Tag Archives: dental volunteers

Team 4, August 2025

Uncategorized, , , ,

August Atsabe and Atauro Adventures

Team 4:

William Hariman

Yvonne Bass

Alison Taylor

Paulo Salsinha Martins

Ana José Martins

Zaino Tison Martins

Diamantino Correir Morais

Ana Paula D.S.T. Salgado

Angelo Moniz Amaral

Friday, August 1

The team gathered in Dili — Alison and I travelling from Darwin, and Yvonne from Denpasar. We spent the afternoon preparing for the coming weeks. The various checklists and inventory lists the TLDP provided were very useful here.

It was a strong team: myself with significant experience with the program, and Alison and Yvonne with a wealth of experience to draw on to mentor our Timorese colleagues. Yvonne and Alison speak Indonesian and Portuguese respectively.

Fun fact: about 15 years ago Alison taught at the University of Adelaide — and taught me how to hold dental instruments and do my first examination on another dental student. Small world.

The Atsabe Team (top back to bottom front):

Dr William Hariman, Paulo “Paul” Salsinha Martins, Yvonne Bass, Alison Taylor, Ana Paula D.S.T. Salgado, Angelo Moniz Amaral, Diamantino “Tino” Correir Morais, Ana José Martins

Saturday, August 2……….to Atsabe

Most of our Timorese colleagues met us at Timor Lodge, and we drove to Maubara to pack the troopie. Packing took time, but considering we were setting up three dental chairs, it’s impressive how compact our inventory is.

It was a tough day of travel on rough roads — leaving at 8 am and arriving at 6 pm. Dinner at the priest’s residence was very welcome. The mountain air and scenery were a pleasant change from the coastal heat and insects, though the worsening roads were tiring.

Last time one of our vehicles went off the road, and this trip was no exception.

Fun fact: Yvonne donated some of her Canadian scalers and curettes to TLDP when she retired. They’re still in use here in Timor-Leste, though a bit worn down and resharpened.

Sunday, August 3

The mountain views were stunning.

Father Fidelius, the parish priest, was impressively organised. Instead of travelling to schools for screenings, he arranged transport for students and teachers to come to our clinic.

We set up in the morning and began treating patients after Mass. Ana Paula, whose organisational skills are exemplary, spoke with all patients initially and allowed for a structured pathway to receive their treatment.

One highlight was doing a surgical extraction with Tino, pushing the usual scope but going smoothly thanks to our combined experience.

We saw about 40 patients. Tino and Ana Martins worked well. Paul Martins was noticeably less experienced than the others, which underlined how important CPD and postgraduate education are in getting a new graduate up to the level of more experienced clinicians. Which isn’t just about hours but also requires deliberate practice and an expert eye. 

He especially needs practice with inferior alveolar nerve blocks, using a luxator, and caries removal.

39 patients seen.
Procedure		ExamTooth ExtractionFillingScalingFS AgF
Total394514312 2

Monday, August 4

A demanding day. I focused on coaching Paul, our new graduate colleague, through extractions. My vocabulary was enough to guide him through extractions, I left restorative teaching to Ana Martins and Tino.

We couldn’t do school screenings as planned — it would have meant closing one of our three dental chairs. 

We saw about 35 patients in the morning and 28 in the afternoon — close to our limit.

One notable procedure: was a sectional extraction of a lower left 6 with Tino.

That evening we visited the local hospital, about the size of a large suburban medical centre. The director said he’d send their therapist and hygienist to join us.The dental room attached to the hospital is very small and clearly has limited supplies. The hospital director reports shortages of anaesthetic, gauze and needles. Their dental chair is a mobile hand-crank model, donated by Tino. 

Father Fidelius’ advance coordination meant we didn’t need to travel between sites, unlike past visits.

ProcedureExamTooth ExtractionFillingScalingFS AgF 
Total626319116 37

I noticed many patients had hard black arrested decay in self-cleansing areas — likely a result of our work here a few years ago. 62 patients seen.

Tuesday, August 5

We walked through the weekly market in the morning — busy stalls of clothes, household goods and produce. A pig was going for $350 USD.

Views of the market with the Priest’s residence (and our clinic) a top the hill

Maria, the local dental therapist, joined us today. She usually avoids firm extractions due to limited tools and mostly only removes mobile teeth. Her infiltration technique could improve — important given their limited supply of anaesthetic.

Tino and Tison each see about 20 patients daily and are known for handling complex cases. Maria usually sees 1–2 patients a day. Some even travel from Atsabe to Gleno to see Tino.

One notable case today was a failed three-month-old filling placed without proper surface preparation or drills.

Paul is steadily building skills. Maria would also benefit from coaching, especially in using luxators properly.

Hand scaling and curetting could be developed here — low-cost and preventive.

Paul treated 13 patients today (11 extractions, 7 GIC fillings, several cleans) under close supervision. Over the next few days, he worked with increasing autonomy — a very short, high-intensity period of mentoring.

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total56551916019

56 patients seen.

Photos of the clinic in action. Notably Tino and Ana Martins are working independently while Paul benefits from closer mentorship

We fed a stray dog who took to guarding our clinic

Wednesday, August 6

Final Day in Atsabe

I took a lighter role while Tino and Ana worked steadily.

We limited treatment to extractions and GIC fillings, capped at 20 afternoon cases.

Bintang, the stray dog, followed us around the clinic, begging for leftovers and, even attending church — smelly but very cute.

We finalised payments: accommodation had been quoted at $20/night including food, but this time they wanted to charge $40. After a sensitive discussion, made culturally appropriate with Ana Paula’s help, we negotiated food down to $9/day. This matters because costs come from Rotary Dili’s account, and higher costs mean fewer communities reached.

Paul showed strong growth under the guidance of Ana, Tino, Yvonne and Alison. Maria improved too and could use donated anaesthetics if she consolidates her skills.

One lesson reinforced: even if someone is inexperienced, close supervision works — starting with the simplest tasks and progressing gradually builds competence.

Father Fideliez said locals prefer our clinic to the public one, even though the public clinic has scaling instruments. In a conversation with Alison, he suggested that the locals only receive medications for pain at the clinic, rather than having any required treatment. 

