Team 4 arrives early today in Timor-Leste. The volunteers consist of Dr Peter Shakes, Dr Martin Ramlah, Dr Jeremy Lung, Dr Hans Raets and Ms Malita McCabe. They will be spending the entire 2 weeks in Atsabe. Have fun team! See you when you get back!
It’s a rapid-fire dental service this year! A mere 3 weeks after Team 2’s return, Team 3 has now completed a lightning trip to TL, leaving scores of happier people in their wake.
The Australian contingent of the team all hail from Darwin – Team Leader, Dr Ashley Freeman, returnee, Dr Stephanie Shields and newcomers, Dr Jordan Kolsky and Dr Evelyne Cheng (a medical doctor). They were joined by our permanent Timorese team, Ana DJB Tilman, Nico TF Pires and Ana Paula DST Salgado.
The team eagerly arrived with 15 boxes of supplies on the Friday morning, but spent the majority of the day cooling their heels in Dili as they waited for the outgoing TLDP Lions team which was late coming in from the districts. The two arms of the TLDP (Rotary and Lions) share the Troopie between them, but rarely meet. Once the handover was complete, the team hightailed it to Maubara to pack – the team was spending one week in the neighbouring island of Atauro.
It was at this point the team realised that no Silver Fluoride had made it over from Australia! A disaster! This preventive treatment is a key component in our program and it allows us to save many more teeth than we would without it. So – the Silver Fluoride needed to be begged and borrowed from somewhere back in Oz, then sent internationally to TL, then picked up and sent to another island – all within 2 days. Was this team stymied? Not this team. They put their cool, problem-solving heads together, liaised with 3 dental surgeries in Darwin, arranged for a pickup and drop off to the airport, convinced Airnorth to bring the gear over with their crew, organised our Timorese friends to collect the material and drop it off to a boat which would then take it to Atauro; it was in the team’s hands for their first clinic on Monday. A BIG THANK YOU to BUPA Dental in Casuarina, Palmerston Dental and Smith Street Dental; to Dr Johnny Chen in Darwin, Airnorth, Isabel Noronha Pereira de Lima Maia in Dili, and Barry Hinton in Atauro for performing this logistical miracle!
Back to Saturday. The team had to arrive in Dili super-early in order to make sure that the 2 vehicles (and all our stuff) got loaded onto the ferry. A previous team had learned that having a ticket did not guarantee getting on the boat. Getting on and off the ferry is extremely stressful – there are people, livestock and vehicles everywhere and the ramps are steep and unstable. We have almost lost a car to the ocean during one of these manoeuvres previously. Apart from a stressful start, the team had an uneventful journey over to Atauro and were soon ensconced in the laidback simplicity of Barry’s Place – their home for the week – where they were well and truly spoilt by Barry and his team. The remainder of the weekend was spent relaxing, setting up, and organising the week ahead.
Steph and Ana Tilman shared a birthday on Sunday – Happy Birthday to them both!!!! What a special place to have a birthday!
The first three days were spent working in the Vila Maumeta Health Clinic. Atauro has a total population of 11500 people, and approximately 1900 live in the administrative centre of Vila Maumeta. The population is largely Protestant, in contrast to the Catholic-dominated TL mainland.
Atauro has no electrical supply between 2pm and 6pm, so during the bulk of the day, the team ran on a generator – not unusual for our clinics. There are also no petrol stations on Atauro, so thankfully Barry came to the rescue again when they ran out of fuel!
As well as the general community, the team was able to treat some of the local schoolchildren. Steph and Ana Paula screened all of Grades 1-6, but were less successful with Grades 7-9 as there was overlap with the school feeding program. Nevertheless, even with a public holiday to celebrate the 20th anniversary of the independence referendum, the team was extremely busy, with Jordan, Steph, Ash, Nico and Ana Tilman all treating patients, whilst Ana Paula translated, maintained the records, and assisted the clinicians. Evelyne functioned as sole steri-nurse, dental assistant and medical back-up for the team.
Most patients required multiple extractions and fillings. Atauro is an island whose population leads a largely subsistence existence. Many of its communities are remote and there is a high level of disease and few resources. Barry told the team that a number of villagers had died over the preceding year as a result of dental infections. Although the Ministry of Health says that they attend this island regularly; in fact, there has been no dental team here since the TLDP visited 2 years ago.
So when the people of Atauro have an acute dental infection, they have only two choices – to take repeated antibiotics (if they are available) or to travel to Dili where they can make arrangements for extractions. However, many locals are unable to afford even the cost of the ferry to the mainland. It is a sobering thought that this is commonplace across much of TL.
The team spent the last 2 days in the village of Beloi, a rough trip across mountainous terrain. Beloi has the largest population on the island – around 2500 people. Here, many of the locals only speak a local dialect, so it was really lucky that Senhor Lucas, the clinical director in Maumeta stayed to support the team throughout their entire trip. He helped with translating, crowd management, distributing pain killers and fresh coconuts for morning tea. Ana Tilman delivered oral health education to the Beloi kids, in true 21st century style – with a smartphone. Again, the team was busy here and they left after dark on their last day.
