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New Insights into Oceania’s Health Challenges

Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.

Oceania

Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.

Vulnerability

Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.

Solutions

There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

Tuberculosis in Timor-Leste: An Overview

Tuberculosis in Timor-Leste
Tuberculosis, also known as TB, is a bacterial disease that affects one’s lungs. The disease can cause symptoms such as coughing fits, sneezing, as well as troubled breathing; however, some people do not exhibit symptoms. Tuberculosis is an air-borne disease that can be exchanged through interacting with individuals who have tuberculosis, typically by either coughing or speaking.

There are also two different types of tuberculosis: latent TB infection and TB disease. Latent tuberculosis occurs when an individual has the bacteria that causes tuberculosis in their lungs but shows no active symptoms of tuberculosis; therefore, there is no spread of the bacteria. Tuberculosis disease refers to when an individual has the bacteria in their lungs and is showing symptoms due to the growth of the bacteria. The disease is typically treated through a mixture of different antibacterial medications, taken for six months to a year.

Though tuberculosis may not sound dangerous, there are some dangers for those who do not receive proper medical treatment. While TB does directly affect the lungs, the bacteria can also affect other organs such as the brain and kidneys, which can cause more concerning health issues like renal failure. Renal failure causes the kidneys to malfunction, so waste is not properly removed from the body. If not treated, tuberculosis can cause the lungs to be filled with fluid and blood and can ultimately result in death.

Which Countries are Most at Risk?

Timor-Leste, located in Southeast Asia, is one of the countries most affected by tuberculosis. Unfortunately, many people are not diagnosed, causing the disease to go on untreated. Timor-Leste has limited medical resources and supplies. As of 2017, the WHO estimates that for every 100,000 people in Timor-Leste, only 498 people are notified that they have tuberculosis, and 106 are killed annually.

83% of the treatment for tuberculosis in Timor-Leste comes with an enormous fee. Due to this, many are reluctant to be treated or even tested for tuberculosis in Timor-Leste. It is also estimated that in 2017, 46% of individuals living with tuberculosis in Timor-Leste have gone undiagnosed. Therefore, there is a dire need for education about tuberculosis in Timor-Leste. Many do not understand the disease or the medical treatment they are receiving and end up not completing the whole treatment.

What is Being Done to Help Timor-Leste?

According to the World Health Organization (WHO), certain programs have been created across Southeast Asia to teach tuberculosis prevention. Overall, there are thirteen districts, each of which focused on a different campaign. Originally, the program was started to address the missing cases in Timor-Leste. The WHO has also implemented more test screenings and treatment. It hopes to execute the “TB Free Core Package” in which there will be more TB prevention, detection, treatment, and protection. This package would be focused on helping low-income families who cannot afford the hefty price tag that comes with TB treatment. As the WHO programs have reached thousands of individuals, there is hope to decrease the number of TB cases and better educate the Timor-Leste public on tuberculosis prevention.

The International Organization of Migration and UN Migration Agency are working with Timor-Leste’s health ministry to help fund more test screenings. Supporting the National Tuberculosis Program will allow screenings to become more available to the public; as of 2018, more than 6,000 individuals have had a screen test. Programs such as this pave the way for more partake in reducing the cases of tuberculosis in Timor-Leste.

– Olivia Eaker
Photo: Flickr

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Mitigating the Effects of Hunger in East Timor

Hunger in East TimorThe situation in Timor Leste (East Timor) has been characterized by war and oppression for decades. In 1975, after Portuguese colonialism finally abdicated control of the region, there began a brutal war between the people of Timor Leste and neighboring Indonesia.

The war resulted in a 24-year Indonesian occupation of Timor Leste, and a cumulative death toll of 200,000 people – nearly one-quarter of the current population. Throughout the country’s occupation, there were guerilla movements working to remove Indonesia from power. However, the final decision to leave Timor Leste to its own devices came after a change of leadership occurred in Indonesia and U.N. intervention.

The Timorese voted for independence in 1999 – the result was a 78 percent majority. Unfortunately, the vote was far from respected. Those who did not wish to be independent of Indonesia instigated yet another insurgency against the majority of Timorese, necessitating more direct United Nations involvement. Finally, in 2002, after two years of U.N. Peacekeeping presence, full independence was attained.

