It also strikes people with weak immune systems, particularly those infected with HIV. In the 1800s, Western Europe saw the number of tuberculosis deaths peak at nearly 25 percent, but with better medical treatment and understanding, the TB mortality rate fell by 90 percent by the 1950s.

Now, as the virus mutates and resists standard drug therapies, developing nations are experiencing the same level of risk as Europe did a century ago. This year marks the second half of WHO’s two-year campaign Stop TB in My Lifetime, a program that is significant to countries ChildFund serves in Africa and Asia.

Globally, tuberculosis is second only to AIDS as the greatest killer from a single infectious agent. At least a third of HIV-infected patients worldwide are also diagnosed with TB, and in Sub-Saharan Africa, tuberculosis is often the infection that is directly responsible for death. In fact, testing positive for tuberculosis often masks HIV-positive status, which makes proper medical treatment far more difficult than for patients who have one disease or the other.

Ugandan girl holds memory book

In Uganda, TB and HIV infections are often combined, making treatment difficult. This child holds a memory book her HIV-positive parents created for her.

Despite the overall decline worldwide in incidences of TB and the development of rapid diagnostics, the combination of HIV and TB and its accompanying challenges have kept Africa from being on track to halve its tuberculosis deaths by 2015, a WHO goal.

WHO estimates that 500,000 children were newly infected in 2011, and 64,000 died. Tuberculosis is particularly difficult to diagnose in children; current TB tests are largely inaccurate for children.

Poor communities and vulnerable populations also suffer disproportionately from TB. At highest risk are young adults, infants, diabetics, smokers, those infected with HIV, people who are malnourished and anyone living in crowded or unclean conditions — such as refugees and others displaced by a natural disaster, political oppression or civil unrest.

Because TB threatens the well-being of children where we work, ChildFund supports local government initiatives and public messaging. Here are some facts about ChildFund-supported countries and their exposure to TB:

Sierra Leone has the world’s highest prevalence and mortality rates; tuberculosis incidence there is one and a half times as high as in the second-ranked country, and Sierra Leone’s mortality rate is almost twice as high.

mother and child in a Timor-Leste garden

Timor-Leste has the world’s eighth highest incidence rate of TB, but good nutrition can make families less vulnerable to infection.

Cambodia ranks fifth for prevalence and Timor-Leste eighth, but both countries tie for fifth-highest mortality rate because Cambodia has an edge in successful treatment.

Joining those three nations as very-high-incidence countries are The Gambia, Liberia, Mozambique, the Philippines and Zambia.

Areas of high prevalence include Afghanistan, Ethiopia, Guinea, India, Indonesia, Kenya, Thailand, Uganda and Vietnam. Uganda, where TB and HIV infection forms a lethal combination, has a treatment success rate of only 71 percent.  Ethiopia and Guinea also have lower-than-average success rates: 83 percent and 80 percent, respectively.

The story isn’t entirely bleak, though. Some countries have made impressive progress. Between 1995 and 2011, 85 percent of all new infections and 69 percent of relapsing cases were successfully treated. And between 1990 and 2011, the overall mortality rate fell by 41 percent.

However, every year funding falls $3 billion short of WHO’s goal to make quality care accessible regardless of gender, age, type of disease, social setting or ability to pay. International assistance is especially critical for the 35 countries designated as low-income — including Afghanistan, Cambodia, Ethiopia, The Gambia, Guinea, Kenya, Liberia, Sierra Leone, Mozambique and Uganda. Of these, The Gambia, Guinea and Sierra Leone are not currently among the top 50 recipients of Official Development Assistance.

Please join us in taking action to end the burden of tuberculosis in the lifetimes of the children we serve. When you sponsor a child or make a donation to Children’s Greatest Needs, you’ll be helping to ensure that children in our programs live healthier lives.

Timor-Leste: Bringing Lessons Home

 By Silvia Ximenes, ChildFund Timor-Leste

Novito, a 5-year-old boy from Timor-Leste, describes “scribbling and drawing a house” as his favorite activity in his Early Childhood Development (ECD) center in the Manatuto district.

five-year-old boy

Five-year-old Novito.

This district in central Timor-Leste has a population of about 42,000, and the economy is based on agriculture, fisheries, small handcraft industries and minerals. Many in Aiteas, the village where the ECD center is located, are involved in farm production activities, such as planting coffee, coconut, vegetables, cassava, corn and rice.

Novito rides his bicycle back and forth to the center, and he also likes to play soccer. He hopes one day to be a professional soccer player.

