Source: Labour Relations Office

Women rarely appear as representatives of trade unions before the Council of Minimum Wages, which is part of the Labour Relations Tribunal. It is clear that women need encouragement to become more actively involved in trade unions. This will require education and training to raise women’s awareness of the role of trade unions and their possible advantages.

Sexual Harassment

According to the current Labour Code, sexual harassment is defined as ‘unwelcome physical or verbal conduct of a sexual nature that threatens the employment of the worker or creates an intimidating and hostile working environment.’

Taking into consideration CEDAW General Recommendation No. 19 24 (k), Section 13.1 of the current Labour Code places a high burden of responsibility on an employer to prevent sexual harassment in his or her workplace. Similarly, in the Code of Ethics for the Civil Service Law, a civil servant should be able to ‘serve the public without any form of discrimination or intimidation, including sexual discrimination, and without verbal or physical abuse in relations at the workplace.’ The new draft Labour Code also reflects this sentiment, in that men and women should enjoy the right to work ‘without any form of discrimination or intimidation, including sexual discrimination.’ This proposed law states that breach of these provisions is an offence, punishable in law by a fine or compensation awarded to the victim. These provisions are similar to existing penalties and remedies outlined in Section 29 of the current Labour Code.

There is much anecdotal evidence to suggest that sexual harassment in the workplace is a significant problem in Timor-Leste. However, women rarely initiate a formal complaint or allege sexual harassment until the situation has become intolerable or they feel they have been unjustifiably dismissed. Coupled with the inadequacies, in particular, procedural inefficiencies of the existing dispute resolution system, this hinders the effective resolution and management of such cases and makes it very difficult to clearly ascertain the extent of sexual harassment in the workplace.

According to figures provided by the MLCR, a total of five women formally complained of being sexually assaulted in their workplace to its Mediation and Conciliation Division during the period 2001-2005. Some of these cases were resolved and compensation provided to the victim following a collective agreement.

An area of particular concern is the growing number of female members of the PNTL who have reported alleged sexual harassment from their male colleagues. Anecdotal evidence suggests that women in the PNTL face significant disadvantage and risk being ostracized if they make a complaint involving harassment. The PNTL, through the VPU, is mandated to investigate complaints of sexual harassment from the public.

Complaint Mechanisms

At present, a Labour Relations Board can meet to determine whether an offence under any provisions of the current Labour Code (including denial of equal pay) has been committed. It is expected that more effective monitoring and evaluation of equal pay practices will also occur with the establishment of the Minimum Wage Tribunal.

Section 57 of the new draft Labour Code further provides that the Employment Relations Tribunal will determine whether there has been a breach of the law and can make such an order that it considers necessary to ensure compliance, which in the case of denial of equal pay, may include, ‘restoration to the worker of any entitlements due, compensatory damages or fines, which in Timor-Leste can range from USD 150- 1500. Statistics provided by the MTRC show that from 2001 to 2005, 199 women made formal claims for compensation as compared with 651 men during the same period.

As referred to in the CCD, despite the existence of a complaints resolution legal framework, mechanisms to enforce the law are still very weak in practice with the result that women’s right to equal pay is often denied. With the absence of specific data or information, it difficult to know the extent of inequality between men and women in the employment arena. The Labour Relations Board has not been functioning due to several reasons such as re-structuring of the MLCR, lack of financial resources and re-organization of priority programmes. In addition, lack of human resources, especially individuals with expertise in gender issues, present a further obstacle to resolution of cases affecting women. Limited understanding of employment processes is yet another significant constraint.

An Organic Law for the MLCR is required, and is currently being drafted, which will assist in revitalizing this Board. Notably, there are also very few employment institutions to address the specific needs of women employees. Women’s organizations are not systematically bringing cases forward on behalf of victims suggesting that there is a need for further assistance for women in this area.

Marital Status and Maternity Provisions

There is no specific law that clearly states that a woman’s marital status should not affect her employment security. Rather the current applicable law affirms that maternity is a state which should be ‘dignified and protected and special protection […] guaranteed to all women during pregnancy and after delivery.’

This special protection is outlined in the Constitution as having ‘the right to be exempted from the workplace before and after delivery, without any loss of benefits’ and further defined in the Labour Code as entitled to maternity leave of twelve weeks paid at a rate of two-thirds of salary.

According to Section 11.11 of the current Labour Code, maternity benefit is paid on the understanding that future social security payments will cater for the benefit; however, in the absence of a social security system, the maternity benefit must be paid by the employer. This section further states that during legal absence from work, the rights of women workers must be preserved and that they should be reinstated in their former position of employment or ‘in an equivalent position compensated at the same rate of wages.’

In practice, however, many women who take maternity leave receive only a small portion of their benefits, do not receive any remuneration, or worse still, find that they no longer have a job to return to after the birth of their last child. Women who marry and, especially once they have children, are not expected to return to work and this social norm is not perceived by the larger population as overly problematic. Only a handful of cases have been reported to MLCR in the past few years and these have mainly involved being refused entry to work after a period of maternity leave or not receiving maternity benefits. At the time of writing, the outcome of these cases is not known.

Paternal leave

There are no specific provisions to provide for paternal leave in current law. Neither the current or draft Labour Codes refer to this issue, though consultations with women on CEDAW have called for a legal recognition of this right.

It is possible to take special or annual leave and some men do avail of a minimum of 3 days or maximum of 5 working days of paternal leave where this has been collectively negotiated as part of a Collective Labour Agreement between an employer and a registered Trade Union.

Some International NGOs and companies also provide paternal leave entitlements to their male employees as a means of supporting women and family relationships, though this practice is at best ad-hoc. At the time of writing, there no data available on the percentage of working men who do opt for paternal leave.

Measures taken to assist women to re-enter the workforce after pregnancy or family leave

Pregnant or nursing mothers as they are entitled, as a matter of constitutional right, to nurse their children and are not obliged to return to work, if they do not wish.

Despite high birth rates and some provisions to enable women to breastfeed there is no formal government programme to assist women in re-entering the workforce after pregnancy. Even though female headed households constitute 19% of all private households, there is also no state-funded child care service available. As such, in cases where women do work outside the home, their children are taken care of by immediate family members such as a mother, sister or trusted family friend. Sometimes, children of poorest families are left at home unsupervised. A few women’s NGOs provide child care during working hours but these are few in number and for a limited time, which clearly does not meet the needs of many working women.

Art. 12 CEDAW: Equality of Access to Health Care Services

General information on health indicators such as the life expectancy of men and women, fertility and infant and maternal mortality rates, challenges facing the health system and government policy have already been outlined in the CCD. Below is more specific information on women and health issues in Timor-Leste, including women’s access and quality of care.

Women’s Access to Health Care

Gender roles in Timor-Leste affect the degree to which women and men can have access to health services. Women are often denied access to health care as the costs associated with their needs are often higher than males in the same household. In the DHS survey in 2003, 59% of women identified getting money as a ‘big’ problem in accessing medical advice and treatment. Health care in Timor-Leste is normally free but reports from regional consultations on CEDAW have indicated that health care workers invariably have to be paid and medicine is almost never free. Research has shown that urban women from affluent households have a better chance of receiving a range of treatments from antenatal care and assistance with deliveries to obtaining medicine and post-natal check-ups.

The heavy workload of women and lack of support during an absence from home or work often prevents them from seeking medical help unless they are seriously ill. Also, formal health care schedules may not correspond to the daily schedules of women and men. A culture exists whereby serious and often painful conditions become so much a part of everyday life, they are accepted as normal and left untreated. Women also fear the consequences of reporting illnesses and being ‘stigmatized’ by diseases such as tuberculosis, which could affect their chances of getting married. Also, double standards exist in the way sections of the population view certain conditions. For example, some people perceive the parasitic infection, urinary schistosomiasis (whose symptoms are similar to those of an STI) with morally suspect sexual behaviour in women but with virility in men.

Women often need their husbands’ permission to receive any treatment and 18% have classified obtaining this authorization as a problem in accessing health care. A lack of confidence and embarrassment at discussing intimate issues also prevent women from seeking assistance. Over a quarter of women have reported not knowing where to obtain treatment and at least one in five do not wish to visit a health facility unaccompanied.

As noted in the CCD, the provision of health care services is particularly poor in rural and remote areas. Women frequently lack the means to travel to health centres or posts for appropriate treatment and must walk long distances to reach the nearest facility. The results from the DHS survey indicate that these are the two foremost concerns for at least two-thirds of women in Timor-Leste. The elderly, pregnant women and those with physical disabilities are particularly disadvantaged. The consequences of this are obvious. For instance, the DHS survey found that mothers in the highlands, those with no education and from poorest households were least likely to use hospitals and 53% of women from the highlands did not receive any antenatal care at all. In response to this, Timor ‑ Leste’s Health Policy Framework seeks to make basic health services are available within two hours walking distance from communities, and that hospital services with surgical capacity will be within two hours drive of sub-district facilities.

