Volunteer Stories

Exotic and intriguing Africa was the destination. I had heard about Uganda, though I wasn't certain were it was. I had even had my excitement perked when, as a dental student forty some years ago, we had been assigned to Nigeria, then Ethiopia, then Kenya, never to get there.  Rather, I was diverted to Bella Vista Hospital's mission dental clinic, when, even with Canadian Boards, a work permit (Kenya dental license) could not be arranged without a year of private practice.  Being asked by Koren Borland, DDS, FADI (Vice Regent, SW US, USA Section, Academy of Dentistry International) a few months ago, I didn’t have to think twice about this.

After much preparation (visas, donations from companies at ADA in Las Vegas, instruments, materials, equipment, etc.), a group of six (about half the team) departed LAX on Thursday, 17 November, destination Entebbe International Airport, outside the capital of Uganda, Kampala.

The mission trip was sponsored by NEEPUganda (www.neepuganda.org), with the goal of correcting the oral disease of students at a Christian school way out in the country.

Uganda is a smaller country with 91,000 square miles and 32 million people, in East Africa. It is on the equator and bordered by Sudan to the north, Kenya to the east, Rwanda and Tanzania to the south, and Democratic Republic of Congo to the west. The monetary unit is the Ugandan Shilling (USh) which yields 2,500 per dollar (USD); a common wage is $50,000 USh/month ($20 USD). Electricity has more demand than supply, so the power is rotated around the country causing unannounced, very inconvenient blackouts from time to time, several per week. In some areas it is off more than on, so cold showers are the norm: I recall the temporary headache I got as I gingerly stuck my head under the cold shower water in my attempt to shampoo my hair. It surely saves water, though! Taxis are riding behind a motor scooter driver, and costs $1,000 USh (about 40 cents USD) to go from place to place shorter distances. Time zone is GMT +3, or 11 hours ahead of California.

English is the official language, though there are 33 indigenous local languages impossible to understand. Luganda is the most popular and to the untrained ear, sounds like chatter. Strange letter combinations exist, such as Mz, Ny, Mw, etc. The former British rule left its mark in word usage, such as: trash = rubbish, yield = give way, and turning off lights = extinguish lights, etc. HIV infection has reduced, but still high at 6%, except for the Boda-boda (motorbike taxi) drivers, at 9%. During November there are a couple of weeks of “grasshopper season,” when they are caught for roasting and eating: At night, bright flood lights can be seen with the attracted swarms being funneled into collection with corrugated tin roof sheets. Before you ask, yes, I did try them, but only a few times! The climate is fairly constantly tropical, with latitudes from 4dN to 1dS: A small monument designates when the equator is crossed.

Green is an understatement for the terrain of Uganda, with verdant, fertile land. Almost 25% of the country’s surface area is covered by water, including Lake Victoria (owned by Uganda, Kenya, and Tanzania), Africa’s largest lake and the world’s second largest fresh water body. From this lake as its source, the Nile River flows northward thru central and northern Uganda, Sudan, and Egypt, on its long 4,130 mile (6,650 KM), 3 month journey to the Mediterranean Sea. Gandhi’s ashes were scattered in this river near its source at Jinja. We were able to travel the river onto the lake, as well as see a variety of elephants, hippopotamus, leopard, bison, and a myriad of bird species in our safari thru Queen Elizabeth National Park, Uganda’s second largest of ten Parks, along with its several other wildlife reserves and forest reserves.

85% of Ugandans are Christian, divided equally between Protestant and Roman Catholic, and 11% are Islamic, tho that number is growing. Kampala (the Capital) near Lake Victoria, is the largest city of 2 million, and Jinja near the Source of the Nile River, is second. 85% of the people live rurally, where the majority are born in a village, grow up in a village, work in that village, and die in the village, never knowing much else of Uganda nor the world.

No report on Uganda would be complete without mention of Amin. Uganda gained independence from Great Britain in 1962 and Milton Obote became the first President of Uganda, for 9 years until 1971. Idi Amin, poorly educated and barely literate, took power while Obote was away in Singapore. By 1974, Amin was fully engaged in his reign of terror. During the 8 years he was in power, 300,000 Ugandans were killed, many of them tortured to death in horrible ways. He was driven into exile in 1979, and died from multiple organ failure in a Saudi Arabian hospital in 2003.