.ProcedureExamTooth ExtractionFillingScalingFSAgF
Total55641413017

55 patients were seen

Thursday, August 7

The drive back was long but smoother than the mountain roads.

The Atsabe parish’s high accommodation fees left the team feeling our work wasn’t appreciated. For now, we’ve agreed not to return soon.

We stopped to buy Timorese coffee and gifts. The local team spent the weekend in Dili with family.

Ana Paula, Tino, Angelo, Ana Martins and Paul gave Alison a heartfelt farewell — Paul even teared up when she said how proud she was of his progress.

Tino and Paul wishing farewell to Alison. Paul and Yvonne

Friday, August 8 ……a rest day in Dili

Alison Yvonne and I visited Cristo Rei. The stairs were breezy and pleasant, we enjoyed the murals and, I even practised manual driving with Yvonne.

We bid farewell to Alison at the airport with more warmth than the usual handshakes. Yvonne jokingly tried to convince her to stay another week.

A very intense week — this rest is much needed.

Saturday, August 9……onward to Atauro

Yvonne got us good seats on the ferry. Boarding was chaotic with livestock being herded aboard.

The priest said their church offices were recently broken into, so boys will guard our gear overnight. The beaches are lovely, seafood plentiful, and hygiene careful.

Making up for Alison’s absence Yvonne spent the evening teaching Ana Martins Uno, igniting her competitive spark.

We met the local hospital priest, who said the hospital has two OHTs and a dentist. Supplies seem fine. The Ministry of Health visits occasionally but mostly for general care.

Dive resort prices: $60USD scuba, $30USD snorkelling — very tempting.

Sunday, August 10…..a day of rest

A simple rest day — beach walks, swims, catching up on sleep and writing home

Anyone for Uno?

Monday, August 11…….into the Clinic

We set up in a hall near the hospital and met local OHTs Benjamin and Victor, and dentist Carmelita (from Dili, trained in Indonesia).

I watched Victor extract a 46. He used three carpules of lidocaine, showing this anaesthetic technique could use some improvement. He worked efficiently, using an elevator well and maintaining forceps control.

They lack restorative materials, root extraction tools, and have only enough instruments for one upper and one lower extraction before reprocessing. No chair or drills.

The Atauro Team left to right:Benjamin, Tino, Victor, William, Ana Paula, Yvonne, Ana Martins, Paul, Tison, Angelo, Carmelita

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total22268105

22 patients seen.

We took brief dental histories and found many patients had waited 5–10 years for treatment, often due to fear or low trust. The new team only started in May — previously a GP acted as dentist, doing what he could- mostly prescriptions.

Currently the Atuaro Hosptial Dental Clinic sees 1–3 patients a day. This shows how much reputation matters: experienced clinicians like Tino and Tison are literally 10x busier because they’ve built trust and a reputation in their community and surrounding areas. Having observed the skill of Ben, Victor and Carmelita, I would say that skill isn’t that much of a limiting factor. The delay in the free healthcare utilisation on the island is probably due to limited awareness and marketing- letting people know that there is a new dental team and they are more capable than the GP who was trying his best 3 months ago.

Some locals hesitant to see the hospital team were happy to see us — perhaps due to seeing friends treated successfully.

Literally every single dental instrument they have at the hospital. This means that they can only extract teeth and, can’t do some complex extractions. And every second patient has to wait for the instruments to be sterilised before being treated.

Tuesday, August 12

One notable case: 30-year-old had persistent bleeding after extractions of 36–38. We used tranexamic acid–soaked gauze (500 mg crushed in water), which stopped the bleeding after suturing alone failed.

Victor, Benjamin and Carmelita were initially absent in the morning as they needed the hospital director’s approval to join us.

I mostly sat and coached alongside Carmelita as she did restorations. Which she rarely does due to limited equipment as this location but, feels she needs to maintain so her skills don’t rust before such equipment arrives in the indeterminate future. 

During conversation learned that this year there has been two other dental teams visiting the island this year. A ministry of health team- which brought extra materials and equipment, proving mostly logistical and administrative support while Carmelita did most of the procedures herself. And a Brazilian dentist who focused on preventative and restorative work.

A long day but slept fairly well considering the sound of the mouse gnawing through the thatched walls of our accommodation- I hope he doesn’t chew through much else.

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total189133011

18 patients seen

Wednesday, August 13

I work up early to watch the sunrise at the beach and when heading back noticed Victor gifting us his morning catch of fish. A very kind gesture to express appreciation for our help.

I worked with Carmelita on fillings and root extractions. We also continues to talk to patients about how long they have been in pain for and why are they seeing us now instead of Carmelita earlier. One interesting observation is that life isn’t easy here and they are tough- waiting a long time for healthcare to be temporarily available has been normal for a long time. This here is the first generation of young dentists. Which probably means that us encouraging the community to attend the dental clinic in the hospital is important.

In the afternoon, Yvonne went diving while I snorkelled — pristine reefs and teeming fish. It was very refreshing to do a little bit of touristy/fun activities while here.Our Timorese Colleagues were able to run the clinic independently and well. Not only seeing patients and maintaining workflows but, also Tino, Tison and Ana Martins very capably mentoring the newer grads as well. In the evening, we grilled Victor’s fish with Ana and Tison’s freshly made sambal.

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total292226

29 patients seen.

Thursday, August 14

Another busy clinical day.

Villa Gracia has been a pleasant base despite noisy neighbours and a mouse chewing our clothes. The shady common area has been perfect for Uno games and escaping from the heat.

Paul has improved greatly, now handling trickier procedures. My concern is consolidating these improved skills — I strongly recommended that he should join future trips.

The young dental team at Atauro have decent fundamentals, are motivated and show great promise. What we covered with them was generally the uncommon and tricky stuff, what I would target most here is equipment so patient don’t have to wait for the hospital central sterilisation to be done after every second patient. Carmelita said the week was busy and she learned a lot. 

Points of improvement next time, earlier on we should match our record formats to match theirs and possibly work inside the hospital to show integration, though their rooms are less well ventilated — which matters on this hot island.

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total4254197220

42 patients seen.

Friday, August 15…….our final day

More patients arrived than we could manage. Victor triaged those needing extractions to return to see him, Ben and, Carmelita next week at the hospital- which fit in nicely with the wider strategy of encouraging patient to attend the hospital. One last thing we did was dispose of our garbage according to local procedures… by dousing it in diesel and burning it.

