Volunteers in Timor-Leste: providing the means to do good

By Ombretta Baggio and Kate Roux, in Timor-Leste

It is a simple concept, and it is effective: take members of a community, train them on basic health and first aid so they, in turn, can support their neighbours. Also known within the Red Cross Red Crescent as the community-based health and first aid (CBHFA) approach, it has been especially effective in places such as Bitirai, a rural community in the south of Timor-Leste.

More than 70 per cent of Timor-Leste’s population lives in rural communities, often in extremely isolated conditions with little access to formal health care. People need to walk a day or more to get to a health clinic, meaning that those too ill to make the trip must stay and take their chances.

According to UNDPs Human Development Report 2011, Timor-Leste has made substantial progress in many health areas such as infant and under-five mortality rates, antenatal care coverage, and treatment of tuberculosis (TB). However, the country remains off-track in curbing the prevalence of underweight children under-five years of age, maternal mortality rate, incidence of malaria, and the proportion of the population using improved sanitation facilities.

“We are giving people the means to do good within their own community,” explains Marcelino Albuquerqua, CBHFA project manager for the Red Cross of Timor-Leste (locally known as CVTL). He goes on to explain that through CBHFA communities have been empowered with information and knowledge on health issues.

By using simple tools adapted to local contexts, volunteers assist communities to identify their key health priorities. The community identified malaria, diarrhoea and malnutrition as the key health challenges. To gain a better understanding of the health practices in the community, a baseline survey of the top five health priorities was conducted, and volunteers were trained accordingly.

People in Bitirai respect the Red Cross. The brightly coloured orange shirts with the CVTL logo on the front are worn with pride. And the community-based health approach is effective not only because of it improves the health and well-being of people in the community; it also works because it builds a strong sense of community.

There are over 500 community members who live in Bitirai. Located in a remote area with no electricity, running water, cell phone reception or even a vehicle, the community relies heavily on one other. They trust each another. And they know exactly who lives in which house, the name and ages of their children.

As a result, when one member of the community is able to share important information on nutrition, handwashing, use of toilets or the best use for mosquito nets, people listen, and things change.

“I know that we can help the community to help themselves,” says Josefa Pereira, a Red Cross volunteer. “Volunteering for the Red Cross is not a burden. So I don’t feel it takes my time.”

But volunteers such as Josefa offer more than information. They also serve as a critical link to the health care system in Timor-Leste.

“As Red Cross volunteers, we are happy to help the community. When people get sick they come to us for help because they trust us. We take them to the hospital or health clinic,” Pereira says. “We don’t ask for money or payment. It is our want.”

CBHFA activities, which include water and sanitation, disaster risk reduction and a livelihood component, have been implemented in 12 of Timor-Leste’s 13 districts, through 35 CBHFA trained facilitators. An estimated 50,000 people have been reached so far through this programme.

Volunteerism is at the heart of achieving Universal Health Coverage.