As it turned out for Uganda, 30 years after Amin was booted into exile, and over two decades of President Museveni, the country bears few obvious scars of what came before. You see, Ugandan optimism says the dark days are in the past, as it embarked on one of the most staggering economic and political transformations of our time, to become, in the words of a recent Oxfan report, “an inspirational economic success story, and a symbol of a more vibrant, successful Africa.” This is the resilience of the East African people in Uganda. Today, Uganda enjoys one of the healthiest reputations of any African country when it comes to crime directed at tourists.

In preparing for this adventure, friends and relatives asked me if I was hesitant or afraid, if I were sure I really wanted to go to Uganda. I confirmed I was steadfast in going to help, I was not hesitant nor afraid, and as it turned out, people are more friendly than expected. No violence nor even hint of danger was evident, just lots of smiles for us on Ugandan faces.

During our time in Uganda, that is what we observed, friendly, smiling people who enjoyed conversing and wanted a picture taken. Our assignment was to work on nearly 400 students, primary and secondary, at Nyamabuga village (translation = place of springs of healing water), operated by Sister Gertrude Kabatalemwa. We were to screen everyone, treat first those with infection or pain, complete the restorative challenge, then educate all in oral hygiene in order to eliminate gingivitis and provide for oral health. With the oral/systemic connection so obvious nowadays, this would give them improved general health. As it turned out, mission was accomplished in a week. Our teacher in the group, Linda McQuarrie, MA, was superb at instructing and entertaining as she demonstrated disclosing solution, brushing technique, and distributed brushes to everyone. In my opinion and from a public health standpoint, this likely was the most important part of our impact there. Perhaps even, we motivated some to get out of the cycle of village living in poverty, to pursue education and strive to be more and break the cycle.

On the last day, before we packed up to leave, the entire school thanked us with a Farewell Celebration. Music, costumes, dance, poetry, were all directed at gratitude for our visit and our help. My takeaway from the Uganda experience is what we were told upon arrival, as well as every day we were there: “You are most welcome.” I just wish you could hear it with that beautiful accent, which is the memory I take home. In all my travels to various countries of the world, I have noted something interesting to me. Whether in India, China, Latin America, or atolls in Micronesia, all of us are alike in many ways. I am impressed that all human beings, whatever the culture, wish for the very same things in life: To find meaning, to be loved and appreciated, to touch and be touched. Indeed, we are more alike than most of us realize, tho circumstances for each can vary widely.

My hat goes off to the hard working group of NEEPUganda and Koren Borland, DDS, FADI, who organized and led the dental team. These are outer directed people who give and give, and then give a little more. Are you outer directed, finding ways to help others, being helpful in ways that bring joy and happiness to others? Or are we inner directed only with concerns about our own wants and comfort, an egocentrism of sorts? In the words of my dental and public health classmate, David C. Brodeur, “I have concluded that we are on this earth to help each other.” Thanks, Dave, well stated. In the words of one of my medical heroes: “I don’t know what your destiny will be, but one thing I do know, the only ones among you who will be happy are those who have sought and found how to serve.” -- Albert Schweitzer, MD, PhD. And in the words of Duane Hulse: “We make a living by what we get, we make a life by what we give.” May we be able to give more when the need appears.

— Ronald E. Fritz DDS, MPH. 