Carmelita said she enjoyed working with us and learned a lot, especially about the procdures she gets less exposure to i.e. fillings, sutures and root extractions.

We left her an extra set of instruments, including root forceps, so she can now do three extractions per sterilisation cycle instead of two. An improvement of 50% throughput increase.

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total2440

24 patients seen.

Reflections

347 patients seen.ProcedureExamTooth ExtractionFillingScalingFSAgF
Total347378135572012

I think revisiting Atauro would be helpful but, what they really need is more extraction instruments so they can more reliably treat patients in a timely manner. These three young clinicians are very promising

Prior to Paul joining, Ana Martins was the newest regular member of the TLDP and mentoring Paul reminded me of watching David, Henry and Ana Tilman take turns teaching Ana Martins years ago. It’s repetitive and takes time, but Ana’s progress is clear — this trip I saw Ana teaching Paul more complex anaesthetic injection techniques the same way she learned from 5 years ago. 

This demonstrates that through the program’s mentorship there is a growing pool of knowledge that has been maintained and passed on multiple times from the slightly older to younger Timorese clinicians with Paul representing the newest generation in that line.

While initially unsure due to his lack of experience, Yvonne, Alison and, I are proud of Paul’s development and look forward to seeing how much of this improvement he consolidates on future TLDP trips. 

It was tiring but, rewarding.

I am grateful to the team for their skills, insight and most of all, company. We have made a small part of the world a slightly better place and that means a lot. –Dr William Hariman 

TLDP Team 3 2025

Uncategorized, , , ,

Railaco, Kasait, Maubara and Maliana

June 20 to July 5

Team 3 followed a well travelled path, following the same itinerary that we have used for the last few years.

However, this year we had a new addition with Dr Charlotte accompanying us for the two weeks. She was the recipient of an ICD scholarship that enabled her to spend time volunteering overseas and we were fortunate to have her join the TLDP. Team 3 also included our long-time Timorese colleagues , Ana Paula, Ana Martins and Tino Morais and also our recent Timorese recruit, Dr Delsita Martins.

Tino, Ana Paula, Dr Henry, Dr Delsita, Dr David, Dr Charlotte and Ana Martins

Dr David and Dr Henry arrived together into Dili on Friday, June 20 after travelling from Australia with the usual odds and ends of dental stock that the new team would require. A well worn path ensued, picking up the Troopy from Mario and Judite at Dom Bosco, shopping for provisions, mozzie coils, paper towels and the like at the Leader supermarket, collecting Ana Martins on the outskirts of town and then heading southwest for the hour long drive to Maubara. We store all of our stock and portable equipment at our Maubara Clinic which is hosted by the Carmelite Sisters. Stocktaking and packing of the Troopy and the Sisters Landcruiser took a few hours before we retired to enjoy a well earned beer.

The next morning saw us screening the children from the local orphanage, generally good teeth courtesy of the watchful eyes of the Sisters but the usual conundrum of potential ortho extractions without the ortho.

Then Dr David and AM departed in the Troopy for Railaco and Father Bong and his fellow Jesuits whilst Dr Henry headed back to Dili to collect Ana Paula and gather Dr Charlotte from her afternoon flight before also heading up into the hilltop destination of Railaco.

Somehow we squeeze 4 dental chairs and the plethora of equipment needed into Father Bongs medical surgery.

Having our presence broadcast at the big Sunday mass ensures that our clinic is busy for the next 4 days.

We have been coming to Railaco for a number of years now and it is heartening to see the improvement in the oral health of the children attending the large boarding school close to our makeshift surgery. We can see the real world effects of removing non viable first molars and having the teeth behind close the gap. Also we can assess how our silver fluoride/ glass ionomer restorations are protecting and saving teeth.

The Jesuits are good hosts and enjoy our company with interesting conversations around the meal table.

The days pass in a haze of mosquito coil smoke and finally it is time to load the cars and make an early morning departure for Kasait where we are to work in a community hall, close to the main highway just southwest of the port of Tibar. It’s hot and noisy with our overworked fans blowing away the diesel fumes whilst trying to keep us cool. However, our presence was appreciated by the locals and we had a busy day and a half of clinical activity.

Lunch is nearly ready!

Then the team moved onward to Maubara where we enjoyed dinner at the orphanage with the Carmelite Sisters. The highlight is the distribution of presents to the children……T-shirts, balls, bubble blowers elicits a lot of gaiety.

Our second week is to be spent in Maliana, a regional town about 3 hours distant. An early start sees us at Balibo where we enjoy pizza and beer at the Balibo Fort cafe. Then onward to our clinic in the Maliana hospital. We enjoy a good relationship with the Director and his staff and they help us unpack into the unused clinic built to cater for Covid patients who never came.

Somewhat disconcertingly, we share the building with the TB clinic.

The spacious clinic allows us to set up our 3 chairs, each with its own portable cart and suction. Whilst in the room next door, some surplus hospital beds make for an impromptu extraction clinic.

We asked the hospital if they could provide some coffee…..it came with biscuits and 5 kilos of sugar. What more could a dental team need!

Dr Charlotte was inducted into the “rooftop bar” hall of fame. We are still waiting for the owner to build the second storey.

Deconstructing an acrylic bridge.

After 5 busy days in our Maliana hospital clinic it is time to pack up and leave. We have a quite formal meeting with the hospital hierachy where we present our impressive statistics and then there is the requisite photos. Their dental clinic is woefully short of many things and they ask us if we could help by providing some odds and ends when we come next year.

Then it is into the cars and we set off for Maubara with a stop at a roadside Warung for lunch.

Some of the orphanage children pose for a pic with Dr David and Dr Charlotte

Unpacking and stocktake completed in Maubara we decamped to Dili for some well deserved refreshments at the Timor Plaza Sunset Bar to celebrate a successful Team 3

TLDP Team 2 June 2025

Uncategorized, , ,

The wettest visit to Timor Leste with the most driving to do much needed dentistry in far flung regions.

31 May to 14 June 2025

Arrival and First Week: Maubara & Vatu Vou

After the usual shopping for supplies in Dili, our team travelled to our Maubara Clinic, the base for the first week.

