Inda at Eaglehawk Rotary

Supporting sustainability – Dr Inda in Oz

There’s an old proverb that says, “.” How true that statement is!  It is one of the foundations upon which all aid programs (and the TLDP) are based, and it’s all about sustainability and self-sufficiency. The TLDP’s overarching aim is to work with the Timorese people to improve their own systems so that one day, they will no longer need us. To achieve this  requires investment in the skills of local people.

Hence, on May 1, with the help of the Australian Dental Association, the Bendigo Maubisse Friendship Committee, Eaglehawk Rotary Club and La Trobe University, the Timor-Leste Dental Program brought Dr Inda Zulmira Dias over to Australia for some much needed continuing professional development (CPD).

Dr Inda is one of the Timorese Dental clinicians whom the TLDP mentors. She is a Phillipines-trained dentist who  works in Maubisse Hospital, supported by two dental therapists and 2 dental nurses. She has had no further formal CPD since she graduated in 2015 (Australian dentists need 60 hours over 3 years to retain their dental registration), so this was badly needed, especially in a country with only 5 functioning dentists!

Accompanied by Dr Blanche Tsetong over 8 days, Dr Inda attended the ADA Congress – the biggest dental conference in Australia – and spent 3 days at La Trobe University in Bendigo attending practical sessions and lectures, as well as discussing possible ways in which La Trobe could support her team in the future. There were also meetings with Eaglehawk Rotary to discuss the improvement of the layout of Maubisse’s dental surgery. The schedule was hectic, but the irrepressible, enthusiastic Inda took it all in her stride!

The TLDP extends our deepest thanks to the many organisations that helped make this happen!!!

 

 

 

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New Wheels for Nico

Big things happening this year!! The TLDP has purchased our first motorbike, a Yamaha XTZ. This will be for Nico to use while he works for us. Nico was previously using his scooter to get to work and around the Liquiça district. Scooters are more commonly used in TL because they are less expensive to buy; however they are not very hardy and although they work well on the streets of Dili, they soon come to grief on the rough roads outside the capital. We are very happy that Nico will be on a more reliable vehicle, and Nico is super-happy because he has a new toy!

Welcome to the team Ana Tilman!

We have had an auspicious start to 2019. Just this week, we have hired a new staff member, Miss Ana de Jesus Barreto Tilman. Ana is a qualified Timorese dental therapist, a University of Dili (UNDIL) graduate. She will be working in the Maubara clinic and in our School dental program with Nico, our full-time dental therapist. She will be assisting with treatment, infection control, sterilisation and record-keeping – tasks that are very hard to do well when working by oneself. Ana Tilman also works for the Kose Nehan toothbrushing program in Aileu, so we are very lucky to have her onboard in her downtime. A warm welcome to the TLDP team, Ana!

UNITY IN DIVERSITY

Our volunteering year is now ended with Team 5 returning a couple of weeks ago from TL. It has been a very busy year, and so we are quite happy to be able to draw a quick breath or two before we start to prepare for the year ahead. (Pic: Isa, Nico, Tino, Bony, David and Ana Paula)

Team 5 was led by Dr David Sheen, one of this program’s founders, and an excellent dentist, teacher and mentor. David has decided that this will be his last clinical trip, so we imagine that this trip tasted bittersweet. David will be sorely missed. He is a gracious, good-humoured and considerate person and a skilled team leader. However, there is no rest for the wicked – David will continue to be involved in the TLDP management committee, and he has taken on the responsibility for getting a Timorese person into and through a dental degree! We haven’t seen the last of him yet!

The remainder of the Australian contingent of Team 5 consisted of returnee, Dr Geoff Knight (Week 1), and newcomers, John Darby (Week 1 and2) and Gaye Dumont (Week 2).

