Timor-Leste: The paradox of malnourishment within fertile lands, and the powerful potential of programmes utilizing ‘word of mouth’ networks.

13 September 2019

Timor-Leste is a country which has been left out of the international spotlight and can often be neglected by humanitarian groups and activists. It is a country of supreme natural beauty, with a subtropical climate and a mountainous, fertile landscape. It should, in theory, be equipped to provide its members with an abundance of food and water (Britanica, 2018), however, many socio, political and historical factors have led to Timor- Leste being the third most malnourished country in the world (HART,2018). Whilst the country technically has the resources to feed its population in terms of the nature of its landmass, the fierce military ‘scorched earth’ tactics from neighboring Indonesia in the ’90s, low public investment, and extreme poverty has left the country in a turbulent situation (Molner, 2009).

A complex web of factors has meant that Timor-Leste is unable to gain the resources, funding, and education needed to provide appropriate nutritional information, healthcare and agricultural solutions to its malnourishment issue. The outcomes of Timor-Leste’s malnourishment crisis relate closely to its infant mortality rate, which is the highest in South East Asia (UNICEF Timor-Leste, 2018). Furthermore, 42% of deaths amongst women between the ages of 15-49 are the result of complications from pregnancy and childbirth (UNICEF Timor-Leste, 2018). These statistics are linked directly to nutrition and healthcare access, but indirectly and primarily part of the wider issue of misinformation.

A child receiving treatment for malnourishment in Timor-Leste

Cultural beliefs and traditions have affected the farming, eating, and childcare practices of Timor-Leste citizens. With much of its population living in rural and tight-knit communities, knowledge is often the result of tradition and passed down orally. There are spiritually fatalist taboos surrounding certain foods, as well as unsuitable farming techniques. Furthermore, research from Wild et al’s (2010) study; found that birthing and childcare practices are often located in ‘word of mouth’ tales from other mothers, accumulated from experiential knowledge, passed down through generations. This knowledge, however, can sometimes be medically incorrect and damaging to the health of mothers and their babies. These include ideas surrounding what foods are best for a balanced diet (HART, 2018) or even traditions which state that complications during pregnancy are the result of a misfortune wished upon you by another person (Wild et al, 2010). The key to malnourishment reduction, therefore, lies in providing new knowledge and skills for the people of Timor-Leste to farm their land in the most effective ways and provide the best possible care for themselves and their children (Worldvision, 2018).

Whilst general aid is helpful, it is short-term and can be inconsiderate of research. For the particular issue of malnourishment in Timor-Leste, the main solution is practical education and its transferral into sustainable skill. Timor-Leste citizen Ego Lamos, in his 2017 Ted talk explained how malnourishment in Timor-Leste could be addressed by a combination of education and sustainable practice (TEDxtalk, 2017). He quoted the then-president Taur Matan Ruak, who explained that their education system is ‘based on knowledge but the market wants skills’. Lamos highlights how a combination of education and skill, revolving around effective agriculture, can greatly improve its statistics surrounding Timor-Leste’s malnourishment and even its global market position.

To achieve this, networks must be harnessed. Ethnographers have described the ‘word of mouth’ transfer of information as the most effective way to change beliefs surrounding food and childcare in Timor-Leste. Human’s inherently social nature and the country’s cultural emphasis on community, mean that ‘word of mouth’ is the portal to educating large groups about nutritional well-being and sustainable farming. In Timor-Leste, eating and childcare practices are the result of community-shared knowledge, spread by social interaction (Wild et al, 2010). Thus, the spreading of new knowledge and skills starts with localized educational programs which allow for information transferral from mother-to-mother or farmer-to-farmer (Raynor, 2018).

Luckily, HIAM health is an organization active in providing knowledge and skills to local people. They have had a great effect on the nutrition of people in East Timor by training and educating farmers and mothers in cultivation and nutrition. Their work has considered the way in which ‘word of mouth’ is the most effective way of reaching mass audiences (Raynor, 2018). Every success story is spread orally via Timor-Leste’s communities, and HIAM Health’s teaching methods about nutrition and farming practices have ended up reaching vast areas of the country. They have inclusive healthcare clinics which take mothers every step of the way, introducing lessons surrounding nutrition and providing services whereby mothers can witness their children’s recovery (, 2019). As described in the research of Wild et al (2010) on the maternal practices of Timor-Leste, women of this country utilize and trust knowledge which was passed on by other women and is experiential.

Women sharing knowledge at healthcare workshop

They engage women in educational classes whilst simultaneously, providing positive results in their babies’ wellbeing. By harnessing the engagement of mothers and allowing them to see the positive benefits that HIAM offers to the health of their children, nutritional knowledge quickly spreads to other mothers and families. These developments have empowered these mothers to become change agents for life, passing down information to their children and friends to create a vast network of informed women with nutritional expertise.

As mentioned earlier, whilst knowledge is vital, so are skills and the means to exercise knowledge received. HAIM Health has trained 900+ agricultural extension workers to disseminate farming and agricultural education in remote communities. Via the ‘oral tradition’, information has been injected into many rural areas and

Cultivation of land through the help of HIAM Health

there have been 180,000 indirect beneficiaries through the work of this agricultural training.


With continual support, HIAM Health can continue its work which is active in reducing the infant mortality and malnutrition rates of Timor-Leste. It is easy to become disillusioned by failed development strategies which are inconsiderate of the needs of the local population in focus, but programs like those at HIAM Health are reminders that it is possible to achieve sustainable and long-lasting results through ethnographic, community-led research.

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Encyclopedia Britannica. (2019). East Timor | Geography, History, & Facts. [online] Available at: [Accessed 5 Sep. 2019].

HART, 2018. Annual impact report. Pp.18-20 (2019). HIAM Health, Home of Sustainable Good. [online] Available at: [Accessed 5 Sep. 2019].

Molnar, A.K., 2009. Timor Leste: politics, history, and culture. Routledge

Raynor, S. (2018). Mothers help tackle malnutrition in Timor-Leste. [online] UNICEF. Available at: [Accessed 5 Sep. 2019].

TEDxtalks (2017). School gardening to tackle malnutrition | Ego Lemos | TEDxDili. Available at: [Accessed 5 Sep. 2019].

UNICEF Timor-Leste (2018). Mothers Support Groups in Timor-Leste are leading the fight against malnutrition.Available at: [Accessed 5 Sep. 2019].

Wild, K., Barclay, L., Kelly, P. and Martins, N., 2010. Birth choices in Timor-Leste: a framework for understanding the use of maternal health services in low resource settings. Social science & medicine71(11), pp.2038-2045 (2019). Improving nutrition in Timor-Leste with nutrition-sensitive agriculture | World Vision Australia. [online] Available at: [Accessed 5 Sep. 2019].





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