Tag Archives: Atauro

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

 

That which does not kill us…..

Team 3 has returned from a difficult trip to Timor Leste this month. The team leader, Dr Wayne Pearson, says that he found it difficult to write a positive report; hence, the tardiness of this update. In addition to Wayne, the Australian contingent of Team 3 consisted of Dr Karen Sloan, Sally Stephens and newbies, Dr Marius Mocke and Abbey Notley. The Timorese component of the team consisted of Nico Pires (our in-residence dental therapist, Bony Cardoso Martins (friend, translator, fixer) and the redoubtable Sr Filomena.

The team ran into their first problems with the airline, Airnorth before even leaving Australian soil. Airnorth’s system refused to recognise the TLDP’s current NGO status and so there were issues with the materials and equipment heading over. The team eventually sorted that out – money will fix almost anything. They arrived in Dili and were met by Judite and Mario, the Rotary Liaison team who handles much of the minutiae for many of the Rotary programs in TL. They liaise with customs to ensure that our dental gear gets through, pay bills for us, and deliver our car to the airport for us, which they keep safe when we were not in town. They are indispensable.

The team then met with Bony, who advised them of the new registration required for foreign dentists volunteering in TL. As mentioned in the previous report, this involved a great deal of documentation – two statutory declarations in Tetum and Portuguese, a copy of the passport, two passport photos, a copy of the dental registration, a copy of the degree certificate, a curriculum vitae in Tetum and, of course, a fee of USD 25. This was to be presented in person to the Ministry of Health and then there would be a wait of two weeks for it to be processed, after which the dentist could carry out their volunteer duties. Logistical difficulties were immediately apparent to the team – our teams are only in TL for two weeks! Having arrived earlier in the week, Sally had already bought the team’s general supplies and they finally got to Maubara in time for dinner with Sr Filomena.IMG_3204

(Pic: TL from afar – seemingly peaceful and pristine)
The next day, instead of starting work, the whole team, plus Sr Filomena and Bony, trooped back to Dili for an interview with the Ministry of Health (MoH). As the team were already in TL and had their AHPRHA registration, Dr Jaõa Manuel, who is in charge of professional registration, gave the team a once-off permission to work in TL. However, the following teams would have to comply with the new rules. As a concession to our short visits, he said that documents could be sent over in advance, but Wayne pointed out that this would be difficult when there is no postal service to TL; in addition, having to translate the documents into 2 different languages might prove to be a big deterrent to volunteers. Dr Manuel agreed, but this was the will of the political arm of the MoH, so it must be complied with. It was decided that the documents would be sent over to Bony by Blanche via email; Bony would do the necessary translations and then deliver the documents to the MoH. The team seemed to have arrived at a workable solution that the MoH was happy with. Disaster averted, the team had a well-earned lunch at Black Rock in Cameo Beach, Liquiça.

[Since then, the Ministry of Health has changed its mind. It wants originals of the CV, in a particular format, and originals of the statutory declarations, not scans. It has now added that it wants a criminal check as well. The TLDP is still trying to work out how we are going to do this in advance of our teams’ arrivals] (Pic: A fuzzy of most of the team: From Left bottom, Bony, Abbey, Sally, Karen and Marius)crew esplanada

The remainder of the week was taken up by a clinic in Guiço, and a couple of days in Klinik Maubara. Karen, Marius and Abbey spent a lot of time with Nico, honing his diagnostic skills; this is of prime importance, as most of the time he has no one else to seek advice. Sally spent a great deal of time sorting out the stores – the MoH has also developed stricter protocols on materials. On top of his clinical tasks, Wayne attended to maintenance, reconstructing the suction unit with the reconditioned motor which Blanche dismantled earlier this year. Wayne and Sr Filomena were summoned to the MoH again, this time to meet with the official who’s jurisdiction includes Atauro. This official told Wayne that he needed to provide her with an official letter so she could inform the people that they were coming. Despite assurance that, in fact, our visit had been planned a year ago with the local Atauro health authority, that Sr Filomena had been in close communication with the Director of the Hospital in Atauro, and that the people already knew the team was coming, a letter was demanded by close of business the next day. This necessitated a return to Maubara, where Sr Filomena produced a very official letter, with lots of stamps and signatures, and a quick return to Dili by motorcycle by Nico by 1pm on Friday.

