Tag Archives: Maubara

Nico and Ana giving oral hygiene instruction to school kids

TWO’S COMPANY, NINE’S A PARTY – LAST TEAM FOR 2019

The TLDP’s volunteering year has come to an end after Team 5’s return last week. The team was big even by TLDP standards.  The Australian contingent  consisted of Team Leader, Dr Blanche Tsetong, returnee Dr Mary Tuituinnik and newbies, Dr Kim Hartley and Dr Lesley Leong, with Mr Keith Mentiplay arriving for Week 2. The Timorese division comprised the usual suspects  – Mr Nico Pires, Ms  Ana Tilman and Ms Ana Paula  Salgado – with the addition of Mr Tino Morais for Week 2 –  plus Dr Inda Dias rocked up for a couple of days during the first week and Mr Savio Moreira snuck in for a day and a bit . The ring-ins come to learn – we welcome all-comers!

The main team
The core crew – Ana Paula, Leslie, Kim, Blanche, Ana Tilman, Mary and Nico

Week 1 was spent in the Maubisse Subdistrict. After the quickest trip to Maubisse EVER – 2.5 hrs up the new, yet still unsealed road, the team was delighted to find that they could stay with the Carmelite community. In the preceding couple of years, our longtime partners had increasing difficulties fitting a team into their accommodation, and so TLDP teams were forced to try their luck elsewhere, with variable results. This time, the team arrived to a newly constructed building, which even had hot running water at times! As usual, it was an absolute delight to take their meals with the Sisters and the team was thoroughly spoiled with big breakfasts, feasts for lunch, scrumptious afternoon teas and multi-course dinners.

The View from Gruto School
The View from Gruto School

The team spent their first 2 days at Gruto School, which is down a steep, rough, dirt road. The views were fabulous. On the second day, as it was just down the hill from Gruto, Blanche, Ana Paula and Ana Tilman went down to see if there were any kids that had pain and wanted treatment. At first it seemed like it was going to be a bust – although plenty of kids dobbed in their mates,  there were no volunteers. It just needed one brave child to break the ice…and then there was a full car!

The next 2 days were spent at Fleixa School, another school with a spectacular view, but with no electricity or running water. This was a large school on the main road to Same, and the team was flat out trying to get through all the kids, as well as see some of the adult members of the community. The difference between the more remote Gruto and Samoro,  and Fleixa was stark – Fleixa’s kids had much more decay than the other two schools, probably because of easier access to junk food.

Day 2 in Fleixa fairly flew by, and  it seemed like the team was going to finish work at a reasonable hour for a change. All the equipment was working, the sterilisation was finished and they were starting to pack up. Then Inda let in a ‘last-minute-easy-patient’. It took the combined efforts of one dental therapist and 3 dentists, plus an extra hour to extract  that ‘easy’ wisdom tooth!

Our senior dental therapist, Nico, is a quiet achiever. After 3 years of mentoring, his skills are formidable.

After an abortive attempt to work at the not-famous-Balibo School, the team’s final day in Maubisse was spent in the Sisters’ Clinic. Despite letters and multiple phone calls to the Principal, the team arrived after a gnarly drive up a goat track to find another spectacular view…. and the school deserted. At least the drive was interesting! The roads in the subdistricts are challenging and Leslie found this out on the job. In Sisters’ car,  he had a near miss with a horse, got stuck in a rut on the steep track out of Gruto and fell into another ditch on the drive down from Balibo. It’s a good thing that he is blessed with unshakable aplomb!

Blanche and Nico fixing suction
Fixing the suction unit

The suction broke down on Day 1, necessitating hours of repair work; mysterious water leaks sprung from the dental units that were ‘fixed’ with gaffa tape and plastic cups; and there was a bunch of other niggly faults in the equipment that had plagued everyone for the whole year. Like all the teams before them, Team 5 treated this as par for the course, all the while counting down the days and hours to when our equipment guru, Keith Mentiplay, would arrive and make it all better. What made these little annoyances easier to bear was the team had managed to borrow 2 extra dental chairs from Solar Smiles while they were in Maubisse, and so the work still flew. Having 5 purpose-built chairs going at once made it easier to mentor clinicians without significantly slowing down the pace at which they saw patients. It was great! Thanks Solar Smiles!

