Tag Archives: dental health

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)

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Last team to TL

Hot on the heels of Cowboy and Snake, TLDP’s last team for 2015 leaves Sydney today. After overnighting in Darwin, they will hit TL’s shores on Saturday. The team is a conglomerate of first time volunteers and seasoned TLDP-ers. Carolyn and David Digges will be joined by yet another member of the intrepid Digges family, David’s sister, Elizabeth, as well as newcomer dentist, Charmaine White. Geoff Knight will also be adding his considerable experience to this team in the second week when this team heads out to Bobonaro. Have fun team!

Cowboy and Snake Ride Again

andy and gordon in prisonTeam 4 returned home last Saturday following an intensely busy 10 days in and around Railaco. It has been a while since Drs Andy Moran (Snake) and Gordon Saggers (Cowboy) have been to TL, so they really noticed the improvements in infrastructure, particularly in the quality of the main roads and the availability of electricity; as well as improvements in public health, especially the reduction in betel-nut usage which has been attributed to a public health campaign.

Andy and Gordon were charged with taking over the pressure cooker steriliser that the TLDP has just purchased from India. The fabulous Rotary Coordinator, Daryl Mills, provided us with a spare gas bottle and the boys bought a gas cooker from a supermarket in Dili and now the new clinic in Railaco has a steriliser that can sterilise a load of dirty instruments in 15 minutes!

The pair had a smallish set of dramas unique to working in this beautiful place – on finding that they had the wrong set of handpieces for the dental cart, they had to endure the 4 hour return trip from Railaco to Maubara to make an exchange. They wrestled with a recalcitrant generator, stemmed the flood from a leaky scaler and negotiated the goat tracks, otherwise known as secondary and tertiary roads with audaciousness and resolve. The roads to Tarasu and Leorema are particularly BAD.

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Team 4 was kept extremely busy by the redoubtable Father Bong, treating patients in Railaco, Nasuta, Leorema, Railaco Leten, Gleno Jail, Daicerlaco, Tocoluli, Cocoa and Tarasu. Super-organised Father Bong had patients lined up and ready to go so the boys had very little downtime. He also organised two excellent support staff; a driver and interpreter, Victor, a Timorese who been a soldier in the Portugese army and had worked in Sydney as a cleaner in St Vincent’s Hospital and as a garbage truck driver in Liverpool; and Natalia, an ex-nun who was their nurse and interpreter.

In total, the team saw 335 patients; did 20 cleans, filled 353 teeth and extracted 425 teeth. As Andy puts it, “Not bad for a couple of old blokes”.

Many thanks to Henry Schein Halas who again stepped up to the plate and donated some much needed local anaesthetic to us, to Father Bong and Daryl, whose hospitality and efficiency we could not do without, and to Cowboy and Snake, for their sheer hard work. Fantastic job!

The lucky team returns!

Our last team for 2014 returned from Timor Leste a couple of weeks ago, tired but triumphant. The team was exceedingly busy both weeks. In the first week our intrepid team, comprising Dr Hans Raets (Team leader), Dr Yvonne Huijser Von Reenen and Ms Breanna Martin, made the first dental visit to the village of Lebuletta, a 90 min 4WD into the hills above Maubara. We are not sure they will be invited back – by hooking up to the village’s brand new electricity supply, they blew all the fuses!

Hans, Yvonne, Sr FilomenaThat same week, the team also visited the nearby villages of Paurobo and Kaikasa where they were dismayed by the high levels of decay. They were also plagued by equipment failures – herniated air lines, seizing of high speed and slow speed handpieces and malfunctioning valves on the steriliser. Luckily the team had Breanna – a secret expert in battling recalcitrant equipment. She singlehandedly fixed both the air line and the valves.

hans team 2014In the second week, the team was joined by Dr Geoff Knight and his daughter, Anneli Knight, as well as Aida, the Timorese Dental Therapist that the program mentors, who works in Liquiça and Maubara.

The team took off to Bobonaro, a 5 hour rough journey with spectacular scenery. They made a stop in the infamous town of Balibo, where Rotary is building a guesthouse and clinic (apparently the rooms and food are 1st class! We have already volunteered to test them out). A lucky team, they were fortunate to be just in time to see the Tour de Timor cyclists cross the Stage 2 finish line!

In Bobonaro the team was swamped by work, which was dealt with most effectively by using a special treatment protocol which Geoff has helped develop. With Geoff’s tutelage, Aida, in particular, has become extremely proficient in treating decay quickly  with basic equipment. A return visit next year is on the cards to assess the 344 teeth treated in this way.

Catastrophe struck on the ‘lucky’ team’s second last day. The compressor kicked the bucket at the worst time – when they were treating Sr Fatinha, our Timorese coordinator in Bobonaro. A 5 min job became a 2 hour job. Well done Geoff!

hotspringDespite equipment failures and  the bells and the dogs of Bobonaro, the team managed to maintain their remarkable spirit and goodwill throughout the trip. Could it be because of Anneli’s sterilisation efficiency  keeping them amply supplied with cold steel? Or was it super-dental assistant Breanna, with her continual rendition of AFL songs? Perhaps it was the pilgrimage with Sr Mendes  to the hotsprings at nearby Marobo? No matter what the reason, they were a great team!

Another successful trip despite many trials. The team treated a total of 578 patients. They extracted 321 teeth, filled 226 teeth and performed 438 preventive operations. Well done Hans, Yvonne, Breanna, Geoff, Anneli, Aida,  Sr Filomena and Sr Fatinha!

Team 2 report summary

Team 2’s visit in June was littered with challenges. An erupting volcano threw travel plans into disarray, a missed turn in the road meant an unplanned trip into Railaco, and  broken compressors and dodgy repairs limited both the work done in the first week as well as the team’s movements. Unfazed, the team – John, Tony and bilingual Sam, with our Timorese partners, Sr Filomena and Aida, the Timorese dental therapist – were able to visit the school in Dair and Liquiça Hospital, as well working in the Maubara Clinic. In total they carried out 829 treatments! Well done team!

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Not enough dentists in Timor Leste

Timor Leste (East Timor) has a population of 1.1 million people. Of the less than 10 dentists in the country, almost all practice privately in Dili, the capital. There are a few free dental clinics – also located in Dili.  In comparison, the vast majority of East Timorese live rurally, reliant on subsistence farming. Hence, for the majority of East Timorese, dental treatment is something that is both financially and logistically unattainable. The Timorese government has tried to address this need by employing Indonesian-trained East Timorese dental ‘nurses’ in some rural hospitals. Unfortunately, these individuals are poorly trained, have minimal experience and are expected to attend their communities’ dental needs with almost no equipment.

The Timor Leste Dental Program is based in Maubara, a town 60km west of Dili, a trip of about 1 1/2 hours. Each year, several teams of volunteer Australian dentists, dental assistants and other dental professionals give two weeks to help our nearest neighbours. The purpose of the program is two-fold: Firstly,  to support the rurally-emplaced Timorese dental nurses with equipment, training and mentoring so that they can better serve their communities. Secondly, to provide much-needed dental care to the people living in rural areas of western Timor L’este.

Timorese communities suffer from high rates of dental decay and much of our treatment involves extraction of teeth that have caused pain for years. Many people have never seen a dentist before. The chewing of betel nut is common and so there are also many extractions due to gum disease. There is also a high incidence of oral cancer and tuberculosis-influenced oral infection. We see many things over there that simply do not exist here in Australia.