The week was rounded off by dinner at the orphanage where, like so many of us before, the team was charmed and entertained by the Sisters’ young charges. All of us are no stranger to the upwelling of maternal feelings during these visits, but apparently, Abbey was particularly affected by the experience.IMG_3003

(Pic: The Nakroma – unloading at the Atauro end)

Saturday saw the team off to Atauro. In true Timorese fashion, boarding the vessel was colourful chaos. Although passenger tickets are available the day before, vehicle tickets are only purchasable on the day of departure – and even with a ticket, there is no guarantee of getting on board. The team had to hustle to fit both vehicles with all the gear onto the boat – Sister’s car was the second last car on! At least one other vehicle was turned away. The trip over was otherwise uneventful and the team arrived, unscathed, at Barry’s Place which, as always, was simultaneously a hive of activity and an oasis of peace. This time they were hosting a TEDX talk in the dining area! After meeting the local administrator, Mr Lucas, and hammering out a few details, the team was then free to soak off the frustrations of the previous week over the remainder of the weekend.IMG_3082

The team set up in the Vila hospital for the first 3 days and they were kept busy as usual. They had few problems with the equipment – only a dicky chair with a threaded screw, which they jury-rigged with a  strap. They even had lights and a fan from Day 2 after paying for some fuel for the hospital generator on Day 1. The final two days they went up the hill to Biquelli for 2 days. Here there was a lot more work, as these people have never had a dental service. They were ably assisted by Mr Lucas and a young German volunteer, Fransiska, who both helped with translation and reassuring patients. Timor is amazing in that way – one gets random help from everywhere.Franciska and Mr Lucas

In total, the team  treated 213 patients, extracting 371 teeth, placing 162 fillings, cleaned 21 people’s teeth and placed 17 fissure sealants. They were disappointed that their trip was not more productive. However, judging their trip by figures undervalues the peace building and diplomatic work that they carried out, which cannot be measured by numbers. In meeting with the MoH, working with Sr Filomena, Bony and Nico, and continuing Nico’s training, the team’s efforts were not only valuable, but vital for the continued growth and evolution of the program. On a personal level, dealing with difficult situations and difficult people inevitably delivers insight into oneself and encourages personal growth. As far as the TLDP is concerned this trip was not only a success, but a big win for all involved. Well done Team 3!! (Pic: Mr Lucas and Fransiska)

THANKYOU. An especially BIG thank you to Bony for his continued trips to above and beyond for this program. We would be a dead duck in the water if not for him. Thank you to Nico for his excellent work ethic and his willingness to learn from us and to take on the responsibility of the clinic. Thank you to Karen and Sal for the hard slog in the storeroom and to Karen for taking Nico under her wing. Thank you to Marius and Abbey for throwing your effort into the team – it’s a hard place to work. Thank you to Barry for his organisational skills and support for our teams in Atauro. Last, but not least, thank you to Henry Schein Halas for continuing to support out work with much needed materials. We appreciate it. No pics at the moment, folks – its slow going!

GO TEAM 3!

This Monday marks the arrival of our third team in TL this year. The team comprises team leader, Dr Wayne Pearson, boomerang volunteers – Dr Karen Sloan and the hardcore supernurse, Mrs Sally Stephens; as well as new blood, Dr Marius Mocke and Ms Abbey Notley; the eastern states of Australia are well-represented here – Victoria, New South Wales and Queensland! Along with Nico, it’s a BIG team! They will be spending their outreach week in the offshore island of Atauro – and braving the big boat – the ‘Nakroma’ – which we have previously used to get to/from Oecusse. The team will be taking 2 vehicles over to Atauro, and the Nakroma is the only boat big enough to carry them. We are a little apprehensive – the last time we put a car onto THAT boat, it nearly fell into the sea! Have fun Team 3! Hope you have red skies at night…..

