Article by Sue Williamson IBCLC, Anne Scollon IBCLC, and Maree Twomy,Dietician
This is the first-hand recollection of volunteering overseas in East Timor as shared by three Australians, two IBCLCs and a Dietician, after their month long experience at HIAM-Health. This facility provides a place for mothers and babies to come for a week after being in Dili Hospital, to learn about health and nutrition. Timor Leste (East Timor) has a population of 1 million, with unfortunately an infant mortality rate as high as 111 per 1000 births in some districts. Over 50% of children under 5 years are malnourished and hungry (MoH 2008) HIAM Health is an abbreviation of the East Timorese words Hamutuk Ita Ajuda Malu “Together we help each other”.
Our time at HIAM health Dili has been an amazing cultural, emotional, and educational experience for Anne, Maree and myself. The Timorese have endured incredible hardships and yet are simple, happy people, interested in learning, especially those in our class room.
We have had 20 days of teaching breastfeeding and nutrition, also laughter, singing, and exercises. Our endorphins are high. We sleep well. The 3 of us have bonded well and our skills complimented each others’ personalities. We could have never picked a better team. We have taught women and men from 3 different communities; Aileu , Ermera district, and Atauro Island. They are valued leaders in their communities – non medical. They have shared with us their culture and stories and we will never forget.
Also the HIAM health workers were in our sessions most of the time. They have heard the information 3 times over, so hopefully they can continue to teach the mothers in the centre. There are nurses amongst them plus those who are studying nutrition, a great benefit to the centre. They have been very impressive. Jill (director at HIAM Health) has chosen well and they have great respect for her and Rosaria. We had about 15 to 20 people at each session. The Mothers and babies/ toddlers in residence, about 10 to 15 at a time, plus some siblings, usually stay for 21 days depending on the conditions. We have children with Tuberculous, heart disease with a weak suck etc. All with malnutrition, they are put on a “plump-up” corn meal program. It takes about 2 months to make a difference in their body structure. There are 10 breastfeeding mothers in the center at the moment and we will be teaching and encouraging them over the next couple of days and spending time with the little one with a weak suck.
Around maternal health, the mothers eat very little in pregnancy so they can have small babies for easier labour. Many still give birth at home and some still don’t give colostrum. Instead they give sugar water. The mother and baby stay beside the fire in a smoky room for a number of days, postpartum. They usually breastfeed for beyond 2 years of age, and all sleep with their babies. Mothers believe when they are pregnant with their next child, that they should wean the first so he / she won’t be infected by the milk. With inverted nipples and delayed milk supply they stop breastfeeding. If their milk is not flowing well by day 2 they give up.
The two directors, Jill Hillary (Aussie) and Rosaria Martins da Cruz (Timorese) are amazing. Jill works as the advisor and Rosaria as the up-front person. Both had a vision for this place, meaning ‘together we can help each other’. You can read all about them on the HIAM Health web site.
There is a miracle tree here, called the MORINGA tree, and it is very high in protein, vitamins, and minerals. Maree has been encouraging everyone to eat it 3 times a day for health and wellbeing. What a blessing as it grows all over Timor. It’s like breast milk… free and readily available.
We visited Dr Dan Murphy’s clinic at Bairo Pite. So many medical problems and then a ward full of stunted young children, oh so much to take in! During our 2 hour round with him, we checked 5 new babies born overnight and witnessed a mother with Tuberculosis, who has been ill for many years, take her last breath! He sees 300 patients a day in his clinic!
Our rest and recreation at Atauro Island over night seemed like a ‘full week’ of rest. We stayed in an Eco hut and enjoyed meeting people who were bringing various skills to help Timor get back on their feet. It warmed our hearts to hear their stories. The clear sea water refreshed us to no end. We enjoyed being at the celebration for Tour de Timor, the extremely tough annual bike ride. We even shook hands with the President, Prime Minister and his Aussie wife, Kirsty. Oh my, what a day! We also were invited to the US Embassy to have cocktails with Judith Fergin the Ambassador. Always so much excitement going on here in Dili, we will never be the same. I think that will be enough for now, see you when we get home.”
Blessing Sue, Anne and Maree
For more information about Sue, Anne, and Maree’s trip to East Timor, please see their article in the February E-Globe.