The 130th Annual Meeting of APHA

Abstract #44988

Mary Anne Mercer, DrPH, Health Alliance International, 1107 NE 45th Street, Suite 410, Seattle, WA 98116, 206-543-8382, mamercer@u.washington.edu and Susan Thompson, MPH, Washington Health Foundation, 999 Third Avenue, Suite 1200, Seattle, WA 98014.

Introduction: East Timor emerged from centuries of external domination after a 1999 referendum in which an overwhelming majority voted for independence from Indonesia. The bloody aftermath was followed by heavy external direction in the development of new Timorese social, governmental, and health systems. Full independence in April 2002 brings the opportunity for East Timor to set its own priorities and develop a Timorese approach to addressing its massive health problems. This paper addresses priorities for health at the village level in Venilale subdistrict of East Timor, and explores local mechanisms through which health promotion efforts can be integrated into local Timorese social and cultural realities. Methods: Qualitative information from a purposive sample of rural Timorese villagers explores the following areas: priority health problems; traditional beliefs related to health, healing and healers; current modern and traditional health resources available; patterns of association of village women and men; village-level leadership, social structures and roles; and changes in dynamics of village leadership since the end of Indonesian domination. Results: Timorese villagers have a strong sense of health priorities and well-defined patterns of social and political relations. Culturally-derived beliefs related to health and illness are strong influences on health behavior, and could be integrated with modern health messages to accelerate the process of health development in rural areas. Tapping traditional and newly emerging leadership structures will improve local responses to village health problems. Discussion: Health assistance for East Timor should take into account existing rural structures, beliefs, practices and social relations to most widely disseminate the benefits of the new health system under development in that country.

Learning Objectives:

• Describe the main health priorities of a group of Timorese villagers;
• Explain how the Timorese village social and leadership structures could assist in the process of improving health understanding and behavior in rural areas.

Keywords: Community Health, Developing Countries

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.