We are proud to say that the Timorese portion of Team 5 was considerably larger than the Australian part, something that is now typical of all our teams, and an ideal that we have been steadily working towards over the past 15 years. We believe that a program is only sustainable if it has local ownership and it can only be locally-owned if there is a preponderance of local participation. The timorese contingent consisted of TLDP dental therapist, Nicolau Tolentino Faria Pires (Nico), TLDP dental assistant and translator, Ana Paula Dos Santos Tavares Salgado, Ministry of Health (MoH) dental therapist, Diamantino Correia Morais (Tino), translator, Bonifacio Cardoso Martins (Bony), translator and organiser, Isabel Noronha Pereira De Lima Maia (Isa), MoH dentist, Dr Inda Zulmira Dias, MoH dental therapists, Armando Da Costa Martins and Ricardo Mendonça, and Carmelite sister, Sr Delfina Soares. With the exception of Sr Delfina, all the Timorese in this team have worked with the TLDP for many years.

The lucky team spent the first week in Oecusse, an East Timorese enclave within West Timor, Indonesia. They were lucky not only because Oecusse is a beautiful area with coral reefs off the beach, but also because they got to spend time with our beloved Sr Filomena da Costa, our old Timorese program coordinator who was uprooted from Maubara to take over the new Oecusse Carmelite community. (Pic: Sr Carmelita, Sr Filomena and Ana Paula)

This team journeyed by ferry, a quite expensive and time-consuming exercise involving putting the 2 packed vehicles on the ferry in the morning, waiting around Dili all day, then boarding at 5pm, before finally arriving at 5am the next morning. Luckily, the team scored the only 2 cabins onboard and were able to sleep! Thanks to Isa for booking the tickets in advance! (Pic: Dedicated Nico and Tino)

The team worked for 3 ½ days within the Carmelite Health Centre, São Domico Clinic, mostly treating the children from the neighbouring high school and the local community. Sr Filomena, Bony and Nico did all the oral health education and screening of the school kids. After that, the team broke up into two teams, each comprising a Timorese clinician with a mentor; Geoff teamed with Tino and Ana Paula to do all the fillings and preventive treatments, while David and Nico did all the extractions. John Darby, a dental prosthetist in Oz, became the team’s super-efficient sterilising nurse and infection control manager. It was a very busy few days! It was a real treat for the team to be able to spend time with Sr Filomena, who is also one of the founders of our program and a delightful lady with a loving and ebullient nature. (Pic: Geoff, Sr Carmelita and Tino)

Another 12-hour boat ride and the team returned to Dili on the Saturday for restocking and team changeover. The team farewelled Tino, Bony and Geoff and welcomed Gaye and Sr Delfina into the fold. Sr Delfina is keen to study dentistry and the TLDP has agreed to support her studies if she gets into a training program. In a meeting with the Carmelite head honchos on the weekend, David suggested that Sr Delfina gain some work experience, so she also joined Team 5 for round 2! Off to the hills of Maubisse! (Pic: John and Gaye atop the Christo Rei)

The trip to Maubisse takes 4-5 hours from Dili. The team was scheduled to work in one of its more remote regions, Manetu, for the next couple of days. The team arrived in the early afternoon in Maubisse town and collected Dr Inda, so they decided to push onto the Manetu-Lebululi Health Centre to set up for the next day. Unfortunately, they travelled via a suggested ‘short cut’, which turned out to be an extremely bad road, and when they finally arrived, the health centre was locked up with no one around, leaving the team to do a u-turn and head back to Maubisse. At least the return trip was on the longer, but much better, road and so the return journey only took 1 ½ hours! (Pic: Gaye and the Maubara sisters)

Manetu is a very poor area, which suffers from severe water shortages when the rain doesn’t come on time. As a result, the villagers have difficulties with personal and home hygiene, and the team saw many people with scabies and badly infected mouths. This is the first time the TLDP has travelled to this village (this was an agreement drawn up in April this year in a meeting with the local chiefs) and the first time this village has had any dental care at all, so it was unsurprising that most of the treatment was extractions. Dr Inda manned 2 extraction chairs all by herself, and David mentored Nico doing restorations.