One of 60 students who attend ECD Aiteas six days a week, Novito is taught by Manuela, Divia and Joana. With ChildFund’s support, the teachers received training in teaching methodology, curriculum design and the Portuguese language.

three boys and two female teachers

Novito, his classmates and teachers at the ECD center in Aiteas, Timor-Leste.

Two years ago, ChildFund helped renovate the ECD center, expanding the building to house three classrooms. ChildFund Timor-Leste supports this center by providing school materials and furniture, school uniforms, snacks and supplementary food. The center also receives a subsidy from the Timor-Leste Ministry of Education every four months to help maintain the facility and update educational materials.

Maria, an ECD coordinator, notes that the center provides learning materials, a proper playground and qualified teachers who work well with the children. Novito often brings home lessons he’s learned at the center and has shown his siblings how to draw a house. He says he is looking forward to moving to the next level of education: primary school.

Home Gardens Boost Nutrition and Income in Timor-Leste

By Aydelfe M. Salvadora and Dirce Sarmento, ChildFund Timor-Leste

Highly nutritious food is often unavailable in Timor-Leste. Many children are malnourished because they don’t have a proper mix of vegetables and protein, but a ChildFund home-gardening program, begun in 2012, is helping improve nutrition and provide needed income for families.

Irene, the eldest daughter of Rosalia and Felipe, started a garden in the backyard of her parents’ small farming compound located in the sub-district of Tilomar. Like others in this community, Irene’s family depends on farming for their livelihood, yet their earnings are meager and uneven.

Irene, who is married with a child of her own, recognized the opportunity for growing nutritious food and helping her parents achieve more steady income. She invited her friends, Felicidade and Guillermhina, to join in the backyard garden project and also share in the benefits.

Before they started the garden, Irene and her two friends received training in farming techniques through Graca, ChildFund’s local partner, with funding from ChildFund Australia and AusAID’s Maternal and Child Health project. The women received tools and seeds for bok choy, kangkung (a type of spinach), eggplant and tomatoes.

woman in garden

Rosalia tends the garden.

Irene and her husband shuttle between her parents’ home and his home in another district, which makes it difficult for Irene to tend the approximately 300-square-foot garden all the time, so her mother, Rosalia, also helps the other two women.

leafy green vegetables

Bok choy grows well.

Last year, the women harvested twice, generating income of US$110 that was shared among them. Irene and her friends now have money for family essentials and a bit left over to buy seeds for the next growing season.

With Irene’s help, her parents now earn $20 monthly from the combined harvests of the home garden and the farm. Sometimes, Rosalia and Felipe also sell chickens raised in their backyard. This income is augmented when bananas are available; the family cooks pisang goreng (banana fritters) and offers them for sale to neighbors.

Without the garden, notes Felipe, the family would not be able to afford extra household items. He and his wife can buy food items like rice, as well as shoes and clothes for their 3-year-old grandchild.

Reflecting on their first year of gardening, the friends noted that their main challenge was access to water. During the dry season, the women had to take a brief break from gardening, and even during the rainy season, they have to fetch additional water for their plants from the neighboring aldeia (village), which is approximately 2 kilometers away.

And, yet, the garden thrived. The division of labor is fair, Rosalia says, and the gardeners look forward to this year’s first growing cycle, which began this month and runs through March.

Mother of 10 Learns New Farming Techniques to Feed Children and Earn Income

by Aloisio Assis and Zoe Hogan, ChildFund Timor-Leste

Rosita and her daughter

Rosita and Elia in the vegetable garden cultivated by the farmer’s group.

Rosita is no stranger to the difficulty of feeding a family. For more than 20 years, she has been farming a small plot of land, growing what vegetables and crops she can, to support her 10 children.  A few months of each year, Rosita and her family experience the “hungry time,” when harvests are sparse. During this time, some families sell a pig or some chickens to buy enough rice to eat, while others struggle to make do.

“Sometimes we didn’t have enough food,” Rosita says. “Normally, the children would eat three times a day, but when we didn’t have enough food they had to eat less. Sometimes we didn’t have very nutritious food, but we just had to eat what we could find.”

Rosita has been farming for decades but just recently learned about new farming techniques that could help her feed her children throughout the year. In 2011, she joined a farmer’s group assisted through ChildFund Korea’s food security program. Since then, ChildFund Timor-Leste has worked closely with that group to facilitate training sessions on horticulture and coffee production and has provided farming tools.

For Rosita, the training sessions have already had an impact – she now sorts through her coffee harvest, dividing the beans in terms of quality. As a result, she can sell her high-quality coffee beans for a better price and increase her overall income.

