As our many friends and supporters know, the TLDP has been supporting a young Timorese lady, Ana Paula Dos Santos Tavares Salgado, in her dental studies in Fiji National University for the last 2 years. (Above Pic: Ana Paula and her good mates, Patisepta and Mena.
David Sheen, Ana Paula & Dr Tara Savou
Ana Paula hit the shores of Fiji in February 2019 – right at the beginning of the pandemic – and has been stuck there ever since. University study is hard enough, but studying in another country, away from family and friends, in a foreign language is even harder. The difficulty is heightened even further with Covid factors; there have been periods of extreme isolation, and much helplessness and distress due to separation from sick and dying family members.
It has been a very hard 2 years for Ana Paula.
Nonetheless, Ana Paula is determined and resilient, and she has had staunch support from Australia; Dr David Sheen and John Tweedie have had almost-weekly WhatsApp meetings with Ana Paula throughout her time in Fiji, and have taken on the responsibility of her welfare in Fiji, while Dr Geoff Knight and Dr Stephanie Shields have provided academic aid. Ana Paula is much-loved by all our team members and many of us keep in touch with her.
Ana Paula and friends
Fiji finally opened its doors last week, and David Sheen flew over to touch base with Ana Paula. She has garnered some amazing supporters in-country, and David was able to spend some time with her friends and tutors, as well as check out the dental program at Fiji National University.
David Sheen, Dr Leenu & Ana Paula
David found that Ana Paula has now settled into student life and regards the rest of the course with positivity. She has supportive friends and is well liked by the university staff and people she meets. Ana Paula is now studying second year Bachelor of Oral Health subjects, and with a credit average, she will be able to transition into the Bachelor of Dental Surgery.
And with a bit of luck, she will be able to head home to Timor-Leste at the end of this year. Stay tuned!
It’s been a pretty strange year for everyone, including the TLDP. Usually at this time of the year, two teams would have already completed their trips to TL. There would have been equipment breakdowns, vehicle troubles and severe depletion of consumables. Hundreds of people would have had their toothaches relieved and broken teeth fixed. And back at home, we would be flat out trying to get ready for the following three teams – begging for and buying equipment and materials, arranging customs documentation for said equipment and materials, Timorese registration of dentists, and millions of WhatsApp texts, emails and Messenger texts flying back and forth trying to organise clinics in the ever-changing landscape of TL.
Instead, this year we have been very quiet. But we haven’t been holidaying – the work has not stopped behind the scenes.
In February this year, our long-time employee, Ana Paula Dos Santos Tavares Salgado, commenced a Dental Degree at Fiji National University in Suva. Ana Paula is progressing well – she passed her first lot of exams, YAY! WOOHOO!- but it has been extremely challenging for her. She has had to adapt to a new country. Covid-19 has increased her social isolation, as well as educational isolation, as tuition has been solely online, and collaboration between classmates disallowed. Luckily, a number of our volunteers have been able to support Ana Paula during these stressful months. Dr Stephanie Shields, Dr Geoff Knight, Dr David Sheen and Mr John Tweedie have been a Godsend for her.
Thankfully, the University recommenced face-to-face teaching in Semester 2. Fiji has had only a small number of Covid cases to date. Ana Paula is a determined and hardworking individual, which is why the TLDP is supporting her during her studies. Ana Paula’s education is a five year commitment for the TLDP, assuming she is successful, and will cost the program $25000 annually.
Meanwhile, back in TL, our full-time dental therapists, Nico Pires and Ana Tilman, were forced to close the Maubara clinic for 2 months, as the Timorese government called a State of Emergency. Like everywhere else, gloves and masks were in extremely short supply. The pandemic caused increased disruptions in shipping, and the TLDP and our friends spent significant effort trying to get supplies to Nico, Ana and our partners, the Carmelite sisters, who continue to run primary health clinics. Thank you to Rod Flavell from the Bendigo Maubisse Friendship Committee for helping us get our gear to Darwin. And thank you to Dr Yvonne Huijser Van Reenen (one of our volunteers) and Dr Jeff Swann from the ABSO Cleft Lip and Palate Program for getting the gear to TL. However, the Timorese government chose this time to implement new rules about importing medical supplies, making a task that is always difficult into an impossibility. At time of writing our gear is still sitting in Dili airport awaiting ‘customs clearance’.
Timor-Leste emerged relatively unscathed from the pandemic. They had only 24 cases of Covid-19 and no deaths. What a relief! Ana and Nico have reopened the clinic and are back to treating patients. At the start of the pandemic, they set up a hand washing station outside for their patients to wash their hands before and after treatment, and they continue to maintain this practice. Well done to both of them!
