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Malnutrition: a global health perspective from a Timorese mountain

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Malnutrition is an unacceptably prevalent and preventable global scourge

Winner — Medical practitioner category

Her name was Rosa and she hailed from a small rural hamlet about 6 hours’ “drive” from Dili in Timor-Leste, as the snaking, boulder-choked mountain pass permitted no more than a crawl past the rusted chassis and blown tires dotting the unforgiving terrain.

Rosa’s story typified so many of Timor-Leste’s young. A 6-year-old girl from a remote subsistence village, she presented to our outreach clinic simply hungry. The rudimentarily performed anthropometry and growth charting was arresting, but then so are national statistics. According to UNICEF, malnutrition is despairingly rife in Timor-Leste. About 58% of children are stunted, 19% severely malnourished with endemic micronutrient deficiency, with poorer outcomes still for rural dwellers. To benchmark, malnutrition in Timor-Leste eclipses that of Ethiopia and Malawi, traditional purveyors of poster-children for global hunger.

Surprising, then, that this mountainous district and Timor-Leste at large are not bedevilled by drought or infertility; rather the contrary. The causes of malnutrition are thus manifold and complex. They…