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.

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.

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