As noted in the CCD, the focus of women’s health services has been on provision for their reproductive health needs. However, women have faced difficulties in accessing health services for non-reproductive problems such as mental health. During regional CEDAW consultations, participants commented upon the lack of care for women suffering trauma and related psychological disorders. They also reported a lack of attention to the needs of older women, especially those undergoing menopause. Domestic violence and rape are also issues that those working in public health services still need to fully address for both victims and perpetrators.

Finally, there is still a lingering distrust of health services among Timorese women which, as noted elsewhere in this document, stems from medical malpractices during the Indonesian occupation. Women avoided the public health system for fear of receiving contraception under the guise of malaria or vitamin tablets. Reports of sterilization being performed during caesarean deliveries or other routine operations became widespread. For this reason, women refused vaccinations as they were unsure as to the kind of substance being injected. More recently though, according to the DHS survey, 12% of households have reported not consulting a medically trained health care provider when a household member was ill; this percentage is highest (16%) in poorest households.

At the time of writing, the Ministry of Health, with the support of UNICEF and AusAid is planning to implement a ‘Family Health Promoter Programme’, in which key individuals such as community leaders will be trained in health promotion. It is hoped that eventual implementation of this programme will raise awareness of health issues, especially in the districts.

Quality of Health Care for Women

Lack of female health professionals

At present, few women are employed in the health service, at the administrative, managerial and service levels. The DHS survey indicates that only a small percentage (4%) of women are concerned about this; however, discussions from the CEDAW consultations have indicated that some women will not seek treatment from a male practitioner for a gynaecological complaint.

According to figures from the Ministry of Health, approximately one-third of doctors, 40% of all nurses and 100% of the 320 midwives working in the health service are female. At the time of writing women account for two out of every five of the total number of employees in the Ministry of Health in 2005 and the highest ranking women in the Ministry is the Director of Health Service Delivery.

Recruiting midwives for remote areas continues to be difficult and in response to this, the Ministry of Health has established a midwifery course. Female nurses, currently working in or with strong links to areas with vacancies, are currently being selected and trained for an additional year on midwifery and then posted to these priority areas. It is also a medium term objective to explore incentive issues for staff to compensate for working in remote, isolated conditions.

The recruitment of significant number of additional doctors from Cuba, sending Timorese students to Cuba for medical training and the establishment of a Medical School in Timor-Leste with support from Cuba has had a significant impact in the human resource capacities available to the health system both in the short and medium term. The expansion of the number of doctors, especially at the level of health post, has improved access to and quality of health care in Timor-Leste. At present, a female Cuban doctor, specializing in forensic medicine, is attached to the PRADET Safe House at Dili National Hospital and attends to victims of domestic violence and sexual assault needing emergency medical care.

Number and conditions of hospitals

The limited number and standard of health facilities has such an impact on women’s health in that many women do not attend antenatal visits. In Timor-Leste, there are 211 health facilities, of which half (104) are community health centres without beds and there are 8 hospitals. The other health facilities consist of 63 health posts, 27 mobile clinics, and 9 community health centres with beds.

Four smaller hospitals have or are being reconstructed to function as small, 24 bed referral hospitals, with the capacity to provide some surgical services such as emergency obstetric care. Baucau hospital with 114 beds functions as a larger regional referral hospital for the three eastern districts, offering surgical and basic specialist services. The national hospital in Dili with 226 beds provides medical, surgical and specialized services including visiting specialists, and is to have a more comprehensive set of diagnostic equipment.

Services closest to the community at the sub-district level are provided by health posts that are staffed by a midwife and/or nurse. Not all health posts have midwives but all have nurses. These are supplemented by mobile clinics operating from community health centres which involve regular visits to remote communities by motorbike. Each sub-district has a level 2 community health centre with a staffing complement of six. Each district has a level 3 or 4 community health centre with a staff component of ten to fourteen including a doctor, some inpatient capacity, and some laboratory facilities. Community health centres are to have radio communications, and access to ambulance services with one ambulance per district.

Treatment of women in hospitals

In discussions with the women in the regional CEDAW consultations, the condition of health care facilities, in particular, hospitals has been raised a matter of great concern. Women going into hospital to give birth have reported a lack of medicine including painkillers and routine check-ups including bathing, due to a shortage in staff. The administration at Dili National Hospital has acknowledged the extent of the problem in that birthing assistants have had to cut bed sheets for use as baby blankets. In almost all cases, family members must accompany both women and men to the hospital and take care of them for the duration of their stay, again partially due to the lack of staff and the fact that it is also a cultural norm.

There have also been anecdotal reports of women being turned away at hospitals because they did not bring ‘overnight bags’ in preparation for birth or did not have sufficient funds to pay for treatment where there were complications in pregnancy. Furthermore, local NGOs working in the field of maternal health have reported incidences of women leaving hospitals in blood-stained clothes as they had no sanitary napkins or additional clean clothing.

After discussions health officials, the ‘Maternity Packs Project’ was launched in February 2006 by the Alola Foundation and this has gone some way to alleviating these problems. At present, maternity packs are given to those women most in need giving birth in Dili and Baucau hospitals.

The maternity packs include clothing and sanitary items in addition to health promotional materials that outline positive health practices including exclusive breastfeeding critical to the good health and survival of mother and baby. It is hoped that the provision of these packs will improve the experience of birthing in hospitals for some women and have a positive knock-on effect influencing other women to attend health facilities for the delivery of their babies. It is envisaged that the maternity packs will be provided to rural hospitals and clinics at a later stage.

Private provision of private health services

Alongside the Government health service delivery system, health services are also provided by private practitioners, faith based and other non-government organizations such as the Café Timor network, Caritas (the health agency run by the Catholic Church), and clinics run by Protestant churches. It is estimated that there are 190 health care workers operating 40 clinics in the non-government sector. This suggests that non-government clinics handle a quarter of basic health service delivery.

The Café Timor network, for example, covers on average 125,000 in 5 districts and Dili. It currently operates eight fixed clinics which provide services similar to Level 2 community health centres in the public system and 24 mobile clinics. The network involves 74 personnel, including 3 doctors (one of whom is female) and 12 general nurses. Many of the patients who attend the clinics in both Dili and the districts are women and young children and are treated for upper respiratory tract infections. The network also provides family planning services, which will be discussed in greater detail in the section on family planning.

Private clinics run by doctors, nurses and midwives and dentists, which have been established in some of the main urban centres, especially Dili and Baucau. Details on the numbers of patients are not available as most do not send regular reports to the health authorities. These clinics are now subject to legislation and will be monitored on the safety of practices. The modified health management information system will include a reporting component for private services.

Ante-natal care

At present there is limited pre-natal and post-natal care in the country. In general, urban women from wealthier backgrounds with a higher level of education have a higher chance of receiving a more comprehensive ante-natal care service than other women. Data from the DHS study in 2003 indicates that almost 60% of women received antenatal care during pregnancy for their most recent birth. Over half of women received this care from a nurse or midwife (56%) with a minority of urban women (12%) attended to by a doctor or obstetrician. The majority of women (49%) received their care in a public sector health centre or health post or public hospital (36%).

The study also shows that the majority of women (57%) had been attended to at least twice during their pregnancy, most in their early stages, before the six month. However, according to medical standards, only 14% had an adequate number and timing of visits. Significantly, just over a third of all women (53% in the highlands) did not receive any antenatal care. Only one third of husbands accompanied their wives on antenatal visits.

The quality of care is an important factor in the quality of the outcome of the pregnancy. The DHS study found that although the majority of women received an abdominal examination and were weighed, only one third had their blood pressure taken and one quarter informed of potential complications.

Complications in pregnancy

Access to a skilled birth attendant, especially to emergency obstetric care, is limited in Timor-Leste. As such many Timorese women and their babies are still dying in labour, often at home.

The kinds of dangerous complications experienced during pregnancy and delivery include premature and obstructed labour, fever and convulsions. A pregnancy can be uneventful until the moment of delivery; however the complications that can arise during delivery include excessive bleeding, where death can occur within 1-6 hours. This is a particular problem in Timor-Leste as often there is an initial delay in deciding to seek care, followed by a second delay in reaching health services before finally being denied appropriate care due to the fact that there are no blood supplies or doctors present at the nearest health facility.

Aside from the high rates of malnutrition and low levels of anaemia in pregnant women, health care professionals have acknowledged a number of factors contributing to maternal mortality in Timor-Leste. These include low utilization of skilled birth attendants; irregular ante-natal check-ups; short intervals between births of children; tuberculosis, malaria and other diseases and a lack of access to essential and emergency obstetric care. Women are dying as a result of eclampsia (pregnancy-induced hyper-tension), haemorrhage (ante and post partum), prolonged labour, infection and complications resulting from a spontaneous abortion.

Prolonged labour and excessive bleeding are the most common complications in deliveries that can lead to maternal death and a very high proportion of babies (88% and 59% respectively) born to mothers experiencing these problems have died within one month of birth.