The last couple of days were spent in the Horaiki High School, which had already been screened and given oral health education by the Maubisse Hospital team (Dr Inda, Armando and Ricardo). Team 5 was assisting the hospital team to follow up with treatment. David and Inda mentored the two Maubisse dental therapists, Armando and Ricardo, while Nico gave additional toothbrushing instruction in the classrooms. In both locations, Gaye, John and Ana Paula kept the team going. Support staff are essential for maintaining good infection control in TL! (Pic: Dr Inda and Ana Paula doing the admin)

Team 5 had brought over our new 34kg suction unit. It worked brilliantly, which meant happy clinicians and happy patients. Lucky for them, there were no equipment breakdowns. NONE! That must be a record! The team also got to spend time with 3 different sets of Carmelites – Sr Filomena, Sr Carmelita and Co. in Oecusse, Sr Joaninha, Sr Lindalva and Co. in Maubara, and Sr Domingas, Sr Rosa, Sr Eva, Sr Veronica and Sr Zeza in Maubisse. That’s a lot of cheeriness and good food right there! (Pic: the Maubisse Sisters)Overall the team saw 443 patients, carried out 318 check-ups, took out 460 teeth, placed 218 fillings and did 42 preventive treatments. Well done Team 5!

Thank you to everyone who continues to support our program! From our donors, to our team members in Darwin who collect supplies and bring them to the airport for the teams, to our biggest materials donors – Henry Schein Halas and SDI – and the Rotary Liaison Team in Dili who do so much running around for us, we are in your debt. Thank you for your generosity. We could not do this without you.

THE SWEETNESS OF ADAPTABILITY

Team 4 was plagued by problems before they had even left Australian shores. Team numbers fluctuated wildly with each loss and gain of dentists and dental assistants, wrong flight bookings were made, translators got other last-minute jobs, supplies went astray or disappeared into thin air!  But the team pulled it together and they did a great job. The team’s core comprised team leader, Dr Peter Shakes, Timorese dental therapist, Nico Pires and Timorese dental assistant and translator, Ana Paula DST Salgado. They were  joined by Dr Andrew Frame and Dr Ashley Freeman during week 1, and Dr Mary Tuituinnik (her 2nd time this year – thank you Mary!) for week 2.

The team spent the first week in Atsabe, a town a few slow/bad/nervous-road hours beyond Letefoho. This was the first dental team to visit this town and as Nico’s travel experience ended a couple of villages short of Atsabe, the last bit of navigation to the town was a little tricky.  They got there by the end of Day 1 and were put up in the grand, but dilapidated house of Father Arnauldo, the Parish Priest. (Pic: Nico giving toothbrushing instruction to the school kids in Atsabe.)

The team treated the community and school kids for 4 1/2 days, however, trouble with the suction unit meant that filling options were limited during this trip. The suction unit limped along for 2 days before packing up all together – the absence of this vital piece of equipment would have tested the patience of a saint – it makes everything harder in an environment where providing quality treatment is already difficult. Nevertheless, the team was on fire. Ashley quietly plugged away at the work, Andrew wowed the locals with his beautiful fillings, Nico served up dental hygiene instructions to the masses and Ana Paula simultaneously assisted 4 clinicians, AND translated for the entire team. The team loved this week  and this new location (they have put dibs on it for next year!). They all agree that despite the cold shower water and the warm beer (no refrigeration here), the hospitality, pleasant climate, and the stunning views from their workplace have pushed Atsabe into their No. 1 spot in TL. (Pic: the stunning views from the ‘clinic’)

Changeover weekend. Andrew and Ashley headed off. Ana Paula and Nico headed home for the weekend. Mary arrived. Peter and Mary paid a visit to Fatuhada, the Carmelite HQ in Dili, where they were delighted to run into Sr Filomena, our long-time coordinator and great friend, who is now running things up in Oecusse. Mary was also able to catch up with Sr Delfina, who the TLDP hopes to sponsor if she manages to get into a dental training program. Peter spent Sunday running around changing over gas bottles – he learned the hard way that there is not a Swap-n-Go at every gas station like at home. LPG gas is only sold at very specific locations in Dili….and not always. Like many things in TL, everything is just a little harder to get done. (Pic: The team in Atsabe with Father Arnauldo and his team)

