Tag Archives: Timor Leste

Team 4, August 2025

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August Atsabe and Atauro Adventures

Team 4:

William Hariman

Yvonne Bass

Alison Taylor

Paulo Salsinha Martins

Ana José Martins

Zaino Tison Martins

Diamantino Correir Morais

Ana Paula D.S.T. Salgado

Angelo Moniz Amaral

Friday, August 1

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

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

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

The Atsabe Team (top back to bottom front):

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

Saturday, August 2……….to Atsabe

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

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

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

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

Sunday, August 3

The mountain views were stunning.

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

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

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

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

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

39 patients seen.
Procedure		ExamTooth ExtractionFillingScalingFS AgF
Total394514312 2

Monday, August 4

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

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

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

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

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

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

ProcedureExamTooth ExtractionFillingScalingFS AgF 
Total626319116 37

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

Tuesday, August 5

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

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

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

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

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

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total56551916019

56 patients seen.

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

We fed a stray dog who took to guarding our clinic

Wednesday, August 6

Final Day in Atsabe

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

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

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

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

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

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

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

.ProcedureExamTooth ExtractionFillingScalingFSAgF
Total55641413017

55 patients were seen

Thursday, August 7

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

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

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

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

Tino and Paul wishing farewell to Alison. Paul and Yvonne

Friday, August 8 ……a rest day in Dili

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

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

A very intense week — this rest is much needed.

Saturday, August 9……onward to Atauro

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

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

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

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

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

Sunday, August 10…..a day of rest

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

Anyone for Uno?

Monday, August 11…….into the Clinic

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

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total22268105

22 patients seen.

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

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

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

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

Tuesday, August 12

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

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

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total189133011

18 patients seen

Wednesday, August 13

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total292226

29 patients seen.

Thursday, August 14

Another busy clinical day.

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

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total4254197220

42 patients seen.

Friday, August 15…….our final day

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

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

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

ProcedureExamTooth ExtractionFillingScalingFSAgF
Total2440

24 patients seen.

Reflections

347 patients seen.ProcedureExamTooth ExtractionFillingScalingFSAgF
Total347378135572012

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

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

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

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

It was tiring but, rewarding.

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

TLDP Team 3 2025

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Railaco, Kasait, Maubara and Maliana

June 20 to July 5

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

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

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

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

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

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

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

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

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

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

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

Lunch is nearly ready!

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

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

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

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

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

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

Deconstructing an acrylic bridge.

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

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

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

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

TLDP Team 2 June 2025

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

31 May to 14 June 2025

Arrival and First Week: Maubara & Vatu Vou

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

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

Equipment Repairs & Limited Clinic Days

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

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

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

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

Maubara totals:

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

Journey to Uato-Carbau: The Long Road East

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

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

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

Dentistry in Remote Villages

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

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

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

Tison volunteers to check the water depth for our vehicles crossing

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

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

Uato-Carbau & Viqueque totals (3 days):

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

We return to Dili

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

Reflections

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

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

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

TLDP Team 6, Nov 2024

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Team 6

Team 6 Report

Dr Mary Tiutiunnik
Ana de Jesus Barreto Tilman (AT)
Ana Jose Martins (AM)
Zaino Tison Martins (Tison)

Week 2

Deonisio Anyonio Mendonca (Maubisse Solar Smiles)
Lucas Mendonca Rodrigues (Maubisse Solar Smiles)
Diamantino (Tino) Correia Morais
Ana Paula dos Santos Tavares Salgado (AP)
Dr Jordan Kolsky

Mary’s Arrival and Clinic Setup

Mary arrived in Dili on the afternoon Qantas flight. Despite the crosses on her bags, she was waved through customs after Ana Paula produced the necessary documents. After some shopping, Mary, Ana Paula, and Ana Martins arrived at the Maubara clinic in plenty of time for dinner.

Sunday, 10th November – Clinic Organization

After Sunday Mass, Ana Paula, Mary, and Ana Martins spent the day organizing the clinic. Tidying up took most of the day, but the heat eventually got the better of us. We decided to cool off with a walk on the beach.

