All posts by tsetongb

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)

Advertisements

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!

Working the dream

The TLDP is pulling out all the stops this year. Team 3 returned just over a week ago after another extremely busy and productive 2 weeks. Team Leader, Dr David Digges, was joined again by return volunteers, Dr Charmaine White and Liz Eberl; as well as newcomers, Dr Henry Gilkes in Week 1, and Dr Stephanie Shields in Week 2. The team’s indispensable Timorese contingent consisted of  dental therapist, Nicolau Tolentino Pires (Nico), dental assistant, Ana Paula Dos Santos Tavares Salgado, and translators, Isabel Noronha Pereira De Lima Maia (Isa), and Bonifacio Cardoso Martins (Bony).

The team’s first week was spent in the Maliana area, which is in the far west of TL. The road between Maubara and Maliana is also the road to Indonesia; so like the Pacific Highway between NSW and QLD, it is super busy. It is also affected by landslides, rockfalls, subsidence and erosion – especially after the wet season – so the going is often slow. Nevertheless,  after  gearing up at Maubara, the team made such good time  that they were able to stop enroute in Balibo for a pizza – quite an exotic experience! (Pic: The team at EBC Raifun School)

The team had to do without Nico for the first week, as he was on paternity leave. His wife, Antonia, had just given birth to a son the week before. Congratulations to them both!!!!

Maliana is Bony and Isa’s home town. This meant that the team was treated like royalty during their stay!  Restaurante Maliana, Isa’s mother’s restaurant, kept them well-fed throughout the week, and frankly spoiled them – delivering food to their accommodation when they thought that the team might be tired after work.  The first 1 1/2 days were spent treating patients at the base hospital, and mentoring José Soares, the local Timorese dental therapist; the next 1 1/2 days were spent in EBC Raifun School, a combined primary and junior high school that has so many students that it has to ‘hot desk’ morning and afternoon classes in order to fit in all the students!(Pic: Rooftop ‘cocktail hour’ in Maliana)

The last 2 days of week 1 were spent in the village of Cailaco, an interesting 1 hour drive from Maliana – the team had to cross a couple of ‘quaint’ bridges and negotiate a mud-crossing to get there! The people of Cailaco had never seen a dentist before, so the team was inundated with work. David said, “it was hard yakka – lunch on the run Thursday, and only a brief respite on Friday”. Week 1 was a baptism of fire for Henry, who despite being totally exhausted by the end of the week, intends to return next year!

As usual, changeover occurred during the middle weekend. The team farewelled Bony, but welcomed Nico back to the fold.  Henry and Liz departed, and Steph arrived. After a quick resupply of consumables in Dili, the team made their customary pitstop at Black Rock in Cameo Beach on the way back out to Maubara, where they would be working for the next week. .(Pic: In Cailaco – Bony, Henry, Isa, Liz, Ana Paula, Charmaine, 2 local doctors, David)

Monday to Wednesday was spent treating the children of Aipelo Bogoro School, in a very poor area in Liquiça district. Despite the presence of a government dental therapist who is responsible for this district, and only being an hour from the capital city, many of the children had never seen a dentist before. The TLDP were there at the request of the school’s principal. There was a massive amount of decay in the children’s teeth – the team extracted 226 teeth in those 3 days alone! Nico is an extremely hard worker and after only a little mentoring,  has become very competent with his extractions.  He was on fire those 3 days! It was a  real boon to the team to also have Ana Paula on board – an Australian-qualified dental assistant, who also speaks Tetum, is priceless. She and Isa sterilised, assisted and translated for the entire team, as if on roller-skates.

As always, the team was well-cared for by our beautiful friends, the Carmelite sisters. Each night they dined with the sisters in the local orphanage and got to spend time with the kids. Steph, in particular, was a real hit with the children, quickly gaining a new bestie, 5-year old Marco, who is quite new to the orphanage. (Pic: Steph and her bestie, Marco)

The last 2 days were spent at our Maubara base clinic treating the community, the Carmelites and the Orphanage kids. With a little more time on their hands, Nico was able to work on his weaknesses, attempting complex fillings with guidance from Charmaine and Steph. The team also carried out the necessary and every-present inventories and equipment maintenance.

The team got off lightly with equipment problems – only the suction unit malfunctioned this trip. This is the third time that this unit has kicked the bucket, but we are hoping to repair it again, as it is quite expensive to replace. Fingers crossed! At time of writing, we are still hopeful, but it is not looking good for our suction unit – unfortunately, it seems we may have to fork out USD2000 soon.