However sweet this victory may have been, it did little to alleviate the problems of poverty, malnutrition and hunger in East Timor. Hunger is arguably the country’s most urgent problem. It affects nearly 100 percent of the population.

In 2010, 57.7 percent of children under the age five were classified as stunting, a term used to describe the condition of weighing too little for your height. Other indicators of malnutrition, such as wasting and generally being underweight, are prevalent, indicating that the situation is dire.

One of the many organizations working to mitigate the effects of hunger in East Timor is Oxfam Australia. The work they do is primarily aimed at educating the public, generally women and children, about the effects of malnutrition and specific ways to increase their family’s consumption of important nutrients.

In classes that they term “supplementary feeding courses,” they demonstrate how to cook nutritious meals, process fresh food so it lasts longer and which ingredients have the highest protein content.

This program, coupled with the organization’s efforts to work with local farmers on improving agricultural yields for their farming cooperatives, has been a formidable attempt to arm Timorese communities with life-saving nutritional and agricultural knowledge.

-Katarina Schrag

Photo: Flickr

 

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The Importance of Preschool in Timor-Leste

Preschool in Timor-Leste

Timor-Leste is a lesser-known nation, one that happens to be the third youngest internationally recognized country in the world. Timor-Leste (also known as East Timor) is a southeast Asian nation that occupies half of the island Timor and was once a part of the greater Timor, which gained independence from Portugal in 1975 and independence from Indonesia in 2002.

The path to independence was tumultuous, resulting in an impoverished community in dire need of reform. The recently sworn-in president of the country, Francisco Guterres, is continuing the work of his predecessors to diversify the small country’s economy.

While engagement with nearby Australia, particularly in maritime industries, is significant and crucial, another method that Timor-Leste is using to improve the lives of its citizens is education, specifically preschool.

As Vivian Maidaborn of Stuff.Co, a New Zealand news outlet, notes, “Every country’s future is in the hands of its children. In the case of Timor-Leste – a young nation stepping out from under the dark shadow of conflict – this statement is true indeed.”

Preschool in Timor-Leste is being promoted through UNICEF, who has partnered with the Ministry of Education, Village Councils and parents to set up community preschools to help children get the best start in life.

Children in rural settings are less exposed to early learning, as there are few public preschools in Timor-Leste for them to access and be more successful in the long run.

With greater access to preschool in Timor-Leste, children are less likely to repeat grades in primary school. The 2016 Ministry of Education reports stated that this was an issue for the country, as 24 percent of students repeated the first grade.

Another element of Timor-Leste’s makeup that makes early education a cornerstone for development is the fact that its population is a young one. Half of the population is under 18 and one-third of the population is under eight years old.

The greatest interference in education in general and for early learning in the country is geography. Timor-Leste is a mountainous country with a lot of agriculture that is difficult for young children to walk through when schools are more than five minutes away, especially when the weather is unfavorable. UNICEF and other organizations teaming up with the government of the small and young nation are attempting to correct this problem, thus giving the majority of the children better chances to learn and learn more often.

Maidaborn continues with her aforementioned argument for preschool in Timor-Leste when stating “Now in this post-conflict era, a new generation of people in Timor-Leste have a chance to create a new country, a country without violence and where children can flourish. The very young kids represent the first hope in a long time of childhood unmarked by conflict.”

– Gabriella Paez

Photo: Flickr

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Human Rights in Timor-Leste: Where Do Women Stand?

Human Rights in Timor-Leste
Most nations balance violations and successes in achieving justice for females. Human rights in Timor-Leste are no exception to this.

For the country’s 2016/2017 report, Amnesty International highlighted a few key issues which are being dealt with by Timor-Leste. Among these brief descriptions, the topic of gender-based violence was very relevant.

The nongovernmental organization cited a statistic for the category that found that approximately 60 percent of women who had experience with a relationship (aged 15 to 49) reported violence—sexual or otherwise.

A 2016 human rights report included the same statistic and expanded upon this issue, emphasizing that slightly less than 15 percent of females experienced rape perpetrated by individuals who were not their significant others.

Furthermore, rates of domestic violence in the nation reportedly only fell behind assault for “commonly charged crimes in the criminal justice system.”