On 2–3 June, we worked at Vatu Vou school. The road to the school has improved greatly since previous years, making it far more accessible. The school had not received a dental visit for several years, so we focused first on the older children, with plans for a return visit to treat the younger students.

Equipment Repairs & Limited Clinic Days

On 4 June, we welcomed Steve Hodgkin, a Canberra-based dental equipment technician, who joined us to service much-needed equipment. Importantly, Steve was accompanied by Januario, a Timorese trainee technician, as there are currently no dental equipment repair specialists in Timor-Leste. Steve was also supporting two other Australian charities and the government clinic in Gleno, so his expertise was in high demand. Despite the challenges of ongoing repairs, Mary worked hard to continue examining patients.

John Denton, Mark Leedham, Steve Hodgkin, Mary and Januario

5 June was another of Timor-Leste’s many public holidays, so the clinic was officially closed, though we still managed to see one patient and treat the Sisters.

On 6 June, we returned to a full clinic day.

Maubara totals:

  • Patients: 121
  • Extractions: 67 teeth
  • Restorations: 40 teeth
  • Fissure seals: 2 teeth
  • Silver fluoride: 7 teeth
  • Cleans: 8 patients
  • Fluoride: 1 patient

Journey to Uato-Carbau: The Long Road East

On 7 June, we returned to Dili to collect Geordie and Shane, two young dentists from Queensland who had previously volunteered in 2024.

The following day (8 June), the team embarked on one of the most demanding trips we’ve attempted: a full-day drive to Uato-Carbau at the request of the Ministry of Health. After a lunch stop at the Pousada in Baucau we arrived after dark to this remote region The nearest government dental clinic is over three hours away, across an unsealed road to Viqueque.

Uato-Carbau is sparsely populated and home to Mundo Perdido (“The Lost World”), Timor-Leste’s last remaining rainforest.

Dentistry in Remote Villages

On 9 June, we travelled more than an hour from Uato-Carbau to a very remote village, where the team was kept busy with extractions.

On 10 June, we set up in another village meeting hall for another full day, again dominated by urgent extractions. That night, heavy rains began — marking the start of travel difficulties that would soon challenge the team.

By 11 June, the rainfall was so intense that patients could not reach the clinic. Concerned about becoming stranded, we made the difficult decision to begin the return journey.

Tison volunteers to check the water depth for our vehicles crossing

On 12 June, after three hours of wet and rough driving, we arrived in Viqueque, staying at Ana Paula’s sister’s guesthouse. We visited the government clinic next door, where we found a broken dental unit — a common problem across Timor-Leste. Encouragingly, the clinic had good supplies of extraction instruments and anaesthetic, and a highly motivated assistant director who shared that a new clinic is planned for the town.

Viqueque also carries deep historical significance. The town’s striking church, built during Indonesian occupation, was the site of a massacre in 1983, where 1,000 people were killed. In front of the church sits a car in which two nuns lost their lives — a stark reminder of the nation’s turbulent past.

Uato-Carbau & Viqueque totals (3 days):

  • Patients: 107
  • Extractions: 167 teeth
  • Restorations: 15 teeth
  • Silver fluoride: 27 teeth
  • Cleans: 8 patients

We return to Dili

On 13 June, the team drove the four hours back to Dili to ensure Geordie and Shane could catch their flight home.

Reflections

Team 2’s 2025 visit will be remembered as one of the wettest and most travel-intensive trips we have ever undertaken. Despite the weather and logistical challenges, we were able to provide essential care to over 228 patients across the districts of Maubara, Vatu-Carbau, and Viqueque.

The trip highlighted both the progress and ongoing challenges in Timor-Leste: improved roads to some schools, but a lack of functioning dental units across government clinics. We must thank Mary for her leadership and importantly, organising her technician Steve Hodgkins to service much of our (and other groups) equipment. He was able to mentor the training of a Timorese dental technician which offers hope for more sustainable solutions in the future.

Even with fewer clinical days than usual, the dedication of the team and the resilience of the communities we serve ensured that our work made a lasting difference.

TLDP Team 4, July 2024

Uncategorized, , ,

TLDP Team 4’s Maubara Extravaganza

Necessity is the Mother of Invention

Usually we plan for our Teams to include one or two experienced Australian volunteers who are on hand to guide any new team member on the twists and turns that visiting Timor Leste will invariably provide. However issues out of our control meant that we would be sending Dr Kristina, our newest volunteer, to Timor Leste with no mentor. It is a testament to the systems we have in place and the abilities of our Timorese colleagues that we could contemplate this. Dr Kristina, a very capable dentist in Darwin was good enough to accept the challenge and so with a flurry of briefing notes and a mountain of supplies she set off for Dili.

It wouldn’t be a proper trip without aircraft delays due to emergency evacuations and the confiscation of dental supplies by officious customs officers due to “missing paperwork”. Met by Ana Tilman (our longtime dental colleague), Dr Kristina was taken to the customs office in town to remedy the paperwork, but no, you will have to come back tomorrow to retrieve the impounded stock. Visiting the Rotary office to say hello to Mario and Judite, picking up the petty cash and then our Toyota troop carrier was on its way to Maubara to deliver Ana T and Dr Kristina in the early evening. The Maubara accomodation induction is fairly simple and Kristina was soon well versed in the fine arts of throwing water over herself and dealing with mosquito nets.

The next morning saw the Maubara clinic humming along with the usual mix of treatments including impacted teeth, silver fluoride restorations and scale and cleans. After lunch it was back to Dili to retrieve the errant stock from customs, pick up a SIM card to communicate with the world and then the hour long return journey to Maubara. The road is generally good, however there are well known potholes and other impediments that necessitate some local knowledge. Our Troopy driver, Abico is all over it.

The ubiquitous Tum-tums, an infestation of electric powered 3 wheeled taxi’s need special care as they seemingly randomly deliver school kids and shoppers along the highway for a 25 cent fare.

Back at Maubara, wanting to get an early start in the morning, the Troopy was packed with stock and equipment for tomorrow’s out reach visit to a local school.

