As of 27 April, 2,986,751 confirmed COVID-19 cases and 206,669 deaths have been recorded across 210 countries and territories. To date, Timor-Leste has 24 confirmed cases with the majority of cases (22 cases) in Dili. 322 tests have been completed, with results pending for 80 suspected cases.3 An outbreak of COVID-19 would be devastating for Timor-Leste. As one of the world’s least developed countries and the poorest country in southeast Asia, it is feared that the pandemic would easily overwhelm the country’s weak healthcare system. In international and regional rankings Timor-Leste is assessed as having weak health systems, low capacity to respond to infectious disease outbreak, high rates of underlying health issues that increase risk of COVID-19 mortality and overall high COVID-19 risk. TimorLeste is ranked second of 25 countries in the Asia Pacific in terms of risk for COVID-19. The 2020 INFORM Global Risk Index identifies that, Timor-Leste is most at risk for; access to healthcare, existing health conditions and food insecurity. Current gaps in the capacity to effectively respond to the virus include under-resourced healthcare facilities, limited communication channels to communities, lack of adequate water, hygiene and sanitation (WASH), difficult geographical terrains, and widespread poverty.
Systemic gender inequality and the exclusion of marginalised groups from leadership positions and decision making, service provision, and access to and control of resources, would exacerbate the impact of the pandemic on vulnerable groups.
A COVID-19 outbreak would disproportionately affect women and girls, including their education, food security and nutrition, health, livelihoods, and protection. Timor-Leste is ranked at 111 out of the 187 countries in the UN Gender Inequality Index (GII) and has one of the highest rates of GBV. In Timor-Leste, women are often the primary caregivers in the family, placing them at heightened risk of infection. Women’s unpaid workloads may increase with the need to care for sick family members and children at home due to school closures. Maternal, sexual and reproductive health services may be less available as resources are diverted to respond to the pandemic, putting women at greater risk of maternal mortality and disability. As with all crises, there is an increased risk of gender-based violence (GBV) in a country where pre-existing rates of GBV are already extremely high.
Prevention and response strategies developed by the government and non-government actors may exclude or be inaccessible to women. With lower levels of participation in the public sphere, women may not be involved in the design and implementation of COVID-19 prevention strategies. Communication materials may not reach women due to lower literacy levels and responsibilities in the home. WASH facilities may not be safe and accessible to women, and financial assistance and food security initiatives may benefit male members of the household before reaching women and children.
Men's gender roles and norms also need to be taken into account in developing responses to COVID-19 to ensure that men are properly targeted to reduce their vulnerability to illness, and to leverage their roles as leaders and decision makers in the home and community to help prevent the spread of the disease.
In addition, rural populations in Timor-Leste have significantly less access to a range of services, including water and sanitation, health, education, food supplies, and finance. Rural populations also experience greater levels of poverty and food insecurity, and lower levels of education and literacy. Persons with disability represent another vulnerable group, who face accessibility issues, discrimination and higher rates of poverty. An intersection of attributions and vulnerabilities, such as gender, age, disability, literacy, socio-economic status, and geography, have the potential to compound the impacts of the COVID-19 pandemic on individuals, families and communities.