Deliveries

The overwhelming majority of women (90%) of women give birth at home, followed by 9% in public health facility and a minority (1%) in a private health facility. Home births are likely to occur with older women living in rural areas who have little or no education and have already several children. Many women in rural areas manage their pregnancies and deliveries without trained medical assistance, relying mostly on indigenous knowledge. Traditional medicine continues to play an important role in Timor-Leste.

The majority of births are assisted by a relative or friend (61%). Next in importance is the Traditional Birth Attendant (19%) followed by a nurse or midwife (16%). The actual number of births attended by midwives in 2003 was only 335 in comparison to 1637 attended by traditional birth attendants. Doctors are only used in 3% of cases. Only 9% of husbands are present at delivery. Since 2001, the Ministry of Health has trained 350 midwives on safe and clean delivery.

Adequate nutrition during pregnancy

In its Nutrition Strategy, the Ministry of Health establishes two key areas requiring improvement, maternal and child nutrition and food security and notes that actions must be taken at the national, service delivery and community and family levels in order to achieve this. As noted in the CCD, this strategy is being implemented as part of the basic package of services and the national primary health care policy. Women are at present receiving Vitamin A, Folic Acid and supplementary feeding as part of a programme administered by the World Food Programme, which aims to ensure that pregnant women have enough food to support a pregnancy and later breastfeed. This programme is being implemented in 2 districts, Liquiça and Ainaro, with planned interventions in Maliana and Suai, followed by expansion into all districts at a later stage. Results from the DHS survey indicate that 62% of children under three years consume food rich in vitamin A, and 34% of children under five years receive vitamin A supplements.

Efforts to reduce maternal mortality rates

As noted in the CEDAW Statistics Annex, it is difficult to calculate an exact figure for Maternal Mortality Rates in Timor-Leste, as the denominator is the number of live births in the country and, at present, these are not being registered. Many births take place at home. This said, as noted in the CCD, the very high estimated maternal mortality rate means that in order to meet the MDG of improving maternal health, the maternal mortality rate must be reduced by three quarters in the period between 1990 and 2015. This means that the maternal mortality rate much decline from between 660-880 deaths per 100,000 live births in 2001 to 252 deaths by 2015.

At the request of the Ministry of Health, in 2005, UNFPA developed and began implementing a training programme for midwives and doctors on basic emergency obstetric and neonatal care. The training is taking place at the National Hospital in Dili and the district referral hospitals in Baucau, Suai, Maliana and Oecussi. In addition, UNFPA provides obstetricians to the Ministry of Health. UNFPA is also supporting the training of 2 health service doctors (male) abroad in comprehensive emergency obstetric care. At present, only the district referral hospitals have the capacity to provide the six elements of basic emergency obstetric care (BEmOC). Dili National Hospital and most of the district hospitals have the capacity to perform comprehensive emergency obstetric care (CEmOC). This requires provision of Caesarean sections and blood transfusion, although blood bank services are only available in Dili. At present, only 1% of births (450) are delivered by Caesarean section, which is below the minimum international standard of 5%.

The Government is also planning to pilot maternity waiting homes in five districts, whereby pregnant women enter the hospital two weeks before their due date. This is part of an overall drive to encourage skilled attendants at birth and to enable access to emergency obstetric care in the event of life-threatening complications. To this end, the Ministry of Health is currently distributing free hygiene kits to those women who give birth in a health care facility.

At the time of writing, a programme to prevent and treat obstetric fistula (a completely preventable complication arising from obstructed labour) is being developed by the Ministry of Health with the support of UNFPA. It is hoped that this programme, which also contains a strategy to assist women back into their communities without suffering further shame, will contribute to the reduction in the incidences of maternal morbidity rates. In 2003, there had been 21 diagnosed cases of obstetric fistula in Timor-Leste and a further 68 cases identified in the period 2004-2006. It is quite possible that women are not aware of this condition and therefore are not presenting themselves at health facilities for treatment. Currently, only Dili National Hospital offers fistula repair surgery due to the presence of an expatriate fistula surgeon.

Breastfeeding

In Timor-Leste, a woman begins breastfeeding her baby very quickly; almost half of all women commence within the first hour and nearly all within one day. Although it is recommended that babies are exclusively breastfed for between four and six months, only 39% of children aged less than four months were breastfed and this percentage dropped to 18% for children under six months. The reason for the decrease was due to the introduction of ‘other milk’ and complementary foods. Overall, the mean duration of breastfeeding was 17.7 months and for exclusive breastfeeding 1.4 months.

Problems arise if a woman is on medication as she cannot breastfeed and wet nurses are not part of Timorese culture. Babies tend to be fed rice water as formula or other substitutes are too expensive and over a period of time they show signs of severe malnutrition.

Based on its Nutrition Strategy, the Ministry of Health stresses the importance of breastfeeding for mothers, exclusively within the first six months and up to two years. The Alola Foundation has established a National Breastfeeding Association and promotes breastfeeding through support groups. At the time of writing, it is working with the Government to develop a National Code on the marketing of breast milk substitutes.

Access to post-natal care

Post-natal check-ups are vital as women are still at risk of dying 48 hours after delivery due to post-partem haemorrhage. Results from the DHS survey found that only 15% of women in Timor-Leste received a post-natal check-up. The likelihood of receiving a post-natal check-up decreased with age and already having several children. Again, wealthier women with higher levels of education from urban and lowland areas were more likely to receive this check-up.

Participation of men in matters relating to women’s health care

Less than one quarter of men (24%) spoke to a doctor or health provider about the pregnancy or health care of the mother of their last child in the five years prior to the survey. Of those who did speak, it was to enquire about the type of foods eaten during pregnancy, how must rest she should get and the types of health problems for which the mother should get medical attention. Wealthier fathers who were younger, living in urban areas or who had secondary education or higher were more likely to speak to a doctor about the health of the mother. However, 58% of men did talk with health professionals about delivery, especially assistance with delivery.

Reproductive Health

The current Government Reproductive Health Strategy focuses on four key areas: Safe Motherhood, Family Planning, Young People’s Reproductive Health and General Reproductive Health. The emphasis on reproductive health within the overall Government health strategy is part of its response to reducing the high MMR and TFR, considering the high percentage of the population who are of reproductive age.

This was also a response to the concerns raised by delegates at the 2004 Regional Women’s Congresses. At this forum, reproductive health was highlighted as a key priority area of intervention in the empowerment of women. They noted that women’s health issues and, specifically, the poor state of women’s reproductive health, reflect the low status of women in Timorese society.

Delegates at the Congresses advocated on a number of issues including the need to educate the community about family planning, breast feeding, the reproductive system and its functioning, and the ‘inadvisability of having more children when a woman has reproductive health problems.’

They also affirmed that maternal mortality needs to be addressed to include the lack of attention by husbands, general lack of information, lack of access to hospitals and clinics, early marriages, lack of proper nutrition for women and well as lack of access to clean water.

Family planning advice, cost and accessibility

Although younger and more educated women were more likely to have discussed family planning, over 76% of Timorese women have reported that that they have never talked about this matter with their husband. Just under two-thirds of women reported that their husbands disapproved of family planning compared with only 21% of spouses who were in favour.

As noted in the CCD, the use of contraception is low and condom use virtually non-existent in Timor-Leste. For the most part, the small minority of women aged between 25-44 years who do use contraception use injections. Women in urban areas who were better off and had more education were more likely to recognize a method of contraception than those in rural areas. Three-quarters of women who were not using contraceptives had no knowledge of where to obtain them.

Despite the desire for greater numbers of children among some Timorese women (the ideal size for ever-married women was 5.7) wealthier and older women articulated a desire for having family planning education. Women from urban areas did not desire fewer children than rural areas. The demand for spacing children (10%) was far higher than for limiting them (3%). The demand for family planning was greater in the urban and rural west regions than rural central and rural east.

Young women were the most satisfied with the family services available at 81.8% in the 15-19 age group whereas 55.6% in the 45-49 age group expressed the greatest dissatisfaction. Overall, three-quarters of the total demand for family planning was being met in Timor-Leste, which suggests a need for increased provision of family planning services.

The Café Timor Clinic in Dili offers family planning services and VCT for free to women, which is supported by the Ministry of Health. At the time of writing, advice on natural contraceptive methods is provided as are injections, implants and condoms. At present there are 2 VCT counselors and 1 doctor trained in the management of STIs. Staff at the clinic have reported a high demand from women for contraception.

In order to increase access, improve quality and widen the range of contraceptive services, the Ministry of Health, with the support from UNFPA, has been upgrading the knowledge and skills of health providers in the area of family planning.

In 2004, a TOT course was delivered to selected health providers from different districts and to trainers from the Institute of Health Sciences (NCHET at that time). The trained national trainers have since delivered the family planning services training to health providers from different health facilities around the country. Approximately 50 health providers have graduated from this course, and more than 100 are due to be trained by the end of 2006, with training for 250 in the districts planned for after.

