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Thursday
Dec122013

« IN THEIR OWN WORDS: UWSoD STUDENTS IN JAMAICA »

 Editor’s Note: For some years, UWSoD students have been making the trek to Jamaica to deliver dental care to the island’s underserved population. We asked them to write a little about their experiences there. What follows are their observations, in their own words. 

Allen Tucker
They say service is the cure to burn out. This humanitarian trip to Jamaica through Great Shape! did not disappoint. At times dental school, and I imagine dentistry in general, can become a bit mundane and stressful. The aid you are offering your patients on a daily basis often goes unnoticed or forgotten. It didn’t take long after arriving in Jamaica to truly realize how great of a skill dentistry is, and the endless opportunities we have to share it. 

Patients I encountered were extremely kind, gracious, and overwhelmingly thankful for the work we were providing them. Many drove miles and miles on busses and taxis just to get to a clinic where they could be seen. Others arrived before dawn to ensure they would be able to be seen. Many had been suffering agonizing toothaches for months on end, waiting until the Great Shape! team would make their annual return to their local clinic. 

This was the first time in my life when I felt like I had an actual skill to offer. I am so grateful for my dental education and the vehicle it has been for me to give back to so many people who are in desperate need. I have felt first hand the power of service in dentistry. I am glad I had this experience early in my career so I can make it a priority for the remainder of my life. 

Blake Quigley
 Blake Quigley and Kate Osborne in clinic with a local childMy first experience with the Great Shape! organization this fall will definitely not be my last.

As a dental student, I was excited by the opportunity to practice my newfound and rapidly developing skills. My expectations and hopes for my clinical experience were met and exceeded. I was also continually impressed with the tremendous need for dentistry in Jamaica, and the gratitude the Jamaican people expressed to us as volunteer providers. During the five days we were able to spend in the Kendal clinic, I was able to perform more extractions than I had in two previous quarters of Oral Surgery and Urgent Care Clinic. As a dental student, this was an invaluable experience, and many of the patients were able to help were in dire and urgent need of these procedures. The Great Shape! organization allowed us to perform these procedures in a safe, supervised environment that facilitated student learning at a much higher volume than we are accustomed to at the School of Dentistry.

Perhaps my favorite patient of the week was a nine year old boy named Andre. Andre was terrified of the dentist. There is no question in my mind he had traumatic dental experiences in his past, and he was generally timid and cautious around adult males in general. He insisted that a female assistant be present during his visit. I later learned that Andre and his four siblings are being raised by a single mother, and he does not have a stable father figure in his life. Andre really struggled during his first visit. 

We eventually had to send him home and told him he could come back the next day if he was feeling up to it. I was impressed and surprised at Andre’s bravery when he came back the next day and were able to complete a large restoration on his adult first molar that would have surely been lost had it been left untreated any longer. Andre felt a tremendous sense of accomplishment and triumph when we finally dismissed him from the chair. The real success we achieved that day was not Andre’s restoration, but his positive experience at the dentist. Andre ended up coming back almost every day that week to watch what was going on at the dental clinic.

I left Jamaica feeling grateful for my experience, there is no doubt that I got out of the week much more than I put in. However, I also left Jamaica impressed by the tremendous amount of unmet dental need that exists there. While our team’s effort over one week may have done very little in the grand scheme of things, there is no question it was a step in the right direction. 

Imahn Moin 
Turning the final street corner in our loaded bus, we got our first glimpse of the clinic we would be working at“Best rehydration drink you could ask for after a long day doing dentistry in 100 degree weather.” for the next week. But it wasn’t the deafening generator, the dimly lit interior, nor the makeshift dental chairs patched with duct tape that served as our wake-up call that we were no longer in dental school. 

After my first year in clinic—a year spent calling, begging and trying to convince patients to come in for the dental work that they needed — I was unprepared for the throng of 50 people standing outside our clinic, many having waited 3 hours for our arrival. For most, the Great Shape! volunteer program would be their only chance at dental care for the entire year, and they were eager to take advantage of this opportunity. 

It never ceased to amaze me how people could wait outside eight hours in the sweltering Jamaican summertime heat, bear the torrential downpour that occurred each afternoon, and still be so ecstatic and thankful towards the end of the day just to be seen. Their gratitude was always apparent from their genuine smiles and “thank yous,” and that was enough of a reward for us, but that didn’t stop them from spoiling us by coming back the next day to bring us fresh coconuts, avocados and sugar cane. 