The water tower at the Maubara clinic which also hosts the clothes line affords a lovely view of the sunrise for the early risers. One of whom wasn’t Abico, our driver who slept in such that we did not make the school until mid morning. After setting up our equipment, with our first patient in the chair, only to have the local power fail. No problems, we have a backup generator, however that refused to proceed so the spare was sent for. Finally getting the clinic in gear to find that most children go home from school at midday. All was not lost with random children and community making a busy afternoon. Welcome to Timor Leste!.

Back to Maubara in time for Dr Kristina to get to the beach and have a swim, watched on in awe by our two Ana’s. Something about crocodiles.

The rest of the week was spent treating all the children from the school we were set up in. For most of these kids it is their first dental experience, however peering through the windows of our classroom clinic gives them an idea of what is to come.

There were also many new experiences for Dr Kristina , both dental and cultural, our local team enjoying her company while looking after her. Here, try this tamarind from the garden, this chilli won’t be hot and the word “doben” will surely come in handy.

Finally the week draws to a close, the equipment is packed back into the clinic to await the next team, the Ana’s do a stocktake of consumables to update our inventory and then it’s time for dinner and a well deserved sleep.

Back to Dili the next morning with time for Dr Kristina to see the museum, art gallery and Christo Rei before flying back to Darwin.

A whirlwind week for her, she left after making new friends, enjoying new experiences and helping provide much needed treatment for the people of Timor Leste.

TLDP Team 3, June 2024

Uncategorized, ,

/        TLDP Team 3 Visits Railaco,  Kasait, Maubara and  Maliana 

June 2024

It was a case of getting the band back together for Team 3 with Dr David joining Dr Henry and old friends Ana Tilman, Ana Martins, Ana Paula and Tino, together with our new travelling colleague, Tison. 

For the first time, we ran two teams back to back which was something new for our Timorese colleagues. This would involve meeting Dr Mary and her Team 2 colleagues in Dili, taking possession of the cars and equipment, dropping them to the airport and we would be on our way. Our rough plan was to travel up to hilltop Railaco to stay with our Jesuit friends, back down to the Kasait medical clinic and then pass through Maubara to visit far flung Maliana close to the Indonesian border.

 Dr Henry arrived first with some concerns as to how the airport customs officers would view his stash of anaesthetic and new equipment. Getting a chalk cross on his suitcase and told to go unpack everything over there didn’t sound great. However, pointing to the Rotary logo on my polo whilst mumbling the words “Carmelite Sisters, Mario and Rotary” seemed to do the trick and I was pointed to the door. 

Dr David who arrived on the next flight took the opposite tack, taking his chalk cross as a tick of approval he disregarded instructions, assumed an imperious air and strode for the exit unhindered.

It was good to catch up with Dr Mary and her new volunteers over lunch, exchange news, hear about their travels and any problems that may have arisen. One of which was the Sisters car needing some mechanical love before it could proceed, which involved running around rush hour Dili to find some expertise.

The next morning saw us depart Dili, picking up our local team members along the way for the trip up to Railaco.

Met by Father Bong, he allowed us to appropriate his small medical facility and we transformed it into a squeezy 4 chair dental clinic. We saw a trickle of patients that afternoon which became a flood after our presence was advertised at mass the next morning.

 

In parallel, we continued our screening and treatment of the children at the secondary boarding school next door. It was gratifying to see that the classes that we saw last year were generally dentally healthy, allowing us to do some less invasive treatments such as scaling and cleaning teeth. However the new (to us) incoming Year 9 class had plenty of problems to attend to with these students coming from a range of socioeconomic backgrounds over a large regional area.    

Father Bong and his Jesuit compatriots are great hosts, understanding that our team brings much needed dental help to their community and we all enjoyed their stash of altar wine and lively after dinner conversations. 

After 5 days we packed our portable gear away and travelled down through the hills to the medical clinic at Kasait, adjacent to two schools and a small University. A mix of academic staff and community were seen on the first day with the next day devoted to students and their self diagnosed issues. There were some clever ones who could get into Ana Paulas queue with a pain issue only to have it disappear in the chair but “could you clean my teeth while I’m here”. 

It can be a problem allocating resources, generally an abscessed tooth trumps teeth cleaning but it’s not easy to keep everyone happy. 

As always, Dr David would wander through the waiting area, triaging the throng, those needing a simple extraction would have their anaesthetic administered sitting on a semi private stool and would be nicely numb when a dental chair became available.

 

Friday afternoon saw us packing up our stock and equipment into the two cars, with all hands on deck we can get this process down to just over an hour with no nook and cranny left unfilled.

An hours drive down the road saw us at our Maubara clinic, a quick wash and a change of clothes and up to the Carmelite orphanage for dinner.

Visiting the children is something of an institution for us, familiar faces to say hello to and then the much awaited presentation of our gifts. T shirts, balls, hair ties and bubble blowers are dispensed with much laughter and general chaos. 

Of course the most famous ex student of the orphanage is our very own Ana Martins, making the jump from being Dr Davids 15 year old dental nurse to studying dental therapy in Kupang and now accompanying us on tour.

The next morning with the cars already fully loaded, we had some time to check the orphanage kids teeth (to be treated in the near future by Ana Tilman) before setting off on the 4 hour drive to Maliana. 

 

The main coast road is much improved with Chinese road building companies in evidence, but the goat track from Batugarde up to Balibo certainly needs a little love. The reward for making the bumpy ascent is to visit the Balibo Fort for pizza and refreshments, always a hit with the Team. 

Then onward to Maliana for our planned rondevoux with the empty Covid ward in the big regional hospital. 

A small fly in the ointment was that they weren’t expecting us, with the security guard suggesting we should make an appointment to see the Director on Monday. But wait…there was the Director making a random weekend visit to his office…….corralling him we explained the situation, blaming the lack of warning of our visit on beaurocratic bungling in Dili and with much nodding and shaking of hands we were given the keys to the  salubrious Covid wing of the hospital. Air conditioning, tiled floors, flushing toilets and plenty of power sockets…….what more does an itinerant dental team need?

News of our arrival spreads fast and for the next 5 days we are kept busy seeing hospital staff, other community, local clergy and many students from a large Catholic boarding school 3 kms away. Not one to look a gift horse in the mouth, their mercurial headmaster sorted out any staff and children with dental issues and drove them to us for treatment.

