The Permanence of Change

The very last team to Timor Leste for 2017 has returned from what the team leader, Dr David Sheen, describes as “the most exhausting trip I’ve ever had”. No surprise there – not only did Team 5 consist of 2 completely separate teams, who did a tag-team swap at the airport midway through the fortnight, but as the TLDP’s last team for the year, they had a lengthy list of objectives, including touching base with the Carmelite leadership, the now-standard meeting with the Ministry of Health and getting things at Maubara base squared away for the end of the year. (Main Pic: Beautiful Sr Filomena, Dr David Sheen, Dr Ashley Freeman, Nico Tolentino Pires)

Week 1’s team consisted of Dr David Sheen (team leader), Ms Liz Thompson, and newcomers Dr Andrew Frame, and Dr Phil Hill. In a culmination of much collaboration between the TLDP and the Bendigo Maubisse Friendship Association, Phil joined Team 5 as the dental representative for the BMFA. So along, with our usual aims of providing treatment to the local people, and mentoring Timorese dental clinicians (in Maubisse, this is Dr Inda Zulmira Dias, Mr Ricardo Mendonça and Mr Armando Da Costa Martins), Phil was there to check out how we organise our outreach clinics, to meet the hospital director and the Maubisse oral health team, and to figure out how the BMFA will contribute to augmenting Maubisse’s oral health services.

Screen Shot 2017-10-29 at 2.37.00 pm.pngThe team arrived in TL, did the necessary shopping and headed out to Maubara to sort out the gear in torrential rain – this is the reason why our volunteering year runs from April to October. They spent one night in Maubara with our beautiful Sr Filomena, who dropped a bombshell on the team (and our program) – the Carmelite leadership was moving her to Oe-cusse in 5 days time. In one fall swoop, the program has lost its Timorese Program Coordinator, master chef, spiritual adviser, chief entertainer, and good friend. Spending time with this wonderful woman has been one of the great attractions to volunteering with the TLDP and we will deeply mourn her absence. We are immensely grateful for the privilege of 15 years of friendship, company and guidance. Nevertheless, even though getting to Oe-cusse is a chore, I am sure that many of will be beating a path to her door, with or without the TLDP.

So – what will the TLDP do without Sr Filomena? Well, it’s a good thing that we employed Nico this year – with the help of Sr Joaninha and the redoubtable Bony, this hardworking dental therapist is to take up the reins of the program coordinator. We are sure he will have it shipshape in no time!

Before leaving for Maubisse, the team had to replace a part in one of the portable dental chairs – this part was essentially a fancy screw, which has to be specially ordered – this was done by Team 3 on their return, so has taken 2 months to get to us!! A couple of stops in Dili for supplies, a meeting with the Minister of Health, and a 3 hour trip up the mountain was in order before the team finally arrived in Maubisse for their meeting with Dr Inda and Dr Pereira. (Pic: Phil Hill, Liz Thompson, Andrew Frame, Dr Gabriela, David Sheen, Dr Inda and Carlota)

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Screen Shot 2017-10-29 at 2.20.50 pm.pngThe first 2 days were spent treating children at the Maubisse Primary School. Dr Inda had already screened the entire school, so that distilled the team’s list down to those children that required treatment. Andrew and Nico, and Phil and Inda were paired up for mentoring, while Liz was in charge of infection control and David performed the hell-for-leather dentist role. Andrew soon discovered that Nico was extremely competent at extracting teeth, and so set about expanding Nico’s filling techniques. Inda and Phil got along like a house on fire – Inda is an excellent clinician, but is a young dentist, and so she will benefit from having a long-term mentor. (Pics: Above: Phil and Inda. Below: Andrew gives Nico a thumbs up)