Lastly, the TLDP can finally, FINALLY, do away with all the exercise books in which we currently keep patient records! We now have our own fully functional digital clinical record which has been constructed specifically for our program. Anyone who has been to TL remarks upon the huge numbers of school children. They are usually seen in the streets in the afternoons – vast hordes of kids in immaculate school uniforms. It is a recipe for writer’s cramp filling out all those names – vast hordes of school kids in the streets means vast schools. Increased accuracy and speed of recording details will make for a better service. Unfortunately, Ana and Nico will have to wait until next year to launch it – we still can’t get over there!
A little request – as with all charities, we rely on people’s goodwill to continue our mission to improve the lives of Timorese people. With wages, and now university fees, constituting the largest part of our expenditure, we need help more than ever. Every dollar that is donated (minus 3% for Rotary admin fees) goes towards helping the Timorese people. All our volunteers self-fund and many of our materials are donations. We truly appreciate any contribution towards our program and we thank you in advance. To donate – hit the button up at the top!
We are extremely pleased to announce that our long-time team member, Ana Paula Dos Santos Tavares Salgado, has had the official offer of a place in the Bachelor of Oral Health Program at the College of Medicine, Nursing and Health Sciences,in Fiji National University. Her first term starts in February and so she will be leaving TL in just over a week.
The TLDP is sponsoring Ana Paula’s studies, so we are very excited for her, although everyone will sorely miss her presence in the coming years. We all wish her the very best of luck and hope she enjoys her new home, with all the new experiences and challenges it brings with it.
The TLDP’s volunteering year has come to an end after Team 5’s return last week. The team was big even by TLDP standards. The Australian contingent consisted of Team Leader, Dr Blanche Tsetong, returnee Dr Mary Tuituinnik and newbies, Dr Kim Hartley and Dr Lesley Leong, with Mr Keith Mentiplay arriving for Week 2. The Timorese division comprised the usual suspects – Mr Nico Pires, Ms Ana Tilman and Ms Ana Paula Salgado – with the addition of Mr Tino Morais for Week 2 – plus Dr Inda Dias rocked up for a couple of days during the first week and Mr Savio Moreira snuck in for a day and a bit . The ring-ins come to learn – we welcome all-comers!
The core crew – Ana Paula, Leslie, Kim, Blanche, Ana Tilman, Mary and Nico
Week 1 was spent in the Maubisse Subdistrict. After the quickest trip to Maubisse EVER – 2.5 hrs up the new, yet still unsealed road, the team was delighted to find that they could stay with the Carmelite community. In the preceding couple of years, our longtime partners had increasing difficulties fitting a team into their accommodation, and so TLDP teams were forced to try their luck elsewhere, with variable results. This time, the team arrived to a newly constructed building, which even had hot running water at times! As usual, it was an absolute delight to take their meals with the Sisters and the team was thoroughly spoiled with big breakfasts, feasts for lunch, scrumptious afternoon teas and multi-course dinners.
The View from Gruto School
The team spent their first 2 days at Gruto School, which is down a steep, rough, dirt road. The views were fabulous. On the second day, as it was just down the hill from Gruto, Blanche, Ana Paula and Ana Tilman went down to see if there were any kids that had pain and wanted treatment. At first it seemed like it was going to be a bust – although plenty of kids dobbed in their mates, there were no volunteers. It just needed one brave child to break the ice…and then there was a full car!
The next 2 days were spent at Fleixa School, another school with a spectacular view, but with no electricity or running water. This was a large school on the main road to Same, and the team was flat out trying to get through all the kids, as well as see some of the adult members of the community. The difference between the more remote Gruto and Samoro, and Fleixa was stark – Fleixa’s kids had much more decay than the other two schools, probably because of easier access to junk food.
Day 2 in Fleixa fairly flew by, and it seemed like the team was going to finish work at a reasonable hour for a change. All the equipment was working, the sterilisation was finished and they were starting to pack up. Then Inda let in a ‘last-minute-easy-patient’. It took the combined efforts of one dental therapist and 3 dentists, plus an extra hour to extract that ‘easy’ wisdom tooth!
Our senior dental therapist, Nico, is a quiet achiever. After 3 years of mentoring, his skills are formidable.
After an abortive attempt to work at the not-famous-Balibo School, the team’s final day in Maubisse was spent in the Sisters’ Clinic. Despite letters and multiple phone calls to the Principal, the team arrived after a gnarly drive up a goat track to find another spectacular view…. and the school deserted. At least the drive was interesting! The roads in the subdistricts are challenging and Leslie found this out on the job. In Sisters’ car, he had a near miss with a horse, got stuck in a rut on the steep track out of Gruto and fell into another ditch on the drive down from Balibo. It’s a good thing that he is blessed with unshakable aplomb!