In April 2006, UNFPA donated various educational tools such as anatomical phantoms, learning posters, medical equipment and instruments to the Ministry of Health, which will assist in conducting family planning training courses. It also provides all contraceptives (condoms, pills, injections, IUDs) to the Ministry of Health, which then distributes via the Central Pharmacy. In addition, as a result of the review of the National Family Planning Programme in December 2005, the Ministry of Health requested a Family Planning Advisor to be assigned to its Maternal and Child Health Department. UNFPA currently supports this Advisor, who took up the position in April 2006.

The Ministry of Health, again with the support of UNFPA, will be developing a Behavioural Change Communication Strategy for Reproductive Health in 2007 which will focus on a number of areas such as Safe Motherhood, Family Planning, Adolescent and Reproductive Health and HIV/AIDS. It is envisaged that this strategy will form the basis for planning behavioural change communication (BCC) interventions in selected districts and, as a consequence, increase demand for and utilization of health services. The strategy will be implemented through the National Family Planning Promotion Campaign.

Teenage pregnancies

In Timor-Leste, the median age at first birth for women aged 20-29 is 21 years and for women aged 30-39, 22 years. This median age is virtually the same for women from different backgrounds. The onset of child bearing is not early in the adolescent period. Only about one in five adolescents have a child and these tend to be older rather than younger. The percentage of 16 year old married women who are mothers or pregnant with their first child is 4.8% compared with 37.2% of those aged 19 years.

Abortion

Abortion is still an extremely sensitive issue in Timor-Leste, especially given the traumatic events of recent years. There is a lack of information on the true extent of its occurrence. The unmet need of unmarried women for family planning for example is not well documented and there is anecdotal evidence of unmarried women requesting abortions in the capital, using medications such as chloroquine, fansidar, tetracycline and traditional medicine including massage. The incidences of unsafe abortions and complications resulting from abortions are not known.

With respect to post-abortion care, emergency obstetrical services are available in Dili National Hospital , where a woman can receive treatment for any complications arising from spontaneous abortion. She may also receive reproductive health advice. However, to date, training on the prevention and management of abortion complications has not been conducted throughout the country.

At the time of writing, there have been discussions between the Ministry of Health, the Alola Foundation and UNFPA regarding research on the causes and prevalence of abortion in Timor-Leste.

Legal provision on abortion

In May 2005, the Government and the Catholic Church issued a joint statement proposing the criminalization of abortion in the forthcoming national Penal Code. There had been support for abortion to be classified as a crime and that anyone involved in supporting an abortion including family members, traditional health workers and male partners should be punished. As a result of discussions with civil society and women’s NGOs, the Government agreed to open up the debate publicly and charged the OPE to engage with Alola Foundation and Rede Feto to establish discussion forums with civil society. These took place in June-July 2005, the objective of which was to share information and explore the complex legal social and moral aspects of this issue.

In relation to abortion, the key recommendations from the discussions were:

There should be exceptions to the criminalization of abortion if a woman has suffered rape, incest or where there is a risk to her health.

There was recognition of the need for data on the prevalence of unsafe abortion in Timor-Leste.

The OPE put forward these recommendations to the Working Group, established by the Government and the Church to consider matters under the joint declaration. As a result, the Working Group recommended that provisions criminalizing abortion be taken out of the draft Penal Code and be dealt with under a separate law.

At the time of writing, under the provisions of the draft Penal Code, those responsible for causing an abortion by whatever means and without the consent of a pregnant woman, will be sentenced to a term in prison of between 3 and 12 years.

Health Care for Older Women

Although the Constitution bestows ‘special protection’ to senior citizens, older persons, especially older women, are an extremely vulnerable group in Timor-Leste. According to PRADET, older women are just as likely to suffer gender-based violence as younger women and some who were referred to PRADET for treatment for sexual assault have been in their seventies and eighties. PRADET are currently developing a manual on how to treat victims of gender based violence, which includes a section on how to examine and treat an older woman who has suffered physical and/or sexual abuse. The Ministry of Health has been developing a policy in this area, but at the time of writing, this has not implemented due to lack of funding and especially human resources.

Mental Health

It is estimated that approximately 96% of the Timorese population have experienced at least one traumatic event in their lifetime. Gender-specific violence including rape and sexual harassment suffered during the Indonesian occupation has contributed greatly to trauma in the female population. Psychiatric disorders such as post-traumatic stress, epilepsy, paranoid psychosis, anxiety and depression are prevalent among women.

Extent of the problem among women

The extent of the problem is unknown, given the reluctance of many Timorese women to speak about gender-based violence or other abuses. One local NGO working on mental health issues has stated that over half (56%) of their patients suffering from mental illnesses are women. The double load of paid and unpaid work drains women’s mental and physical health in a way that does not affect men’s health. The burden is even greater for women who are heads of households.

In 2004, the Ministry of Health undertook a mental health study in Becora and Hera area outside Dili. The results were that 1.9% of the population was identified by the community as mentally ill. Almost all cases had severe disabling mental illness in urgent need of treatment. The most common disorders were the severe psychoses with most sufferers experiencing major disability and/or chaotic social behaviour. Data on women sufferers is not available. Those identified with severe illness were at great risk of sexual abuse, assault, malnutrition and physical illness. According to the Census 2004, mental disorder among the population is of the rate of 2.8%.

Lack of mental health services

In regional CEDAW consultations, women have raised the problem of the little support available for people experiencing mental health issues, especially those women who have suffered sexual violence. The difficulty is that prior to independence, no mental health services were available to the population. Also, there has been no qualitative or quantitative assessment of the mental health status of adult and juvenile population by gender, so it is difficult to assess the impact of traumatic experiences on both men and women and what gender differentiated needs are to be met by national mental health policy, planning and services. This is particularly so for women who are experiencing gender-specific abuses either in their homes or in public. NGOs working in this area have treated cases of women suffering from bi-polar disorder who are engaged in sex work.

Government response

Since 2001, mental health services have been developed and implemented with the support of East Timor National Mental Health Project (ETNMHP) and also PRADET, who had previously treated over 400 cases since 1999. However, there are a number of constraints to the provision of adequate mental health services including financial and competing priorities in the context of poor health indicators across the country.

The Government recognizes that there is a greater need to provide both financial and technical support for civil society organizations working on mental health issues. There is also a great need to provide more information to families about care for mental illness.

As set out in its Mental Health Strategy, the Government plans training for specialist mental health workers to include knowledge on areas such as children, gender, drug and alcohol, developmental disability, as well as continuous education to build upon existing knowledge in other areas. It envisages the NGO sector delivering services that are complementary to but not duplicating government services through the provision of psycho-social support, counselling and non-medical interventions in conditions such as traumatic stress anxiety and less disabling forms of depression.

Currently the Mental Health Unit based in the Ministry of Health is working towards providing mental health services through the government sub-district and district health centres, health posts and clinics outside the government service network where arranged. For those patients unable to access fixed clinics, services will be provided by a mobile outreach service.

Legislation on Mental Health

There is currently no national mental health legislation in Timor-Leste. Current law is a mix of Indonesian law and UNTAET Regulation, which is used as a guide in courts but there is no means of detaining a person with mental illness or protecting their human rights.

As such, the Government recognizes that legislation needs to be developed in order to support planned policies. These include regulation of service provision by non-government providers, workforce (including training and accountability) and prescription and administration of pharmaceuticals. It acknowledges that further research into indigenous approaches to mental health, diagnosis and cultural norms, psychosis, trauma, epilepsy, suicide prevalence as well as family systems and community care models is necessary to understand basic issues such as prevalence as well as further insight into actions to develop mental health services in Timor-Leste. Further information can be provided in the First Periodic Report.

Alcohol and Drugs

The problems of substance abuse and alcoholism are recognized by the Ministry of Health as common disorders, particularly in men; however, the true extent of the problem in Timor-Leste is not currently known. Increased consumption of alcohol among men due to untreated trauma and chronic stress also puts women at risk of physical violence. NGOs working as part of the referral system for victims of domestic violence, sexual assault and child abuse have noted that a significant proportion of their cases are alcohol-related. Palm wine is widely available and consumed by both adults and children.

Little is known about the extent of drug use in Timor-Leste or how this affects women. Results from the DHS survey indicate that few numbers of women smoke, partially due to the fact that it is culturally unacceptable for women to smoke, especially in public. The survey also reports that both women and men likely know that smoking is bad for their health. There have been anecdotal reports of soft and hard drug use among teenage youths, mainly in the capital, but this has not been verified.

At the time of writing, there has been no official anti-drug or alcohol information campaign warning people about the effects of substance abuse. However, at the time of writing, one local NGO, PRADET, is planning to conduct a series of awareness-raising training for its own staff and other health workers that deal with alcohol-related illnesses as part of their work.