At 4:53 PM local time on Tuesday, January 12, 2010, one of the most catastrophic natural disasters in recorded history occurred in the country of Haiti when a magnitude 7.0 earthquake struck the country. Haiti which is the most impoverished nation in the Western Hemisphere occupies the western 1/3 of the second largest island in the Caribbean, Hispaniola, with its neighbor the Dominican Republic. Although there has historically been a Haitian presence in the Dominican Republic, this disaster resulted in even more Haitians heading West in search of a better life and better health. Ironically, the healthcare delivery system in the Dominican Republic leaves much to be desired for even its own citizens by International standards. After practicing dentistry for almost 20 years and retiring back to my home state of Delaware in 2000, my wife and I relocated to the North Coast of the Dominican Republic in 2005. In the past 5 years, we have attempted to volunteer when possible, despite there not being any well organized way to help. We were so pleased to have met Chuck Ritzen just a month or so ago and learn more about his organization HADAC (http://hadac.org/index.html ) that is dedicated to offering medical and dental care to those in need both in Haiti and the Dominican Republic. After having run clinics in Durac, Jacmel, and Cap Haitian Haiti, Chuck and his wife have opened a brand new clinic in the hills outside the town of Sosua. The medical and dental needs of both local Dominicans and Haitians living in the area are presently far in excess of the care that can now be delivered. Trained volunteers (medical doctors, dentists, hygienists and assistants), equipment and supplies are desperately needed to increase the number of patients that can be treated. I have offered my services to work diligently in an attempt to recruit volunteers, procure donations through HADAC’s U.S. non-profit organization as well as personally assist in the coordination of all aspects of a volunteer’s visit in order to make it a most successful one. This is an opportunity to make a direct positive impact for many much less fortunate. Trips of any length, alone or in combination with vacation plans can be arranged. I look forward to hearing from any one that may be interested or have any ideas regarding volunteer recruitment.

Please contact me directly via email at: rob@drreba.com for any further information.

— Dr. Robert S. Chenvert

I went on a Medical/Brigade to Honduras June 22-28, 2008. Light of the World Charities runs 7-8 Brigades each year to one of the poorest neighborhoods in Comayagua, Honduras. Surgeons and nurses from the USA come down and do surgeries all week. The mission site has a full time medical clinic staffed by Honduran physicians. The clinic also has a two-chair dental suite which is staffed by Honduran dentists and assistants. But the people up in the mountain villages had no dentistry at all. A dentist from Florida, who had a number of years of experience doing field dentistry in the mountains of South and Central America, volunteered for service in Honduras. So our little team included Dr. Dave Girlinghouse, two Honduran assistants, two American missionaries (who also acted as translators) and myself.

On Monday we treated patients in the clinic in Comayagua. I used the field unit set up in the clave area. Tuesday we loaded a 4 X 4 pick-up and drove 3 hours to a mountain village named San Luis. Once there we set up the field unit, a portable chair and a donated dental chair that the local priest had in storage. We set the chairs side by side one going north and one south; then we set the field unit, portable evacuation, compressor and light between the two so that both Dr. Dave and I could use them. It all worked pretty well except when there was a power outage for an hour or so. There was one rheostat for the unit, so only one of us could use the handpieces at any given time. That is when a cordless handpiece came into play. It was donated by my local dental hygiene component, Lake County Dental Hygienists Society (IL). When Dr. Dave needed the corded handpiece, I could use the cordless. We worked there Tuesday- Thursday. Our “sterilization” area was not much more than disinfection. One of the missionaries was set up with three plastic tubs, gloves and a mask. He would clean debris off with plain water in the first tub, then submerge the instruments in bleach water in the second and finally rinse with plain water in the last.

Then we drove back to Comayagua on Thursday evening; we were told when we returned that we had operation room cases the next day. Neither of us had ever worked in a O.R. so that too was a new experience, but the nurses and anesthesiologists were of great help. The first four days I did 76 patients with about 2/3 of those being sealants and the rest being prophys (mostly using the piezo ultrasonic scaler that the field unit had). In the O.R. we only did two cases due to the time needed for general anesthetic and the fact that we did virtually everything that the children needed while they were under.

In spite of their extreme poverty (one of the four poorest countries in the Western Hemisphere) the Honduran people are gentle and open. They welcomed us and wished to share what they could with us.

The trips are one week long and most of the expenses can be covered by Light of the World unless you wish to donate your airfare, too. It is very helpful if you can get donations of supplies from companies and people before you go.

I hope that Light of the World Charities will be able to continue and expand the dental team on its brigades. www.lightoftheworldcharities.com

I Was There...

