Remote Birth, Timor-Leste


Nestled in the Malay archipelago, Timor-Leste is a small Southeast Asian nation. In the 16th century, the Portuguese occupied and colonised the island where they remained for centuries.

Following the 1974 Portuguese revolution and bitter internal conflict, Timor-Leste was declared an independent state on 28 November 1975. Nine days later, the Indonesian military invaded and began a brutal occupation of what Indonesia declared its  27th province. 

In 1999, a United Nations backed referendum resulted in the reinstatement of Timor-Leste's independence, however this was not without a punitive campaign of violence by Indonesian militia and military. Many were killed, and key infrastructure was destroyed.

A democratic government was elected in 2001, and with it, Asia's newest nation was born. 

With a subsistent agrarian population, medical access to remote areas remained a key development issue. The maternal and neonatal mortality rate is ten times that of Australia (located approximately 700 kms away) and childbirth can be a trying time. Midwives play a crucial role in the community. 

Marcellina's Story

Marcellina is one of hundreds of Timor Leste's dedicated traditional birth attendants. Each day, she walks between ten to fifteen kilometres assisting expecting and young mothers with antenatal and neonatal care in and around the remote mountainous village of Asulau. 

Trudging through rice paddies, up steep slopes, and through coffee plantations, Marcellina dutifully weighs babies, checks temperatures, inspects rashes, and battles with the humidity to ensure she can provide the best care she can.  

Marcellina was trained in basic contemporary birthing practices through the Dili based Bairo Pite Clinic and Japanese NGO, Frontline. 

On 2 July 2011, Marcellina was called to assist Eliza Soares, 25, with the birth of her fifth daughter. The birthing process was far from smooth. A breech birth three hours from Timor-Leste’s capital city, Dili meant that both the young mother and baby were in real danger. Using contemporary medical techniques while respecting the traditional environment of a home birth, Marcellina managed to correct the breech birth saving Eliza's life. 

Surrounded by family, Eliza lay on the floor. She was surrounded by the women of her family. Traditionally, men are not to be present, but as the situation grew increasingly perilous, Eliza's husband entered to provide comfort and make preparations to travel to Dili. The small child emerged, silent. 

Eliza's newborn child refused to cry. After what seemed like an agonising eternity punctuated by the hushed whispering of the word 'moris?' (alive?) by Eliza's relatives, Marcellina managed to revive the infant Noleberta by breathing through a thin piece of gauze. Shortly after bursting into tears, Noleberta fed on her mother's milk. The tension melted, as the word 'moris' was again uttered, this time with exclamations of relief.

On 20 June 2016, I was afforded the opportunity to revisit the remote village of Asulau. Marcellina met me by the side of the dusty road, which leads through the main street. After a few kilometres down a narrow path punctuated by thatched buildings, a group of young children laughed as they played in the water draining from nearby rice paddies. As I approached, the children ran towards the thatched home by the road. Eliza welcomed me with a smile, and yelled out to Noleberta to come greet me. A grumpy young girl, whose only wish was to play with her friends, pulled faces as Eliza and I asked her to smile for a photo of three generations of women in her family. ‘Moris’, I smiled to myself. 

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