Happenstance and Opportunity

Pure luck. Being in the right place at the right time. Knowing the right people. Where you were born. Who your family is. Where you grew up. From this, comes opportunity. All of us who volunteer for the TLDP are lucky. We have had the opportunities to thrive in our own communities and we have been given the opportunity to help other communities. We count ourselves blessed.

Team 3 returned from a 3 weekIMG_9566 stint in TL late last Friday. They had already lost one dentist, Yvonne, to health issues a month ago, so they were left with a team of 3 – Blanche, Wayne and Eve. The team lugged in 90kg of supplies to TL, including the new Forrest dental cart and the repaired ultrasonic scaler unit, and sailed through customs, thanks to our soon-to-be departing Rotary Liaison Officer, Daryl Mills. The team bought a mobile phone for the use of the teams’ in-country – only USD 10!!! (Pic: Sr Filomena, Bony, Afonso and the big truck)

Once at Maubara, the team got the gear prepped for the first week in the subdistrict of Letefoho. They left later than expected on Sunday, as they had to wait for Bony, our translator, who was coming from Maliana, where he had just attended his uncle’s funeral. They also had to execute some unforseen repairs on the old and new Forrest units, with help via phone from guru, Keith Mentiplay, in Australia.IMG_9589 But soon they were on their way, with Afonso (One of the Sisters’ drivers who has been on many of our trips before) and Bony, in a borrowed yellow tip-truck, carrying all our less-sensitive gear, and Wayne, Eve and Blanche in T2. The trip took 5 hours; the roads were a quagmire due to unseasonal rain. IMG_9719 (2)

Week 1 was a mixed bag – there were some inauspicious moments – discovering that they had left the needles back in Maubara, continual problems with the electrical supply, the splitting of the team at night for 2 days due to the unsuitability of their first accommodation option (think rats and fetid bathrooms); but there were also multitudinous incidences of care and kindness, joy and thankfulness. The first 2 days were spent in beautiful Lakau. There had been a lot of activity since the team visited this tiny village last year – there is a new Garden of Peace, complete with fishponds and gazebos, a covered community meeting place, and they are in the process of building a grand new church. The villagers were wonderful hosts – Eve’s diet did not get off to a good start. The needle issue arose on Day 1 and was resolved, with amazing rapidity, by Tino bringing them some needles on a borrowed bike, from Gleno (a 4 hour return journey). Tino had just been released from hospital (which is why he wasn’t working with the team)- he is our hero. Bony was also heroic in coordinating the team’s salvation – the negotiation of Lakau’s telecommunication network involved a great deal of climbing atop rickety structures.IMG_9683 (3)

The last 2 days of Week 1 were a dream spent in Goulolo School; the teachers were super-organised and helpful and provided the team with lunch and morning tea; the team was also back together, staying at the well-known Bakhita Centre, a health clinic and guest house ‘down the hill’ from Letefoho, in a pretty valley. Bony came into his own when presented with a microphone at the school; out came tooth brushing instructions, diet advice, jokes and encouragement for the kids – he is a born showman! He  is also a great networker, extremely sociable, very enthusiastic and takes great selfies- we reckon he’ll be President one day! The team’s highlight was the spontaneous eruption of song from the remaining children towards the end of the 2nd day – they  boosted the team’s flagging energy! The joyous song of Goulolo kids

The first weekend had been earmarked for the workshop that Sr Filomena, Blanche, Tino and Aida had been planning IMG_9889 (2)since last July. Also heavily involved was Ligia Ximenes, an attaché to the Timorese Consul General, whom Blanche had met at our big fundraiser in 2014, and who generously gave up her time to do the initial translation of the workshop material – thank you Ligia!!!! Bony had been recruited in April and he had spent a lot of time with Tino and Blanche discussing the workshop. The plan was for all three to meet back at Maubara in the afternoon on Friday to go over the presentation and to set up for the next day, which was to start at 8am. The reality was vastly different. The borrowed overhead projector had no cords with it. Tino and Bony stayed in Dili until 8pm at first looking for a replacement, and then waiting for the cords to be delivered to them. They arrived in Maubara at 9pm, and the team stayed up into the wee hours going over the material. IMG_9927 (2)The next day the projector refused to work for 2 hours, but no one showed up until 10.30, so that was ok! IMG_9912 (2)The presentation went well – Tino’s delivery was excellent – and all the participants (local doctors, nurses and midwives) found the information enlightening. Success! Tino was especially happy to have been given the opportunity to present the workshop and is keen to do it again. Tino is the TLDP’s longest mentored dental therapist and  he has now been given the opportunity to teach students of his own from the University of Timor Leste – he is a measure of our program’s success.