According to the team, it was a busy and wonderful 2 weeks. Henry and Steph did fabulously as first time volunteers and we are hoping that we did not wear them out too much! The veterans, Liz and Charmaine, also worked tirelessly, despite being a little under the weather towards the end of Week 1. The team saw 1261 patients, extracted 527 teeth, did 406 fillings, and 241 preventive treatments. Go team!

One of the delights of volunteering in TL is spending time with the local Timorese people – both working and hanging out with them is a real pleasure. The Carmelites are joy incarnate and are so caring and happy and helpful, while the young Timorese are so eager to learn, hardworking and congenial. Nico, Ana Paula and Isa are prime examples of Timorese youth – keen as mustard, full of grace, focussed on the future. (Pic: David, Steph and kids)

 

 

CONVIVIALITY OVER FRUSTRATION

Team 2 returned from TL on the 6thJune after a 10-day whirlwind trip. The team consisted of team leader, Dr John Moran, his steadfast mate, Dr John Whyte, newbie volunteer, Emma Whyte, the TLDP’s dental therapist, Nicolau Tolentino Pires (Nico), and Australian-trained, Timorese dental assistant, Ana Paula dos Santos Tavares Salgado.

This team is well known for its efficiency. They covered a lot of ground; dividing their time between the Railaco, Kasait and Maubara areas. In Railaco, they were hosted by our Jesuit partners, and as usual were kept thoroughly fed, watered and entertained by the ebullient Father Bong, with his team, Fathers Truong, Phong, Siriak and Sagi, plus trainee Jesuit, Ismal. Lively dinner discussions, well-oiled by wine, ranging from attitudes towards eating pets, to a coffee delicacy produced from predigested coffee beans, and libido-limiting fruit, kept the team recharged during their stay in Railaco.

The first 2 days were spent treating patients in the Railaco Parish Clinic Centre, where the team treated patients from the local community. The team was augmented by Ismal and a local man, Victor, who performed the vital task of interpreting – neither Nico, nor Ana Paula, are from Railaco, so they don’t speak the local language of Railaco.  Timor has 2 official languages – Portuguese and Tetum, but there are also scores of local languages, or what the people call ‘mother tongues’. Many people struggle with Portugese, and even Tetum can become sketchy the further out one ventures. In most of the tiny, remote villages, knowledge of the local language is essential. (Pic: Emma Whyte, John Whyte, Fr Bong, Ana Paula, John Moran, Nico)

The team had a single day before equipment issues started rolling in. Day 2 saw the foot pedal of one of our dental units go bust, necessitating a 4 am dash back to Maubara for Nico on Day 3 to get the spare. Luckily for this team, Railaco is one of the closest locations to Maubara. Nico was back 3 ½ hours later, the offending foot pedal fixed, and the team headed off to Railaco Leten, almost 2 hours drive away.

The team worked in the Sacred Heart of Jesus chapel in Railaco Leten, which is a lovely space and has great views; however, electricity is dodgy in Railaco Leten and this played havoc with the electric autoclave that the team had chosen to take with them. This meant that the team spent most of the night sterilising on their return to Railaco, where the electricity is more reliable. (Pic: Our Steri-Room)

Day 4 saw the team heading up the hill to Tocoluli, where they worked in a community hall overlooking Mt Ramelau. At this point they started to run out some of the anaesthetic. Despite being small in height, many Timorese, especially the ones in the remote areas, have large teeth, with massive roots, and need more anaesthetic. It must have been a very tiring day, but at night, the team were rewarded with a feast at the Order of St Paul of Chartres Convent – the sisters are superb cooks and their singing is a real treat. (Pic: John Whyte in his room with a view)

Day 5 was a day of endurance and patience for the team – they had to set up and break down the portable clinic twice. Their clinic in Nasuta was stymmied not only by yet another new public holiday – Children’s Day – but also the Sacred Heart of Jesus Procession. After only a few patients, the team packed up and headed back down the hill and spent the rest of the day in Railaco Parish Clinic Centre.

Days 6 and 7 were spent in Kasait, back on the coast. The two days were productive and busy and were only marred by the suction motor burning out on the first day. Nico, with local, Nani, drove the suction motor and one of our generators to Dili for repair. The suction unit’s motor was replaced with a vacuum cleaner motor overnight and was in action again the following day (albeit with less power)! (Pic: The team about to farewell Kasait)

The final 2 days were spent in Maubara, first at the senior high school, then finishing up at our base clinic. The team experienced their final breakdown – one of the dental carts turned up its toes – but reached the finish line with their good humour unscathed! They spent some time at the Maubara Orphanage, where they were treated to a coffee, biscuits and a little concert. A fabulous way to end a visit!

