Health and Nutrition in Coleate Leotelo
According to the People of Coleate Leotelo
Presented 30 November 2000, by Ms Watson on behalf of Mrs Fernandes, Mrs Santos and the chief of Coleate Leotelo, Mr Borges and on behalf of the people of Coleate Leotelo, a village of the subdistrict of Hatolia in the district of Ermera, East Timor. This report is comprised of statements by the people of Coleate Leotelo and data collected and recorded 23-24 September, 2000.
(a) This report shows that the people of Coleate Leotelo are not only vulnerable, but already suffering from widespread illness, weakness, and lack of nutrition (although not necessarily 'acute malnutrition'). If their access to food is not improved soon, the population will be vulnerable to high mortality as well. I recommend that WFP take a sensitive approach when determining the vulnerability and nutritional needs of the population of Coleate Leotelo by taking into account not only the weight, height and biceps circumference measurements of the people, but also the health of the population and the information provided by the people of Coleate Leotelo (as presented in this report).
(b) I recommend that WFP instigates regular distribution of food to the general population of Coleate Leotelo; that WFP ensures that seeds are given to Coleate for the next season's planting (asking the local population what crops they need to plant); and that WFP continues food distribution to Coleate Leotelo until the people have sufficient resources to feed themselves.
(c) AMI-Portugal, responsible for the health of Coleate Leotelo, has conducted two consultations in Coleate Leotelo and collected some data on serious illnesses in the area. However, in Coleate Leotelo, where the greatest health problem is not serious but lesser illnesses, I recommend that AMI-Portugal change the focus of its mobile clinics to the villages and instead of checking for indications of 'severely ill or malnourished children or adults' only, focus on the lesser illnesses of the general population of Coleate Leotelo - infections, weakness, coughs and colds. If their research shows similar results to the results of this data, AMI-Portugal should try to discover why such an extraordinarily high percentage of the general population is suffering from weakness or sickness and perhaps suggest a remedy - whether it be extra food assistance, extra medical care, or something else. Thus, AMI-Portugal might be able to assist the improvement of health of the general population of Coleate Leotelo.
(d) Given the fact that there have only been two mobile clinic visits (one in July and one in August, 2000) to Coleate Leotelo since before the Referendum (in August 1999); and given the population's 97% rate of illness or weakness; I recommend that AMI-Portugal immediately commence to implement consistent medical assistance (regular mobile clinics) in Coleate Leotelo.
(e) I recommend that WHO (UN's World Health Organisation), WFP and INGOs (international non-government organisations) responsible for health and nutrition in East Timor be made aware of the relationship between the diet of general populations and the state of health (or ill-health) of those populations, not only in Coleate Leotelo but also in other villages and districts of East Timor. If a large percentage of a population is suffering from lesser illnesses and those people say they have limited access to food (don't get enough to eat), professional investigation might show that diet of the general population is lacking in certain nutrients; that is, that lack of sufficient nutrition is having a detrimental impact on the health of that population. It might be found that the addition of nutrients to that population's diet would improve the population's health. I suggest that the policies of humanitarian organisations responsible for health and nutrition should be based on the assumption of a correlation between health and nutrition.
(f) I recommend that WHO and INGOs responsible for the improvement of health in East Timor collect data not only for serious illnesses suffered by a population, but for complaints of lesser illnesses or weakness if the general population seems to be suffering from ill-health. If they find lesser illnesses are widespread in a population and they know why, perhaps they could help resolve the problem. If they don't know why those lesser illnesses are so widespread and are not sure that the general population is getting enough food to eat, the organisations responsible for the area should ask a nutritionist to look at the diet of that population to see if the addition of certain nutritional components would improve the health of the population. That is, organisations responsible for health and nutrition should take seriously the relationship between nutrition and health.
(g) Organisations responsible for health and nutrition (such as WHO, WFP and INGOs) should take seriously their responsibility to publish in their monthly reports not only their activities (mobile clinics, data collected, the rebuilding of clinics, etc.) but also those health problems in their districts which they have not yet addressed, or which they doubt they will be able to improve.
(h) It is likely that many people in East Timor who are sick but who are 'not suffering from malnutrition' according to UN guidelines (based on weight, height and biceps circumference measurements) are in reality suffering from insufficient nutrition to maintain good health which leads to weakness, contributes to illness and sometimes indirectly contributes to death (caused by illness). I recommend that WFP use more sensitive methods than those currently used in East Timor to determine the nutritional needs of populations. I recommend that WFP take into account the health (or ill-health) of the general population when determining the nutritional needs of that population.
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