Archive for April, 2008

Oneida and I are discussing a case with Dr. Stan Appleton.

We saw old and young, poor and rich(?) (Were there any rich?  What would rich look like in that town?), some with severe needs and some with more minor needs.  All the townspeople were very kind, and very appreciative.  They put up with difficult conditions and long waits.  It was very noisy in our ‘clinic’… one of the dental units had an internal compressor that ran continually.  It was so obnoxious we tried to muffle the sound by placing a cardboard box over it with holes cut for access and cooling.  It helped some, but still made a terrific racket! 

There were people moving everywhere!  Mopping or sweeping the tile floor, emptying the ‘spit buckets’ that all patients had to hold in their laps, replenishing the supply tables with freshly cleaned instruments or scurrying to the same tables to get needed instruments or supplies to those treating patients.  Add to that the requests for ‘I need an interpreter over here!’ or ‘we need to send this patient across the room for and x-ray of #19′ or ‘these students have come a long way “I know it’s almost six, but can’t we see them?  Just the 18 of them…?”  So we saw as many as we could, and they were so grateful!  Many had their pictures taken with their dental care providers. 

A rooster was our alarm clock every morning.

I’ve already mentioned about how we set up our clinic… what is so difficult to explain is what it felt like! Outside were dozens of people clamoring to get in… not impatiently, but insistently. Dr Booker would look in each one’s mouth, and ask what was bothering the patient the most. He would then mark on the patient’s one sheet ‘chart’ what was decided to be the most urgent problems. If the patient needed teeth extracted, he would proceed to the ‘surgical’ side of our makeshift clinic, under the direction of Dr Stan Appleton. If restoring teeth was the primary need, he was sent to my half of the clinic, the ‘restorative’ side. If the patient needed both services, Dr Appleton and I would discuss the most effective treatment plan; perhaps restorations first, then extractions, or maybe extractions today and restorations tomorrow.

The most frustrating aspect of this whole adventure was that we could do so little! A patient would have eight or ten cavities; we could take care of two or three… I was really determined to do more for each one, till I realized the enormity of the need. We would have to ration our care – there was only so much in the way of materials, time and manpower. Was it better to do half the work needed on a small fraction of people, or less work per person on a much greater percentage of the population? We ended up trying to do the most important treatments for the greatest percentage of the town, but it still felt like so little compared to the great need.

 Dr Booker just visible in front of tree trunk.



Dr Booker screening patients as viewed from just inside clinic