Issues for women in the country involve matters such as:

  • A lack of prosecutions and investigations regarding sexual-based violence.
  • Difficulties in the enforcement of legislation regarding domestic violence due to “cultural and institutional obstacles.”
  • Questionable classification for the level of the crime.
  • Poor acknowledgment of victims’ needs relating to their protection.

In spite of these hurdles, improvements are consistently made for the sake of women and their human rights in Timor-Leste.

The country’s legislation to combat domestic violence (mentioned above) receives praise despite impediments to its usage—seen as a method that enables individuals to feel comfortable going to law enforcement and reporting their experiences.

Amnesty International noted that the nation joined other countries in southeast Asia by taking on a National Action Plan for Women, Peace and Security, spanning from 2016 to 2020.

Other successes for women in the country (according to the 2016 report) include:

  • More abuse-related cases being examined in the justice network.
  • Greater instances of incarceration for individuals guilty of domestic violence from the beginning of the year until August (about nine).
  • The Ministry of Social Solidarity’s operation in districts, each of which involved a “gender-based violence focal point to coordinate a referral network, a coordinator for the Bolsa de Mae (Mother’s Purse) support fund, and two additional staff who focused on children’s issues.”
  • Coordination with other organizations—in the face of shortages in personnel—enabled individuals to access nutrition, places to reside, funding and other forms of protection during times of need.

Although Timor-Leste must still address many issues relating to the disproportionate difficulties females face in its country, it continues to make improvements to the lives of those subjected to brutalities and violence.

– Maleeha Syed

Photo: Flickr

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Understanding the Main Causes of Poverty in Timor-Leste

Causes of Poverty in Timor-Leste
After almost three decades of Indonesian occupation, Timor-Leste gained its independence in 2002. The widespread violence during the years of occupation has taken its toll, however, and, since independence, the nation has striven to rebuild. Despite these efforts, Timor-Leste remains one of the world’s poorest nations, with an estimated 42 percent of the population living in poverty. Before investigating methods by which this issue can be alleviated, it is important to understand the main causes of poverty in Timor-Leste.

  1. Much of Timor-Leste’s economic infrastructure became severely damaged during the years of Indonesian occupation. This has negatively impacted many of the country’s essential services, such as healthcare, agriculture and education. The lack of infrastructure has further exacerbated the country’s food insecurity. With many people reliant on harvested crops as their primary source of food, large amounts of these crops have been improperly allocated or are traded on the black market, compounding the issue of hunger.
  2. Timor-Leste faces challenges from its surrounding geography. The country’s uneven terrain makes both farming and water-gathering difficult, with only 30 percent of arable land currently used in farming. Around 70 percent of the nation’s population lives in rural areas and are reliant on agriculture as their primary food source. However, they are faced with the challenges of tackling the wet and dry seasons. Natural disasters also make this difficult, with floods and droughts the cause of large losses. As a result, many families who are reliant on farming are only able to produce enough food for eight months of the year.
  3. Food shortages contribute to a large number of illnesses and diseases in Timor-Leste. Malnutrition is widespread, and proper health care is hard to come by, particularly for those in rural areas. Maternal mortality rates are among the highest in the world, and 45 out of every 1,000 children are expected to die before their first birthday. Of those who survive, many are stunted due to poor nutrition.
  4. Water and sanitation also create problems for health care. Of all Timorese, 300,000 do not have access to clean water, with large numbers of the population using public taps and unprotected springs to get the water they need. Additionally, 700,000 people are without adequate sanitation. The lack of these basic facilities enables disease to spread, resulting in unnecessary deaths, particularly of young children.
  5. Education attainment levels in Timor-Leste are low, with a lack of literacy among the population being particularly problematic. Prior to independence, many of the country’s schools were destroyed and teachers were in short supply. A 2015 UNESCO report found numerous challenges facing the education system. Dropout and attendance rates, particularly those of girls, is one of the key issues the country is facing.
  6. One of the primary reasons education is a major cause of poverty in Timor-Leste is the direct impact it has on employment. While more than three-quarters of Timor-Leste’s workers are employed within the primary sector, employment outside of this area is limited. The country’s educational issues prevent the development of a skilled workforce, which hinders the ability of the government to function effectively. This skill gap is particularly problematic for Timorese youths, where educational inadequacies have led to a 40 percent unemployment level. Further compounding this issue is the lack of job creation outside of government, with the private sector only able to create an estimated 400 jobs per annum.
  7. While Timor-Leste receives foreign aid from a multitude of sources, questions have been raised as to whether aid has delivered any observable results. Policies of donors may not necessarily be in line with what is best for the country, particularly when focused on the public versus private sector. Despite this, a recent government report shows that critical areas of health, agriculture and education are receiving significant investment through foreign aid. As some of the primary causes of poverty in Timor-Leste, further investment in these areas may enable at least a small alleviation of the poverty facing the country.

