OECUSSI, Timor Leste -- The musty air in the clinic’s waiting room was palpable.
Many walked all morning to be there when the Americans arrived. A mother held her baby, a son sat next to his father, and a girl led her grandmother by the hand.
One father sat expressionless, aged by many years under an intense sun. In his arms was the limp body of his 4-year-old son. There was emptiness in the boy’s brown eyes, as if weeks of pain in his jaw and neck left him detached from the world.
An abscess jutted from under his jaw. An infection in the child’s neck, caused by rotted teeth, was growing exponentially. It was closing his airway.
He badly needed the teeth removed and the infection drained. Left untreated, he would suffocate.
On the morning of Oct. 17, a team of Navy medical personnel from the 11th Marine Expeditionary Unit flew to Santa Rosa Hospital in the enclave district of Oecussi in East Timor. The sailors had been providing health services at remote locations in the country since Oct. 15.
Navy Lt. Billy Turley, a general dentist, just finished treating a patient when the father and son came in.
“Immediately I knew this was a case that needed surgical intervention,” he said.
The boy had difficulty breathing and swallowing, and his father said he had eaten only small amounts of rice in the past three days.
Turley feared for the boy.
“My initial concern was that due to the isolation from advanced medical care, the child might not make it,” said the Auburn, Ky., native.
In an American hospital, an operating room would have been ready shortly after the boy arrived. But this was Timor Leste, a Southeast Asian nation with few doctors and even fewer dentists.
“I was told by the nurse here that the only dentist nearby was in Dili,” Turley said.
The capital city is more than 80 miles from the isolated district, and there was no guarantee a dentist would see the boy, let alone be capable of performing the surgery.
Turley ran through the possibilities in his head. They could fly the boy to Dili or to the amphibious assault ship USS Bonhomme Richard anchored off the coast. Those courses would take time.
Those close to Turley know him as a man of action.
“If something needs to happen, Doctor Turley makes it happen,” said Petty Officer 2nd Class Rachel Arndt, a hospital corpsman who has worked with Turley for 14 months. “He doesn’t sit around. He takes the bull by the horns.”
The child’s condition was severe, and Turley said the boy needed to be unconscious during the surgery. However, anesthesia is a rare specialty in the underdeveloped country.
The 28-year-old dentist went to the director of the clinic in hopes of finding someone qualified. He was in luck. There was a team of Cuban doctors working at the emergency room next door.
After a confusing mix of translation – Turley speaking English to a translator who spoke local Tetum to a Cuban who relayed Spanish to the doctors – the Cubans were on board.
The director made the arrangements with the anesthesiologist and the doctors ensured the boy was fit for surgery.
“Putting him under was a risk,” said Turley, a graduate of Western Kentucky University. “But not doing the surgery was a far greater risk.
“I told the father that he had an extremely severe infection, and without emergency surgery, his son would lose his airway”
Turley said the father, a local police officer, turned to him with a stone-cold look on his face, realizing the problem was serious.
The worried father said yes to the surgery, and within an hour, the child was in green scrubs lying on a gurney.
The boy’s eyes were wide. He squeezed his mother’s finger with his tiny hand. Cuban nurses wheeled the weeping boy away into an operating room. The anesthesiologist silenced the boy’s cries.
It was Turley’s turn.
After pulling seven badly rotted teeth, Turley opened the neck abscess with a small incision, about two centimeters.
Pus and blood oozed.
Jonnes Vallejo, a Cuban surgeon, assisted Turley in draining the infection and stitching the boy up. They leaned over the boy; their experienced hands weaved the stitches with a natural ease, like one ties a knot in a shoe.
When the last stitch was made, Turley backed from the operating table and waited for the Cuban medical team to revive the boy.
The procedure was done.
“I was glad it was over and that we didn’t have any complications, ” he said. “We got everything out.”
With the boy breathing on his own and his heart rate stable, the doctors removed their masks and gloves and retired to a small break room outside the operating suite.
"That makes the whole trip worth while," Turley said as he sat. "Knowing that you saved a kid’s life."
Members of the Cuban medical team rolled the boy’s gurney out of the operating room. A nurse brought the boy’s mother in. She found her son and gently embraced him. The medical team quietly left the room.