Monday, 11th November – St. John Paul II School

We returned to St. John Paul II School at Pauirobo to continue treating the Class One students. We had previously visited this school in October 2023 and January 2024 and were keen to finish the treatment. Unfortunately, only five children had returned consent forms. Despite this, we had a full day treating the students, community patients, and the Carmelite sisters.

A Team Effort

Tuesday, 12th November – Public Holiday (Santa Cruz Massacre)

As it was a public holiday, only one patient came in. He had a severely damaged anterior tooth from a motorbike accident—a common occurrence in the region. This allowed for a tutorial on anterior root canal procedures. Inspired by the messiness of the root canal box, Mary and Ana Paula spent the rest of the morning and early afternoon organizing all the root canal supplies in the clinic.

Wednesday and Thursday, 13th and 14th November – Tapamanuhulo Primary School

We visited Tapamanuhulo Primary School, located about a 45-minute drive from Maubara along a spectacular coastline. The 208-pupil school had not been visited for years. We screened Classes 4, 5, and 6 and treated the students in the morning. The afternoon was spent treating the teachers and community patients. Despite the lack of previous dental care, the children’s teeth were not in too bad a shape. The teachers only required a cleaning. On Thursday afternoon, we packed up to prepare for a meeting with the vice minister of health, which was unfortunately canceled later that evening.

In the Classroom

Friday, 15th November – Return to Tapamanuhulo

Mary, Ana Paula, and Ana Martins decided to return to Tapamanuhulo to screen Classes 1, 2, and 3. We also applied silver fluoride where needed. Upon returning to Maubara, we found that 21 local residents had presented for treatment. As word spread about the foreign dentist, a second chair was set up. Surprisingly, 15 of these patients only required cleanings, and we finished just after 1 PM in time for lunch. Interestingly, Maubara people seem to have better teeth compared to other parts of Timor-Leste. One theory is that their water source—bore water—may contain some natural fluoride.

Saturday, 16th and Sunday, 17th November – Maubisse

We met Dr. Jordan Kolsky at 1:30 PM upon his arrival from Bali. After a quick shopping trip for supplies, we headed to Maubisse. The cool weather in Maubisse was a welcome relief. We met Deon and Lucas, the Maubisse dental nurses employed by the Solar Smiles charity. Lucas was a classmate of Tison and Ana Martins in Kupang, and they were happy to reconnect.

Intrepid Drivers Needed

After Sunday Mass, we set off to the health centre at Suco Liurai, where we would set up our first clinic. The road was rough, but after about an hour, we reached the small village.

Maubisse Sunset

Monday, 18th November – Suco Liurai Clinic

The weather was bright and sunny after a heavy shower the night before. As usual in Maubisse, we were kept busy removing decayed, infected teeth. The oral health of people in the Maubisse area seems to be in worse condition compared to Maubara.

Team , drivers and health centre staff at Suco Liurai

Tuesday, 19th November – Suco Betulala

Mary and Ana Paula drove to Dili early for a meeting with the Minister of Health, but it was canceled halfway there. The rest of the team spent the day at what they considered the worst venue, dealing with challenging extractions. We managed to see all the patients by mid-afternoon, and the Maubisse dental nurses quickly arranged for us to shift to another health centre.

Wednesday, 20th November – Flexia

Flexia Health Centre turned out to be our busiest unplanned clinic. Many patients required multiple extractions and fillings. We worked until early evening and had to pack up in semi-darkness after realizing there were no lights. Luckily, Flexia is located on a good, sealed road, so the drive back to town was relatively smooth despite the fog.

Thursday, 21st and Friday, 22nd November – Suco Edy

Our last venue was an open-air health centre in a small village. Despite the rough road leading there, we managed to treat patients for one and a half busy days. We were pleased to pack up only once, rather than twice.

Suco Edy

Suco Edy

Return to Dili and Farewell

On Friday, we returned to Dili to farewell Dr. Jordan Kolsky and meet Dr. Jeremy Lung, a former team dentist who is now a businessman at Timor Plaza.