Going to Jamaica made me a better clinician, no doubt about that. But it also helped make me a better person. Putting yourself out of your comfort zone, interacting with new people, learning new cultures, and giving back to those less fortunate, made me realize how fun, rewarding and fulfilling dental volunteering can be. 

Sean Collette
I had the pleasure of serving in Greenland, which is so remote that even the locals in Negril thought we meant the urban city “Green Island.” Greenland is a small, rural area in the hills, surrounded by lush wilderness. The Greenland United Church hosted our clinic, offering plenty of room for our patients and equipment. Storms are common and the electrical grid is unstable. When a storm knocked out our power, our backup generator was just able to maintain sterilization.

I was able to render surgical and restorative care to dozens of people. One young woman presented with signs of congenital disease and severe dental decay. Her complaint was the black lesions between her anterior teeth. I did as many composites as time allowed (we were usually swamped with patients) and gave her the mirror. I appreciated her warm giggle of approval, and invited her to return later in the week if possible.

I enjoyed this wonderful week restoring smiles and getting people out of pain.

Melanie Garcia
Being able to be a dental volunteer in Jamaica was such a rewarding and memorable experience. Starting my last year of dental school, I think it is very easy to forget the passion we have for helping people and why we got into dentistry in the first place. We start to focus only on passing boards, completing competency exams, and what we are going to do after graduation. This trip was a great reminder that there is more to life then worrying about exams. Not only were we able to help change the lives of so many Jamaicans who have never been to the dentist, but also the Jamaican people reinforced how much I love dentistry and cannot wait to help more people in the future.
 Melanie Garcia and Jonathan An laugh with Jamaican children
One of the most memorable patients I had was a man who went by the nickname Bitty. Bitty said he was very eager to get two of his front teeth filled (he needed #7M and 8D class 3 composite fillings done). He said that he had been out of a job for several months and he felt the reason he was unable to get a new job was because of the decay on his front teeth. During the time Bitty was in my chair, the electricity went out at least four times. Bitty was such a cooperative and understanding patient. Every time the power would come back on, he would eagerly open his mouth so we could continue with his fillings. At the end of the procedure Bitty was so appreciative and happy with the results. He said, “now I can get a job and be a good example to my three little angels.” I personally felt so touched at how doing two simple fillings will change this patient and family’s life forever. 

Amanda Patterson
Our clinic location was particularly special, as there was a kindergarten beneath the educational complex. This prompted the idea to have an all pedo day. For most of the kids, we “tickled their teeth,” but some kids had to have extractions of retained primary teeth or even extensive restorative work. I had to take out a carious tooth on Sophie, the younger of two sisters. She had never seen a dentist before, as was the case for many of the other children, and even adult patients alike. Her big sister stood at my side and watched the whole procedure.

Amanda Patterson with Jamaican childrenAfterwards, I taught Sophie how to brush her teeth and demonstrated it on the oversized dentoform with the oversized toothbrush. After I moved on to the next patient, Sophie and her sister came back. They remained at my chair until the end of the day and insisted on teaching each new patient how to brush their teeth on the oversized dentoform. The big sister told me she wanted to become a dentist and asked to keep the dentoform. I was excited to hear her say this, as the eventual goal of the Great Shape! 1000 Smiles program is to have Jamaican dentists donate their time to fellow Jamaicans.

Overall, this experience was particularly illuminating for me. I was shocked to see that some of the older adults I treated had never seen a dentist in their lives. I was equally astounded that many Jamaican adults had never used ibuprofen, whereas it is completely commonplace in the US for even the most minor of pains. I have performed volunteer dental work in Seattle before, but it was the experience in Greenland that impacted me the most to date. It made me truly realize that I want to volunteer in a dental capacity for the rest of my career. 

Nam Thien Vu
 NamThien Vu (right) and volunteer Alyssa Crane with local childrenThis family was one I vividly remembered. They all came in on our last day of clinic with their mother. She was a single mother and had three young children at home. Each child all had baby teeth that needed to be extracted, and boy, were they brave. The eldest son was first. He was the most brave. It was Friday and he wanted to leave as soon as possible to play with his friends. He sat in my chair and immediately took off his hat and shoes as a sign of respect. He had a loose lower primary tooth. As I gave him the injection, he was so calm and collected. I removed the tooth with ease and he was so excited. He was out of pain and his friends could no longer tease him about his decayed tooth. We let him go home with his tooth in the envelope.