It’s always a blast with the Sisters

The team left their beer in Maubisse. DISASTER. Luckily, this was mitigated by the arrival of two old friends – miracle-working equipment-whisperer, Keith, and long-time mentee, Tino – so Week 2 was off to a great start! Although the entire team stayed at Maubara this week there were so many people that they had to split into 2 locations to sleep. Dinners were raucous feasts with the Sisters at the Orphanage, which kept everyone super happy.

The second week was characterised by long commutes, dust-choked air and crowded cars.  The TLDP’s School Dental Program includes 17 schools. Some of these are impossible for Nico and Ana Tilman to get to by motorbike – they are too far away and the roads are too rough – so a team is needed to help them out.

The crazy kids in Faulara

The team spent the first 2 days at Faulara, which is on the farthest edge of Maubara subdistrict. The drive took 1.5-2 hours each way and resulted in some extremely long days. There were lots of waterway crossings, and then a drive UP a waterway to the school. The first return trip shredded one of the tyres on our precious Troopie.

Beers and tyres
Keith the equipment whisperer
Keith the equipment whisperer and his newest acolyte

The teeth in Faulara were not too bad – again, probably due to the remote nature of the village. And there was electricity! Over those 2 days, the team managed to check all the kids, Ana Tilman performing  her by-now-familiar toothbrushing pitch to all the classes, and everybody pitched in with treatment and mentoring. And in the meantime, Keith fixed and tested everything! The team was now working like a well-oiled machine, so they managed to finish early at Faulara, break down the clinic, and drive to nearby-ish Guiçu School to set up the clinic for the next day.

 

Keith and Tino on a road trip
Keith and Tino on a road trip

It was a huge relief to the team that Guiçu is closer to Maubara – only 1 hour each way on bad roads for the next 2 days! While most of the team was tasked to see the school under Mary’s watchful eye, Blanche and Keith were absent for most of the next 2 days. Blanche headed into Dili for meetings (and to buy tyres). Keith accompanied a grateful Tino on a 4-hour return motorbike adventure to Gleno Hospital in order to check out Tino’s non-functioning chair. He was able to get the  drills, light and triplex working, but was unable to get the chair moving again – luckily, it is stuck in a good position! Keith also serviced all the equipment in our Maubara clinic and ran his eye over the clinic’s big generator, as well as the solar panels at the orphanage –  the Sisters were so happy to have him there!

Mary mentoring Tino

Working in TL requires adaptability, and our teams are characterised by a fluidity of roles. Team 5 was no different. All the dentists shared all the tasks, from mentoring of Timorese clinicians to accompanying  Ana Paula to do a share of the examinations; Ana Tilman and Nico delivered oral health education either en masse or class-by-class; Kim, Nico, Ana Tilman, Mary, Tino and Leslie were at different times the work horses of the crew; and everyone functioned as steri-nurse and dental assistant.

Kim demonstrating with Leslie assisting

It was a very busy 2 weeks and so the last day spent in Maubara clinic, winding down and taking stock was much-needed. Kim did a vital skill demonstration for our mentees, a few patients were treated, there was a bit of tidying up and the team had important personnel and team meetings, but essentially the day was for closure, and farewelling the Sisters for the year. Later that night the extended team, including translators Bony and Isa, reconvened for a rowdy end-of-trip-end-of-year dinner in Dili. After being kicked out of a cafe at the end of the night, the team lingered in the carpark – it is always difficult to say ‘Goodbye’ to our Timorese family.

Team 5 examined a total of 836 patients, extracted 348 teeth, filled 368 teeth, did 383 preventive treatments and 2 root canal treatments. YAAY team! We will see you all next year!

 

 

 

The Power of Many

Team 2 has returned home safe and sound. In the past couple of years, our teams seem to have become quite large as a general rule, as our Australian volunteers are matched in numbers by Timorese employees. This team consisted of Australian volunteers, Dr David Digges (Team Leader), Dr Henry Gilkes, Ms Liz Eberl, and the tag teamers – Dr Geoff Knight and newcomer, Dr William Hariman. The Timorese contingent consisted of Ana de Jesus Barreto Tilman (AT), Ana Paula Dos Santos Tavares Salgado (AT), Nicolau Tolentino Faria Pires (Nico), Isabel Noronha Pereira De Lima Maia (Isa), Bonifacio Cardoso Martins (Bony), and Diamantino Correia Morais (Tino). Hence, at any given moment, this team had 3 dentists, 2 or 3 dental therapists, a dental assistant/steri nurse and 2 translators/dental assistants/admin officers. A massive team!