Fixing the suction unit
The suction broke down on Day 1, necessitating hours of repair work; mysterious water leaks sprung from the dental units that were ‘fixed’ with gaffa tape and plastic cups; and there was a bunch of other niggly faults in the equipment that had plagued everyone for the whole year. Like all the teams before them, Team 5 treated this as par for the course, all the while counting down the days and hours to when our equipment guru, Keith Mentiplay, would arrive and make it all better. What made these little annoyances easier to bear was the team had managed to borrow 2 extra dental chairs from Solar Smiles while they were in Maubisse, and so the work still flew. Having 5 purpose-built chairs going at once made it easier to mentor clinicians without significantly slowing down the pace at which they saw patients. It was great! Thanks Solar Smiles!
It’s always a blast with the Sisters
The team left their beer in Maubisse. DISASTER. Luckily, this was mitigated by the arrival of two old friends – miracle-working equipment-whisperer, Keith, and long-time mentee, Tino – so Week 2 was off to a great start! Although the entire team stayed at Maubara this week there were so many people that they had to split into 2 locations to sleep. Dinners were raucous feasts with the Sisters at the Orphanage, which kept everyone super happy.
The second week was characterised by long commutes, dust-choked air and crowded cars. The TLDP’s School Dental Program includes 17 schools. Some of these are impossible for Nico and Ana Tilman to get to by motorbike – they are too far away and the roads are too rough – so a team is needed to help them out.
The crazy kids in Faulara
The team spent the first 2 days at Faulara, which is on the farthest edge of Maubara subdistrict. The drive took 1.5-2 hours each way and resulted in some extremely long days. There were lots of waterway crossings, and then a drive UP a waterway to the school. The first return trip shredded one of the tyres on our precious Troopie.
Beers and tyres
Keith the equipment whisperer and his newest acolyte
The teeth in Faulara were not too bad – again, probably due to the remote nature of the village. And there was electricity! Over those 2 days, the team managed to check all the kids, Ana Tilman performing her by-now-familiar toothbrushing pitch to all the classes, and everybody pitched in with treatment and mentoring. And in the meantime, Keith fixed and tested everything! The team was now working like a well-oiled machine, so they managed to finish early at Faulara, break down the clinic, and drive to nearby-ish Guiçu School to set up the clinic for the next day.
Keith and Tino on a road trip
It was a huge relief to the team that Guiçu is closer to Maubara – only 1 hour each way on bad roads for the next 2 days! While most of the team was tasked to see the school under Mary’s watchful eye, Blanche and Keith were absent for most of the next 2 days. Blanche headed into Dili for meetings (and to buy tyres). Keith accompanied a grateful Tino on a 4-hour return motorbike adventure to Gleno Hospital in order to check out Tino’s non-functioning chair. He was able to get the drills, light and triplex working, but was unable to get the chair moving again – luckily, it is stuck in a good position! Keith also serviced all the equipment in our Maubara clinic and ran his eye over the clinic’s big generator, as well as the solar panels at the orphanage – the Sisters were so happy to have him there!
Mary mentoring Tino
Working in TL requires adaptability, and our teams are characterised by a fluidity of roles. Team 5 was no different. All the dentists shared all the tasks, from mentoring of Timorese clinicians to accompanying Ana Paula to do a share of the examinations; Ana Tilman and Nico delivered oral health education either en masse or class-by-class; Kim, Nico, Ana Tilman, Mary, Tino and Leslie were at different times the work horses of the crew; and everyone functioned as steri-nurse and dental assistant.
Kim demonstrating with Leslie assisting
It was a very busy 2 weeks and so the last day spent in Maubara clinic, winding down and taking stock was much-needed. Kim did a vital skill demonstration for our mentees, a few patients were treated, there was a bit of tidying up and the team had important personnel and team meetings, but essentially the day was for closure, and farewelling the Sisters for the year. Later that night the extended team, including translators Bony and Isa, reconvened for a rowdy end-of-trip-end-of-year dinner in Dili. After being kicked out of a cafe at the end of the night, the team lingered in the carpark – it is always difficult to say ‘Goodbye’ to our Timorese family.
Team 5 examined a total of 836 patients, extracted 348 teeth, filled 368 teeth, did 383 preventive treatments and 2 root canal treatments. YAAY team! We will see you all next year!
Timor-Leste Dental Program 