After breaking down the clinic in the dark, repacking the cars, catching the ferry back to the mainland, driving back to our Maubara base, then unpacking the cars and repacking the stockroom, then discovering a flat tyre on one car and changing the tyre, I am sure that the team was super-relieved to fall into the welcoming arms of the Sisters at the end of their trip.
All our trips are taxing, but due to the restricted days and remote location, this one was particularly intense. The team in total saw 371 patients. They extracted 657 teeth, placed 294 fillings, and carried out 40 preventive treatments. Good job Team 3!
Team 2 has returned home safe and sound. In the past couple of years, our teams seem to have become quite large as a general rule, as our Australian volunteers are matched in numbers by Timorese employees. This team consisted of Australian volunteers, Dr David Digges (Team Leader), Dr Henry Gilkes, Ms Liz Eberl, and the tag teamers – Dr Geoff Knight and newcomer, Dr William Hariman. The Timorese contingent consisted of Ana de Jesus Barreto Tilman (AT), Ana Paula Dos Santos Tavares Salgado (AT), Nicolau Tolentino Faria Pires (Nico), Isabel Noronha Pereira De Lima Maia (Isa), Bonifacio Cardoso Martins (Bony), and Diamantino Correia Morais (Tino). Hence, at any given moment, this team had 3 dentists, 2 or 3 dental therapists, a dental assistant/steri nurse and 2 translators/dental assistants/admin officers. A massive team!
The team spent the first few days hosted by the Sisters in Bobonaro. The girls got to stay with the Sisters themselves, but the boys were housed in the Sisters’Tuberculosis clinic – we suspect that they will be looking for some new digs next year! The team spent the first 2 days operating in the meeting room of Gumer Primary School, with the nearby High School kids walking over. Gumer is an isolated valley between Bobonaro and Maliana and there are 800 children in these 2 schools, many of whom have very poor oral health. The team soon realised that on Day 1, but were able to broaden their scope on Day 2.
For the remainder of the week, the team shifted accommodation to Maliana – this is the Big Smoke in this area, and the team gets to enjoy a little luxury. Isa’s Mom runs Restaurant Maliana, so the team is well-fed when they live here. Day 3 and 4 saw the team working out of a very impoverished village called Memo, 30 minutes west of Maliana and within spitting distance of the Indonesian border. They found it a little unerving to be able to see an Indonesian Military checkpoint from the school where they set up. The villagers here had never seen a dentist.
Day 5 was changeover day – the team started working out of Maliana Hospital. Bony and Tino arrived together on what would have been a very long, dusty and bumpy tandem ride from Dili. Bony still managed to look immaculate coming off that bike – some people just have that knack! Geoff headed back to Dili – any team lucky enough to have Geoff with them benefits from his wealth of knowledge, especially with Silver Fluoride, which we use extensively in our work over in TL. William had been picked up from the airport by one of Isa’s friends and was put straight on the tools when he arrived in Maliana – no problem for William!
The team spent the next 2 days treating the community as well as students from the High School. This team is impressive with its logistics. They split into two teams, with screening and transportation of the students carried out by Bony, Willian, Tino and Liz, and treatment carried out in the hospital by Nico, Henry and David. Translation, sterilisation and patient marshalling were efficiently handled by AP, Isa and AT. After working late, the team had sunset drinks on the rooftop terrace – a last hurrah with Isa, who is now employed by Maluk Timor as the Oral Health Coordinator for all the dental charities that come to TL – we wish her well, but are very sad that she will no longer be spending so much time with us!
Week 2 was spent closer to our home base, Maubara. Three days were spent visiting Loes Orphanage, which we have never been before, Loes School (one of our regular schools) and Tapamanolu School (last seen in 2012 – very hard to get to). This involved a commute of 40 min along the crumbling coast road. The last 2 days were spent in Ediri School, one of the schools in our program.
What a hectic schedule!!! The team did a fabulous job – there was heaps of mentoring for Nico, Tino, Ana Tilman and Ana Paula, a whole stack of work got done, and they all had a great time! Henry did a super job of keeping us updated on social media. What more could we ask for?
The TLDP is exceedingly lucky to have so many dedicated volunteers who continue to come back year after year. We are even luckier that we are supported in our work by dental companies such as Henry Schein and SDI. And we are the luckiest to have so many enthusiastic, hardworking, talented Timorese people working with us. We are immensely grateful in particular, to our primary partners, The Carmelite Sisters, who smooth our way through the bureaucracy of TL. Our program has carried on unabated despite constant changes in the Ministry of Health over the past few years.
Nico and AT have become an excellent home team. They are in charge of the Maubara Clinic and our school dental program – Nico is an excellent operator and has the confidence of the Sisters – that is a HUGE endorsement! Although we initially employed Ana Tilman as a dental assistant, she too is trained as a dental therapist and so is now also benefitting from mentoring within the team environment. Her skills are on the up!