As a young nation with limited resources, assistance from the developed world is critical to progress in Timor-Leste. Increased foreign aid, focused on the primary causes of poverty in the country, will be a strong starting point to enabling a stable economic future for Timor-Leste.

– Gavin Callander

Photo: Flickr

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6 Facts About Hunger in Timor-Leste


Since Timor-Leste gained independence in 2002, it has made significant improvements in economic and human development. At the same time, while hunger in Timor-Leste has decreased, rates of malnutrition and stunting are still the highest in Asia. The U.N. has provided assistance aimed at stabilizing the government since 2006.

  1. According to Oxfam Australia, 41 percent of people in Timor-Leste live on less than $1.25 a day. Timor-Leste ranks very poorly in GDP and GDP per capita, making it one of the poorest countries in the world. A weak economy and an unstable political environment have made it difficult for residents of Timor-Leste to escape extreme poverty and hunger.
  2. Timor-Leste is a small country with only 1.13 million inhabitants, of which 74 percent live in rural areas. Because residents often depend on local agriculture to supplement their diet, the high instances of drought, flooding and cyclones in Timor-Leste lead to food insecurity.
  3. Persistent food insecurity and hunger in Timor-Leste have resulted in high rates of malnutrition among Timorese youth and adults. In fact, UNICEF reports that 58.1 percent of the population suffers from moderate and severe stunting, affecting the growth of many children and young adults.
  4. Life expectancy for the Timorese population is about 69 years, up from about 61 years in 2002. This increase is largely attributable to reductions in poverty through foreign aid that has led to an increase in the availability of food.
  5. In 2014, Timor-Leste became the first country in the Asia-Pacific region to adopt the U.N.’s Zero Hunger Challenge. The program aims to eliminate food insecurity and childhood stunting by improving food infrastructure, increasing the productivity and income of small farm-owners, and lessening food waste.
  6.  Since 1999, the World Food Program has provided supplemental nutrition for the most vulnerable Timorese and worked to reduce maternal and infant mortality rates. Eventually, the U.N. hopes to turn the supplementary feeding program over to the government of Timor-Leste.

A recent report by the World Bank indicates that Timor-Leste has made significant strides in reducing poverty and projects that the economy will rebound with high growth rates in the coming years. As more Timorese escape poverty, continued foreign aid will be key to sustaining development and reducing hunger in Timor-Leste.

– Yosef Gross

Photo: Flickr

10 Hungriest Countries and the Reason Why

10 hungriest countries
This year, 870 million people in the will face continual, day to day hunger. Ninety-eight percent of these hungry people live in developing countries, even though these countries are the ones producing much of the world’s food.

In October 2013, international humanitarian organization Concern Worldwide published a list of the 10 hungriest countries in the world, most of which were in Africa. The list includes Burundi, Eritrea, Comoros, Timor Leste, Sudan, Chad, the Yemen Republic, Ethiopia, Madagascar and Zambia. Patterns as to why these particular countries are hungry have strong historical correlations.

Here are five reasons why these countries are suffering from hunger.

1. Landlocked countries are resource scarce

Countries like Burundi and Chad are landlocked, and they struggle to connect with the coastal areas of Africa. Landlocked countries as a whole have poor transportation links to the coast, either by their own fault or through developmentally and infrastructurally challenged neighbors. Without access to the coast, it’s difficult to integrate with global markets. Thus, they are also cut off from global flows of knowledge, technology and innovation, and unable to benefit completely from trade. Often, the cost of transportation for importing and exporting raw materials is exorbitantly high. Burundi experiences 6 percent less economic growth than non-landlocked countries in Africa, and as many as 58 percent of Burundi‘s citizens are chronically malnourished.