Overall the team did 849 treatments, including 266 fillings, 229 extractions, and 132 preventive treatments. The two Johns are also great teachers and they spent a large amount of time with Nico, honing his restorative skills. Despite the setbacks, the entire team had a fantastic time and enjoyed working and living together immensely. Go Team 2!

 

 

THANK YOU!

At this point in time we would like to thank all our generous donors of cold hard cash. Maintaining a dental program is not a cheap operation. While we try and make our funds stretch as far as possible by utilising volunteers – who all pay their own way – as the muscle of the program, and by obtaining generous donations of dental materials, we aim to reduce the welfare component of our program in order to make the program more sustainable.

That is why we employ a number of local Timorese people. We employ a full-time Timorese dental therapist, Nicolau Pires, who runs the program while the teams are not in Timor Leste. We employ Bonifacio Cardoso on a casual basis, to handle our registrations and liaise with some of the outlying communities; and when the teams are in-country, we also employ a slew of dental assistants, translators and sometimes, drivers.  Now, we are funding a Timorese sister, Sr Delfina, to attend university in Indonesia so that she can become a dentist. It’s a 5 year course and a massive financial commitment for the TLDP. She starts in September this year and the cost of the first year’s tuition is USD 29 000. It’s a lot of money! It is our hope that once she graduates and gets a bit of experience, she will then become the backbone of our program.

So apart from helping us to purchase and maintain our dental gear in our clinics, and to maintain our car and the Sisters’ car which the teams borrow, and helping to support   three other Timorese government clinics, your precious donations are helping us to provide employment, training and experience for young Timorese people. Thank you for investing in their futures.

Thank you, in particular, to the International College of Dentists, which has pledged $4000 annually for Sr Delfina’s education. Thank you to the Rotary Club of Bendigo who recently gave us $2000 to buy local anaesthetic for all the clinicians we support, as well as some instruments that were on Dr Inda’s Wishlist. Thank you to the Melbourne Dental Wellbeing clinic, who threw a film night and donated $1405 to the program, just for the hell of it. Thank you to everyone who has given us even a small donation – every little bit counts!

As I write this, our next team is preparing to head off to TL this weekend. Team 2 consists of  Dr John Moran, Dr John Whyte and Emma Whyte , as well as Nico Pires and Ana Paula do Santos Tavares Salgado. They will be living it up in Railaco! Good luck team!

Together we are an Ocean

Team 1 arrived home a week ago, tired – and some of us sick – but triumphant. This trip was difficult to organise and challenging on the ground due to the conglomeration of different organisations during the first week- The Timor Leste Dental Program had been joined by Solar Smiles Dental Charity (SSDC), the Bendigo Maubisse Friendship Committee (BMFC), and the Maubisse Referral Hospital (MRH). We all had  different ideas and agendas for this first week, but we shared a common goal – to improve the dental health of Maubisse Subdistrict; this made us a highly effective team.

Week one saw us in Maubisse Subdistrict. The TLDP consisted of overall team leader, Dr Blanche Tsetong, the TLDP’s Timorese dental therapist, Mr Nico Tolentino Faria,  and translator (as well as sterilisation nurse and dental assistant), Miss Isabel Noronha Pereira de Lima Maia. SSDC was represented by founder, dental recruiter and former dental assistant, Mrs Kim Groizard. Standing with a foot in both camps was Dr Phil Hill, who was volunteering for the TLDP, but was also a member of the SSDC. Dr George Waters represented the BMFC and the MRH brought into the mix Dr Inda Zulmira Dias, dental therapists, Mr Armando Da Costa Martins and Mr Ricardo Mendonça, and assistants, Carlotta and Imelda.

The TLDP and MRC spent the first couple of days in Turiscai treating the community and the school. Turiscai is and isolated village 1 1/2 hours from Maubisse town along the type rough, dirt ridge track that TL is famous for. The scenery is spectacular. We were very busy – the community rarely gets dental services – but our plans for a community oral health workshop were stymied by the campaigning for the upcoming election. (Pic: Phil, Nico & Ota)

The next 3 days the TLDP and MRC visited Rimori School, in a village fringed by sharp mountains, Samoro School, in a valley accessed by a skinny dirt track running beneath towering Madre de Cacao trees and coffee bushes, and the Carmelite Sisters’ Health Clinic back in Maubisse town. Kim Groizard lent a hand at both Rimori and Samoro Schools , enabling her to see a functional outreach clinic in TL in action. As we all know, working in TL has its unique challenges and peculiarities! (Pic: Phil, Isa & Kim)