DD, HG, Isa, AP, AT, LE, Nico, GK

The team spent the first few days hosted by the Sisters in Bobonaro. The girls got to stay with the Sisters themselves, but the boys were housed in the Sisters’Tuberculosis clinic  – we suspect that they will be looking for some new digs next year! The team spent the first 2 days operating in the meeting room of Gumer Primary School, with the nearby High School kids walking over. Gumer is an isolated valley between Bobonaro and Maliana and  there are 800 children in these 2 schools, many of whom have very poor oral health. The team soon realised that on Day 1, but were able to broaden their scope on Day 2. 

The fabulous GK in action with the equally fabulous Isa

For the remainder of the week, the team shifted accommodation to Maliana –  this is the Big Smoke in this area, and the team gets to enjoy a little luxury. Isa’s Mom runs Restaurant Maliana, so the team is well-fed when they live here. Day 3 and 4 saw the team working out of a very impoverished village called Memo, 30 minutes west of Maliana and within spitting distance of the Indonesian border. They found it a little unerving to be able to see an Indonesian Military checkpoint from the school where they set up. The villagers here had never seen a dentist.

Tino and the omnipresent Ana Tilman!

Day 5 was changeover day – the team started working out of Maliana Hospital. Bony and Tino arrived together on what would have been a very long, dusty and bumpy tandem ride from Dili. Bony still managed to look immaculate coming off that bike – some people just have that knack! Geoff headed back to Dili – any team lucky enough to have Geoff with them benefits from his wealth of knowledge, especially with Silver Fluoride, which we use extensively in our work over in TL. William had been picked up from the airport by one of Isa’s friends and was put straight on the tools when he arrived in Maliana – no problem for William!

The team spent the next 2 days treating the community as well as students from the High School. This team is impressive with its logistics. They split into two teams, with screening and transportation of the students carried out by Bony, Willian, Tino and Liz, and treatment carried out in the hospital by Nico, Henry and David. Translation, sterilisation and patient marshalling were efficiently handled by AP, Isa and AT. After working late, the team had sunset drinks on the rooftop terrace – a last hurrah with Isa, who is now employed by Maluk Timor as the Oral Health Coordinator for all the dental charities that come to TL – we wish her well, but are very sad that she will no longer be spending so much time with us!

Week 2 was spent closer to our home base, Maubara. Three days were spent visiting Loes Orphanage, which we have never been before, Loes School (one of our regular schools) and Tapamanolu School (last seen in 2012 – very hard to get to). This involved a commute of 40 min along the crumbling coast road. The last 2 days were spent in Ediri School, one of the schools in our program.

The team with HG, WH and DD on the tools

What a hectic schedule!!! The team did a fabulous job – there was heaps of mentoring for Nico, Tino, Ana Tilman and Ana Paula, a whole stack of work got done, and they all had a great time! Henry did a super job of keeping us updated on social media. What more could we ask for?

Back in Maubara with Sister

The TLDP is exceedingly lucky to have so many dedicated volunteers who continue to come back year after year. We are even luckier that we are supported in our work by dental companies such as Henry Schein and SDI. And we are the luckiest to have so many enthusiastic, hardworking, talented  Timorese people working with us. We are immensely grateful in particular, to our primary partners, The Carmelite Sisters, who smooth our way through the bureaucracy of TL. Our program has carried on unabated despite constant changes in the Ministry of Health over the past few years.

The home team watched over by Henry

Nico and AT have become an excellent home team. They are in charge of the Maubara Clinic and our school dental program – Nico is an excellent operator and has the confidence of the Sisters – that is a HUGE endorsement! Although we initially employed Ana Tilman as a dental assistant, she too is trained as a dental therapist and so is now also benefitting from mentoring within the team environment. Her skills are on the up!

We are especially lucky to have an unofficial Timorese Committee of bright, young people – AP, AT, Nico, Tino, Bony and Isa – they are expert problem-solvers and can-do people. They are unstoppable!

Henry trials the new hand washing unit

Team 2 itself was pretty lucky – there were minimal repair issues, although they did get a flat tyre on the way home from Maliana – changing tyres in the dust and heat could not have been fun. They also were the first to try out our brand new custom-made portable hand washing unit – for all those places with no running water (it was a hit! Conceived in the Sunshine Coast, Made in Grafton), and they were the first team to wear our new spic uniforms!! 

