Tag Archives: Nico Pires

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!

 

 

 

New Wheels for Nico

Big things happening this year!! The TLDP has purchased our first motorbike, a Yamaha XTZ. This will be for Nico to use while he works for us. Nico was previously using his scooter to get to work and around the Liquiça district. Scooters are more commonly used in TL because they are less expensive to buy; however they are not very hardy and although they work well on the streets of Dili, they soon come to grief on the rough roads outside the capital. We are very happy that Nico will be on a more reliable vehicle, and Nico is super-happy because he has a new toy!

Farewell Team 4

Team 4 will farewell Australian shores next Saturday. Team Leader, Dr Peter Shakes will be joined by Dr Ashley Freeman and Dr Andrew Frame in the first week, who will then be replaced by the redoubtable Dr Mary Tuituinnik in Week 2.  The Timorese team members include Nico Pires, TLDP’s hard-working dental therapist and new Dad, and  Ana Paula Dos Santos Tavares Salgado, the team’s translator and dental assistant. Team 4 has already been plagued by misdirected supplies, team members dropping out, and confusion with scheduling;. Hopefully, all the wrinkles have been ironed out now and this team will have some smooth sailing once they get to TL. They are heading to Atsabe and Maubara. Good luck and have fun Team!

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!

 

 

THANKYOU AND MERRY CHRISTMAS!

It seems that the years fly by faster and faster as we get older. Here we are again at the end of the year, with the silly season looming. At this time, I reflect upon everything that has happened during the year – good and bad – all our achievements, all our losses, and how we have handled it all.

This year has been tumultuous for the Timor Leste Dental Program; we hired a new dental therapist, Nico Pires, at the beginning of the year, in a bid to increase the local ownership for the program. He has proved to be a true asset – a hardworking and competent clinician, who is unafraid to take charge even in the presence of some extremely authoritative (bossy) Aussie dentists. We simultaneously entered into a partnership with the Maubisse-Bendigo Friendship Association, which has increased the support for the Maubisse District, but has also had the effect of increasing (temporarily, we hope!) our workload, as we bring these newcomers up to speed. Maubisse Hospital acquired a new dentist – Dr Inda Zulmira Días –  who has already shown her skill in organising the Maubisse sectors for Teams 1 and 5, as well as an ability to connect with the community though our dental workshops. Everyone who got to work with her this year fell in love with her charm and enthusiasm.

Overshadowing everything was a great deal of frustration dealing with the moving goal posts of the new Timorese dental registration process – delays, lengthy meetings with government officials, multiple trips to Dili, mountains of paperwork, and emails, and submission and resubmission of documents…this is still ongoing. All the teams felt the absence of our translator, and friend, Bony, who was in his final year at university. Although he couldn’t work with the teams, he still set aside time to help the TLDP with the registration, as well as sorting out many other details for our teams. Thank you Bony!

The TLDP sent over 5 teams this year. We had a host of new volunteers – Dr Mary Tuituinnik, Dr Marius Mocke, Mrs Yvette Young, Ms Abbey Notley, Ms Liz Thompson, Dr Mengzhu Wang, Ms Malita McCabe, Dr Andrew Frame, Dr Phil Hill and Dr Christine Underhill. It was wonderful to see the way these new volunteers took the Timorese people into their hearts. We also saw the return of our regulars – Dr John Moran, Dr David Digges, Dr Wayne Pearson, Dr Karen Sloan, Dr Geoff Knight, Dr David Sheen, Dr Blanche Tsetong, Ms Bella Miller, Dr John Whyte, Dr Ashley Freeman and Dr Peter Shakes. The people who return, year after year, is what keeps this program running. They are gold.

Sadly, two of our team leaders, Wayne Pearson and David Sheen, claimed that this was their so-called ‘last’ trip to Timor; however, it is hard to resist Timor’s siren song – we think that Timor hasn’t seen the back of them yet! However, by far the biggest blow to the program this year, was the loss of Sr Filomena da Costa – our Timorese Program Coordinator. The Carmelite exec ruled that she had to move to Oecusse to head the community over there; as a relatively young community, they need someone with her 26 years of experience. In one fall swoop we have lost our boss, the best chef in Timor, our spiritual advisor, local folklorist and a quirky, mischievous friend. No prizes for guessing that everyone will be vying for the Oecusse spot from now on! Nico and Sr Joaninha have big shoes to fill.

This year the TLDP treated over 2330 people; we extracted over 1851 teeth, placed over 937 fillings, and carried out 411 preventive treatments. This treatment is worth about $977,650. We facilitated one dental workshop and mentored 6 Timorese dental clinicians over a period of 10 weeks.

We would like to wholeheartedly thank all our fabulous volunteers, who never stint on giving their time and effort to the Timorese people. We would also like to thank their families and friends who support them – they would not be able to do what they do without you. Thank you to all our Timorese workers, partners and helpers. There are always a multitude of local people, often unsung and unseen, who help keep the program running while we are over there – they are teachers, drivers, groundsmen, elders, nurses, passersby – they give because they can, and we are awed by them.  A massive thank you to Henry Schein Halas and SDI for their extremely generous donations to our program this year – we would not be able to function without your donations of vital dental materials and equipment. Last, but not least, thank you to our donors – 97% of your valuable contributions go directly towards helping the Timorese people. We are more than grateful for your support. Your contributions pay for equipment and vehicle maintenance, for material and equipment purchases and for the salaries of Nico and other Timorese translators and fixers. Thank you. Thank you. Thank you.

From all of us at the Timor Leste Dental Program, we wish all our volunteers, our supporters, our donors, our partners and their families, a happy Christmas. We wish you all the best for the new year. Keep safe and well and we will see you in 2018.

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!