Week 2 the team was back to the grindstone. The driver we had hired for the second car failed to show up – he got a better paying job – so Sr Joaninha, head of the clinic in Maubara, stepped into the breach. Despite only having learnt to drive earlier this year, she made short work of the difficult 90 min drive to Lebutelo, and she made an excellent scrub nurse as well! (Pic below: Ana Paula, Sr Joaninha, Nico and little Marco at Maubara Clinic)

Thankfully, another driver was found for the rest of the week, as the team made several trips up and down the treacherous coast road to the west of Maubara. Despite being sealed, the road has several sudden, unmarked and unexpected drops, as well as large washouts leading to the cliff.  The many broken barriers (separating the road from the sheer drop down into the ocean) are silent reminders that this road is not for the unwary or the foolhardy.

The team spent Day 2 in Caicasa School, which Peter’s team had visited a year ago. At the time the school had funding for a feeding program, and the team was impressed by the children’s general and dental health. The feeding program managed to feed 194 kids for only USD 50 per day; unfortunately the funding ran out April this year.

They  also visited Faulara; the road to this village is terrible – the last hour was spent entirely in 1st gear. The team was disappointed as there was a lower-than-expected attendance to the clinic, as it coincided with the official opening of a new police station, with speeches and free food. The team ‘only ‘ saw 180 people that day (these are high achievers). The last 2 days were spent at Loes Junior school and Paurobo Primary School. The team was very busy indeed! They worked in 5 different locations that week, which means 5 times of unloading, setting up, breaking down, and reloading over 300kg of equipment. That’s a lot of heavy lifting! Mary, Peter and Nico worked seamlessly together, like a machine well-oiled by Ana Paula’s presence – for the second week in a row, she performed all clinical assistance, translating, and sterilising duties!

The team treated a total of 1154 people over the 2 weeks. They extracted 557 teeth, restored 82 teeth, cleaned 11 sets of feet and did 15 preventive treatments, despite having almost no suction and only one dental assistant between all the dentists. Adaptability! That’s what we like! Well done team!!!

(Pic: the everlasting enthusiasm of the kids)

The Old Switcheroo

It’s coming to the end of our volunteering year. Phew! Team 4 arrived back safely 2 weeks ago, but  we have been super-busy trying to address some of their problems, as well as sort out some tricky logistics for Team 5; so we have yet to update our friends and supporters on what Team 4 got up to! Sorry for the delay – the team leader’s report was just posted last night – we will update you as soon as possible.

Meanwhile, our last team for the year, headed by Dr David Sheen, arrives in TL tomorrow. Accompanying David, is long-time volunteer, Dr Geoff Knight, and Sydney prosthetist, Dr John Darby. Team 5 is working in the Oecusse and Maubisse areas. Oecusse is an East Timorese enclave within West Timor (Indonesia). It is Timor Leste’s East Berlin – difficult to get to, significantly poorer,  and with less services than the rest of TL. With equipment and vehicles, one gets there via road or via sea. The road option takes a several hours visit  to the Indonesian embassy, a whole day drive through 60km of West Timor, stopping at  multiple military checkpoints, and multiple ‘extra’ payments. It was a total pain the last time we chose the road. So, this time, the team is trying to get their by boat; however, the last time a team took the sea-option, our vehicle almost went for a swim. So…Good Luck Team 5!

Farewell Team 4

Team 4 will farewell Australian shores next Saturday. Team Leader, Dr Peter Shakes will be joined by Dr Ashley Freeman and Dr Andrew Frame in the first week, who will then be replaced by the redoubtable Dr Mary Tuituinnik in Week 2.  The Timorese team members include Nico Pires, TLDP’s hard-working dental therapist and new Dad, and  Ana Paula Dos Santos Tavares Salgado, the team’s translator and dental assistant. Team 4 has already been plagued by misdirected supplies, team members dropping out, and confusion with scheduling;. Hopefully, all the wrinkles have been ironed out now and this team will have some smooth sailing once they get to TL. They are heading to Atsabe and Maubara. Good luck and have fun Team!