Overall, the team examined 1350 people, they extracted 467 teeth, placed 770 fillings, and carried out 722 preventive treatments. Well done Team!

UNITY IN DIVERSITY

Our volunteering year is now ended with Team 5 returning a couple of weeks ago from TL. It has been a very busy year, and so we are quite happy to be able to draw a quick breath or two before we start to prepare for the year ahead. (Pic: Isa, Nico, Tino, Bony, David and Ana Paula)

Team 5 was led by Dr David Sheen, one of this program’s founders, and an excellent dentist, teacher and mentor. David has decided that this will be his last clinical trip, so we imagine that this trip tasted bittersweet. David will be sorely missed. He is a gracious, good-humoured and considerate person and a skilled team leader. However, there is no rest for the wicked – David will continue to be involved in the TLDP management committee, and he has taken on the responsibility for getting a Timorese person into and through a dental degree! We haven’t seen the last of him yet!

The remainder of the Australian contingent of Team 5 consisted of returnee, Dr Geoff Knight (Week 1), and newcomers, John Darby (Week 1 and2) and Gaye Dumont (Week 2).

We are proud to say that the Timorese portion of Team 5 was considerably larger than the Australian part, something that is now typical of all our teams, and an ideal that we have been steadily working towards over the past 15 years. We believe that a program is only sustainable if it has local ownership and it can only be locally-owned if there is a preponderance of local participation. The timorese contingent consisted of TLDP dental therapist, Nicolau Tolentino Faria Pires (Nico), TLDP dental assistant and translator, Ana Paula Dos Santos Tavares Salgado, Ministry of Health (MoH) dental therapist, Diamantino Correia Morais (Tino), translator, Bonifacio Cardoso Martins (Bony), translator and organiser, Isabel Noronha Pereira De Lima Maia (Isa), MoH dentist, Dr Inda Zulmira Dias, MoH dental therapists, Armando Da Costa Martins and Ricardo Mendonça, and Carmelite sister, Sr Delfina Soares. With the exception of Sr Delfina, all the Timorese in this team have worked with the TLDP for many years.

The lucky team spent the first week in Oecusse, an East Timorese enclave within West Timor, Indonesia. They were lucky not only because Oecusse is a beautiful area with coral reefs off the beach, but also because they got to spend time with our beloved Sr Filomena da Costa, our old Timorese program coordinator who was uprooted from Maubara to take over the new Oecusse Carmelite community. (Pic: Sr Carmelita, Sr Filomena and Ana Paula)

This team journeyed by ferry, a quite expensive and time-consuming exercise involving putting the 2 packed vehicles on the ferry in the morning, waiting around Dili all day, then boarding at 5pm, before finally arriving at 5am the next morning. Luckily, the team scored the only 2 cabins onboard and were able to sleep! Thanks to Isa for booking the tickets in advance! (Pic: Dedicated Nico and Tino)

The team worked for 3 ½ days within the Carmelite Health Centre, São Domico Clinic, mostly treating the children from the neighbouring high school and the local community. Sr Filomena, Bony and Nico did all the oral health education and screening of the school kids. After that, the team broke up into two teams, each comprising a Timorese clinician with a mentor; Geoff teamed with Tino and Ana Paula to do all the fillings and preventive treatments, while David and Nico did all the extractions. John Darby, a dental prosthetist in Oz, became the team’s super-efficient sterilising nurse and infection control manager. It was a very busy few days! It was a real treat for the team to be able to spend time with Sr Filomena, who is also one of the founders of our program and a delightful lady with a loving and ebullient nature. (Pic: Geoff, Sr Carmelita and Tino)

Another 12-hour boat ride and the team returned to Dili on the Saturday for restocking and team changeover. The team farewelled Tino, Bony and Geoff and welcomed Gaye and Sr Delfina into the fold. Sr Delfina is keen to study dentistry and the TLDP has agreed to support her studies if she gets into a training program. In a meeting with the Carmelite head honchos on the weekend, David suggested that Sr Delfina gain some work experience, so she also joined Team 5 for round 2! Off to the hills of Maubisse! (Pic: John and Gaye atop the Christo Rei)

The trip to Maubisse takes 4-5 hours from Dili. The team was scheduled to work in one of its more remote regions, Manetu, for the next couple of days. The team arrived in the early afternoon in Maubisse town and collected Dr Inda, so they decided to push onto the Manetu-Lebululi Health Centre to set up for the next day. Unfortunately, they travelled via a suggested ‘short cut’, which turned out to be an extremely bad road, and when they finally arrived, the health centre was locked up with no one around, leaving the team to do a u-turn and head back to Maubisse. At least the return trip was on the longer, but much better, road and so the return journey only took 1 ½ hours! (Pic: Gaye and the Maubara sisters)