Disability

The Constitution provides for equality and non-discrimination on the basis of ‘physical and mental condition’ and further states that disabled citizens shall enjoy the same rights and duties as all citizens and be protected, ‘except for the rights and duties which he or she is unable to exercise or fulfil due to his or her disability.’

Several facilities in Timor-Leste such as the Asosiasaun Hi’it Ema Ra’es Timor (ASSERT) and Klibur Domin, based in or close to the capital, focus on people with physical disabilities, providing them with, inter alia , mobility aids (prostheses and orthoses) and physiotherapy as well as providing long term accommodation and social support. These institutions work closely with the MLCR and the Ministry of Health to support local organizations to coordinate services for disabled people, to reintegrate disabled people into the community and to train local rehabilitation staff. In the case of Klibur Domin, the home provides free accommodation, supervised medication and health education for patients awaiting or recovering from surgery, or with conditions including tuberculosis and malnutrition referred from Dili National Hospital and regional health clinics.

Data on patients with disabilities

Through its centre for rehabilitation, ASSERT has treated 132 clients since opening in April 2005; 59 adults and 68 children. 56 of these patients have received prosthetic/orthotic devices (artificial limbs/orthopaedic braces/shoe orthosis) and 76 clients have received physiotherapy alone.

ASSERT also treats men and women are treated for polio, orthopaedic problems and tuberculosis, though sees more male clients with conditions such as amputations than women. This is due to a high number of occupational and road accidents involving males. The gender divide is approximately equal in children, who receive treatment for cerebral palsy, cerebral malaria, developmental delays and orthopaedic problems.

Staff at Klibur Domin treat more adult men for tuberculosis than women, but this may be due to the fact that many women need permission from husbands to seek treatment and therefore do not report suspected tuberculosis. They also see many women for treatment of broken bones, perhaps as a result of violence within the home. Undoubtedly, poor standards of maternal health, nutrition, sanitation and lack of access to health care facilities contribute to high numbers of diseases and sickness leading to disability in women and children.

Although there is a lack of reliable data on disability in Timor-Leste, studies carried out by NGOs working in the field have provided an insight into the nature and extent of the problem. In 2002, it was estimated that just over one third of persons with a disability were female. The main forms of disability were physical, sight and speech impairment with disease and sickness contributing to just under two-thirds of all disabilities followed by birth and accidents.

HIV/AIDS

Women’s exposure to HIV/AIDS

There are a number of factors that can increase women’s exposure to HIV/AIDS in Timor-Leste. These include population displacement, violence which took place during the Indonesian occupation in addition to possible interaction with male expatriates, including peacekeepers, post-1999. In addition, the high prevalence of domestic violence and sexual assault, as noted by delegates at the Regional Women’s Congresses, low literacy and education levels, economic dependence on men as well as cultural constraints preventing open discussions on matters of gender, sexuality and reproductive health could create high-risk conditions for the spread of the disease among women.

The first phase of the National HIV/AIDS Strategic Plan advocates the ‘ABC’ strategy, i.e., Abstinence - Be Faithful – Condoms as a means of minimizing HIV infection. However, given the results of the Family Health International Study indicating significant levels of bisexual and extramarital sex among men, coupled with the high prevalence of sexually transmitted diseases and extremely low condom use by men, a significant risk to women still exists even if they only ever have one sexual partner i.e. their husband or partner. The inferior position of women in Timor-Leste effectively means they cannot negotiate condom use or indeed fidelity from their spouses or partners nor are they in a position to abstain if they are being sexually assaulted.

Raising women’s awareness of STIs and HIV/AIDS

As noted in the CCD, there are very low levels of awareness or knowledge of HIV/AIDS in Timor-Leste, especially among women, although younger more educated women in urban areas were much better informed than older women in rural areas. An issue which has emerged strongly from recent workshops on HIV/AIDS is how the traditional role of women in Timorese society is an impediment to HIV/AIDS and sex education. As such, and in accordance with CEDAW General Recommendation No. 15, a range of measures in Dili and some of the districts have been introduced to increase awareness, especially among women and girls of the risks and effects of sexually transmitted infections, particularly HIV/AIDS.

Foremost among these has been the information campaigns by the Ministry of Health to increase understanding of HIV/AIDS. The Ministry has distributed brochures and posters containing information about HIV/AIDS and other diseases for the community at health centres, private clinics and hospitals. It has also made several broadcasts on local television and radio. A large event was held in the Kampo Demokrasia the capitol to raise awareness about the condition and there have been additional events held annually to commemorate World Aids Day.

In addition, seminars have been held in junior and senior high schools to raise awareness. In most of these cases, the training has been initiated and provided through a faith-based organization, an UN Agency or NGO. In the districts, both Government and NGOs have provided HIV/AIDS health and education services. For instance, Baucau District Hospital and the smaller clinics and health services provide HIV/AIDS education and (IEC) communication materials. Through the UNDP Baucau Civic Education Programme, a programme of training for staff from high schools in Baucau has been conducted. Although VCT services are available in Dili and the districts, there have been reports of lack of confidentiality and, as such, men and women are reluctant to use these services.

The Government recognizes that despite efforts at awareness raising, there is still difficulty in discussing and little understanding about HIV/AIDS and sexual health problems in Timor-Leste. These types of health conditions are perceived as a source shame to those suffering them and both men and women are afraid to access health services due to the stigma and discrimination surrounding these conditions.

At the time of writing, Family Health International and NGO partners Fundasaun Timor Har’i and CVTL, with USAID support, implement highly targeted HIV and STI prevention projects among groups which have been identified as being at high risk for HIV/AIDS and STIs. The target groups are female sex workers, also men who have sex with men, the national police force and national military forces. Family Health International and its partners have designed projects which use a peer outreach methodology to provide beneficiaries with targeted behaviour change communication materials, information and advice about HIV/STI prevention and condoms. The project also provides STI treatment for targeted groups and voluntary counseling and testing.

The project targeting female sex workers emphasizes the need for women to know about HIV/AIDS, ways of transmission as well as learning about their HIV status and knowing how to prevent HIV and STIs through abstinence, fidelity or condom use. Free condoms, STI and VCT services are provided. Life skills training is also planned for female sex workers so as they can protect themselves with clients. This project also includes skill training designed to provide female sex workers with other professional options. It targets approximately 340 Timorese and Indonesian female sex workers in Dili, Cova Lima and Bobonaro. This represents almost all Timorese and Indonesian female sex workers in these towns and Dili.

Counseling services available to women and girls with reproductive and sexual health problems

With USAID support, Family Health International and its partners Café Timor Clinic and Bairo Pite Clinic provide HIV counseling and testing services. Female sex workers are a large beneficiary group; as such, particular attention is taken to ensure that these services are friendly and non-stigmatizing. In addition, Dili National Hospital and the National Laboratory also provide VCT.

As described in more detail elsewhere in this report, local NGOs PRADET and Fokupers provide counseling for women and young girls who are victims of domestic violence, sexual assault and child abuse which includes some counseling on sexual health problems.

With the support of WHO and UNFPA, the Ministry of Health has developed standards on counseling and information for women on both traditional and modern methods of contraception, which has been adapted to a local context. The standards have been translated into Bahasa Indonesian and relevant information into Tetum. Also, as described earlier in this report, the Ministry of Health, with support from UNICEF and the Alola Foundation has introduced the ‘Life Skills’ training to the school curriculum (see relevant section in ‘Equality in Education’ in this report).

Art. 13 CEDAW: Social and Economic Benefits

Equality in Social Benefits and Assistance

As already outlined in the CCD, the rights to social and economic benefits are constitutionally affirmed for every citizen and it is incumbent upon the Government, ‘in accordance with its national resources’, to promote the establishment of a social security system; however, current budget limitations have precluded the formation of such a system to date. In theory, a framework for family benefits does exist, though Government policy has concentrated on improving the efficacy of the child maintenance system. As noted elsewhere in this report, there have been few judicial rulings in child maintenance cases and women in recent regional CEDAW consultations have indicated that receiving any payments from spouses or partners remains a problem.

Although there is no discrimination in theory on the basis of gender in current laws relating to the provision of social assistance and security, in practice the situation is different. For example, while Art. 10. 33 (a) of the NDP refers to need to provide services such as day care centres for working women with children, the reality is such that only a small percentage of women are engaged in the national labour force and therefore in a position whereby they could benefit from these services. As already noted, women are not normally encouraged to work and those in employment outside the home would normally have to rely on extended family members to look after children. To date, no formal system of child care services exists in Timor-Leste.

Emergency Social Benefits

As detailed in the CCD, and in accordance with Article 56 (3) of the Constitution, a Social Solidarity Fund exists for emergency cases, administered by the DNSS in the MTRC. Current emergency assistance is given to both women and men, but prioritizes those most in need such as children of poor families, including those with single mothers, women with no means of economic support, women survivors of domestic violence, older and disabled women and widows.

