Tag Archives: volunteer dentist

Leslie Admiring the view

Notes from the Edge – Dr Leslie Leong

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You know that feeling when you flop down onto a chair, tired and exhausted from a hard day’s work, yet feel strangely rejuvenated and fresh? Timor gives me that feeling in the bucketloads. You might think that’s from piling through patient after patient. Through lifting box after box from the Landcruiser to the classroom cum clinic, setting up and doing it all in reverse by the end of the day. And some days you’d be right. Other days, I get that feeling from chasing kids around the school with a broomstick and squeezy bottle of water.

I get such a sense of family and community being around these amazing individuals. I first met Nico (the dental therapist) while filtering through the dental supplies to bring to Maubisse. Complete with the cheeky smile, tooth gem on his lateral incisor and tough guy exterior, Nico is the best problem solver. Repairs to the suction unit with composite resin comes second nature, thus earning the title Nico ‘sempre diak’ (translate: Nico always good). Learning Tetum, there is a definite ‘go-to’ Ana to ask for advice. Ana ‘diak’ (Ana Paula) will give you sound translations that had me somewhat conversing with my patients. Ana ‘la-diak’ (Ana Tilman) might have you buying lollies when all I wanted was a bottle of water.

You have to be ready to get uber basic when it comes to lifestyle habits. Fortunately, I love putting my technology away and find a certain joy in living and eating simple. One trip to the Maubisse market yielded the tiniest, reddest strawberries and plump avocadoes. As not to offend the sisters, who were accommodating and feeding us, I gifted both of these items to them. I found that evening they already had mountains of strawberries ready for us to stuff our faces.

Those avocadoes though, I never saw those again. Count me moderately devastated. Safe to say then, I’m coming back for those avocados.

(The indefatigable Leslie will be joining another team this year – he really wants those avos! – Ed)

The Power of Many

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

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

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

The fabulous GK in action with the equally fabulous Isa

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

Tino and the omnipresent Ana Tilman!

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

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

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

The team with HG, WH and DD on the tools

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

Back in Maubara with Sister

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

The home team watched over by Henry

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

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

Henry trials the new hand washing unit

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

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

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)

And so it begins…gearing up for 2018

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It seems like we’ve just stopped to draw breath from the helter-skelter of 2017, yet here we are – 6% of 2018 already done. So the TLDP year begins with an admin and planning trip. This is especially needed this year, as we lost our beautiful Timorese coordinator, Sr Filomena, to the Oe-cusse Carmelite Community at the end of 2017. Armed with calendars, forms, and loads of blank paper, Dr Blanche Tsetong is set to head to TL for 3 intense days of meetings and brainstorming. Of course, she’ll be taking some much needed supplies – we can’t let that valuable luggage-space go to waste!

Blanche will be meeting with Sr Inacia, one of the heads of the Carmelite order in TL and, at the same time, she hopes to meet the young Sr Anna, whose dental studies we hope to support in Indonesia. Whilst in Dili, she will also be meeting with the Ministry of Health to discuss the ongoing saga of dental registration. Then a big planning session is in the works with Bony, Nico and Sr Joaninha in Maubara. With Sr Filomena gone, the coordinator role will be shifted onto Nico, the dental therapist, who will be aided by the redoubtable Bony. As the only dental clinician within several districts, Nico has a big job ahead of him.

The Ermera and Maubisse contingent will be met back in Dili – Blanche is looking forward to a big gathering of some of our long-standing, dedicated Timorese clinicians – Tino from Gleno, Dr Inda from Maubisse, Ana Paula from Balibo, and Ana Tilman from the Kose Nehan Program in Aileu. These people are a joy to be with. There is much work to do, especially now that the TLDP bas been joined by two NGOs, the Bendigo-Maubisse Friendship Association and Solar Smiles. We all want to help, but it takes effort not to get in each other’s way. We will be looking to our Timorese friends for guidance!!!

And fingers crossed – at the end…..we’ll have a plan for 2018!!!! Wish us luck!

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!