Manetu is a very poor area, which suffers from severe water shortages when the rain doesn’t come on time. As a result, the villagers have difficulties with personal and home hygiene, and the team saw many people with scabies and badly infected mouths. This is the first time the TLDP has travelled to this village (this was an agreement drawn up in April this year in a meeting with the local chiefs) and the first time this village has had any dental care at all, so it was unsurprising that most of the treatment was extractions. Dr Inda manned 2 extraction chairs all by herself, and David mentored Nico doing restorations.

The last couple of days were spent in the Horaiki High School, which had already been screened and given oral health education by the Maubisse Hospital team (Dr Inda, Armando and Ricardo). Team 5 was assisting the hospital team to follow up with treatment. David and Inda mentored the two Maubisse dental therapists, Armando and Ricardo, while Nico gave additional toothbrushing instruction in the classrooms. In both locations, Gaye, John and Ana Paula kept the team going. Support staff are essential for maintaining good infection control in TL! (Pic: Dr Inda and Ana Paula doing the admin)

Team 5 had brought over our new 34kg suction unit. It worked brilliantly, which meant happy clinicians and happy patients. Lucky for them, there were no equipment breakdowns. NONE! That must be a record! The team also got to spend time with 3 different sets of Carmelites – Sr Filomena, Sr Carmelita and Co. in Oecusse, Sr Joaninha, Sr Lindalva and Co. in Maubara, and Sr Domingas, Sr Rosa, Sr Eva, Sr Veronica and Sr Zeza in Maubisse. That’s a lot of cheeriness and good food right there! (Pic: the Maubisse Sisters)Overall the team saw 443 patients, carried out 318 check-ups, took out 460 teeth, placed 218 fillings and did 42 preventive treatments. Well done Team 5!

Thank you to everyone who continues to support our program! From our donors, to our team members in Darwin who collect supplies and bring them to the airport for the teams, to our biggest materials donors – Henry Schein Halas and SDI – and the Rotary Liaison Team in Dili who do so much running around for us, we are in your debt. Thank you for your generosity. We could not do this without you.

CONVIVIALITY OVER FRUSTRATION

Team 2 returned from TL on the 6thJune after a 10-day whirlwind trip. The team consisted of team leader, Dr John Moran, his steadfast mate, Dr John Whyte, newbie volunteer, Emma Whyte, the TLDP’s dental therapist, Nicolau Tolentino Pires (Nico), and Australian-trained, Timorese dental assistant, Ana Paula dos Santos Tavares Salgado.

This team is well known for its efficiency. They covered a lot of ground; dividing their time between the Railaco, Kasait and Maubara areas. In Railaco, they were hosted by our Jesuit partners, and as usual were kept thoroughly fed, watered and entertained by the ebullient Father Bong, with his team, Fathers Truong, Phong, Siriak and Sagi, plus trainee Jesuit, Ismal. Lively dinner discussions, well-oiled by wine, ranging from attitudes towards eating pets, to a coffee delicacy produced from predigested coffee beans, and libido-limiting fruit, kept the team recharged during their stay in Railaco.

The first 2 days were spent treating patients in the Railaco Parish Clinic Centre, where the team treated patients from the local community. The team was augmented by Ismal and a local man, Victor, who performed the vital task of interpreting – neither Nico, nor Ana Paula, are from Railaco, so they don’t speak the local language of Railaco.  Timor has 2 official languages – Portuguese and Tetum, but there are also scores of local languages, or what the people call ‘mother tongues’. Many people struggle with Portugese, and even Tetum can become sketchy the further out one ventures. In most of the tiny, remote villages, knowledge of the local language is essential. (Pic: Emma Whyte, John Whyte, Fr Bong, Ana Paula, John Moran, Nico)

The team had a single day before equipment issues started rolling in. Day 2 saw the foot pedal of one of our dental units go bust, necessitating a 4 am dash back to Maubara for Nico on Day 3 to get the spare. Luckily for this team, Railaco is one of the closest locations to Maubara. Nico was back 3 ½ hours later, the offending foot pedal fixed, and the team headed off to Railaco Leten, almost 2 hours drive away.