Week 2 was spent with 3 days in Maubara Clinic, a day at the community centre in Guiço, and 2 days in Atabae Hospital, where Bony’s brother is a doctor.IMG_9975 (2) Three very different locations – a small clinic; an open-air pavilion where the team was helped by the local health post director, Mr Paulino, who made all announcements to the patients via loud speaker; and the foyer of Atabae Hospital’s newly built administration building. In all three locations, electricity was sporadic. IMG_9947 (2)

Only in Maubara was there water on tap. Bony had lots of experience with sterilisation, with giving post-operative instructions,  and with divining what the dentists were trying to say. (Pic: Mr Paulino in Guiço)IMG_0059Unfortunately, the dentists discovered that nodding and saying ‘yes’ was not truly indicative of our translator’s understanding. A pact was made with Bony – he would tell them what he thought they were trying to convey (before delivering it to the patient) and they would give him more context. Bony was an excellent member of the team. His light-hearted company and the insight into Timorese culture was priceless. The team, especially Mana Eva, sadly parted from him at his home in Dili, which is almost prophetically close to the Presidential Palace! (Pic: Mana Eva and Bony)IMG_0066.JPG

Week 3 saw a 2 hour lumbering boat ride bring the green-hued team to the beautiful, reef- encircled, mountainous island of Atauro, which sits between two of the deepest ocean trenches in the world – 3000 and 5000m apiece! In contrast to the rest of TL, the population is a largely protestant. The people live in scattering of villages, many only accessible by water or foot. On a short visit last year, Wayne and Blanche had been asked by some of the locals to provide a dental service for this remote area. Two expats, Kevin Austin, who runs boat transfers to the island, and Barry Hinton, who owns an eco-resort with his wife, Lina, offered to help the team get over to the island, and to house, feed and transport them. IMG_0076So lucky Team 3 found themselves dossing down in waterfront grass huts at Barry’s Place in Beloi. Quiet, relaxing, super-clean with great food – the team recommend this as a great place to get off the treadmill and de-tech. Click here to go to Barry’s Place. Barry, Lina and Kevin provide many employment opportunities and training for the local Timorese people and are heavily involved in improving health and well-being on the island. (Pic: Blanche’s hut)

The team set up shop in a corridor of the Vila Hospital, about 10 min drive from Barry’s. Vila hospital opens at 9am, closes at 3pm and has no running water or electricity.IMG_0116 (2) Barry had spent a week fixing a diesel generator for the team (thanks Barry!), but they had to carry water in. Already tired, the team slogged through 3 days of heat, diesel fumes and some of the longest, largest teeth and hardest bone they had come across in TL. Many of the patients had walked for hours, often starting in the dark, to attend the clinic. Due to the patient’s early morning habits, the team ran out of patients by about 3pm each day, and so there was time for a recuperative snorkel and restorative beer. Unfortunately, Barry’s own generator was on the blink and his fridges had to rely on town electricity – available from 6pm to 6am. This equated to warm beer…or warm coke in the case of Mana Eva – yuk. (Pic: One of Lina’s health initiatives for local women – Zumba! They will be entering a Zumba competition in Dili at the end of the month)

IMG_9932

It was a productive trip. The team saw 387 patients, did 266 examinations, extracted 394 teeth, filled 185 teeth, did 108 preventive treatments, 27 cleans and 1 root canal treatment. They put a successful workshop under their belt and tested all the TLDP equipment. Mana Eva also went snorkelling for the first time, got on a small plane for the first time, and ate every strange vegetable that came her way! Good job Team 3! (Pic: Bony, Mana Eva, Blanche, Tino and Wayne)