This assistance consists of foods stuffs and basic amenities such as oil, candles, and kitchen kits and mosquito nets. Some specific recreational programmes targeting the elderly and widows have also been designed and are expected to be implemented shortly. The number of women who have asked for assistance has significantly increased in recent years. In 2003, equal numbers of women and men (272) received assistance, which increased to 279 women and 448 men in 2004. In 2005, the figures had approximately tripled, with 854 women as compared with 820 men seeking assistance.

Emergency assistance has also been administered to women through the Urgent Reparations Programme established by the CAVR. However, women have encountered obstacles in accessing these benefits, which include difficulties accessing information about the work of the CAVR as well as the cultural belief that men already represented families’ experiences of the conflict. These difficulties also partially reflect the overall logistical problems of providing emergency assistance for those most in need, as they often live in rural and remote areas and are not easily identified. To offset this, the CAVR tried to ensure that more women than men were invited to its healing workshops organized as part of the Reparations Programme, where they received monetary assistance. It also enlisted the help of two women’s NGOs to deliver services to groups of women in an attempt to address the gender imbalance. The issue of reparations for women will be further explored in the section on ‘Women in the Conflict.’

Equal Access to Financial Credit

Women’s lack of access to credit facilities

In principle, and in accordance with the guarantees of non-discrimination as asserted in the Constitution, access to credit should be made available without discrimination. However, the lack of access of women to credit has been identified as a major issue at the Regional Women’s Congresses and the Government through the NDP recognizes the need to improve such services for women.

At the outset, there are few formal credit facilities which provide assistance to the micro and small enterprise sector in Timor-Leste. The successes of small loan schemes have been mixed and whether women and those living in rural areas receive credit depends very much upon the respective institution. An ADB survey carried out shortly after the end of Indonesian occupation found that 56% of the respondents, of whom two-thirds were women, had no access to credit. In order to obtain credit, women had to prove they were in a public sector job, had a husband in such a job, provide reference letters and fill out application forms. Their husband’s signature was also required in the applications in order for women to obtain loans. A current additional requirement is that all women and men must provide a health certificate from their doctor to state that they are in good health and can pay back a loan.

A UNDP/ILO survey carried out in 2001 stated that only 6% of entrepreneurs interviewed had received a loan of any kind. Many of these enterprise owners stated that the lending interest rate was too high and loans tended to be given to a very narrow set of activities.

At the time of writing, there are only three foreign banks operating in the country all of which are located in the capital. All provide some form of credit lines; however, they tend to target what they consider productive activities and for the most part ignore activities in the informal sector. One bank provides loans only if the borrower deposits an amount equal to the sum on loan. This is a major barrier to many women as most do not have the necessary collateral to obtain the loan in the first instance. One bank though does provide credit to women in their own right for small businesses based in Dili and has noted that, on the whole, women are less likely to default on repayments.

To date, the largest scheme for small enterprise programmes in Timor-Leste has been the World Bank Small Enterprise Project (SEP). A positive aspect of this project has been the creation of 1,326 jobs; however 72% of these positions were filled by men.

The results of this project also indicate a trend to fund male-dominated activities. Two-fifths of total loans have been granted to transport services and one in four loans given to operations in Dili. The majority of the remainder of the loans have gone towards purchasing taxis, mini-buses, shops, carpentry and repairs workshops and coffee processing. A recent market survey into community business opportunities in Timor-Leste carried out by the MLCR in 2005 confirms a clear gender divide in enterprise ideas. Women look to commercially develop traditional skills of cooking, sewing and handicraft production whilst men’s ideas for potential businesses tend to focus on mechanical and technological skills. Of the 335 loans dispersed as part of the SEP, only 16% of loans were awarded to business women.

Another difficulty of loan schemes such as the SEP is that they are not intended for micro-enterprises in the informal sector, where the majority of Timorese women work. These smaller schemes usually require loans of between USD 50 ‑ 100. Some donor-funded micro-credit programmes do exist to fill this gap and are implemented by NGOs. Whilst there have been attempts made to both coordinate and regularize these programmes, further evaluation of these projects needs to be carried out.

Measures to provide credit facilities

The Asian Development Bank (ADB) is currently implementing a Micro-Finance Development Project which seeks to:

Develop the policy and strategic framework that will be conducive to, and supportive of, the development of micro-finance institutions (MFI’s);

Develop appropriate local capacity to set up proven models of effective MFI’s;

Rehabilitate and expand the operations of credit unions (CU) that existed in the country prior to the 1999 conflict;

Establish a micro-finance bank, managed and operated entirely by national staff.

Acknowledging the barriers that women face in obtaining formal credit, the ADB aims to provide micro-enterprise programmes that make access to credit easier for women by offering loans at affordable rates and quickly. Women are assisted in completing the necessary paperwork while social pressure and the incentive of future loans are methods used to ensure repayment. Under the STAGE Project, to date, approximately 5000 women in several districts have benefited from micro-credit programmes.

Participation in Recreational Activities, Sports and Cultural Life

As already outlined in the sections on education in this report, the Government has made it a priority to include sports education in the school curriculum as part of overall efforts to raise the profile of sport in Timor-Leste. Many of the challenges against successful introduction in schools such as limited technical capacity and insufficient equipment apply equally to local sports centres targeting the wider community.

In accordance with the provisions of the Constitution, every citizen has the right to cultural enjoyment and creativity. Timorese women regularly showcase their talents at local art exhibitions and are active in dance and theatre groups, such as the ‘Kuda Talin’ group, often performing pieces specifically relating to the situation of Timorese women. A popular expression of Timorese culture is traditional dance and song, which is performed by women and young girls and regularly broadcast on local television.

At present, little data exists regarding the diversity of Timorese culture, including the production of its many handicrafts. Given the lack of traditional teachers, predominantly female, who can pass on skills such as tais weaving, this knowledge is in danger of being lost to future generations. Other popular cultural activities such as cockfighting are almost exclusively male; nonetheless, they can have a detrimental impact on the lives of women. In the CEDAW consultations, this activity has been associated with gambling and alcohol consumption, which can have negative consequences for the family and women in particular. Vital income for food, education and healthcare is lost and family members adversely affected by alcohol-related violence.

Art. 14 CEDAW: Rural Women

Rural Women in the Population

As noted in the CCD, men outnumber women in Timor-Leste and this ratio is greater in rural areas. The figures also vary quite considerably between districts. According to the 2004 Census, just under three-quarters of the total population live in rural areas and women account for 49.7% of the total rural population.

Migration patterns of rural women

This pattern is due to migration, where mainly young men, who have greater mobility, are moving between districts and coming to the capital. Those migrating have tended to have received some schooling. Research has suggested that many rural residents are travelling to urban areas in search of employment, to study and/or to escape family problems. The additional impact of international development agencies also increases migration and mobility, attracting people to the capital. If ease of mobility and access to education are factors influencing migration from the districts, then rural women may be less likely to travel to urban centres with the same frequency as men.

Female Headed Households in Rural Areas

As already noted in this report, 19% of all private households are headed by women; however, a large proportion of these are headed by older women. For example, 42% of household heads over 64 years of age are female. In rural areas, 19.2% of all private households are headed by women as compared to 17.9% in urban areas. This percentage varies quite considerably by district, with 12.8% of female headed households per private households in Manufahi as compared with 31.7% in Manatuto.

Female headed households have been identified among the most vulnerable population. As these households’ main occupation is agriculture, without joint support and a lack of local waged labour, it is very difficult for women to manage their work by themselves.

Rural Women and Unpaid Labour

As already described in the section on ‘Equality in Employment’, women play a significant role in the informal economy and in the survival of their families. In rural areas, just less than 90% of all female employment is in the agricultural sector. In accordance with CEDAW General Recommendation No. 16, the Government can report that 70% of women in agriculture compared with 46% of women in non-agriculture do not receive payment for their services; however these figures must be put in context in a society heavily dependent on subsistence farming. Of those women who do receive a cash income, 1% work in agriculture and 25% outside this sector. Most of women’s unpaid labour in the agriculture sector is family labour.

Most women working in the agricultural sector work part time. Only 9% of women in agriculture worked all year round, the majority of whom (86%) are seasonal workers. No information on men’s occupation was collected in the DHS survey for the purposes of comparison.

Rural Women’s Access to Social Services

The problems facing rural women in relation to access to health care, training and education and credit have been described throughout this report. As noted, they are less likely to receive ante-natal and emergency obstetric care than women in urban areas. Infant mortality rates are especially high in western districts. They are also less likely to discuss matters relating to family planning with their husbands than urban women and a low level of knowledge about sexual health in general increases their vulnerability to STIs and HIV/AIDS.

Rural women are likely to have low levels of education and have limited access to secondary schools and tertiary institutions. High levels of illiteracy are prevalent among this group and poverty, cultural biases as well as a lack of transport effectively precludes their attendance at school. Women receive less food than men; they usually eat last and only one meal per day. The highest levels of chronic energy deficiency (CED) has been found among women aged 45-49 years, from poor households, with no education and those from the rural west, rural central and highland regions.

