Tag Archives: ana tilman

The Fast and the Furious

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 delightful Team 3 – Ashley, Steph, Evelyne, Jordan, Ana Tilman and Ana Paula – Nico is behind the camera

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.

The Silver Fluoride Arrives

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!

No OH & S people here – getting Sisters’ car onto the ferry
We get spoilt when we are at Barry’s Place

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!

Beautiful Atauro

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!

5 clinicians at work

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.

Ana Paula is invaluable in explaining treatment to worried parents.

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. 

Jordan eagerly awaits his mid-morning coconut.

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.

Ana Tilman gives oral health education with some digital assistance

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!

The team back in Dili

 

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!

The Sublime Grace of Good Friends

Team 1 has returned from a fortnight of fun, food and friendship with our Timorese friends in Maubara and Maubisse. On this trip, our 3-person contingent from Australia (Dr Mary Tuituinnik, Dr Blanche Tsetong and Mrs Yvette Young), was happily far-outnumbered by the Timorese part of the team. (Pic above: Gentle Tino; below: The beautiful Sisters in Maubisse: Sr Eva, Sr Rosa, Sr Inacia, Sr Loudres, Sr Helena – with Yvette, Blanche and Mary)

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Amongst our team members in Maubisse, were Dr Inda Zulmira Dias, the new dentist in Maubisse Hospital, as well as Armando da Costa Martins and Ricardo Mendonça, the Maubisse Hospital dental therapists. In addition to our usual tasks, the TLDP is currently assisting the Bendigo-Maubisse Friendship Group, who has been asked by the Maubisse Hospital Director to help improve dental services in Maubisse District. Hence, this trip we worked with the Maubisse dental team to develop a plan about how this could be achieved.  Dr Inda is a young and enthusiastic dentist, educated in the Phillipines and full of great ideas and a passion for promoting good oral health. (Pic: Clinical supervision in Maubisse Hospital)

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In Maubisse, we were also joined for a day by the bubbly, Ana Tilman, a dental therapist who works with the Kose Nehan group out of Aileu. She was super-fun and a joy to work with. Team 1 also had the task of ‘road testing’ a Timorese dental therapist, Nicolau Tolentino Faria Pires (aka Nico), that we hoped to employ for the TLDP. Nico has a couple of years’ experience, has worked for a couple of other NGOs previously, and has been recommended to us by our mate, Dili dentist, Dr Fernando. Our last team member in Maubisse was our driver, Dionisius Gonsalves (Dion). (Pic: Ana and Nico)

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We were so fortunate to have the opportunity to mentor so many clinicians at the same time!  We had three days of treatment and clinical supervision in Maubisse, peppered with lots of treats – joyful, delicious and noisy dinners with the Sisters, a soujourn at the Maubisse branch of AHHA helping young Timorese learn English, listening to the haunting notes of the Sisters’ singing early in the mornings, Mary and Dion’s afternoon jaunt with Sr Lourdes to deliver meals (on wheels) – and an oral health workshop for the community thrown in at the end! (Pic above: Dr Inda presenting at the Oral Health workshop; below: Ricardo welcomes the community at our workshop)

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For their last 2 days in the mountains, Dr Inda organised an outreach clinic in Hatubulico, a beautiful, extremely peaceful village at the foot of Mt Ramelau, Timor’s highest mountain. Like Mt Fuji, Mt Ramelau has a very particular shape and is instantly recognisable – over the years we have been lucky to view it from all sides. Hatubulico is a 2 hour, super rocky drive from Maubisse, with plenty of spectacular scenery, narrow roads and sharp drop offs to occupy passengers and drivers alike. (Pic: Mt Ramelau from Hatubulico)

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As is the case in many remote communities, the dental need is massive and we had a very busy couple of days – four clinicians working, two in ‘normal’ chairs (oh, our backs!!), one dentist supervising the therapists, Yvette assisting everyone, checking the post operative conditions of the patients and sterilising instruments, and Dion doing admin and a very relaxed kind of crowd control. (Pic: Our alfresco clinic – 2 chairs manned by Nico and Ricardo)

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We always love alfresco clinics! The team had fun in Hatubulico. We stayed in a pretty swish place (despite the need to share beds and a dearth of blankets, it had running hot water showers that mostly worked!), enjoyed the views and friendly locals whilst walking to work, and even attempted the gnarly track to the start of the Ramelau ascent path (we had to abort halfway because Sister’s car threw a hissy fit. (Pic: Inda and Blanche – impromptu checkups for the crowd)

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Week 2 saw the team descending from the cool mountain air into the miasma of the coast. The heat and humidity affected us all, but struck down Yvette one day and Mary the next. The sea, usually a welcome relief, was lukewarm and full of debris and sea-lice. Still, we soldiered on and the second week proved just as exciting as the first. Tino joined the team on the Tuesday and Bony rocked up on Wednesday night. It was lovely to see them both! During the week, the team worked in Maubara Clinic for 2 days, giving the two therapists (Tino and Nico) the benefit of working under Mary’s exacting eye, and Blanche, the opportunity to effect some repairs. (Pic: Yvette, Nico, Blanche, Dion and Mary)

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The team also spent a day in Lebotelo treating the primary school and the community and a day in Loes SMP School – both journeys took longer than before. Road degradation continues on apace in Timor! Lebotelo is now a 90 min journey via goat track, not a 30 min soireé up the hill from Maubara, and the road to Loes is literally falling into the sea!

The team fell into a natural rhythm: Sr Filomena and Tino screened the kids, Bony did admin duties and tag-teamed with Tino to give toothbrush instruction, and Nico (tag-teaming with Tino), Blanche, Mary and Yvette got the treatment done – a well-oiled machine!

20170504_100551 (2)The only thing that went slightly awry was in Loes when Yvette – driving Sister’s car – temporarily forgot the existence of those rather large drains. Nobody was hurt and there no damage to the car, but Yvette provided a whole bunch of entertainment for the locals at the cost of a slightly bruised street cred.

Although Bony and Tino are old mates, they soon took Nico under their wing and all three were soon carrying on like long lost brothers. Nico was a super hard worker and a careful clinician. We are sure that he will make a good addition to our program. From now on, he will be permanently employed by the program to work both in the clinic and the surrounding Loes/Maubara subdistricts, as well as to work with the teams when they are in Timor. For now, we have enrolled him in English classes in Dili. Hopefully, he will have picked up a word or two by the time John’s team rolls into town in 9 days! All he needs is “No worries!”

IMG_8658 (2)Many thanks to all our team members, and to their families, who support them, to our lovely Sr Filomena, Sr Joaninha, and to the Maubisse Sisters. Thankyou to Mario and Judite in the Rotary Liaison office in Dili – your help is essential to our work, and thank you to Henry Schein Halas, who continues to support our program. (Pic left: Novagenerian who fought with the Australians in WW2; right: Full of grace, Sr Filomena and everybody’s favorite dish, Brinzela).

A final note: In my excitement, I forgot the all important stats! Team 1 saw 540 patients, did 378 examinations, filled 94 teeth, extracted 234 teeth,  and carried out 21 preventive treatments.20170505_145409 (2)