2. Productive land remains unused

In some countries, land is not being effectively used. In Eritrea, almost a quarter of the country’s productive land remains unused following the 1998-2000 Eritrean-Ethiopian war. The war displaced nearly 1 million Eritreans, leaving the country with a need for skilled agricultural workers, as well as plaguing the lands with mines. There is a lot of potentially fertile land in Africa, but the majority of farmers don’t have the technology or means to use the land to its full value. Because of these discrepancies, incomes remain low.

3. War and violence destroy country infrastructure

Countries with a low level of income, slow economic growth, and a dependence on commodity exports are prone to civil war – and most of the hungriest countries have experienced war and violence for decades. Once a cycle of violence and civil war begins in a country, it’s hard to break the pattern. Timor Leste is still paying for seeking independence from Indonesia, which damaged the country’s infrastructure. Sudan is slowly recovering from two civil wars and war in the Darfur region. Chad has had tensions between its northern and southern ethnic groups for years, which has contributed to its political and economic instability.

4. Extreme climate conditions and climate change

Sometimes, causes for hunger are unavoidable – like weather. The 2011 Horn of Africa drought left 4.5 million people in Ethiopia hungry, and since 85 percent of the population earns their income from agriculture, any drought has a detrimental impact on Ethiopians. As an island off the coast of Africa, Madagascar is especially prone to natural disasters like cyclones and flooding, and experienced its worst locust plague yet in 2013. Climate change is also viewed as a current and future cause of world hunger. Changing climatic patterns across the globe require changes in crops and farming practices that will not be easy to adjust to.

5. Increasing refugee populations

Finally, the presence of refugees in a country adds to the growing pressure on already limited resources. This is the case in Chad, which has over 400,000 refugees from Sudan and the Central African Republic due to political instability and ethnic violence in those countries. Ethiopia is also home to refugees, but because of a different reason – the country continues to welcome refugees from Sudan, South Sudan and Somalia after the Horn of Africa drought.

— Rachel Reed
Sources: GCC, Global Citizen, U.N., WHES
Photo: Mirror

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Countries Starting to Reach Development Goals

Data from the World Bank released last week reports twenty fragile countries who are starting to reach development goals.  As the Millennium Development Goals near the end, news of progress is exciting and hopeful. Progress in fragile countries ranges from efforts in reducing poverty, improving the education of girls, and cutting down on deaths during child birth.

The Millennium Development Goals are set to expire in 2015 and these 20 countries were not on track just a few years ago. The progress that has been made since 2010 is remarkable. In addition, six more fragile countries are on target to hit the goals by 2015. Countries like Afghanistan, Nepal, and Timor-Leste have seen a 50% reduction in people in extreme poverty and increased the number of girls in school.  These are strong accomplishments for any nation, but for these nations who are coming out of war and devastation, the results are even more extraordinary.

The data serves as a call for the global community to not strike countries off as hopeless or lost causes, but to seek the development of all nations.  While these twenty have seen remarkable progress, many war-torn nations are still lagging far behind the benchmarks set up by the Millennium Development Goals. These nations are also very prone to relapse as is the case of Yemen who was on target to meet the goal of reducing death during childbirth until the violence during the Arab Spring in 2011.

World Bank leaders are calling for a bridge between long-term development and humanitarian assistance to help countries in the middle of crisis.  When the international spotlight leaves a country in distress, often so does the humanitarian aid, leaving the country devastated and struggling to rebuild itself. To rebuild requires support that focuses on clear actions, steps, and transparent and accountable goals. As nations tighten their spending in the midst of the economic downturn, effective aid is even more important. The World Bank is committed to working more closely with the United Nations to see that long-term development happens in fragile countries.

Community involvement is also key in addressing and meeting needs and designing appropriate projects.  As aid organizations work together with communities, they can address the causes of conflict and also create programs and plans that emerge as long-term solutions.  In the final push to accomplish the Millennium Development goals, this type of aid is going to be increasingly important.

– Amanda Kloeppel
Source: Reuters
Photo: World Hunger