The lack of employment and income-generating activities leaves rural women and especially widows in an extremely vulnerable position. Having no other option to support their families, they can very easily turn to commercial sex activity and seek underage marriages for their female children. Despite continuing efforts by support services and taking into consideration CEDAW General Recommendation No. 19 to ensure that special services are provided to isolated communities, there is less access to emergency medical and counseling services in rural than urban areas for victims of domestic violence, sexual assault and child abuse. Only 11% referrals to the Victim Support Services of JSMP in the period January – June 2006 came from the districts. The high incidence of reported cases of gender-based violence as a whole in Dili district as compared to all districts may also be due to better access to police in urban than rural areas.

As noted in the section on ‘Economic and Social Benefits’, obtaining credit is a problem for women in Timor-Leste; however, it is also a problem for the rural sector generally. It is estimated that half of farmers borrow from traders and a further 14% from relatives and friends. The remainder have no access to any form of credit. At the time of writing, the Ministry of Development and Environment is examining the possibility of introducing co-operative credit unions. Although the NDP explicitly identifies increased women’s participation on rural councils, the reality is that women’s opinions are not sought on matters affecting their communities nor their participation encouraged, despite their playing a vibrant role in community activities. To date, rural women have had little say in the design and implementation of policies and programmes affecting them.

Government Response

Government attempts to address some of the problems outlined above have been described in various sections throughout this report. In its NDP, the Government recognizes the need to improve the quality and quantity of social services in rural areas, with a special focus on the poor, women and other vulnerable groups.

In particular, the Government is attempting to address the needs of rural women in its policies in the agricultural sector; however, at the time of writing, it acknowledges that these are statements of intent and concrete programmes and projects have yet to be developed.

The Government intends that agriculture and livestock programmes will be aimed directly at food security and poverty reduction for all rural households. The proposed programmes will include particular activities that address household labour productivity, food production and nutrition and it is expected that these will have direct benefits for women and children. Attention will also be given to the particular needs and time constraints faced by women and female-headed households.

Under the Food Security Programme, the special needs of women and disadvantaged groups will be mainstreamed, particularly in the attention to food supply, quality and preparation, home gardens and small animals and food wastage and storage. New education programmes in agriculture will be introduced in the Maliana, Natabora and Fuiloro Agriculture Vocational Schools , which will be of benefit to rural women.

The Government is also proposing gender training for the predominately male staff at the Ministry of Agriculture, Forestry and Fisheries to ensure that women are fully engaged in the new food security, service delivery, and commercial agriculture programmes. Techniques such as separate group activities for women, technologies targeted at women’s interests and needs, and extension methods that accommodate low literacy and numeracy levels will be employed. However, it is recognized that, at present, there is few staff to cover many districts and this may be a factor hindering effective implementations of plans.

In the forestry sector, the Government recognizes the need to involve women in traditional resource management processes though at the time of writing, no details of specific programmes can be provided. Further information on individual programmes can be included in the First Periodic Report.

In relation to the fishing sector, women participate in the processing and distribution of catches, although in Timor-Leste the catching sector is male dominated. As the offshore fishing resource is yet to be utilised, there is not yet any on-shore processing as seen in other well established fisheries in other regions. Once processing starts, attention must be paid to providing equal access to male and female employees at all levels. With the advent of community-based management concepts, it is well accepted that gender plays an important role, as some non-canoe based fishing (reef gleaning) is undertaken by female and children in many areas. It is envisaged that the proposed focus on community-based management projects will specifically address gender issues. Again further information on developments in this sector can be provided in the First Periodic Report.

Living Conditions of Rural Women

As already described in the CCD, access to safe water, sanitation, adequate housing and electricity supply is very low in rural areas, which greatly impacts on the lives of women in these areas. Access to roads and communications is another major constraint facing rural women, with disruption to both road systems and communication, particularly in the higher mountain areas, and particularly during seasonal wet periods. Infrequent transportation has a negative impact on productivity; it hinders access to health facilities, schools, markets and information. To date, programmes aimed at improving infrastructure and services have been executed largely with the intent of improving the lives of whole community and have not included a gender-specific component.

Water and Sanitation

Participants at the Regional Women’s Congresses identified clean water and sanitation as a major health and economic issue linked to their social roles as women. Gender-specific research carried out in this area has indicated that although Timorese women have a specific responsibility to collect water and oversee its use in their homes, they are not considered to be knowledgeable on water, nor is their knowledge considered necessary. In some rural areas, women have been excluded from decision-making on issues such as location of tap stands or wells as this was viewed as too technical. Women have reported that they did not know there was a water management group in their community or that they had to pay a water tariff.

Clearly women are spending more time on water supply and sanitation activities thus decreasing time available for income generating activities or their own leisure time. Young girls who collect water early in the morning are often tired when they arrive at school and some do not attend at all.

Women and Land Rights

Legislative Framework

Land and property ownership is a major issue in Timor-Leste due to the large numbers of properties that are currently untitled. A history of land dispossession from Portuguese times through to Indonesian occupation has resulted in a current batch of complicated competing land claims. There are four categories of land claimants which include disputes relating to titles issued under Portuguese and Indonesian rule, long-term occupation and underlying traditional interests.

Furthermore, while a legal framework for land and property ownership in Timor-Leste has been developed by the Directorate of Land and Property (DNTP), which is part of the Ministry of Justice and supported by the USAID-ARD Land Law Programme, many of these draft laws have yet to be promulgated.

Law No. 1/2003 on the ‘Judicial Regime for Real Estate: Ownership’ and the ‘Law and State Property Administration/Leasing on State Property’ are currently in force. However, the Law on ‘Leasing between Private Individuals’ has been passed by the Parliament but has yet to be promulgated. Finally, the laws on ‘Land Dispute Mediation’ and ‘Property System, Transfer, Registration, Pre-Existing Rights and Title Restitution’ have, at the time of writing, yet to be presented before the Council of Ministers.

It is estimated that there are approximately 200,000 land parcels in Timor-Leste, of which one quarter have been formally registered. Most of these were registered in Indonesian times and therefore it is not surprising that of the 10,000 claims made on land since independence, 90% of these have been filed by Indonesian citizens. Very few land and property disputes have been registered with courts in the districts; the majority have been received by Dili District Court constituting just under 30% of all civil cases received by this court. In many of these cases, no final decision has been reached, principally due to the many problems besetting the justice system described elsewhere in this report. To date there has been no analysis conducted on the types of ownership disputes in urban and rural areas being received by the courts. Data on the number of cases filed by women and the results of these cases is unavailable.

The majority of land disputes, which are the most common legal disputes faced by people in Timor-Leste, are settled out of court via mediation. The DNTP assumes a supervisory and administrative role in relation to disputes over public and private property and has special powers under the Law on ‘Judicial Regime for Real Estate Ownership’ to settle these using mediation. The DNTP regularly involves traditional leaders in mediation on disputes over land in the districts. Almost three-quarters of Timorese feel that the adat process is the best way to pursue a remedy if discussions on land issues between disputing parties fail. Working women are amongst the group (wealthier, more educated from urban areas) who are in favour of legal resolution through the courts.

The DNTP also provides training to traditional leaders and the community on mediation. There has been no research carried out to determine whether traditional dispute resolution mechanisms are suitable for resolving the different types of land disputes. It has been noted that traditional leaders have been allocating land in local communities in a certain ‘ de facto’ manner.

Women’s enjoyment of land

The current lack of clarity on land and property issues in Timor-Leste creates obstacles to rural and economic development and especially affects women’s economic prospects. Land is the main asset in Timorese households and without any title to land, farmers are reluctant to make a long-term investment.

This is particularly so for female farmers who have been left with even greater insecurity in access to land. Women farmers, particularly those who have returned to Timor-Leste after 1999 as heads of households have been faced with changes in village boundaries, and the relocation of community hamlets or re-settlements to ancestral lands. They are also mindful of their insecure land ownership and user rights. Although Art. 54 (1) of the Timorese Constitution acknowledges private rights to possession of property for ‘every individual’ and can ‘transfer it during his or her lifetime or on death’, as noted in the CCD, ‘ownership’ of land customarily passes down the male line, with the exception of matrilineal systems.

In a survey carried out by the Timor-Leste Land Law Programme (LLP) in 2004, with respect to inheritance rights of an unmarried woman after her parents die, in matrilineal systems, respondent replied that she will normally inherit the land with male siblings; in patrilineal families, over 30% stated that she will mostly likely inherit some land, but her rights in the land will pass to her brothers if she marries. In some patrilineal families (just under a quarter of all cases) she will not inherit at all, and either must live on land owned by her brothers or her family may decide to give her some land.

