Tag Archives: volunteer dentistry

Nico and Ana giving oral hygiene instruction to school kids

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

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

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

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

The View from Gruto School
The View from Gruto School

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

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

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

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

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

Blanche and Nico fixing suction
Fixing the suction unit

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

It’s always a blast with the Sisters

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

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

The crazy kids in Faulara

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

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

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

 

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

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

Mary mentoring Tino

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

Kim demonstrating with Leslie assisting

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

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

 

 

 

TAG TEAM

It’s only a week after Team 4’s return to Oz – just enough time for then to pass the baton to our final team for this year. Team 5 hits Timor’s shores today and will be bringing with them enough materials to sustain our Maubara crew (and all our mentees) on the ground for the next 6 months – we won’t be sending anyone over until March next year. Fingers crossed we got the numbers right!

Team 5 consists of the TLDP Program Coordinator, Dr Blanche Tsetong, TLDP veteran, Dr Mary Tuituinnik, and two new volunteers, Dr Kim Hartley and Dr Leslie Leong. The team heads to Maubisse for a week and then will be finishing off the work in 5 schools in the Maubara and Loes regions. Have fun team!

 

Farewell Team 4

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

CONVIVIALITY OVER FRUSTRATION

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

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

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

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

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

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

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

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

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

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

 

 

Together we are an Ocean

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)