Week 1 was peppered with meetings, but the most crucial was that with the Chiefs of all the Sucos (akin to shires) in the Maubisse Subdistrict. Phil, Nico and the rest of the gang remained slogging at Samoro, while Blanche, Kim and Inda attended this meeting with George in tow (SSDC will function under the BMFC umbrella). At what Kim described as a “horse auction”, the chiefs sought to get more services for their Sucos. In the end, we came out with a working plan of cooperation between the Chiefs, the Carmelite Sisters, the MRH, the TLDP and the SSDC. Success! (Pic: The view from Rimori)

The weekend, as always, brought the changeover and we said goodbye to the cool hills of Maubisse, the Maubisse crew, and to Kim and George. We were now a solely TLDP team. Blanche, Phil, Nico and Isabel happily welcomed Dr Mary Tuituinnik; less welcome was  the oppressive heat and humidity of the coast .

Week 2 had a different flavour to it – the climate introduces an additional layer of difficulty to our job. Also, by that time, both Nico and Blanche were ill; nevertheless, the team carried on – they spent 2 days in the slightly cooler climes of Vatuvou School, in the foothills behind Maubara, and a day in each of the airless, dusty, piping hot schools of Ediri and Vatunau, with one fan, a tin roof and a generator. What made the week flow easily was Phil’s can-do, ever-optimistic attitude, Mary’s gentle humour, Isa’s graceful, caring nature, Nico’s dogged work ethic, and the non-stop gentle pitter patter of Phil and Mary’s chatter – those two can talk underwater!

One of the days we spent assessing and mentoring a dental therapist, Savio, who the SSDC hopes to employ. Like most of the dental therapists we come across in TL, his skills are woefully lacking; however, with the right attitude towards learning, and with lots of support, we know that he could become an excellent clinician. Many of the dental therapists we mentor are now excellent clinicians. (Pic: Savio, Isa & Mary)

Week 2 also had its share of meetings as the TLDP worked with Phil (with his SSDC hat on) to establish more connections in TL. There were many trips back and forth on the Dili Road – meetings with Judite and Mario from the Rotary Liaison in Dili, the Rotary Club Lafaek in Dili, and the Rotary Club Dili at the Klibur Domin Tuberculosis Clinic in Tibar, with a fortuitous meeting with another new dental NGO in Tibar, which works within Kilbur Domin, under the Ryder-Cheshire banner. Developing links is important, especially in this setting, as it allows us to support each other and to share resources – TL is an impossible place to work in solo.

Blanche had meetings with Sr Inacia about the Sister Delfina who the TLDP hopes to support in her dental studies in Indonesia. The TLDP believes that local ownership is the only way for a program to be sustainable. Although Nico is hardworking and committed, he is a “mere” dental therapist and so lacks the clout that being a dentist would give him. He also has family ties that may force him to leave the program one day. Hence – in supporting Sister Delfina to become a dentist we hope to safeguard the program for the future. However, the TLDP was originally led to believe that the degree would cost approx USD 9000 for the first year of study. Instead, it is closer to USD 29000 – a big difference! Nevertheless, we are determined to support her – I see some fundraising in our future!

Team 1 luckily had few equipment issues –  3  broken triplexes, a non-functioning generator, malfunctioning head torches, a dental unit water leak, a total loss of water supply in the accommodation in Maubisse and, at the end, a broken air-conditioning fan belt in the SIsters’ car. Most they managed to fix during the 2 weeks! (Pic: Isabel, Blanche & an iPhone)

Team 1 saw a total of  415 patients, extracted 363 teeth, restored 245  teeth and carried out   39 treatments. With the TLDPs support, the MHR and Nico had screened, given oral health education and carried out a selected treatment to 1439 children prior to the Team’s arrival.  A fine example of what cooperation can accomplish!

Thank you to the entire team – you make this program. Thank you to Bony Cardoso Martins, who continues to help us with our Timorese dental registration, which is an exercise in tedium. Thank you especially to Henry Schein Halas, who continues to support our program with stacks of consumables and equipment team after team, year after year. Your generous donations allow us to give more to the Timorese people. Thank you also to SDI who has also helped us with donated materials over several years. Thank you to our partners, the Carmelite Sisters who, with their grace and good company, make it a joy to work in TL.  (Pic: Phil, Sr Joaninha, Blanche, Sr Isabel, Mary)