The Power of Many

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!

DD, HG, Isa, AP, AT, LE, Nico, GK

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. 

The fabulous GK in action with the equally fabulous Isa

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.

Tino and the omnipresent Ana Tilman!

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.

The team with HG, WH and DD on the tools

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?

Back in Maubara with Sister

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.

The home team watched over by Henry

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!

Henry trials the new hand washing unit

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!

A little late…..the adventures of Team 1

(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!!!!).

The team spent the first 4 days working in the Railaco parish clinic and in Railaco Leten.  The Railaco clinic is run by Father Bong and his team at the Jesuit Mission, who always takes very good care of our teams. As usual there were issues with equipment, but after a little bush mechanics, the team rolled on as usual. Rough travelling conditions, the tropical climate, and the outreach nature of our clinics, means that equipment breakage and breakdown is a fact of life. Ingenuity is a prerequisite for all our team members!

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.

Team 2 heads out this weekend

 

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 BACK HOME!

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!

timorese farm

TEAM 1 ARRIVES THIS SUNDAY

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!

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!!!

 

 

 

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)