We even were able to co-opt some of the students as dental nurses, the 10 minute rapid training module proving adequate to hold a dental sucker or the hand of one of their colleagues.

Our evenings included time for discussion about issues that may have arisen through the day, ranging from endodontic treatment, bleeding control through to how to treat a dislocated jaw.  

One situation we needed to give consideration to is what to do when a very young child presents with multiple abscessed teeth that would be best treated using a general anaesthetic. We are placed in a difficult situation, wanting to help those in pain but facing the reality of dealing with unwilling patients and not wanting to traumatise them if it all goes pear shaped.

Finally on Friday, our time at Maliana comes to an end, the full executive of the hospital meets with us to thank us for our efforts and we are presented with traditional Tais as a parting gift. 

Back on the road again we pass through Balibo too early for pizza and drive right through to Maubara with just a quick stop at a nascent beach bar for the obligatory selfies.

Unloading our equipment, a stocktake to make sure our next team has the neccessary materials, goodbye to Tison who lives near the clinic, handing the Sisters car back to the Sisters and then packing the 3 Ana’s into the back of the Troopy we roll back into Dili.

Goodbyes said, data collated, promises to write, the Troopy delivered to Rotary Mario and suddenly a busy two weeks with our team is over.

Having gleaned an impromptu invitation to a garden party being attended by the President and other officials, Dr’s David and Henry set off to the presidential palace where we were able to buttonhole the Deputy Health Minister to appraise him of our work and of the great need for dental education and services, particularly in the rural districts of Timor Leste.

Debriefing with refreshments back at the Timor Plaza Skybar we were able to reflect on a busy and successful trip.

Patient Statistics

Total Patients Examined: 702

Extractions: 565 teeth

Fillings: 479 teeth

Fissure Sealants: 79 teeth

Silver Fluoride treatments: 338 teeth

Scaling: 120 patients

Endodontic treatment: 3 patients 

On the Road…again – memoirs from Team 2

Uncategorized, , , ,

How quickly the months roll around.

It seems that I’d only just finished taking my antimalarials from my last visit to TL, when it was time to visit the Doctor to get a new prescription and update my shots. 

Of course, there had been a preamble for months. Organising our new team members, a flurry of emails from Blanche, the program coordinator, various docs for various bureaucrats, the logistics around stock and equipment and then who will transport what from where.

Team 2 consisted of the old guard Henry Gilkes, David Digges, Ana Tilman, Ana Martins, and Nico Pires, with the new faces of Rupa Mannan in the first week and Niamh Grant and Ben Abbott in the second.

Henry and David arrived into Dili on Friday, June 23 to be met by Mario, our Rotary man on the ground. Troopy delivered into our hands, we set off for the Timor Plaza Hotel to negotiate an upgrade to our budget single room. Fortunately, success was on our side. We also had the pleasure of catching up with Isa, a long-time helper of the TLDP, and meeting her very partner Levi. Isa regaled us with tales of her busy life, juggling work and studies.

Next morning it was an early start in the Troopy, picking up Ana Tilman (AT) and Ana Martins (AM) on our way to Maubara to collect the Sisters’ car and load both with our equipment. We’re met by Nico and in his usual efficient manner both cars are loaded with everything but the surgery kitchen sink and we set off back toward Dili. With a little time to kill, we visit the Carmelite stronghold at Fatuhada to fly the flag and chat with the Sisters and some of the young adults who live there whilst studying. 

As ever, David managed to pull a crowd! 

We split into two – Sisters’ car departed for the airport, raiding the Leader supermarket on route before collecting Rupa with her cargo of stock, whilst the Troopy headed up the mountain to get a head start on our portable surgery setup at the Jesuit stronghold in Railaco.

Reunited somewhat later, we completed the finishing touches, testing the equipment to find that the much travelled refurbished triple syringe was still misbehaving. Rupa was acquainted with the bathroom facilities and relived school camp by bunking with AT and AM in the dorm. We suspect there was a lot of talking after lights out! 

Catching up with Father Bong and the other Jesuit priests for the evening meal before an early night to ready ourselves for the next day.

Somehow the news of our dental caravan is woven into Sunday mass and we hit the tools as soon as people left the church and wandered across to our clinic. No rest for the wicked – we had a full day of patients in their finest church attire.

Our working days start typically around 8am, usually rolling in to a group of locals who gather patiently at the clinic awaiting our arrival. 

Our primary objective in Railaco was to work our way through the school students at the nearby Jesuit boarding school, finishing the job that we started last year.

With 6 operators we sent three of us on the 5 minute walk through the cemetery to the school. AT marshalled the children, they fill in brief details on a chit and then filed past two of us to be examined by headlight and loupes using a no-touch technique. 

Having now created 2 groups, the “neehan diak” (good teeth) group wandered back to the classroom whilst we escorted those selected for treatment back to the clinic.

There is much nervous chatter discussing whether their paper says “solda” (filling) or “fokit” (extraction). The children face the dental unknowns ahead with stoicism, you can’t help but wonder how this would be going down in Australia. 

We see many instances of children who have had chronic pain for months, unable to eat properly and surely affecting their academic performance.

The days settled into a similar clinical pattern, 4 chairs working generally flat out until we ran out of patients around 5.30. We rotated operators as needed, particularly when there was something interesting happening where we could observe and offer guidance to our local colleagues. We can see an improvement in their clinical skills from last year, Nico proving to be a master of extractions and AT revelled in rebuilding smiles!

After our last patient, floors are mopped, benches tidied and we hit the bathroom to wash off the daily grime. Dinner with our hosts with wide ranging discussions and then sometimes a quick tutorial about something pertinent such as nerve blocks and filling techniques. 

One evening a guitar was procured and Rupa and AT regaled us all with their lovely voices and impressive musical prowess. 

An equally noteworthy event took place during our time in Railaco, when an Australian couple, who had sponsored AM throughout her three-year dental hygiene course in Kupang, paid us a visit. Emotions ran high as AM, who had limited contact with her sponsors over the years, finally had the opportunity to showcase the skills her benefactors’ gift had bestowed upon her as a young woman from the Maubara orphanage.

