Dentistry In Haiti
As described in the previous blog, a team of two dentists, five dental hygienists and one assistant along with 9 non dental team members participated in a short term mission trip to United Christians International in Haiti. Our dental portion of the trip started well before we left the US. Being that a clinic had been established for a Haitian dentist at UCI, some of the basics were already down in Haiti for extractions and fillings.
Our trip was a bit different as our goal was to provide preventive services of basic cleanings, education, and sealant placement. A challenge in logistics was the fact all these preventive services would be be provided outside the dental clinicin an open air church. This was due to the size of our team and the space needed to see the number of patients we had hoped. Therefore we needed to plan ahead as to the equipment and supplies needed to accomplish our dental service portion of the trip.
Two months prior to the trip, the Haitian dentist Jocenel informed us that he was out of anesthetic and also the hand pieces had worn out along with other needs. Knowing that we had a team of 17 going, we knew we could take a lot of dental supplies. Dental supplies are not cheap, therefore we sourced supplies that we could bring that are not available to be used in the US but we were able to obtain and bring in to Haiti. Without going into the minutia - we had gathered several thousand dollars of equipment and supplies, unpacked and repacked in a way to get through customs and split it up among all team members to keep the baggage weight under the allowable. It was a logistical feat which, by God’s grace, worked out with all 34 bags making it to Haiti and through customs and nothing was broken or missing once there.
The mission site at UCI is only 98 miles from the Port au Prince airport, but on the night we arrived, November 7, it took us 6 hours to traverse the Port au Prince traffic and windy mountainous roads up to the central plains of the country. Once there, we quickly reduced the 34 bags and totes down to half that with just the dental equipment.
On our first morning we spent a half hour organizing ourselves in the open air church at UCI. We set up 5 dental stations and began seeing kids from the primary school one class at a time. Pastor Mark Vande Zande was our lead organizer of children, would go up the hill to the school and escort the children in classes of 20-30 at a time down to the makeshift dental clinic. He would then entertain the children along with Dr. Joiner’s father (a retired band director) by teaching them to play the recorder and also educating with a video of how to brush teeth and floss. There may have been a few poor attempts at the floss dance as well!
The children were brought to each dental station two at a time to be seen. Through interpreters, college age Haitians who work for UCI we encouraged proper oral hygiene and avoiding chewing sugar cane along with a very basic cleaning with scalers and a toothbrush. Children with large decay were treated with Silver Diamide Fluoride which is a treatment to slow the progression of decay and in some
instances will slow it long enough for the baby tooth to fall out before the cavity progresses and cause pain or an infection. We also applied fluoride treatments and sent a note with the child and told them through the interpreter to see the dentist for dental care.
The dentist at UCI is part of the mission, therefore is allowed to treat at a greatly reduced fee to make it possible for kids to be seen even I. A poverty stricken country. The goal of UCI is not just handouts, but rather to create a sustainable economic model which requires some degree of personal buy-in with minimal payments for services in order to keep the mission, and dental clinic functioning.
Every child seen was given a toothbrush in the process as well. In total over three days we saw nearly 600 children and a few adults. Our goal was to be a positive influence and not be competition for Jocenel, the Haitian dentist. Therefore we were thankful that Jocenel was gracious enough to work along side us during the three day clinic. Another part of making it a positive experience was to avoid any negative experiences, therefore we had Jocenel treat a few kids in the dental clinic who had infections on the first two days so the other children wouldn’t see any injections since there was no privacy in the clinic. On the third day, we did decide we needed to treat more of the severe cases due to the number of abcsessed teeth and deep cavities found in children who likely
wouldn’t make it to see Jocenel. To accomplish this, we altered our system and switched to having three stations for dental hygienists to clean teeth and two for the dentists to extract and place fillings. This is a challenge given the setting as placing anesthetic requires good communication to avoid scaring kids, but unfortunately the interpreters were not well enough versed in English nor dentistry to follow our instructions well. Therefore we had a couple scared children but were able to work through it.
Other challenges in our set up was dealing with the heat and non ergonomic chairs. Our modern dental chairs and equipment help decrease the back strain from dentistry, but it was unavoidable when using portable equipment.
UCI has grown over the years and had a university start several years ago which includes a medical program. The idea of starting a dental hygiene program has been discussed in the last year. Therefore another part of our service project included having a couple of potential future dental hygienists to shadow, help and learn some of what a dental hygienist does.
The two longest lasting effects our dental service will have are equipping the dental clinic to remain operational and preventive dental care - educating and encouraging good oral hygiene habits, cleaning teeth, placing fluoride and sealing permanent teeth to prevent future cavities.
Hopefully this blog post gives you a sense of the dental mission project logistics and accomplishments. The next post will describe the overall experience of Haiti on our team and what we are trying to take away from the experience.