Next was his younger sister. She had never had a tooth extracted before. She was a little scared, but Allysa, my assistant was such a great mother figure. She calmed the girl’s nerves after the injection. The little girl explained that she just wanted to go home and watch Dora the Explorer. As I explained to her, the faster we can do this, the faster she could watch Dora. I began to wiggle her tooth, and slowly but surely it came out and as she wiped her tears away, it was suddenly over. She went over and sat next to her brother. 

Then it was the youngest sibling’s turn, and she was the most difficult. She had multiple loose teeth, but it was the lower right that was causing her the most pain. She cried from the beginning. Nothing Allysa or I did to help her worked. I tried to give her the injection without pulling the cap off to show her that it was nothing to be worried about, but she continued to cry. Her mother came to the chair and tried to reason with her. I asked her if she was a brave little girl. As she wiped the tears from her eyes, she nodded. I told her that brave girls are especially brave at the dentist. Nobody was going to hurt her and the faster she got this done the faster she could begin her weekend! As we reasoned with her, we were able to get a small injection around the tooth. We talked her through the whole process and as I was talking to her, we extracted her baby tooth. I massaged her back as she cried. I gave her a toy and she began to stop crying. I told her she was going to be all right. All three kids hugged their mom and they lined up and took a picture with us. It was a pretty cool experience.

Amandeep Kaur Virk
 Going on a mission trip to Jamaica has been one of the most valuable experiences I have had since entering the field of dentistry. Not only was I able to gain tremendous amount of experience with dental procedures, I was able to learn about the different cultures and outlooks people around the world have about dental care. One can only imagine the oral health conditions in a country where there is a ratio of 1 dentist for every 100,000 Jamaicans. I was not surprised at the poor oral health conditions knowing there was such a shortage of dental care, but I was surprised about the outlook people had about dentistry. It was clear there was a lack of understanding about the connection oral health has on overall health, and vice versa.

Most of the adult patients I saw had severe periodontal disease, but to them it was not a disease but a norm. Getting teeth extracted was the standard for many patients, and in some cases an extraction was preferred over a filling. One of my patients asked me, “will you be back next year because by then I will need more teeth extracted”. The expectations the natives had about their oral health were very low. Therefore,  education was an important aspect of this trip. Due to the lack of resources, it is understandable that they felt extractions are their only option. However, it is our job to educate people on how to obtain optimal oral health and how a healthy mouth can improve the their overall health and quality of life. I feel the most important aspect of this trip was the effort to educate Jamaicans on how they can prevent tooth loss from dental diseases by practicing proper oral hygiene.

Kim Trieu
I’ve always wanted to be a part of something bigger than myself. Being a mother of three toddlers, I feltKim Trieu and one of her patients, “Harry” called to the opportunity to work with Great Shape! Dental Mission. My mind and heart was set on the vision of shaping the lives of the locals, but little did I know that they would in return, shape me.

Great Shape! brought in a community of youthful, local Jamaican leaders to support the dental volunteers from all the States. During orientation, I had a chance to meet Caithlin Williams, a Jamaican student that will be graduating in the first dental class. Our conversation went late into the night as we discussed about neglected care, challenges in community health clinics, and how cultural perspectives play out in our ability to delivery our care. We talked about the differences between our cultures, where in the United States, we can be filled with the frustrations with regulations, and in contrast, Caithlin wished that she could have this problem because regulations and standards is what Jamaica lacked. 

I realized how blessed dentistry is in the United States. We have had so many that have gone before us to define the standards, and then others that have pushed and raised those standards so we as young dentists can push them even more; all this with the intention to create better oral health and better communities for those around us. 

There is a Jamaican proverb which states, ʽbowl go, packy comeʼ which describes a common practice in their culture to send a bowl of treats to a neighbor to share their good fortunes, but in return, it should be returned with the same hospitality.

As I enter into my fourth year of dental school and my elected role with ASDA, the Jamaican trip taught me that ʽbowl goʼ was the offering that those that have gone before us have offered, and ʽpacky comeʼ is what I need to do to return the favor. I need to remember to leave this industry better than when I found it. Good luck to you Caithlin, we will both make our mark.

 

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