Dr David and Ana Martin, her two benefactors, and Father Bong

Halfway through the first week, we received disconcerting news about our planned access to the Maliana Hospital in our second week. A high-ranking bureaucrat at the Ministry of Health (MoH) had taken it upon himself to disregard all previous correspondence regarding our legitimacy and insisted on additional documentation. It appeared that the change in government had brought everything to a grinding halt. Determined to resolve the matter, we procured necessary numbers, made calls, and engaged in back-and-forth discussions with the Carmelite Sisters. Finally, a vague promise was made that a decision would be reached by the end of the week.

By Wednesday afternoon we had finished in Railaco, so the next morning, we trundled down the mountain stopping for some photos in a traditional village, to the expansive Jesuit institution at Kasait.

Ensconced in the medical clinic, we unpacked and saw a trickle of patients who magically appeared.  Treating ourselves to a pizza dinner at the nearby Lauhota Beach Bar in the late afternoon we found daylight fading early with a swiftly appearing thunderstorm. Note to self: driving at night is not much fun with other traffic sometimes having no lights and the Sisters’ car headlights powered by votive candles.

Friday saw a full day of children, arriving with their very organised signed parental consent forms.

Still, the decision from the MoH remained elusive. In a stroke of genius, we reached out to the Director of the Maliana Hospital, Dr. Monez. A call was made to the MoH, and later that day, we received the long-awaited good news: we would be welcomed with open arms.

Saturday morning saw the team arrive back at our “home base” in Maubara clinic. Our plan was to only see the orphanage kids and any Sisters that might require some dental attention. We are trying to teach the local community that our two Timorese colleagues are more than competent to treat them and not to wait until the foreigners come before seeking treatment.

Rupa enjoyed looking after her cute little patients before it was time to whizz her into Dili for her flight back to Darwin. In a seamless transition we also picked up Niamh and Ben from the airport with their much needed cargo of gauze. Then back to Maubara we went – it’s becoming a familiar trip with us now knowing the potholes on a first name basis.

We retired up to the peaceful surroundings at the Carmelite stronghold of Fatubese. Perched up on the ridge with lovely views over the ocean, its a pleasant introduction to life on tour for our new crew.

Back to the orphanage for dinner with the highlight being the distribution of presents to the assembled children. There is much excitement as balls are thrown, bubbles blown and T shirts tried on. Good luck getting them to bed early that night!

Sunday morning saw us on the long and adventurous drive to Maliana. It’s quite a picturesque journey, initially following the coast south toward the border with expansive views toward offshore islands and then passing large swathes of rice paddies. Coastal villages whizz by with their slowly drying fish dangling in bunches and newly minted bags of salt set neatly in rows. Children line the road in their Sunday best clothes, returning from church, often walking barefoot and carrying their high heel shoes.

At Batugade the road turns away from the coast and ascends the mountain toward Balibo. Memories of bitumen with a white line are soon forgotten and it’s slow driving with the road no more than a rutted gravel track with some forlorn strips of old tar. 

The reward is a lunch of pizza and beer at the Fort Hotel in Balibo, an unlikely oasis in this rural part of Timor Leste. It’s also an opportunity for our new team members to visit “Australia House” and read the history of the 5 journalists who lost their lives here in 1975. A poignant place that has a small dental surgery attached, supported by dentists and donations from Victoria.

Then it’s back down the other side of the mountain, across the long bridge over the wide pebbled river, skirting the Indonesian border and we arrive into Maliana. With much low rise housing and  plenty of trees, it is hard to see how this is Timor-Leste’s third biggest city.

Met at the hospital by Mia, our friend and local organiser, we were shown to our new clinical home for the next week – the hospital’s new Covid annex, purpose built a couple of years ago it sits unused, full of fancy hospital beds, flushing toilets and air-conditioned. Laying out our instruments and consumables, setting up our portable chairs in this perfect situation it seemed strange that until a couple of days ago the MoH was making our life very difficult.

Accommodation was up the hill at Bethania, a partially used seminary and not a hardship posting. A wide bed, air-con and mozzie screens left Niamh and Ben wondering what I was on about with my pre-team missives about the challenges of life on the road. To Niamh’s relief, we were yet to meet a crocodile, although it was early days.

Our brief for the next 5 days was to screen and treat the children in a local middle school, see the community who invariably arrives after hearing of us on the bush telegraph and minister to the young hospital staff.

Starting early, the team splits into those who start on already-formed queue we encounter as we arrived and those who head to the school in the Troopy.

At school, Ana Tilman works her magic, taking names and ages whilst those with loupes and lights pass down the row of desks, the children standing and opening wide to expose their teeth. Once we had a suitable number for the Troopy ( a number not found in the Toyota manual but we suspect close to 20) they were shepherded outside and transported back to our makeshift clinic. Clasping their small chits inscribed with their fate, they cluster in the hallway under Mia’s watchful eye.

How many kids fit in a troopy? https://vimeo.com/849710805?share=copy

Tuesday saw Dr David leave in a thunderstorm for the long trip back to Dili, an unenviable journey in wet and gloomy conditions. Thankfully, he survived!

By the end of the week we were a well-oiled machine, our favourable working conditions enabling a lot of dentistry to be performed.

Just as Rupa had shown our local colleagues some tips and tricks, Niamh’s oral surgery skills and knowledge provided valuable insights for us all. One lucky banana skin is still in ICU after being put back together in our evening tutorial.

Finishing our school project in the nick of time on the Friday afternoon, we carefully packed up after the last patient, took the obligatory photos with the local dignitaries and got ready to hit the town for a big night out in Maliana. 

For the two Ana’s, this involved a mysterious ritual known as “preperating” that involved hair washing, a selfie, clothes trying on and selection, more selfies, makeup application, a final selfie for the road and then appearing fashionably late! 

An early start on the Saturday for our trip back to Dili enabled us to call into a small orphanage in the Loes area to remove any painful teeth and perform some basic silver fluoride treatments.

We continued on to Maubara to unload the cars, stocktake and sterilise our recently used instruments. Delivering the Sisters’ car back to the Sisters, we farewelled Nico to bike it back to his family in Dili, while we continue on in the Troopy. Those sitting on the rear bench seats discover that leaf springs and potholes make sports bra wearing mandatory. And that was just the for the guys!

Spying a large plot of flat land near the road, Dr Ben provided some driving instruction to Ana Tilman who is becoming more accomplished (or less dangerous) every year.