We are especially lucky to have an unofficial Timorese Committee of bright, young people – AP, AT, Nico, Tino, Bony and Isa – they are expert problem-solvers and can-do people. They are unstoppable!
Team 2 itself was pretty lucky – there were minimal repair issues, although they did get a flat tyre on the way home from Maliana – changing tyres in the dust and heat could not have been fun. They also were the first to try out our brand new custom-made portable hand washing unit – for all those places with no running water (it was a hit! Conceived in the Sunshine Coast, Made in Grafton), and they were the first team to wear our new spic uniforms!!
Overall, the team examined 1350 people, they extracted 467 teeth, placed 770 fillings, and carried out 722 preventive treatments. Well done Team!
(Pic: JM training AT)
Team 2 has returned home safe, sound (and exhausted) last weekend. They had a great trip! We can’t wait to hear all about it!
Meanwhile, here’s a quick rundown on what Team 1 got up to in May……
Team 1 consisted of Australian volunteers, Dr John Moran, Dr John Whyte, Bella Miller and Rebecca Bushell. They were joined on the ground by our Timorese crew, Ana de Jesus Barreto Tilman (AT), Ana Paula Dos Santos Tavares Salgado (AP), Nico Tolentino Faria Pires (Nico) and Diamantino Correia Morais (Tino).
As always for the first team the year, Team 1 had to carry in loads of consumables, and endure interminable discussions with airline staff about excess baggage. They arrived in TL after an otherwise smooth trip to find that the brakes had seized on our Troopie, which necessitated that we borrow a vehicle from the Rotary Liaison office in Dili (thank you for coming to our rescue, yet again!!!!).
Our primary purpose in TL is the mentoring of Timorese dental clinicians. Hence, although the Team was busy providing treatment to patients throughout their entire trip, there was a great deal of training happening at the same time. This is the reason that Tino joined our team in Railaco. Tino is a dental therapist who works in nearby Gleno Hospital, and he has been mentored by the TLDP for many years. Tino never misses an opportunity to increase his skills and clinical knowledge!
Bella reviewed the all-important infection control and sterilisation procedures with the team, John Whyte trained with Tino and AT on improving extraction techniques, and John Moran worked with Nico on aesthetic fillings and root canal therapy. In return, AT and AP provided some much-needed Tetum language training for the team. (Pic: Nico and JM)
The newly fixed Troopie was delivered to the team on the second-last day in Railaco and after a day in Railaco Leten, the team moved onto Kasait.
The team spent the next 5 days in the Centro De Saude Daniel Ornelas , the church-run health clinic in Kasait. Sr Eliza and her helper, Manuel, ensured that this clinic ran like clockwork. Equipment issues continued to plague the team, with autoclave malfunctions, failure of the air syringe on one of the dental units, leaking pipes and blocked drains in the clinic, as well as a flood in the kitchen. They were further hindered by a local celebration for St. Francis, whose statue was carried down from a remote village, bringing Kasait to a standstill. There was, nonetheless, a steady stream of patients and any lull was quickly taken up by more training.
The team had a great time – the Australian volunteers are always impressed by the competence and enthusiasm of the Timorese members of the team, as well as the willingness of many other Timorese to help. In turn, the Timorese contingent enjoy the work, value the opportunity to learn, and are alternately mystified and amused by Australian foibles.
(Pic: The Team in Kasait with Sr Eliza and Manuel)
In total the team carried out 268 examinations, placed 246 fillings, extracted 235 teeth, and did 188 preventive treatments. WELL DONE TEAM 1!
Our heartfelt thanks to the unstinting support we receive from Henry Schein Halas and SDI Ltd – without their donations of essential consumables, we would not be able to do our work over in TL.
Although we have yet to hear from Team 1 (they worked themselves to the bone!), the TLDP rolls on. Team 2 is due to head out this Friday. This team is comprised of team leader, Dr David Digges, returnees, Dr Henry Gilkes, Liz Eberl and Dr Geoff Knight, and newbie, Dr William Hariman. They will be working mostly in the Bobonaro and a Maliana areas. Have fun and good luck, Team!
Team 1 is now safely home. They had a very busy and productive trip AND, if you managed to follow them on Instagram or Facebook (the TLDP is now on both!) you will have also noticed that they had a great time too!! Welcome home Team!
Our first team arrives in TL this Sunday. Dr John Moran, Dr John Whyte, Bella Miller and Rebecca Bushell are headed for a stint in the communities of Railaco and Kasait. As usual, the team will also include the TLDP’s full-time dental therapists, Nico Pires and Ana Tilman, as well as dental assistant and interpreter, Ana Paula Salgado. Tino Correia, a dental therapist who we have mentored for many years, and who works in Gleno Hospital clinic, also intends to join the team for more training. A big busy team!! Have fun and good luck!
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!!!
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!
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!