Our Final Dinner

Monday, 25th November and Tuesday, 26th November – Tapamanuhulo School (Final Visit)

Mary, Ana Tilman, Ana Paula, Tison, and Ana Martins returned to Tapamanuhulo to finish the treatment for the younger students in Classes 1, 2, and 3. After the cool weather in Maubisse, it was hard to adjust to the heat again. Many of the children we had screened earlier in the week were absent, as school was almost finished for the year. Nonetheless, a steady stream of community patients kept us busy.

Summary of Treatments

  • Total patients: 408
  • Exams: 408
  • Extractions: 317 teeth
  • Fillings: 144 teeth
  • Fissure Sealants: 64 teeth
  • Silver Fluoride applications: 126 teeth
  • Scaling: 56 patients

Conclusion:

The team made excellent progress in treating a wide range of dental issues, despite the challenges posed by the heat, limited resources, and difficult roads. The local communities were very receptive, and the overall health of the patients we treated was improved through these efforts.

TLDP Team 5, Sept 2024

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Date: 14/09/2024 – 28/09/2024

Team 5

Team Members

  • Dr Leslie Leong
  • Dr Tom Li (Tom)
  • Dr Yoyo Hung (Yoyo)
  • Ana Paula Salgado (AP)
  • Ana Tilman (AT)
  • Ana Martins (AM)
  • Diamantino Morais (Tino)
  • Tison Martins (Tison)

Saturday – Arrival in Dili

We arrived in Dili on the afternoon Qantas flight, where we were warmly greeted by AT and AP. To our delight, we acquired SIM cards from the airport kiosk in under 10 minutes, an impressive improvement compared to previous years when we spent hours at Timor Plaza.

With the Sisters requiring the Landcruiser in the first week, we decided to rent a Toyota Hilux.
After a swift trip to Maubara to pack our gear, we made a memorable journey back to Dili,
navigating the roads in the dark. A noteworthy observation: many motorbike riders in Timor Leste forgo using lights, believing it saves fuel!

Sunday – Travel Day

Sunday commenced with a quick shopping trip to Leader supermarket before we set off for
Letefoho. The roads remained as bumpy as ever, leading to some discomfort. During the
journey, we contacted the priest in charge to find he had inadvertently forgotten our visit, but fortunately, he had ample accommodations available.

Our new lodging was “new” in the quintessential Timorese sense—faded paint, questionable
ventilation, and some cracks in the concrete. However, each room boasted a private bathroom,
and we had plenty of space for the entire team.

Monday > Thursday – Letefoho’s Tough Jaws

Screening the Children

The first week began unusually quietly, perhaps due to a lack of notifying the town of
our impending arrival. However, once the Troopie was filled with senior high school students, we quickly got to work.


Extractions became the main focus, proving to be more challenging than anticipated for Tom
and Leslie. Our new team member, Yoyo, seamlessly joined the fray, displaying enthusiasm that
belied his inexperience.

Our expansive hall

Initial difficulties with the new dental units were resolved through creative zip-tying of air lines,
enabling us to increase compressor pressure to a range of 80-110 psi. With the upgraded dental
and suction units, the setup has never been easier.

While Leslie and Yoyo battled colds, Tom dedicated his efforts to teaching AFL to the local
children. Impressively, several of them exhibited kicking skills that rivaled those of some
Australians, particularly Tison, who showcased an impressive range of talents.

Friday – Transition Day Challenges

Our transition day on Friday was initially planned to be relaxing—returning the hire car,
collecting the Landcruiser, and heading back to Dili. However, the day took a turn characteristic
of Timor Leste. Upon returning the hire car, we noticed it had taken on a distinct brown hue.Finding a car wash proved easy, but persuading them to wash our vehicle was less
straightforward. After some negotiations, they ultimately found a way to accommodate us.