Foregoing mass, we took a Sunday drive to the Cristo Rei statue with its views over the bay toward Dili before heading back to the airport, delivering the Troopy to Mario, expressing fond farewells and suddenly it’s all over.

Team 2 examined 1126 patients in our two weeks, removed 592 teeth, filled 173 teeth, sealed 470 fissured teeth, silver fluorided at least 520 teeth, and provided a clean for 52 new friends.

In addition, we had Ana Tilman stand in front of various groups of children to provide oral hygiene instruction, whilst in the clinic we pleaded “decrease your sugar intake” and “could you please limit your betel nut chewing to one a day”.

Of course none of this would be possible without those that sponsor us, in particular Henry Schein and Southern Dental Industries ( providers of the wonderful silver fluoride/potassium iodide). Also we operate under the aegis of the Rotary Club of Chatswood / Roseville which provides insurance cover for the team and a mechanism for tax deductible donations to the TLDP.

To all those who have donated, your contributions have been instrumental in supporting education, salaries for our Timorese staff, and the procurement of essential anaesthetics and dental supplies.

timordentalprogram.org/donate-now

Finally, a big shout out to our program coordinator, who finds time in her busy life to marshal the teams, deal with sponsors, herd the cats, grey her hair with bureaucratic dimwittery, point the Carmelites in the right direction, WhatsApp the local crew and occasionally stamp her foot when required. (Thanks Henry-B)

Henry, July 2023

The Delightful Frustrations of Being Back.

Uncategorized, , ,

Deep in our hearts we knew that the first trip to TL in almost three years was always going to be an unknown quantity. A change in government with the accompanying change in administration meant that we had to renegotiate to be able to continue to provide the same services that we have provided for the past 20 years. And after over 6 fruitless months of texts/emails/calls to seemingly every official person in TL, we decided upon a new strategy:

Wing it.

So we sent in Team 1. The Australian contingent consisted of a single sacrificial victim – Dr Peter Shakes – who was to brave the sea of endless red tape for the rest of us. Luckily, he had the support of a hefty, indefatigable Timorese contingent, consisting of TLDP veteran dental therapists, Nico Pires and Ana Tilman, who have continued to run the Maubara clinic throughout the pandemic; our very able first mentee, and now head dental therapist in Gleno Hospital, Tino Morais, and new graduate, Ana Martins, who the TLDP supported through her studies. (Title image: From Left Nico Pires, Tino Morais, Ana Tilman. Image below: Ana Martins assists Tino Morais)

The trip was the typical mixture of trial and tribulation. After much paper shuffling prior to arrival, and expert shepherding by super-reliable Rotary Liaison Officer, Mario Jesus, Peter glided through customs. However, even Mario was unable to ensure that those pre-arranged meetings (that Peter had arrived early for) with the Departments of Registration, Pharmacy and Cooperation went ahead. The meetings were rescheduled for Monday and Team 1 lost a clinical day.

The weekend was spent prepping equipment for the week ahead and the boss of Maubara Clinic, Sister Fatima, ensured Peter received the full Carmelite spoiling. Peter and Mario returned to Dili on Monday morning for the big meetings – described by Peter as, “impacted third molar extraction without local anaesthetic would have been quicker, more productive and much more enjoyable”. 

While the dealings with the government were unsurprisingly less-than-useful, the team’s woes continued, with the outreach plan being thrown into disarray by a mix-up with accommodation. There was no room for all of them in Maubara, so the team upped sticks and headed to west to Kasait.

Kasait was a treat for the team. The clinic staff were very helpful and the working conditions and digs were positively luxurious – three rooms with running water, power AND lights! The team worked in Kasait until the Saturday lunchtime, reluctantly declining another week’s hospitality.

Saturday afternoon saw a first in TLDP history.

The team made their way to an open flat area where Peter bravely conducted the Inaugural TLDP Driving Course. All Timorese members ‘had a go’ and all went well. Peter only had to employ the (emergency) handbrake once and although they only made it into second gear, considerable progress was made. Yet another step towards self-sufficiency! Well done Nico, Ana, Tino and Ana!

The second week was spent in Railaco, in the tender and efficient care of the redoubtable Father Bong. The team conducted clinics in Railaco Vila as well as Railaco Leten. As expected, Railaco was extremely busy and the team worked long hours. Luckily, with the exception of Ana Martins, everyone in Team 1 was a well-seasoned TLDP worker – Peter found that it was easier to just get out of the way of that well-honed team when there was any packing/unpacking/setting up/breaking down of the mountains of gear that we carry around. Indeed, the Timorese team members were at great pains to take good care of Dr Peter, affectionately calling him”Katuas” i.e. old Grandfather.

What was patently obvious to Peter this trip was that the TLDP’s Timorese mentee clinicians can now consistently provide high standard restorative treatment as well as competent extractions. They have highly-developed standards of professional competence, motivation and conduct – a testament to their efforts and those of the volunteers who have contributed to the TLDP.

Tino farewelled the team after the week at Railaco. The TLDP started mentoring him in 2011 and it is truly wonderful that he continues to take leave to help out the TLDP teams. He returned to his clinic in Gleno Hospital with the team’s excess local anaesthetic – a treasure in a place where supply is extremely limited. Meanwhile the rest of the team headed back to Maubara and thence to Dili and Oz.

The work with the government is ongoing. Team 2 is now in the zone.

First impressions – from Dr Jordan Kolsky

Uncategorized,

The Timor-Leste Dental Project expanded the horizons of my dental career. It was the first opportunity I have had to synthesise my passions for dentistry and travel alike – and found the experience to be deeply fulfilling. As our neighbours and a nation that has suffered tremendously in recent decades, the culture is profoundly welcoming and kind. Dental care is very low hanging fruit to pick in the pursuit to better the lives of people in Timor Leste – so your involvement is impactful. This is a reassuring feeling when working in an environment without any perks or luxuries that I am accustomed to in Australia! I loved the team and thoroughly enjoyed my time participating with the project. Moreso, my nurse even says I am more laidback after returning!Dr J and a happy patient

The Fast and the Furious

Uncategorized, , , , , , ,

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

 

timorese farm

TEAM 1 ARRIVES THIS SUNDAY

Uncategorized, , ,

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!