Screen Shot 2017-10-29 at 2.02.03 pm The final 2 days were spent in Turiscai, about 1 1/2 hours from Maubisse, where the team worked in the Health Centre. Nico continued to wow everyone with his rapid setting up of the clinic – He has done it with 5 teams now….I’d say he’s an expert at it.
There were only a couple of hiccups in the Maubisse visit- Firstly, the team was unable to stay with the Sisters for the first 2 days (we had been beaten to the post by a nursing team!), and had to cope with mosquito-ridden, smelly, dirty accommodation. Luckily, this horrible experience was offset somewhat by the Guesthouse in Turiscai, which also had good food! Secondly, Inda had brought along a couple of Timorese non-practising dental technicians,Mel and Ota, who work as nurse’s aides at the Sisters’ Clinic in Maubisse. David put them to record-keeping, only to discover – much, much, much later – that they had no idea that there were differences between fillings and fissure sealants. You know that they say about assumptions….Screen Shot 2017-10-29 at 2.30.38 pm.png

A night in Dili was followed by the team changeover. Team 5 Mark 2 – Dr Geoff Knight, Dr Ashley Freeman and Dr Christine Underhill joined David (Geoff minus is bag, which had decided that it would rather go to Bali instead) from the morning flight and after a visit to Toyota to address car problems and more supply pick ups in Dili, they headed to Black Rock (Team 2’s pied-a-terre) at Cameo Beach for the night. (Pic: Liz- sterliser-in-chief)

Sunday was a day of a much needed pause to take stock. Geoff headed to Dili for his bag which didn’t arrive. Isabel Noronha Pereira de Lima Maia arrived. She is Bony’s cousin and was joining the team as translator for the week. Otherwise the only event was Sister Filomena’s “Last Supper”. We will miss that woman!

The five days in Maubara were spent in Maubara clinic, Liquiça High School (30 min, good road from Maubara, east), Vatunao Primary School (15 min, good road, east) and Fila Delfia High School in Lisadila (2 hours, very bad road, west, several river crossings). The 4 locations highlighted the continuing issue of electricity in TL. Maubara and Liquiça are connected to electricity, but supply is often unreliable. The team had to use a generator in all locations except for Maubara. Liquiça’s electricity was only on for half the day; Vatunao, between Maubara and Liquiça wasn’t connected; Fila Delfia had solar power.

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(Pic: Geoff gives Nico some theory) The team powered through the work. Isabel was an excellent interpreter (rivalling Bony!). In the last couple of days, she was joined by Ana Paula dos Santos Tavares Salgado, whom the TLDP and the Hatubulico Friendship group helped to study dental prosthetics in Brisbane. She is currently working in the Balibo Dental Clinic. Geoff, a natural teacher, took on the mentoring of Nico, while Ashley and David plugged through the patients. Christine, who is an orthodontist, and was actually in Timor to join a cleft palate team the following week, helped the team with infection control and sterilisation – it must have been a breathe of fresh air for her!

Screen Shot 2017-10-29 at 2.33.51 pm.pngIt was a hectic 2 weeks – for the team leader, with so many balls in the air. The only real problems that plagued the team were run-of-the-mill for TL – the issues with the Sisters’ car, Geoff’s missing luggage (and supplies!) which did surface eventually, and the malfunctioning of Generator 2. (Pic: Geoff and Christine with teachers in Liquiça)

Team 5 together treated 805 patients, extracted 615 teeth, restored more than 305 teeth and did more than 18 preventive treatments ( the last two are underreported due to the screwy record keeping in Maubisse). A brilliant effort by the team. Add to that the meetings with the Carmelite leadership, the Maubisse Hospital leadership, the Maubara Clinic leadership and the Ministry of Health – well done David!

We are fortunate to have so many people to help us out behind the scenes. Mario and Judite from the Rotary Liaison Office in Dili have taken up the reins after our mate, Daryl left last year and they have been doing a great job. They deliver and pick up our car from the airport, liaise with customs for us, sort out car registrations and servicing and do a thousand necessary admin tasks that keep us going. Bony, who worked as an interpreter with us last year, continues to function as out ‘fixer’. He helps us out with interpretation, liaises with the Ministry of Health for us, sorting out the documentation and filling out forms, acts as a messenger between us and the sisters, who often don’t respond to calls or texts, and with Nico, who’s English is uncertain at the moment, and books ferry places and accomodation. These three people are invaluable. We are so grateful to have them!

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