Regarding the types of land transactions in which a woman can engage depends again on whether she is from a matrilineal or patrilineal family. In matrilineal families, it was found that a woman can buy, sell or lease urban or suco land; however, by contrast the vast majority of respondents in the survey from patrilineal homes (approximately 80%) indicated that women may not be involved in any land transactions.

There has been little discussion surrounding East Timorese women’s land rights within the current national land debate. Women in the regional CEDAW consultations have emphatically stated that traditional land laws deny them their rights to own land and other resources thereby reinforcing their marginalization in a post-independence economy. This lack of formal recognition of land rights was also raised by delegates at the Regional Women’s Congresses in both 2000 and 2004. The LLP survey found that at least half of all women from both matrilineal and patrilineal lines aspired to a greater access of land-related options than those presently open to them with a higher percentage (60%) of those surveyed from patrilineal families indicating the same.

Art. 15 CEDAW: Equality before the Law and in Civil Matters

Equality before the Law

As noted in the CCD, Art. 17 of the Timorese Constitution states that ‘Women and men shall have the same rights and duties in all areas of family, political, economic, social and cultural life’. Despite this provision, women’s participation in both the traditional and formal justice sectors is limited and often superficial.

As noted earlier in this report, women have little or no knowledge of or access to their basic legal rights or formal legal mechanisms. In customary law, women can exercise little or no real legal capacity. The Survey of Citizen Knowledge on Law and Justice in Timor-Leste carried out by the Asia Foundation in 2003 is one of the primary sources on the use of traditional systems of justice. Unfortunately, although it includes a special section on Women and the Law and included 49 % females in the survey sample, most of the results are not disaggregated by sex. Thus, detailed analysis of differences between women and men in both uses of and attitudes toward traditional justice mechanisms is quite limited. However, the findings of the report do indicate that the majority of Timorese support gender equality within the law, in particular for women to enjoy greater land rights and to speak out in traditional ‘adat’ processes.

The majority of cases in which women come into contact with the formal justice system are cases involving physical and sexual assault and their treatment before the courts has already been outlined in the section on ‘Anti-Discrimination Measures: Gender Based Violence’ (Art. 2). In both the traditional and formal justice mechanisms, decisions handed down tend to reflect the cultural beliefs and biases of the respective justice administrator and society’s views of women as a whole. International standards in relation to women’s rights are not given adequate consideration in local justice proceedings and cases are not resolved in an expedient manner.

This said, however, in March 2006, in the case of attempted rape of a minor, a defendant at Dili District Court was given a sentence of two and a half years, which compares favourably with other sentences handed down for crimes of sexual violence. Both aggravating and mitigating circumstances were taken into consideration by the presiding judge and the case was dealt with in a timely fashion. To an extent, this represents an improvement for women victims seeking justice for gender-based violence offences.

Equality in Civil Matters

At the time of writing, the Timorese Civil Code is being finalized and the content of the Code has not been made public.

In relation to freedom to choose residence, Article 21 of the Indonesian Civil Code, the current applicable law, states that a ‘married woman who is not separated by bed and board, shall not have any residence other than that of her husband.’ She is also obliged to follow him, ‘wherever he deems fit to reside’ and cannot, without his written consent, ‘give away, dispose of, encumber or acquire’ the property in which they are living. In practice, marriage does affect where a woman can live; normally she moves to her husband’s property to live with his family unless she is from a matrilineal line, in which case, she enjoys the right to live on her own family’s property. In the event of divorce or separation, a woman must often return to her family’s home.

Also, as noted throughout this report, women enjoy limited ability to engage in employment, business or other contractual dealings. Under current applicable law, a woman’s personal assets are to be managed by her husband, unless otherwise stipulated. A woman may request, in the course of marriage, for a division of assets if her husband has been acting improperly or mismanaging his affairs.

Under current law, a woman may not appear in court without the assistance of her husband , except for when she is being prosecuted in a criminal case or applying for a divorce or legal separation, or separation of assets.

In the National Development Plan, it is acknowledged that further work needs to be done to ensure the protection of women’s fundamental rights and to address the social and cultural obstacles that favour men’s access to opportunities. At the Regional Women’s Conferences in 2004, emphasis was put on justice and governance as priority areas for women’s empowerment.

Additional Section: Women in the Conflict

Recognising the contribution of Timorese women during periods of occupation and considering the importance of Security Council Resolution 1325 (2000) as a crucial step forward in the achievement of women’s empowerment for peace and security, an additional section on ‘Women in the Conflict’ is included in this Initial State Party Report to CEDAW.

Years of occupation have had a devastating effect on the lives of ordinary Timorese. Although violence had occurred before the invasion of the Indonesian security forces in 1974, investigations by the CAVR covering the subsequent twenty-five year period found evidence of systematic violence, abuse, extra-judicial killings, detention and torture.

Women and men experienced the conflict in different ways. Men were viewed as political opponents, specifically targeted by the Indonesian military and were detained, tortured and killed. Women too, in smaller numbers, suffered gross human rights violations such as the right to life, security of person, a family life, torture and inhumane and degrading treatment; however, they were the principal victims of sexual violence, accounting for two out of every three persons reporting this crime to the CAVR. They were also the sole victims of rape and sexual slavery, the two most frequently reported forms of sexual violence.

The conflict exacted a heavy price on Timorese women, for when male members of their families were injured, killed or disappeared, it was the women who became solely responsible for their families survival and protection, with little means of supporting themselves and became increasingly susceptible to further abuse by others. Violence suffered at the hands of security forces often lead to discrimination and ostracization by their own community who viewed them as ‘fallen’ women.

Reasons for Targeting Women

The results from the CAVR hearings found that women and girls who suffered sexual abuse and other forms of violence at the hands of the Indonesian military were targeted for several reasons, such as direct involvement in the resistance movement, as combatants, members of the OMPT or providers of food and medicine for resistance fighters. A separate group of women were also targeted because of their relationships with resistance fighters or belonged to communities which were suspected of harbouring or sympathizing with the resistance. Women and young girls from this particular group were often detained, tortured and sexually abused. Two notable cases included the burning of the village of Mauchiga , Ainaro District in 1982 by the Indonesian military and the massacre in Kraras in Viqueque in 1983. A further third group of women were targeted as they were simply part of large-scale military operations that singled out civilian populations.

Reproductive Health Abuses

In another example of the gendered experience of the conflict, Timorese women suffered violations of their reproductive rights. As noted earlier in this report, although the Indonesian Family Planning Programme caused widespread fear among the population and prevented women and young girls from attending health clinics and schools, a very small number of these cases were eventually reported to the CAVR. This may be due the fact that the programme was largely unsuccessful in its aims or that those who gave testimony at the CAVR hearings did not realize that their human rights were being violated through this programme.

Six cases of alleged abuses of reproductive health rights were reported to the CAVR, where women were either directly or indirectly forced to use birth control, as were three cases where pregnant women were tortured or subsequently miscarried and two further cases where those individuals holding women in a type of sexual slavery forced them to have an abortion. The CAVR was eventually unable to substantiate allegations of forced sterilization during the conflict.

Women and the Serious Crimes Court

As noted in the CCD, the mandate of Serious Crimes Unit of the Special Court finished in May 2005. Unlike the Special Crimes Panel, it had sole jurisdiction to investigate and prosecute international crimes, rape and murder. At the time of its closure, a number of the arrest warrants were and still remain outstanding. Despite the fact that local women’s NGOs presented information on gender-based crimes to investigators, only a small number of crimes involving sexual violence against women were investigated. This may partially have been due to the fact that some women did not wish to bring t heir cases forward to the Court.

The result of this is that many Timorese women feel that justice in their cases has not been delivered. While there has been some recognition of their role and sacrifice during years of occupation, partially through their testimony at the CAVR hearings, many of the perpetrators of the crimes remain free, outside the jurisdiction of courts.

Women and Reparations Programmes

A number of healing workshops, conducted by the CAVR with the aid of Fokupers, a local women’s NGO, have provided both a safe and supportive environment for women to speak about and heal from their past traumatic experiences as well as to identify important needs. Both men and women participated in these workshops.

By the end of its operations, the CAVR had provided reparations, in the form of cash grants, for 516 men and 196 women. Some of these men and women also benefited from home visits and follow-up care from local NGOs. However, some women had difficulty though in accessing the reparations programme, mainly due to the cultural belief that men already represented families’ experiences of the conflict.

Women’s organizations have called for a wider reparations programme, developed in full consultations with women. The following groups should be included as beneficiaries: women veterans, widows, survivors of sexual violence and torture and single mothers. As noted in the CCD, the Government of Timor-Leste has implemented the RESPECT programme, to fund livelihood and employment activities for vulnerable groups in society such as veterans, widows and young people. However, it is recognised that, in the past, the role of women in the design of reparations programmes has been limited. One of the difficulties of implementing such programmes is reaching out to women survivors. Only a small percentage of women participated in the CAVR’s statement-taking process and ways in which to further engage these women need to be developed.