Rosita is also now able to grow enough vegetables to feed her family and sell the extras. Twice a year, at the end of each harvest, she earns an estimated US$200 from selling her surplus crops. She uses the additional income to cover school costs for her children and other basic needs of her family. “With the money from vegetable harvests, I can buy uniforms, books, pens and bags,” she says.

Through the provision of seeds, vegetable cuttings and a new water tank, ChildFund Timor-Leste is also helping to establish a small aquaculture enterprise in Rosita’s community. Farmers are able to grow more, which increases farm productivity and enhances the nutritional value of families’ meals.

“During the hungry time from January to March, we usually just eat cassava, maize, jackfruit and bananas. We had to conserve foods so we’d have enough to eat at that time of year,” says Rosita. “The project is supporting us with seeds and cuttings to plant in our farm.”

Rosita's daughter, Elia

Nine-year-old Elia says her favorite vegetable from the garden is black mustard.

After school, Rosita’s 9-year-old daughter Elia sometimes helps her mother by watering the vegetables. She says her favorite vegetable from her family’s farm is black mustard. If the farm continues to improve, Elia will have the opportunity to pursue an education, an accomplishment Rosita has experienced with only one of her children.

Midwife Training in Timor-Leste

By Dirce Sarmento

Maria in Training

Maria during the practical training session at the National Hospital, Dili.

It was her first midwife training session in more than 10 years, but Maria de Fatima Moniz made it clear she was up for the challenge. She seized a valuable opportunity this past June and participated in a two-week midwife training facilitated by ChildFund Timor-Leste and Instituto Nacional de Saude (National Institute of Health) in the Covalima district.

During her first week, Maria, 38, learned the “55 Steps” — guidelines used by midwives to ensure the safe delivery of newborns and appropriate care for pregnant women. The second week of training, based in Dili’s National Hospital, gave the group of 17 midwives the opportunity to use their practical skills while under close supervision.

“During this training, I felt very fortunate to be able to learn new knowledge about the 55 steps and safe deliveries,” Maria says.

With more than 15 years of experience caring for mothers and newborns, Maria will use the information she learned to improve the delivery process she practices in her community. She is the only midwife for five sucos (villages) in Covalima — a community of approximately 7,500 people — and works at the Tilomar clinic. Tilomar has no running water, so she has to ask families to bring their own to use during and after delivery.

“The problem we have now in our community is that we don’t have any materials for delivery, like baby napkins, and no sterile delivery set,” Maria says. Despite these challenges, Maria has successfully delivered countless babies at the clinic. She hopes that conditions will improve.

As a mother of four children, Maria understands how important it is to support pregnant women at each stage of their delivery. “After this training, I hope what I learned will help local women have clean and safe deliveries and that [maternal and infant] mortality in Timor-Leste will be reduced.” Since she began working at the clinic in 2000, she says, eight women have been taken to Suai hospital for caesareans, and two babies have died.

Tilomar Clinic

The Tilomar clinic was repaired by ChildFund’s local partner, Graca, in 2011.

In Maudemo suco, where Tilomar clinic is located, 48.7 percent of births from 2005 to 2010 were assisted by a skilled health provider. Comparing this to Timor-Leste’s countrywide average of 33.5 percent highlights how Maria’s hard work is making a real difference to women and children in her community.

With new skills and support through ChildFund Timor-Leste’s project, Improving Health Outcomes for Children in Covalima District, Maria can improve the level of care for pregnant women and newborns in Tilomar. “I am grateful for ChildFund helping us in Covalima. I hope we can improve the future of this cooperation, because we still confront problems implementing the safe delivery,” says Maria. “I hope next year ChildFund can support us to give us refresher training on safe motherhood and supervision.”

Carving Out a Future: Youth Apprentices in Timor-Leste

By Belchior Goncalves and Zoe Hogan, ChildFund Timor-Leste

In many ways, Timor-Leste is a young country – just 10 years since the restoration of its independence, more than 60 percent of the population is under age 25 (2010 Census). As more young people leave school and look for work each year, the majority find that employment opportunities are few and far between. In the rural district of Bobonaro, about 56 percent of the people do not have formal employment (2010 Census). Many young people work on their family’s subsistence farms or admit that they “do nothing.”

trainer in carpentry shop

Yohanes, 59, is training five Timorese youth in carpentry skills, so they can open their own small businesses and build sustainable livelihoods.