Expectation of the Sister’s driver to delivering the Landcruiser by mid-afternoon turned into a disappointment. Following a delightful dinner with Dr. Jeremy Lung at Timor Plaza, the time grew late with still no car. By 10 PM, with an early ferry ride looming, we decided to proceed to Atauro with just one car, the Toyota Troopie.

We carefully sorted through the equipment and stock, packing essentials while leaving behind the second generator and ultrasonic scalers in the interests of saving space.

Repacking in the Timor Plaza Carpark

Saturday > Friday – Atauro Island

After a scenic ferry ride, we arrived to see the stunning beaches of Atauro.

While setting up the clinic in a cozy hall, we were to enjoy the balance of work and leisure, taking in the beach and indulging in snorkeling over the coral.

The clinic’s pace in Atauro was surprisingly relaxed. However, many patients presented with severely decayed front teeth, hoping for immediate aesthetic relief. A few fortunate individuals received composite bridges to rebuild their smiles. We noted that extractions seemed to be easier in Atauro—perhaps due to a softer diet from the local seafood?

On our final day in Atauro, we aimed to climb the impressive peak of Mt. Manukoko. Though it was only 6.5 kilometers one way, the ascent of 995 meters was quite challenging. While Tom, Leslie and Yoyo felt the strain, AP and Tison ascended with the grace of seasoned climbers. Our
guides, effortlessly maneuvering in flip-flops, made it look all too easy.

After our trek, we celebrated our achievement with a delightful meal of coconuts and spaghetti,
a simple meal but in the setting it was a feast to us.

Atauro views

TLDP Team 4, July 2024

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TLDP Team 4’s Maubara Extravaganza

Necessity is the Mother of Invention

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

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

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

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

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

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

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

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

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

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

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

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

TLDP Team 3, June 2024

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

June 2024

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

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

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

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

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

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

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

 

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

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

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

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

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

 

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

Patient Statistics

Total Patients Examined: 702

Extractions: 565 teeth

Fillings: 479 teeth

Fissure Sealants: 79 teeth

Silver Fluoride treatments: 338 teeth

Scaling: 120 patients

Endodontic treatment: 3 patients 

TLDP Team 2 June 2024

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Visiting Maubara, Don Bosco and Maubisse from June 2nd to June 16.

Team Leader: Dr Mary Tiutiunnik

Australian Team Members: Kayleen Alexopoulos – Dental Assistant (Week 1)

                                            Dr Geordie Meekin – Dentist (Week 2)

                                            Dr Shane Fernando – Dentist (Week 2)

Timorese Team Members: Ana de Jesus Barreto Tilman (AT) Dental Nurse

                                           Ana Paula dos Santos Tavares Salgado (AP)

                                           Ana Jose Martins (AM) Dental Nurse

                                           Zaino Tison Martins (Tison) Dental Nurse

Timorese Dental Nurses (Solar Smiles): Deonisio Anyonio Mendonca 

                                                                Lucas Mendonca Rodrigues

Timorese  Helpers: Diamantin0 Correia Morais (Tino) (Don Bosco)

Locations of Operation: Loes Vatuboro (Maubara Subdistrict) Yrs 1-6

                           Don Bosco Technical College Dili 

                           Fatubessi School (Maubisse Subdistrict)

                           Carmelite Sisters’ Clinic Maubisse

After some weeks of preparation, organising people, supplies and other logistics necessary for a successful trip, Mary and Kayleen arrived on the late flight from Darwin, delayed due to bags needing to be offloaded in Darwin due to weight restrictions. One of which was Mary’s, full of gloves and stock. The ever reliable Mario, on hand with the Troopie to pick up the Team, assured them that he would gather the bag tomorrow. Quickly shopping for consumables, we headed to Maubara to find a number of boxes from Rotary in Adelaide containing a dental potpourri of stock and equipment, including the much needed gloves.

We try and educate our Timorese colleagues about many aspects of dentistry and after dinner, Kayleen impressed upon AT and AM the importance of stock control and packing in an orderly manner so that things can be easily seen, collated and repacked for our road trips. Importantly, AP and Tino had recently sourced sharps boxes from the Maubara Health Clinic who will also dispose of them for us…..saving the less professional repurposing of water bottles.

