I always wanted to be an architect – I just loved drawing things. I enrolled at UNPAZ (University of Peace in Dili) to study Architecture, but in my third semester, the Ministry of Education opened a scholarship programme with Brazil. There were no architect courses, but there were courses to study to be a Dentist. My dad has always had problems with his bad teeth, but more importantly, I knew there weren’t many dentists in Timor-Leste. I passed all my exams and tests and in 2012 I flew to Brazil. I was scared as I had never travelled without my family before, and I had never left my country, but I was determined to do it.
The University was in Campina Grande, in the State of Paraiba. “Semester Zero” was our first semester – here we focused on reading, writing and comprehending Portuguese so that we would be at the level of a native Brazilian speaker. Dentistry is a difficult degree to pursue, but while challenging, it was really interesting – I like that. I was there for five and a half years; in the middle of my studies, the university was closed for a whole semester because they were on strike! I really missed my family, but it was too expensive to fly back to see them.
After the third semester, once or twice a week, we would go out of the town and do oral health promotion in the community, and in the last semester, I completed an internship with a Brazilian dental clinic.
In 2019, I came home to Timor-Leste, and as part of the scholarship agreement, I had to do a Professional Internship. I did this at Bairo Pite Clinic, and that’s where I met Efi, a dental nurse. We are both passionate about oral health and we worked well together. Efi moved on and started working at Maluk Timor with the Oral Health team. When I finished my internship, she encouraged me to send my CV to MT, and now I am now proud to say that I am a Dentist with Maluk Timor.
My work with MT began based at Klibur Domin, our partner NGO in Tibar (about 17 km west of Dili) to deliver health services to both urban and rural communities. On average the clinic receives about 15-20 patients a day but given circumstances during the COVID-19 pandemic this number dropped down on average to 9-10 patients a day.
Nearly everyone who comes to the clinic comes because they have a bad toothache, or can’t eat or sleep because of tooth pain. It is a pity, as very few come to have a routine check-up. In Timor-Leste, it seems pain levels is what makes someone go to the dentist; “if it can’t kill me like HIV or TB, I don’t have to worry – just put up with the pain”. Timorese don’t pay enough attention to their teeth.
We say Saúde komesa husi ibun-laran – health starts from your mouth. Everything we eat goes through our mouth into our body.
With all our patients, we don’t just counsel them on the importance of oral health, we go beyond to work with them to find solutions on how they can actively play a role to maintain their health. It so important to look after your teeth because of the impact it has on your overall health and wellbeing; but the mindset of institutions and communities in Timor-Leste is hard to change… neineik-neineik – slowly-slowly.
Out of the many issues we face with oral health, there is just not enough resources, human or financial, allocated to tackle problem. In Timor-Leste there are around seven government dentists and around 15-20 dentists in the private sector including NGO’s – including those on internship’s from overseas. However, there is over 1.3 million people in Timor-Leste, so you see there is nowhere nearly enough to serve the population.
While the government has a clear goal for oral health in the Health Sector Strategic Plan II (2020-2030)*, from the current situation of oral health in Timor-Leste, what and how we can expect such results?
Let us all join together with every donor, UN Agency, NGO and Civil Society to support the Ministry of Health so these Goals, Vision and Expected Results so we can start having some strong oral health outcomes
Its funny (well not really), but when you look at a village, maybe 2 or 3 people at most will have TB, but when you look at the same village – we know that 95% of people will have oral health problems. Dental problems and oral health are almost completely preventable if you do the right things… It is easy to care for your teeth and mouth, but people wait until the last minute to seek health (if at all).
We try to encourage people to save their teeth – to treat them and not pull them out where possible. If you lose a tooth, you lose it forever, people are scared about losing a finger, but they should also be worried about losing a tooth.
* According to Health Sector Strategic Plan II Edition 2020-2030, has clearly mentioned Oral Health:
Goals: to improve oral health status of the Timorese People through evidence bases, integrated, multi-sectoral approach to oral disease prevention and control, oral health promotion, health systems development and enabling policies.
Strategies:
a. Build on the strategic foundations established through the production of the National Oral Health Strategic Plan while linking ongoing oral health strategic activities to the umbrella NCD policy framework that affirms integrated and cross-cutting initiatives;
b. To ensure access to appropriate oral health services to the population at all facility levels.
c. To reorient clinical service delivery from a curative model of care to a blend of promotive, preventive and curative interventions.
d. To promote community awareness and participation in priority target groups who are at risk of critical oral conditions.
Expected Results:
a. Integrated and coordinated approach to oral health illness management developed and implemented;
b. Priority focus on child and adolescent oral health and oral health as part of primary care
c. Increased number of scholarship opportunities to oral health professionals such as Dentists, Dental Nurses and Dental Technicians;
d. 75% of health centres implement oral health programs;
e. Baseline data on periodontal diseases and oral cancer in Timor-Leste registered and targets set by 2024;
f. At least 40% of primary and secondary schools participate in oral health promotion and education activities