The team worked in the Sacred Heart of Jesus chapel in Railaco Leten, which is a lovely space and has great views; however, electricity is dodgy in Railaco Leten and this played havoc with the electric autoclave that the team had chosen to take with them. This meant that the team spent most of the night sterilising on their return to Railaco, where the electricity is more reliable. (Pic: Our Steri-Room)

Day 4 saw the team heading up the hill to Tocoluli, where they worked in a community hall overlooking Mt Ramelau. At this point they started to run out some of the anaesthetic. Despite being small in height, many Timorese, especially the ones in the remote areas, have large teeth, with massive roots, and need more anaesthetic. It must have been a very tiring day, but at night, the team were rewarded with a feast at the Order of St Paul of Chartres Convent – the sisters are superb cooks and their singing is a real treat. (Pic: John Whyte in his room with a view)

Day 5 was a day of endurance and patience for the team – they had to set up and break down the portable clinic twice. Their clinic in Nasuta was stymmied not only by yet another new public holiday – Children’s Day – but also the Sacred Heart of Jesus Procession. After only a few patients, the team packed up and headed back down the hill and spent the rest of the day in Railaco Parish Clinic Centre.

Days 6 and 7 were spent in Kasait, back on the coast. The two days were productive and busy and were only marred by the suction motor burning out on the first day. Nico, with local, Nani, drove the suction motor and one of our generators to Dili for repair. The suction unit’s motor was replaced with a vacuum cleaner motor overnight and was in action again the following day (albeit with less power)! (Pic: The team about to farewell Kasait)

The final 2 days were spent in Maubara, first at the senior high school, then finishing up at our base clinic. The team experienced their final breakdown – one of the dental carts turned up its toes – but reached the finish line with their good humour unscathed! They spent some time at the Maubara Orphanage, where they were treated to a coffee, biscuits and a little concert. A fabulous way to end a visit!

Overall the team did 849 treatments, including 266 fillings, 229 extractions, and 132 preventive treatments. The two Johns are also great teachers and they spent a large amount of time with Nico, honing his restorative skills. Despite the setbacks, the entire team had a fantastic time and enjoyed working and living together immensely. Go Team 2!

 

 

That which does not kill us…..

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

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

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

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

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

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

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

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

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

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

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

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

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)

They’re back!

Team 1 arrived home 1 week ago. Since then the TLDP has been busily prepping for the upcoming trip of Team 2, which leaves in 2 weeks. Hold onto your seats; Team 1’s report is coming forthwith!!!

Dental care in Motion

Team 2 returned from another productive trip in TL 2 weeks ago – we have yet to hear the official ‘down low’ from them, so stay tuned. Meanwhile, it is rumoured that the ship that carries TLDP’s precious supplies (which were sent in February) has docked – finally – in Dili. Accidentally mixed in with the goods destined for the new Balibo Dental Clinic, another Rotary initiative, they will be then delivered to Balibo. Our good friend, Ricardo Krauskopf, who will be sorting out the mess at the Balibo end, has volunteered to personally deliver our supplies to Maubara – Yaaaay!

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Bony, Tino’s wife, Ghya, Tino and Blanche

 

Team 3 has lost a team member, but is otherwise ready to head off in July. The usual crew of Dr’s Wayne Pearson and Blanche Tsetong will be joined by super-enthusiastic dental nurse, Eve Sheppard. Together with the redoubtable Sr Filomena, Aida, Tino, Bony and Blanche are presenting an Oral Health workshop to health workers and youth workers this visit. It has been an enjoyable challenge producing the Powerpoint presentation and handout for the workshop. Apart from the meetings with Sr Filomena, Aida, Tino and Bony in April to discuss content and translation, the air has been burning with the number of WhatsApp messages and emails crossing the atmosphere! A huge thank you to Ligia Ximenes, an aide to the Timorese Consul General in Sydney, who generously volunteered her time for the huge task of the initial translation. Thank you so much Ligia!!!