This year we have implemented a more thorough oral health program with the nearby schools that seems to be going quite well. AT, AP, and AM have screened, treated, and given oral health education to the children at the three preschools in Maubara and are working their way through the 595 students at the primary school a few doors down the road.

We started the weeks outreach work in Loes, a community about 20 minutes down the road from Maubara. As most of the Maubara district schools are only open until 12, we left early for Loes with Tison, a dental nurse from Maubara who is presently volunteering at Liquicia Hospital and enjoying learning with our Team. After the Oecusse trip in May, Tison, a helpful and amiable young man, became very able at setting up our equipment. He speaks the local Maubara dialect which was great for oral hygiene instruction and patient communication. The mornings were filled with primary school students and then after school we saw the community, many who seemed to be related to Tison. 

These Loes patients all had large multi rooted teeth, perhaps the biggest we have seen in Timor, however AT was very competent at removing them, albeit needing to swap hands to relieve the strain. Mary was able to tutor Tison about doing simple fillings and the use of silver fluoride in arresting large carious cavities.

We extended our stay in Loes, it was important to not leave any school children still suffering infections. Nothing is written in stone with our trips and it is important to remain flexible with our scheduling to accomodate first hand information.

Finally, it was time to leave Maubara and head toward Dili and then on to Maubisse for the second half of our trip. This needed some careful planning as the cars would not return to Maubara before handing them over to the next Team, necessitating carrying extra stock. Kayleen’s instructions about recording and packing proved very useful in organising the cars.

Don Bosco Clinic

After the 1 hour trip back to Dili, we set up our clinic in the Don Bosco vocational training centre on the edge of Dili. Usually we try and look after regional communities but as many of the young people at the centre came from the country, with limited funds for dental treatment we felt that we should help look after them. 

Saying goodbye to Kayleen, we picked up our two new team members, Geordie and Shane who are working in rural Queensland. Joined by Tino and the many helpers at Don Bosco, the mobile clinic was quickly established and we were able to see many young people over the weekend. The brothers and priests were extremely grateful for our service, and we are hopeful we can come back in November to complete our tasks here.

The Sisters car suffered two broken windows overnight, a rare negative to our trips and Mary and the Don Bosco driver needed to tour the car repair workshops of Dili to find something that looked like the originals.

Sister Joaninha de Araujo, Sister Joaninha dos Reis, Dr Mary Tuituinnik and Sister Odette

Being in Dili afforded an opportunity to meet with the Carmelite Sisters who are integral to us efficiently doing our work. Unfortunately, the news wasn’t good as the felt they did not have the time to attend to our accreditation and customs clearance. As the Sisters are licensed to run health clinics, we can use their credentials to bring essentials such as anaesthetic into Timor Leste. We left for Maubisse wondering about the future and how we might need to restructure our arrangements.

Maubisse is up in the hills and quite cold, especially for Tison who lives on the hot coast and appeared quite stunned with the change in climate. Our arrival coincided with a visit from the Cardinal and we enjoyed seeing the colourful celebrations with many dancing Timorese in native costumes. Our accomodation was within earshot of the church, loud music continuing until luckily there was a power outage which sent the noisy throng home.

Maubisse

School starts a little later because of the cold and so there was less need for an early start, just as well as the road was rough with the last 300 meters more suited to a mountain goat. Shaun, a keen 4 wheel driver enjoyed the challenge but baulked at the last decent thinking that losing the Troopy over the edge wouldn’t look good on his resume. Luckily a bevy of locals appeared and kindly carried our equipment down the hill to the small school.

Portage of our equipment down the hill

Lucas and Deon, the two Solar Smiles dental nurses met us up with us and joined the Team for the week. Solar Smiles is another Rotary backed group that concentrates on oral health in schools in the Maubisse region.  After a short ceremony from the teachers where we were presented with the local woven tais we set to work. As often is the case the power supply at the school was not quite enough requiring more helpers to climb the hill and fetch our generators.