Last week I met a Peruvian Woman in a small village near Cusco, Peru. She was in her 80s which is old for her culture. Her clothes were dirty and worn. Her hair was strewn in small tangled wisps above her head. Her skin was weathered, dirty, and dry. It appeared as though she was in her final days. Her face was swollen from a lower, infected tooth. This was a poor woman, and life and time has taken its toll on her body. This tooth had ravaged her for weeks and brought this proud woman to our makeshift dental clinic. She was in pain, unyielding pain. Our dental hygienist anesthetized her with several injections of local anesthetic, and we waited for the drug to take effect. She never made eye contact with any of us. She just sat there quietly and waited. We waited. The tooth was mobile but had some attachment and most of her teeth were already removed. When I applied a forecep to the tooth, she winced, so I stopped and waited some more. More anesthesia was given and we waited again. The tooth never was completely numb, but I knew that if I didn’t remove it now she might never get another chance.

After the extraction, we moved her to a small seating area, where she sat alone and cried softly. I had hurt her…and I felt miserable. In these clinics we move on to other patients quickly, so I did and started another procedure. Soon, one of the interpreters interrupted me and said the old woman wanted to see me. I wasn’t sure what to expect. But, when we met, she reached out with her arms and wrapped them around me and hugged. This was not just a hug. It was her way of thanking me, and it was deep and powerful. I cried a little. This was pure love and appreciation. It was wonderful.

As dentists we are seldom appreciated; but we, in a matter of minutes, we can eliminate the pain in a tooth and make a person’s life better, more comfortable. This is a wonderful gift…use it and feel good.

— Dr. Jules T. Frere, DDS, Wings World Wide – The Air Medical Foundation

When I left Laos, I felt I had fulfilled a lifelong dream, except I hadn’t dreamed it yet – the dream had created itself while I was awake.   So deep were the connections, so new and diverse were the experiences, and so warm were the friendships, that my life’s values were expanded and recalibrated.

I went to Laos with the ADA sponsored program through Health Volunteers Overseas – a non-profit organization that supports healthcare education in developing nations.  It was the HVO concept – to teach and share ideas for capacity building that would have a long-term sustainable positive effect on the health of an underserved population - that struck me as a worthy goal for a volunteer activity.  As a private practice dentist, my teaching had primarily been with patients and staff, but I was happy to develop a presentation on various preventive, restorative and patient management techniques. Specifically, I worked with the dental school in Laos’ capital city, Vientienne, to share ideas in restorative dentistry with the faculty and students.  Drs. Vanpheng, chair of restorative dentistry, and Dr. Khombay, chair of pediatric dentistry, served as my hosts, interpreters, and colleagues.  We shared ideas about emergency treatment of abscesses, promoted enhanced infection control, discussed pediatric and adolescent patient management, presented techniques for caries prevention, and helped in treatment planning for removable prosthetics - all in a dental school clinic that had sporadic access to compressed air, frequent power outages, and rarely any suction available.  We worked together in the clinic, where I observed these talented clinicians to deliver quality dentistry with very limited supplies, and teach students as well.  They taught me very quickly a more intense version of adaptability! The limit in resources seemed to make them even smarter and more compassionate. With good nature, they only laughed politely at my clumsy language attempts in Lao, where one of my dental words seemed to mean some kind of underwear in Lao language. The good humor of the faculty was even more impressive as I learned that they all went off to their private practices in the evenings after working all day in the dental school.

Drs. Vanpheng and Khombay quickly became more than colleagues – they shared Lao food and traditions with me, along with an insider’s look into the temples, sights and shopping of Vientienne. I learned how to wear one of the traditional skirts properly and how to love laap, a chicken and rice type of salad. The surroundings and the culture seemed to flow naturally through these two brilliant and compassionate women. In fact, I found a specific form of Lao atmosphere to be present in all that I encountered– the sense of family. And I was welcomed. I will never forget the generous spirit with which they shared their professional knowledge and personal friendship. I have since returned twice to Laos, and will continue to return. Each time, I see advances in the dental school – specifically in prevention and infection control, despite the ongoing lack of resources.

With the sharing of ideas through a number of HVO volunteers, there are changes that will make a difference for the oral health of many people in Laos, and the success of the oral health care professionals in treating their own population. And it has made a huge difference in me – I will share the Lao adaptability and sense of family.

It is the journey that I dreamed about, and now I see the path.

— Dr. Sally Hewett, DDS