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The Luscious Luxury of Language

(Photo: Neil Langley, Macu, Sr Filomena, Bony, Denise Salvestro, David Sheen, Ben Sheen)

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Team 1 has returned from a vastly entertaining, happy and successful trip to TL. They lost a team member before they had left the country – seemingly a very common occurrence for this program – Dr Mary Tuituinnik had to again bow out due to illness (we hope you feel better soon!); nevertheless, by all accounts, the team revelled in each other’s company and work proceeded it its normal chaotic fashion. In the first week, the team consisted of Dr David Sheen, Patrick Fitzgerald on his second trip, and Dr Neil Langley – he and his wife, Dr Denise Salvestr0, are both dentists in remote Northern Territory and long-time advocates for indigenous health. They were joined by Bonifacio Cardoso Martins (aka Bony), who was recommended to us by our friend, Mimi Chungue, as a translator. Bony is a student at the University of Timor Leste and is studying Linguistics. Bony kept the team’s spirits high with his cheerful, helpful nature. He was so enthusiastic that he ended up staying with the team for almost the entire trip! (Pic: Patrick and Co. at the Poussada)

Bony and co

In the second week, the Team farewelled Patrick, and welcomed David’s son, Ben Sheen, and Dr Denise Salvestro to the workforce. They were also joined by another student recommended by Mimi, Immaculada (aka Macu) for a few days. According to Sr Filomena, they were a boisterous bunch, who worked hard during the day and stayed up all night carousing!(Pic: Bony registering kids at Tapamanolu)

Usually our two week program consists of the first week in the Maubara/Liquiça subdistricts followed by a week in a more remote community; however, Sr Filomena has decided to reverse this structure, thereby preventing the disorderly haste (and accompanying mess) when returning from afar and closing down the program. She’s not just a pretty face! Hence, Team 1 spent the first week in Maubisse, treating patients at the hospital clinic and in the health post of the more remote village of Maulau. Neil did the bulk of the slog, ably assisted by Patrick and Bony, while David got down to the nitty gritty of supervising Armando Martins and Ricardo Mendonça.

You may remember these infamous Maubisse boys – enthusiastic dental therapists, so dedicated to learning that last year they took the 8 hour return trip to Letefoho to work with Team 3 for half a day. David gave them valuable experience and knowledge in tooth extraction methods as well as in the use of different filling materials and preventive measures. They would have loved working with David and his team! (Pic: Denise, Neil, Bony)

 

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Week 2 saw the team back in Maubara clinic, as well as in the Loes area, where they spent 3 days in Tapamanolu School and a day in Guiço School. They spent the last morning visiting the kids at the orphanage in Maubara, where Bony added his own special flavour to toothbrushing instruction. The team especially enjoyed Bony’s company, his exuberance and work ethic, so we have asked him to join us; he will be working with all future teams, except those heading out to Railaco – Father Bong has translators aplenty. Welcome to the TLDP, Bony! (Pic: Guiço gals)

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The team had surprisingly few problems with equipment this trip. The ultrasonic scaler refused to work, and one generator was on the blink, but everything else must have shared in the general mood of this team and just worked!

Overall the team saw 456 patients, extracted 306 teeth, placed 196 fillings, and  carried out 223 preventive treatments. Good going Team! Thank you to you all for such wonderful work! (Pic: Bony demos toothbrushing)

The team, along with all of us at the TLDP would like to thank Sr Inacia, Sr Lourdes, Sr Rosa and Sr Eva in Maubisse for their hospitality and their delicious food – the team certainly did not starve over there. Thank you to Bony and Macu who helped the team tremendously not only with translation, but with a myriad of other tasks, which made their job much easier. Thank you to Sr Filomena who rules us with her heart of gold. It is always a privilege to spend time with her. Thank you to Daryl and Mario for keeping our car in top shape and making sure that our battery doesn’t die between trips. And a massive thank you to Henry Schein Halas, particularly Kelly Wood, for dealing with our latest disaster (the boat we sent with our supplies in February is seemingly on a worldwide cruise and we can expect to see our gear in July-ish). Thank you to everyone that makes our work possible.

The extraordinary nature of Serendipity

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A late nani tasi

Team 3 returned to Australia last week following a productive fortnight. This was team leader Blanche Tsetong’s tenth trip to TL, so for her, this trip had a celebratory glow from the outset!

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Lunch in Loes

The team also comprised Dr Wayne Pearson – on his 8th trip – and Sally Stephens – already on her 3rd trip in one year! The team was joined by Aida in the first week and together they treated patients in Maubara Clinic, Pauirobo Primary School and Loes High School. Blanche and Aida tag-teamed a chair, while Sally and Wayne made a dynamic duo. The team were particularly impressed with the kids’ teeth at Loes. This school had last been visited by one of our dental teams in 2010, however, it was also one of those schools targeted by a oral health education workshop run in 2008 by Sandra Meihubers and Timorese dental therapist, Elisabeth, as well as a toothbrushing program run by Sr Filomena. The team was pleased that the fillings that the dentists had placed were still there – good quality work – but they were even more impressed that the oral hygiene and decay rate had dropped significantly – evidence of the importance of education. Plans are afoot for Aida, Blanche and Sr Filomena to do a refresher workshop next year and will involve not only school teachers, but also local doctors and nurses.