We found that the children and community had quite poor oral health however their teeth were quite small and easy to remove, unlike those of the folk in Loes down by the coast.

The next day it was a late finish to our clinic as the local men who were to carry our gear up the hill wished to have their teeth cleaned before they would start.

We then worked for two days at the Carmelite Sisters clinic in Maubisse, unfortunately they did not have their government contract renewed and the once busy clinic was very quiet. The slower change of pace allowed for some quality mentoring, particularly in filling techniques of the Solar Smiles boys and Tison, Geordie and Shane were of a similar age to their new Timorese friends and enjoyed the chance to share their knowledge which was received with great interest.

The Solar Smiles boys had a treasure trove of materials and we were able to “borrow” tubes of hand sanitiser which was in short supply and donate other materials to Tino who never has enough in hid government run clinic.

Back down to Dili where Mary was knee deep in the documentation rigmarole for the next team. Nothing seems straightforward in Timor Leste, working out who to approach at the MoH for our accreditations and designating someone to get that job done.

Helping the children, relieving pain and infection sometimes seem the easy tasks to do.

More running around to get the essentials for the next Team, a trip to the airport to pick up newly arrived Henry, introductions, debrief and lunch, back to the airport for the Australian contingent and all of a sudden our trip was over.

For an impromptu trip, Team 2 was very busy , importantly helping the locals in need and also introducing new team members to our work in Timor Leste.

Second week Team 2 Team members

Together we are an Ocean

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Team 1 arrived home a week ago, tired – and some of us sick – but triumphant. This trip was difficult to organise and challenging on the ground due to the conglomeration of different organisations during the first week- The Timor Leste Dental Program had been joined by Solar Smiles Dental Charity (SSDC), the Bendigo Maubisse Friendship Committee (BMFC), and the Maubisse Referral Hospital (MRH). We all had  different ideas and agendas for this first week, but we shared a common goal – to improve the dental health of Maubisse Subdistrict; this made us a highly effective team.

Week one saw us in Maubisse Subdistrict. The TLDP consisted of overall team leader, Dr Blanche Tsetong, the TLDP’s Timorese dental therapist, Mr Nico Tolentino Faria,  and translator (as well as sterilisation nurse and dental assistant), Miss Isabel Noronha Pereira de Lima Maia. SSDC was represented by founder, dental recruiter and former dental assistant, Mrs Kim Groizard. Standing with a foot in both camps was Dr Phil Hill, who was volunteering for the TLDP, but was also a member of the SSDC. Dr George Waters represented the BMFC and the MRH brought into the mix Dr Inda Zulmira Dias, dental therapists, Mr Armando Da Costa Martins and Mr Ricardo Mendonça, and assistants, Carlotta and Imelda.

The TLDP and MRC spent the first couple of days in Turiscai treating the community and the school. Turiscai is and isolated village 1 1/2 hours from Maubisse town along the type rough, dirt ridge track that TL is famous for. The scenery is spectacular. We were very busy – the community rarely gets dental services – but our plans for a community oral health workshop were stymied by the campaigning for the upcoming election. (Pic: Phil, Nico & Ota)

The next 3 days the TLDP and MRC visited Rimori School, in a village fringed by sharp mountains, Samoro School, in a valley accessed by a skinny dirt track running beneath towering Madre de Cacao trees and coffee bushes, and the Carmelite Sisters’ Health Clinic back in Maubisse town. Kim Groizard lent a hand at both Rimori and Samoro Schools , enabling her to see a functional outreach clinic in TL in action. As we all know, working in TL has its unique challenges and peculiarities! (Pic: Phil, Isa & Kim)

Week 1 was peppered with meetings, but the most crucial was that with the Chiefs of all the Sucos (akin to shires) in the Maubisse Subdistrict. Phil, Nico and the rest of the gang remained slogging at Samoro, while Blanche, Kim and Inda attended this meeting with George in tow (SSDC will function under the BMFC umbrella). At what Kim described as a “horse auction”, the chiefs sought to get more services for their Sucos. In the end, we came out with a working plan of cooperation between the Chiefs, the Carmelite Sisters, the MRH, the TLDP and the SSDC. Success! (Pic: The view from Rimori)

The weekend, as always, brought the changeover and we said goodbye to the cool hills of Maubisse, the Maubisse crew, and to Kim and George. We were now a solely TLDP team. Blanche, Phil, Nico and Isabel happily welcomed Dr Mary Tuituinnik; less welcome was  the oppressive heat and humidity of the coast .

