Stunting: A Country's Lasting Burden: An Interview with Jessica Fanzo

Journal of International Affairs, Spring-Summer 2014 | Go to article overview

Stunting: A Country's Lasting Burden: An Interview with Jessica Fanzo


Stunting, or low height for age, currently affects more than 165 million children worldwide. It is caused by long-term insufficient nutrient intake and frequent infections before age two with effects--delayed motor development, impaired cognitive function, and poor school performance--that are largely irreversible. Timor-Leste has the third highest stunting rate in the world--around 58 percent for children under five. Jessica Fanzo, director of nutrition policy at Columbia University's Center on Globalization and Sustainable Development, is working with the Timorese Ministry of Agriculture to integrate nutrition into the country's food security efforts. She spoke with the Journal about what nutrition-sensitive agriculture entails, and the progress made in Timor-Leste.

Journal of International Affairs: In Timor-Leste, around 60 percent of children under the age of five are chronically malnourished, and almost 39 percent suffer from anemia. You are working with a program called Seeds of Life embedded within the Ministry of Agriculture to improve food security through increased productivity of food crops. Can you tell us a bit more about this project, and how you got involved?

Jessica Fanzo: I was originally asked to work with Seeds of Life to develop a nutrition-sensitive agriculture strategy, which was shared with the Ministry of Agriculture. Timor-Leste has a long history of conflict. They were colonized by Portugal and almost immediately after the Portuguese left, Indonesian forces invaded the country. Many atrocities were committed against the Timorese, including deliberate starvation. The UN called for withdrawal, but on their way out, the Indonesian forces decimated the infrastructure of the country. UN and Australian peacekeeping forces remained in the country for nearly ten years and left in December 2012. Timor-Leste is an interesting case because it has only recently become independent. Despite being considered a middle-income country with about $11 billion worth of oil off the Timor Sea, it has dismal health and nutrition indicators, with one of the highest burdens of undernutrition in the world. They are a population of approximately one million people, and 60 percent of children are chronically undernourished or stunted. They are not simply short for their age, but are also cognitively impaired, and this can become a multigenerational issue that could take a long time to mitigate. Stunting is like a photograph of a country's history. When you have been neglecting a country for so long, it shows on the body of a child. With the help of Seeds of Life, Timor-Leste hoped to improve their agriculture outputs and increase food production. They grow mainly staple crops like rice and cassava, so the goal when I arrived was to improve the nutritional aspects of their agriculture program by integrating nutrition into their agriculture approaches, and advocate for more investments in nutrition-sensitive agriculture interventions.

Journal: What are some of the challenges of working with the government and tiying to influence the government?

Fanzo: It is really hard to convince the Ministry of Agriculture to think about agriculture from a nutrition perspective, because they are really thinking about increasing productivity for income generation. It is interesting to discuss the data on undernutrition with ministers or other Timorese in the country. Sharing and discussing the stunting data, where more than half of children are chronically undernourished, is difficult to swallow because of the insinuation that they are less smart. Many in the country respond to those figures by saying, "We are a wealthy country. These numbers are not real. The Timorese are naturally short." Data is very political, and trying to communicate it in an effective way is very challenging. Not everyone trusts numbers, so it is important to communicate these data in a gentle and rational way.

Journal: Among the policies that you suggested to the government, was any of those implemented? …

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