Learning from Ritual: Covid-19 Public Health Measures and Messaging in Timor-Leste

Abstract

In this paper, I reflect on the significance of ritual activity directed towards COVID-19 in Timor-Leste. What, if anything, it tells us about East Timorese beliefs and attitudes regarding infectious disease and why understanding the cultural dimensions of infectious disease is critical to public health responses. Timor-Leste recorded its first COVID-19 case on March 21st, 2020. Over the course of the following weeks elders held ritual ceremonies across the country to mobilise the ancestors and ask for their assistance to keep COVID-19 at bay. These ceremonies circulated widely on social media within Timor-Leste and among the East Timorese diaspora. In parallel to this initial flourishing of ritual activity the government swiftly enacted legislation to declare a state of emergency, closing international borders and establishing quarantine centres across the country. In many ways the health authorities’ response to COVID-19 has been exemplary, with low case numbers and 0 deaths throughout 2020. However, since February 2021 COVID-19 cases have increased exponentially, exposing social cleavages based on education, language and socio-economic position. With limited resources, the health authorities, and in particular the Centre for Integrated Crisis Management, have focused on prevention, contact tracing and testing, adhering to WHO guidelines and emphasising ‘best practices. Yet, the response has been criticized for being top-down and heavy handed. For example, certain public health measures, such as mandatory testing and burial protocols, have been poorly communicated to the broader community. The use of bio-medical language and introduction of new terms and concepts has been excessively didactic and lacks local contextualization. For the majority of the population of Timor-Leste, especially those living in rural areas, lived experiences of illness and disease are interpreted primarily through and by customary beliefs and practices. The rituals directed towards COVID-19 demonstrate a clear understanding of the nature of infection, contamination, disease, models of causality and fears around infection. They also reveal local capacities to contain epidemics and the ability to learn with the bio-medical response. The levels of participation observed in COVID-19 rituals online and local support for these initiatives expressed on social media suggests at the very least that health authorities should engage with local communities in a two-way dialogue to discuss beliefs and existing prevention strategies that can assist and support public health objectives and measures.