Aida with some help from Mom
Aida and a helpful Mom

Aida’s skills in diagnosis have improved dramatically and she is now a dab hand at extractions (although she says that her confidence diminishes without the team’s ‘safety net’). We are now working on increasing her experience with fillings in the front teeth. She is a great clinician and the team thoroughly enjoyed their week with her.

The first week was plagued by team erosion – Sr Filomena is now the Big Boss at Maubara and so she had to attend several meetings over the week; Sally was struck by a lurgy which took her out of active service for a day (although she spent that day doing more stocktaking than resting!), nevertheless, the team still managed to finish treating all the students in Loes, in part due to exceptional teacher management.

P1010791 P1010768The end of the first week marked the 25th anniversary of Sr Filomena’s entry into the Carmelite order. This extraordinary woman has been serving the Timorese people for a quarter of a century and she remains humble, joyous and full of love and energy. All who have participated in the program feel truly privileged to have spent time with her. Congratulations Sr Filomena! Felicidades! Parabéns!

Night work in Letefoho
Night work in Letefoho

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Week 2 was spent in Letefoho subdistrict, where the team worked again in their room-with-a-view under the imposing Letefoho church, and visited the nearby villages of Lakau and Lauana. It was a busy, tiring, amazing week. The team arrived in Letefoho just in time to witness the celebration of the Bishop’s inaugural visit – they spent half a day immersed in the spectacle of the crowds, the traditional music and dancing, soaking up the fervour. Once mass was over, the crowds progressed to the dental clinic – the team worked late that night.

Pre- Sr Bernadette
With Sr Bernadette
With Sr Bernadette

For the rest of the week, the team was joined by the ebullient Sr Bernadette, who undertook the tasks of patient registration, catering, drug, sticker and toothbrush dispensing, and crowd control – the team was Organised! Her happy company lifted our hearts the entire week.

Our Lakau clinic
Our Lakau clinic

The visits to Lakau (8.6km) and Lauana (17.8km) were each an hour’s worth of 4WD adventures away from Letefoho. Lakau was extremely windy, perched on the side of a mountain and the team worked in a little bamboo building with a metal roof that threatened to take off with each gust. Lauana, at a little lower altitude, was surrounded by towering Madre de Cacao trees; the church at the top of its steep streets commanding beautiful views over the valley.

The team with the Maubisse boys
The team with the Maubisse boys

The team was in for yet another happy surprise that week. Tino (the Timorese dental therapist we support in Gleno), who had been unable to accompany us due to illness, showed up on Wednesday with Armando, the Timorese therapist we support in Maubisse, who had also brought Ricardo Mendonça, the new dental therapist working with him! Tino was still sick, but was needed as a guide for the Maubisse boys.

With wonderful Tino
With wonderful Tino

Armando felt that he urgently needed more tuition in extractions and reasoned that the 3 hours they spent with the team was worth the 8 hour round trip from Maubisse. It is such dedication that inspires and motivates us in the TLDP. It was a fabulous treat for the team to reconnect with all our Timorese dental therapists in one trip, as well as to meet a new one!

P1020054 The team had a great time in Letefoho. Despite the bracingly cold showers in 12 degree temps (the Fathers are hardcore!), our host, Father Elio, was great company and the hospitality of his crew was second-to-none. Now that he has built a new guesthouse, larger teams will also be able to experience this beautiful area with it’s friendly people.

As always there were the equipment issues particular to working in TL – leaking foot pedals, out-of-control algal growths, the mysterious and inexplicable disappearance of an oil cap after leaving it aside for 60 seconds – but the team took it all in their stride. It was a successful trip – Team 3 treated 516 people, did 370 examinations, 393 extractions, 186 fillings and 169 preventive treatments. Well done team! Thank you to the Maubara crew – Sr Cecilia, Sr Filomena and Idalina; the Letefoho crew – Fr Elio, Fr Ino, Fr Eduardo, Fr Alberto, Mana Lulu and Sr Bernadette; and our Dili crew – Daryl – for making this trip so memorable.

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