Week 2 had a different flavour to it – the climate introduces an additional layer of difficulty to our job. Also, by that time, both Nico and Blanche were ill; nevertheless, the team carried on – they spent 2 days in the slightly cooler climes of Vatuvou School, in the foothills behind Maubara, and a day in each of the airless, dusty, piping hot schools of Ediri and Vatunau, with one fan, a tin roof and a generator. What made the week flow easily was Phil’s can-do, ever-optimistic attitude, Mary’s gentle humour, Isa’s graceful, caring nature, Nico’s dogged work ethic, and the non-stop gentle pitter patter of Phil and Mary’s chatter – those two can talk underwater!

One of the days we spent assessing and mentoring a dental therapist, Savio, who the SSDC hopes to employ. Like most of the dental therapists we come across in TL, his skills are woefully lacking; however, with the right attitude towards learning, and with lots of support, we know that he could become an excellent clinician. Many of the dental therapists we mentor are now excellent clinicians. (Pic: Savio, Isa & Mary)

Week 2 also had its share of meetings as the TLDP worked with Phil (with his SSDC hat on) to establish more connections in TL. There were many trips back and forth on the Dili Road – meetings with Judite and Mario from the Rotary Liaison in Dili, the Rotary Club Lafaek in Dili, and the Rotary Club Dili at the Klibur Domin Tuberculosis Clinic in Tibar, with a fortuitous meeting with another new dental NGO in Tibar, which works within Kilbur Domin, under the Ryder-Cheshire banner. Developing links is important, especially in this setting, as it allows us to support each other and to share resources – TL is an impossible place to work in solo.

Blanche had meetings with Sr Inacia about the Sister Delfina who the TLDP hopes to support in her dental studies in Indonesia. The TLDP believes that local ownership is the only way for a program to be sustainable. Although Nico is hardworking and committed, he is a “mere” dental therapist and so lacks the clout that being a dentist would give him. He also has family ties that may force him to leave the program one day. Hence – in supporting Sister Delfina to become a dentist we hope to safeguard the program for the future. However, the TLDP was originally led to believe that the degree would cost approx USD 9000 for the first year of study. Instead, it is closer to USD 29000 – a big difference! Nevertheless, we are determined to support her – I see some fundraising in our future!

Team 1 luckily had few equipment issues –  3  broken triplexes, a non-functioning generator, malfunctioning head torches, a dental unit water leak, a total loss of water supply in the accommodation in Maubisse and, at the end, a broken air-conditioning fan belt in the SIsters’ car. Most they managed to fix during the 2 weeks! (Pic: Isabel, Blanche & an iPhone)

Team 1 saw a total of  415 patients, extracted 363 teeth, restored 245  teeth and carried out   39 treatments. With the TLDPs support, the MHR and Nico had screened, given oral health education and carried out a selected treatment to 1439 children prior to the Team’s arrival.  A fine example of what cooperation can accomplish!

Thank you to the entire team – you make this program. Thank you to Bony Cardoso Martins, who continues to help us with our Timorese dental registration, which is an exercise in tedium. Thank you especially to Henry Schein Halas, who continues to support our program with stacks of consumables and equipment team after team, year after year. Your generous donations allow us to give more to the Timorese people. Thank you also to SDI who has also helped us with donated materials over several years. Thank you to our partners, the Carmelite Sisters who, with their grace and good company, make it a joy to work in TL.  (Pic: Phil, Sr Joaninha, Blanche, Sr Isabel, Mary)

That which does not kill us…..

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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!