Kerrin Thomas – An Australian dentist and a small group of volunteers have managed to check more than 1,200 mouths in just two weeks on Timor Leste.
That amounted to 527 extractions and 406 fillings for Charmaine White, from Narooma on the New South Wales south coast, and her volunteers.
Dr White was on her second trip to Timor Leste to provide dental services as part of the Timor Leste Dental Program – a joint initiative of Rotary, Lions, and the Carmelite Nuns who are based there.
Conditions in Timor Leste were challenging for the small team of volunteer dentists, nurses and translators, navigating difficult roads and dealing with power blackouts. Dr White said many people in Timor Leste chewed betel nut to get relief from toothaches.
The chewing of betel nut has been linked to oral cancer, and a musician who recently came to Australia from Papua New Guinea for surgery to remove a cancer from his mouth says he's now scared to chew it. "It's like their form of [paracetamol] but it's addictive as well," she said.
"So what would happen to the children is they would wake up in the middle of the night with a toothache and there's no [paracetamol] so the grandmother, usually, would say 'Have some of this, it will help the toothache go away' and that's what they do but then the kids get used to it.
"And then you get the oral cancers and there's no treatment over there for oral cancer. If you want treatment you have to go to Australia. If we can stop the toothache or alleviate the toothache, the betel nut doesn't get chewed, then the oral cancer comes down."
'Toothache for months, if not years'
Many of the 1,200 children Dr White and the team treated during the two-week trip were seeing a dentist for the first time. "Our main focus was to get the children out of pain, some of them would have had toothache for months, if not years," she said.
She estimates about 75 per cent of the children she saw had good teeth but about 25 per cent had issues. And there was a recognition in the team that the children may never see a dentist again.
"You might have to take three permanent teeth out because you knew you may be the only dentist they'd see in their lifetime," she said.
"That was pretty hard, when you've got little eight-year-olds and you're taking three teeth out in one sitting, and they've never seen you before but they are so stoic, they're so brave."
Working in Timor Leste was rewarding for Dr White – but also challenging. "I sit on the plane [coming home] and I think 'I could do so much more if I was here in East Timor', but it's quite exhausting," she said.
"You're having to pack up and move heavy equipment [almost] every day and then you get a room with louver windows and it's noisy because all the children want to see what's happening in the room where all the noise is coming from.
"Then the power goes out so you've got to set up the generator and then you've got to get the gas ring going with the pressure cooker to sterilise all the instruments. You're on your feet all day... so it is totally different to working here in a very sterile, infection-controlled environment."
But one exchange with a principal whose school was visited by the program two years ago helped highlight why her work was so important.
"He said 'Your team came to our school two years ago and none of the parents complained, everyone was really happy, all the children felt better, there were less sick days because they weren't home with toothache, and we're so pleased you've come back to our school again'," she said.
"I thought that was really nice because you go and then you don't get to the same school again, so to know that the other teams were effective, that's really good."