With the support of ChildFund Timor-Leste, one man is taking action on what he sees as an opportunity, rather than a problem. “There are many youth I see who could grow, develop and support themselves,” says Yohanes, a 59-year-old carpenter. An experienced trainer, Yohanes has partnered with ChildFund Timor-Leste’s community-based organization in Bobonaro to provide young people with the opportunity of a lifetime – a chance to learn a trade and start their own business.

Young men using carpentry tools

Yohanes oversees the apprentices’ work.

ChildFund Timor-Leste identified five unemployed young people in Bobonaro district who had limited education but displayed the determination to work for a brighter future. Yohanes is working alongside these five apprentices, showing them how to make quality chairs, desks, doors and windows. For five days a week, the center is a hive of activity as Yohanes and his apprentices try to keep up with local demand for their well-made products. After the apprentices complete the 12-month program, ChildFund Timor-Leste provides each one with carpentry tools so they can use their newfound skills to start a small business.

Apprentice in carpentry center

After 12 months of practical training, Natalino will receive carpentry tools to start his own business.

Natalino, a promising apprentice, was forced to leave primary school after just one year because his parents could no longer support him. “There are lots of youth in the village, but they don’t go to school. They will end up the same as I was before, just farming,” Natalino says.

Natalino is in no doubt of how important the support of ChildFund Timor-Leste and Yohanes is to his future: “If I stay here for one year, I will leave as a carpenter. It will change my life.”

Watch a video of the apprentices at work.

From a Leaky Roof to a Comfortable Classroom

By Aydelfe M. Salvadora, ChildFund Timor-Leste

For nine years, the Parent Teacher Association for Eskola Basiko Liaro sought assistance for its deteriorating school. But those requests went unanswered, says Raimundo de Carvalho, PTA president at the school, which is located in Suco Builale, Ossu, in the Timor-Leste district of Viqueque.

The school is surrounded by hills, making the temperature cold even during the day, and it easily penetrates inside the bamboo-walled classrooms.

Deterioating classroom

Liaro School classrooms were in disrepair.

When ChildFund first visited Liaro School, we knew that urgent assistance was needed. The school had a poor infrastructure, lacked water and sanitation facilities and didn’t have the most basic classroom and learning materials.
Given the poor condition of the school and the long list of areas for improvement, ChildFund worked with the school community to identify its main priorities for improvement. Classroom rehabilitation was on the top of the list, as it would deliver significant benefits within a short timeframe.

With the participation of community members, schoolchildren, PTA members and the Suco and Aldeia local councils, ChildFund Timor-Leste worked with Liaro School to quickly develop a proposal to be considered for UNICEF’s Participatory School Rehabilitation project.

The proposal was accepted, with Liaro School becoming part of the Child Friendly Schools (CFS) approach promoted by UNICEF, in partnership with the Ministry of Education. It is a distinct initiative that promotes and nurtures the inclusive involvement of parents, community members and children in education.

With approval, funding and technical assistance from UNICEF and ChildFund, construction commenced in the first week of November 2011. In less than two months, four new classrooms were constructed and ready for the beginning of school year in January.

new classroom

Newly constructed classrooms.

Built with concrete walls and tin roofs, the classrooms are comfortable and secure from the elements. When asked how their new learning environment makes them feel, the school’s 150 students give an enthusiastic chorus of “kontente [happy].”They no longer fear water leaking from the roof and persistent cold through the bamboo walls. More importantly, they now have an environment conducive to learning that motivates them to study harder.

The PTA members and council chiefs say they’ve learned a lot about the importance of community participation and cooperation to benefit children. They also point to another benefit with lasting impact – not only do they have four new classrooms, but they now also have the skills to write more project proposals to gain additional funding for their community.

Connecting Children Through ChildFund

Courtesy of ChildFund Australia, a member of the Global ChildFund Alliance

A global education program called ChildFund Connect is promoting a sense of community and friendship among primary school children in Australia and their peers in developing countries.

Through a variety of multimedia tools, with a central website serving as a hub for communications and child-created content, the program facilitates cross-country exchanges and collaborative education projects to increase children’s understanding of the world.

One of those projects is Our Day, a film that documents a day in the life of children around the world. Using pocket video cameras, hundreds of children in Australia, Laos, Vietnam and Timor-Leste captured the detail and color of their day, providing incredible insights into their childhood experiences.

Filmmaker Clinton J. Isle took on the creative task of combining this footage to create Our Day. The film shows how daily life is very different, but, also, in many ways the same, in different parts of the world.

This project was supported by the Australian Council for the Arts, the Australian Government’s arts funding and advisory body and by the Queensland Government through Arts Queensland. ChildFund Connect is also partly funded by Australian Aid, managed by ChildFund Australia on behalf of AusAID.

