Preventing the Spread of COVID-19 in Timor-Leste through Peer Education

“When I first heard about COVID-19, I was told that it kills people and I didn’t know that people could recover. I was afraid and didn’t want to leave my home. My family was also very scared. Other young people were also afraid and sometimes when I went to meet them they said, ‘don’t get close to us’ because they knew I had just come from Dili and they thought maybe I had COVID.”

During the COVID-19 state of emergency in Timor-Leste, Sarah left the capital, Dili, to return to her family in Covalima, where she had lived until the age of 20. She had moved to Dili in early 2020 to begin her studies as a medical student at the National University.

Sarah heard about COVID-19 from others in her community, but didn’t know where to get information she could trust. She didn’t do any research about COVID-19 on the internet because she didn’t think she would find accurate information and she didn’t want to go to the community health center. “I was scared to go near the hospital or the community health Center to get information because I thought I would be at the greatest risk of catching COVID-19 in those places.”

Sarah finally received reliable information about COVID-19 after she was invited to become a COVID-19 educator with the youth organization JDN. JDN youth facilitators had run adolescent reproductive health workshops at Sarah’s school in Covalima the previous year with support from our USAID Reinforce Basic Health Services project.

Sarah was thrilled when she was asked to join the JDN COVID-19 education team. “I wanted to learn more about COVID-19 and gain new experience and skills. When I talked to my mother about this project, she encouraged me to join because she said it would be good for my development and would help me gain new skills.”

JDN members quickly had realized that there was a lot of confusion and fear about COVID-19 in the community. They were concerned that so many young people did not have the information they needed. They were aware that a lack of information was leading to unnecessary fear and stigmatization among young people ages 15-24, who make up 20 percent of Timor-Leste’s population.

Early in the COVID-19 state of emergency, USAID’s Reinforce Basic Health Services project again supported JDN to train youth educators – this time about COVID-19 symptoms, transmission, and prevention and how to share this information with other young people, families, and neighbors. JDN trained five team leaders, some of whom had been adolescent reproductive health facilitators. The team leaders then recruited four teams of four youth educators: one team worked in Covalima and three in Dili. One team leader researched and posted COVID-19 messages on JDN’s Facebook page.

JDN trained the team leaders on how to conduct pre- and post-tests, how to develop fact sheets to address the misconceptions identified in the pre-test, how to research COVID-19 facts, and how to share this information with others in the community. JDN educators made sure that COVID-19 preventive measures were followed during the small group trainings and workshops as a way of demonstrating how to put them into practice.

A major strength of the approach was that the JDN youth team leaders had full responsibility for training their teams to work in their local communities. Over a period of two months, the team leaders worked to ensure their teams knew the main facts about COVID-19 and understood the importance of sharing accurate information with others through informal channels and workshops.

The youth educators began by conducting a pre-test with 166 young people ages 14-24 to learn about their knowledge of COVID-19 and understand possible discriminatory attitudes.

The results of the pre-test identified the considerable effort that would be required to educate their peers:

• 81 percent of respondents thought COVID-19 is a disease by which everyone dies
• 40 percent thought that only people traveling abroad could get COVID-19
• 59 percent thought that they had to avoid people who have recovered from COVID-19 to remain safe
• Almost 30 percent of respondents did not know the main symptoms of COVID-19 and more than 70 percent stated wrong symptoms
• Most respondents could say that physical distance would keep them safe from COVID-19 but very few could explain the reasons why this distance is important.

JDN youth educators facilitated three workshops in Covalima and three in Dili. Facilitating was a new experience for Sarah, who said, “When I started training as a COVID-19 youth educator, I felt nervous. But…I started to feel more confident [after] I talked to the team leaders and read all the information to learn the truth about COVID-19. Because I was responsible for educating other young people, I felt it was very important to know more about COVID-19,” said Sarah.

Workshop post-test results indicate considerable shifts in knowledge, attitudes, and practices around COVID-19. Many participants expressed similar views as Sarah, who said, “After I learned about COVID-19, I realized it was very important to practice the prevention steps. I increased the number of times I washed my hands and when I went out I used a mask to protect myself and I did physical distancing.”

Sarah said she feels enthusiastic about doing more peer education with JDN. She wants to continue to use the knowledge and skills she gained from the adolescent reproductive health workshops and as a COVID-19 youth educator.

“Because I have a lot of knowledge now and new skills, like public speaking and leadership, I feel confident. I have the courage and motivation to show other people how we can prevent COVID-19.”