Midwife Francisca Wonga holds a new born child that she helped deliver at Bairo Pite Clinic in Dili, Timor-Leste. (Photo by Michael Coyne)
Joanico Soares married his wife Domingas dos Santos when they both were just 19 years of age. Six years later, the couple already have four children.
They live in a Leotela village in Liquica district, about 40 kilometers west of Dili, the capital of Timor-Leste.
Life has become tough for Soares as he has so many mouths to feed. He said he finds it a constant battle to meet their daily needs and keep them in good health.
"Every day we only eat corn mixed with vegetables, beans and cassava. Rice is a luxury we can't afford every day," he said.
Soares was among hundreds of people who received free groceries prior to Holy Week. It was provided by students of the Institut Superior Cristal, a private university in Dili, in cooperation with Australia's Charles Darwin University and Timor-Leste's Ministry of Social Solidarity.
The family live in a seven-meter by six-meter house that Soares built last year. At present, the zinc-roofed and bamboo-walled home offers basic comfort and shelter and can just about accommodate all six of them.
Genoveva Viviana Ximenes Alves, 64, from Aileu district, got married just before Timor-Leste was invaded by Indonesia in December 1975, sparking a long conflict.
Like thousands of other families, she was forced to hide in the jungle, where she gave birth to her first child. The couple now have eight kids as one got sick and died in 2016.
She said that back then there was no such thing as family planning centers, so couples considered it normal to raise large famlies.
"Raising many children is a tough job for a mother. It requires patience and endurance from the time of pregnancy, through delivery and then as they grow up," said Alves, whose husband died soon after Timor-Leste gained its independence in 2002, making it the first new sovereign state of the 21st century.
"Even after the children have grown up, the mother is still responsible for their moral and spiritual growth," said Alves.
Joana Carvalho, a lay woman from Dili Diocese, explains about the Billings Ovulation Method on March 27. (Photo by Thomas Ora/ucanews.com)
Birth rate and poverty
Since becoming independent, the country has conducted a population census three times.
These charted population growth from 927,000 people in 2004 to 1.1 million in 2010 and 1.2 million in 2015, when males slightly outnumbered females.
About 349,000 people live in cities, while about 834,000 live in rural areas.
However, Elias dos Santos Ferreira, the country's director general of statistics, said the fertility rate decreased from 7.8 births per woman in 2003 to 5.7 in 2009 and 4.2 in 2016.
"This shows that the programs of the Ministry of Health in collaboration with civil society and the church have been very positive," Ferreira said.
"More people are aware of the impact of having too many children nowadays, not only the well educated but the general population including farmers," he said.
The statistics agency has also conducted a study of poverty on three occasions.
In 2001, about 36 percent of the population was classified as living on or below the poverty line. That jumped to 49.9 percent in 2007 but receded in 2014 to 41.8 percent.
According to Perreira, the high poverty rate in 2007 was a result of the political crisis in 2006 sparked by military infighting that led to an attempted coup and breakouts of violence nationwide.
The study was based on individual consumption of calories, the general condition of people's houses, access to basic utilities like potable water and electricity, and ownership of consumables like cars and televisions.
Gender challenges are inherent in Timor-Leste due to its male-dominated, patriarchal culture, especially at important decision-making levels.
After wedlock, a wife must obey her husband and provide him with as many children as she is able to.
Martinha da Silva, director of the Feto Hadomi Familia Foundation, a non-profit group that trains women in agricultural skills, said many men still believe that more children means more income for families.
"It's sad to see what the women are going through. After they give birth, they must be prepared to get pregnant again. It definitely impacts the health of the mother," Da Silva said.
She said when her group informs them of the risks associated with having too many children, they often respond by saying children are a blessing from God.
However, many fail to consider the economic challenges and pressure involved in having to provide for their offspring, which can degenerate into bouts of domestic violence and cause widespread malnutrition, she said.
"Husbands can end up beating their wives. The kids drop out of school because they have to help their parents sustain their family," Da Silva said.
She believes women must be trained not to be dependent on their husbands. Her organization, Feto Hamodi Familia, was founded in April 2007 with a mission to educate women about how they can use their backyards to grow vegetables. It even provides them with the seeds.
Elias dos Santos Ferreira, Timor-Leste's director general of statistics, said the decreasing birth rate shows that the government programs and the church's efforts are having a positive impact. (Photo by Thomas Ora/ucanews.com)
The women are also trained how to process agricultural products into modern foods. For instance, cassava can be turned into chips to sell at markets.
"These programs aim to help women by teaching them about family planning, health and the economy," Da Silva said.
Joao Pinto Soares, head of the health department under the Timor-Leste Red Cross, said most people living in rural areas don't have much awareness of these things. It's not uncommon to see families with seven to 12 children.
The Red Cross is continually working to change people's way of thinking from the traditional mindset that "many children mean many blessings." Since 2016, the Red Cross has been cooperating with Marie Stopes International Timor Leste, which specializes in sexual and reproductive healthcare, to educate woman about maternal health and how they can improve their income.
"We don't put any set limit on the number of children they should have, but parents must work out a future plan so they can take care of their kids," she said.
The Billings' method
The church operates on a similar basis. It avoids recommending a cap on the number of children but has a moral imperative to educate families.
It favors a natural method of family planning known as the Billings Ovulation Method.
This focuses on patterns in a woman's fertility cycle and recommends when to have and when to avoid sexual intercourse based on things like a woman's hormone levels or menstrual bleeding.
It was named after Dr. John Billings, a neurologist, and his wife, Dr. Evelyn Livingston Billings, a pediatrician. The two Australians passed away several years ago.
Divine Word Father Jose Tacain, who heads the Commission on Family in Dili Diocese, said the Timor-Leste Church encourages this method because it does not have any negative impact on couples.
For many years, during Timor-Leste's occupation by Indonesia, families were forced to use contraceptives such as condoms and anti-pregnancy pills to keep the population growth in check.
"Many mothers got cancer and died," Father Tacain said.
Joana Carvalho, who works with her husband coaching couples about natural family planning, said since 2011 they have promoted the Billings Ovulation Method in 30 parishes throughout Dili Diocese.
"We are now counseling many married couples in the dioceses of Baucau and Maliana," Carvalho said.
Meanwhile Father Ludgerio Martins da Silva, who coordinates the natural family planning team in Timor-Leste, said the government has recognized the church's work in organizing natural family planning campaigns nationwide.
"We are also entrusted to train doctors, midwives and other nurses on family planning using natural methods," he said. Thousands of couples have benefited from this already, he added.