Take a few minutes to enjoy this absorbing film.

A Mother’s Plea for Clean Water

By Zitu Fernandes, ChildFund Timor-Leste

For most of us, drinking a glass of water is a simple undertaking. Yet for women like Estela in Timor-Leste, it can take the better part of a day to fetch and prepare water to drink.

Estela lives in Maliana, a remote town near Timor-Leste’s border with Indonesia. Every morning, Estela walks about a kilometer [0.62 miles] from her house to the river to collect water. “In the rainy season, the water in the river is very dirty.… Then in the dry season we sometimes can’t find water in the river,” she says. “We must dig a little bit into the bank of the river in the early morning to get water.”

Estela and her children.

Once Estela collects the water, she filters it for four to five hours. She then collects wood to build a fire on which to boil the filtered water. Finally, sometime in the afternoon, the water Estela collected in the morning will be ready to use for drinking and cooking. Even then, she admits, “sometimes, we can’t filter it enough.”

When her children get sick, Estela worries that it’s because of the water. “For many years we have lived in Maliana…and the water we use is dirty. We never get clean water,” she says.

On the whole, water quality is steadily improving in Timor-Leste. In 2009, 66 percent of the population had access to an improved water source, compared with 48 percent in 2001. However, there are still many people, usually women and children, who spend hours each day trying to source clean drinking water.

ChildFund Timor-Leste has been working with communities in Maliana and surrounding villages to build long-lasting water and sanitation systems. In the last eight months alone, 42 toilets have been built in the district with the active participation of community members. In addition, ChildFund has rehabilitated and upgraded one school water supply system, benefiting more than 400 schoolchildren. ChildFund Timor-Leste has also held hygiene promotion sessions attended by around 400 schoolchildren and community members.

Now, ChildFund is planning the next phase of its water and sanitation program, which will include establishing water access in Estela’s village. Each new water system will save many women and children hours of work each day, while also improving their health. “We hope someday that we will have clean water in our village, the same as people in other villages… [that] we are not alone,” says Estela.

Clean Hands Save Lives

Reporting by Zoe Hogan, ChildFund Timor-Leste

Timor-Leste has some of the highest rates of maternal and child mortality in the world. More than 5 percent of Timorese children die before their fifth birthday, in comparison to 0.4 percent and 0.8 percent of children in Australia and the U.S., respectively, according to UNICEF reports.

Through health, water and sanitation projects, ChildFund is working to save children’s lives by increasing community knowledge about the prevention and treatment of common diseases.

men and women at exhibit booth

ChildFund Timor-Leste staff, led by National Director Dr. Geoffrey Ezepue (third from right), meet with government representatives, led by Health Minister Dr. Nelson Martins (fourth from right) and President of the Commission F of the National Parliament, Virgilio Maria Dias Marcal (far right).

Last week, the Ministry of Health in Timor-Leste organized a national conference on non-communicable diseases. ChildFund was one of the conference exhibitors, setting up an educational booth about our community health programs in Timor-Leste. Staff members provided antibacterial soap, health information and hand-washing advice to conference attendees and passersby, including university students, local children, academics and dignitaries.

man demonstrates hand washing

Prime Minister Xanana Gusmao discusses hand washing with ChildFund Timor-Leste WASH Project Manager Sigit Pramono.

The exhibit caught the attention of Timor-Leste’s Prime Minister Xanana Gusmao, who spent 10 minutes at ChildFund’s booth, demonstrating proper hand-washing techniques with ChildFund Timor-Leste staff.

Hosted by the Ministry of Health, ChildFund Timor-Leste, Church World Service and the World Health Organization, the conference, held in the capital city of Dili, sought to improve collaboration and strategic planning between government and NGOs in the health sector.

“People who are poor or who live in underserved communities have less access to medical care and good nutrition,” said Dr. Nelson Martins, Timor-Leste Health Minister. “They face greater environmental health hazards and are harder to reach through outreach and education efforts. So as we move forward, we understand that we must also address the social and economic factors that can put people at greater risk for chronic disease.”

children and youth wash hands

ChildFund staff members show local children how to wash their hands properly.

Martins also visited the ChildFund booth, asking numerous questions about ChildFund Timor-Leste’s health projects in rural communities.

Throughout the conference, ChildFund staff engaged young people at the event, with competitions to test their hand-washing and fingernail-cutting techniques. In partnership with the Alola Foundation, ChildFund also ran a trivia quiz about nutrition and maternal health. Nearly 250 conference-goers participated in these fun and educational activities. Prizes included practical items like towels, nail cutters and T-shirts.

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