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• Project 2000 Overview
CONTACT INFORMATION
T: 905.567.8899
F: 905.567.9097
info@healthoutreach.ca
117 Queen Street South Unit 2,
Mississauga ON L5M 6B5
PROJECT ARCHIVES
1996 DECEMBER - Manabi Province, Ecuador, S.A. - Foster Parents Plan of Canada
"Tim at the school in Manabi"
1998 JANUARY - Antigua and surrounding area, Guatemala, C.A. - Poco a Poco Service Society (Can.)
The Dental Screenings
On the morning of Tuesday Feb. 3rd, I accompanied the physicians to a small community for the purpose of screening and examining individuals for medical or dental treatment. All people who turned up for medical exams had intraoral exams performed by myself. Generally speaking, there were many dental and periodontal problems observed. Patients were booked for the following day at Obras Sociales de Hermano Pedro hospital. Because of limited resources, only those with emergencies (pain or infection) or urgent needs (discomfort or likelihood of pain or infection) were appointed. Patients were given an appointment form. Patients were told of possible complications. A list of the appointed patients was made for easy reference the following day.
Dental screenings are an excellent way of "reaching" needy people who have urgent dental problems. An interpreter is critical. With the lack of diagnostic equipment and objective testing, diagnoses are based much on subjective complaints. top
The Hospital Dental Clinic
On Feb. 3rd, the Hospital Administration and dental staff were informed that I was bringing in patients to be treated in the afternoon. The staff dentist and his assistant, Fernando, saw patients between the hours of 9 am . and 12 noon . It was only logical to see our patients in the afternoon. Every attempt was made to not interrupt the usual routine of the dental clinic and staff. Fernando was notified beforehand of incoming patients. Sundries donated to me were used and even given to the clinic to avoid depleting their stock. Patients were booked during regular hours. It was good to see a 100 per cent turn out for appointments. All nine patients booked from the previous day turned up.
It was refreshing to see patients who were patient and appreciative. To my knowledge all patients donated some money to the church to cover their procedure.
The San Rosa Dental Clinic- "Setting Up"
The dental equipment and supplies were stored in a room at Adventure Travel courtesy of Real. It was really disorganized. Every storage box was opened and all was basically inventoried. Everything necessary to start a basic dental operatory was there. Unfortunately there were spoiled items. The local anesthetics, some analgesics, and composite resin restorative materials were expired. There were plenty of disposables. There was an impressive number of instruments. However, when sorted, only the surgical equipment made up the excess. And this was only forceps and elevators. These numbered two hundred. Many were in moderate to poor condition, meaning they were rusty or had stiff hinges. These were set aside to be re-conditioned.
The following day, Tuesday morning, practically everything was transported, on top of
Real's van, to the Clinic. The Clinic building was at a good location. It had two rooms
in an open concept. It was clean and well lit. It took over four hours to sort and sterilize
equipment and prepare for patients, and final preparations were still required. The
compressor was placed outside the window with the air hose barely able to reach. There were
two autoclaves. The smaller one appeared bent out of shape and was not operating properly.
The larger one was working at this time. There was a lack of counter and storage space.
Some tables and chairs were borrowed from the other co-op building. On Wednesday morning,
furniture and garbage pails were bought and delivered to the Clinic. top
The day I laid eyes on the clinic facilities, I had a vision of that clinic up and operating. That is likely why I got things going so quickly. I was excited. Monday afternoon saw me sifting through the dental sundries and supplies like a kid opening Christmas presents. I was pleased and disappointed at the same time. Much of what I found was expired or rusting. At that time, I realized why Poco a Poco had went as far as to advertise for dental personnel. I was amazed at the variety of instruments. Essentially, everything was present to perform basic general dentistry.
We set up the Clinic with the intention of having one room used as the medical side. However, it became apparent that this was not going to happen. There was not enough privacy for medical exams and the other co-op building had tables for this purpose. Everything was present to mount the overhead dental lamps. The co-op plumber even volunteered to do the work. However, it was not done after considering how temporary our operation was. We were extremely lucky to find a cabinet/counter for the new clinic. It was beautiful with plastic surface for easy cleaning. Delivery was free. Even better, we even got a ride up to San Rosa. Only, I had to sit in the back of the pick-up. top
The San Rosa Dental Clinic - "Operation"
Potential patients for the clinic were notified from various sources. Mercedes had informed schoolteachers in the community to bring children to the Clinic on Thursday and Friday mornings. On a more informal basis, "Blanca", the secretary of the co-op, notified others in the community and help spread the word. Others were referred by Poco a Poco physicians doing medical screenings.
Our dental team consisted of a dentist, chair side assistant, sterilization assistant, oral hygiene educator, and interpreter. Each team member had a defined role. The dentist stayed on the clinical side, behind drawn curtains, with the chair side assistant. The interpreter was also the administrator, who registered the patients. All patients were questioned about their medical health. The sterilization assistant received dirty instruments from the clinical side and returned sterile instruments. The oral hygiene educator demonstrated correct brushing technique, dispensed toothbrushes and gave out toys for good behavior after a dental procedure.
The response from the San Rosa community was overwhelming. The most memorable scene was the several classes of children waiting outside the clinic on the first morning. We were all excited. Everything was planned out before we started. To focus our energy where it was needed most, it was my sole decision to see children and people in discomfort only. I also realized that it was going to be difficult to set up such an operation again with such a large team. We had to see as many people as possible in a short amount of time.... and that's what we did! For such an inexperienced group, I must say we flowed very well.top
I estimate that we saw almost 300 Guatemalans for screenings and procedures. The screenings on the kids did not take long at all. They came into the room in fours. They were so relaxed in this way that they joked around with each other. For many, it was the first dental visit- and I believe the most significant one they will ever have. We impressed upon these kids so much, that they will now take their teeth much more seriously. The numbers are not as impressive as the fact that we did not turn away anybody who was in pain. Dental procedures included extractions, amalgam fillings and antibiotics and analgesics for infections. Some white fillings were done. A few individuals did try to receive free elective dentistry, including cleanings- but they really aren't hard to figure out. I found out that there was no denture service outside Guatemala City. This fact alone made people hesitate in having teeth extracted.
General Impression
All in all, the experience at the hospital dental clinic and the San Rosa Clinic was fantastic. The Guatemalan people were a pleasure to work with. Patients were patient and most appreciative of treatment. The children impressed me the most. Despite the fears that most children have, they were surprisingly cooperative. Of the 150 screening or operative appointments for children, we were only unsuccessful with two children. One two year old was too scared and another boy had been traumatized by a previous dental experience.
For other groups who wish to set up a similar operation...organization is the key. This is the only way to see a large number of people. Considering the effort to organize a team, I would not have it any other way.
Improvements in booking patients and reliable announcements of Clinic days would make a difference. Like the medical side, we had some misinformed patients. A reliable means of appointing patients is necessary. This applies to both the hospital and country clinics. I found that screening my own patients and booking the appropriate treatment time made things run efficiently at the hospital. top
Tim Lee
1996 DECEMBER - Manabi Province, Ecuador, S.A. - Foster Parents Plan of Canada
"Tim at the school in Manabi"
1998 JANUARY - Antigua and surrounding area, Guatemala, C.A. - Poco a Poco Service Society (Can.)
The Dental Screenings
On the morning of Tuesday Feb. 3rd, I accompanied the physicians to a small community for the purpose of screening and examining individuals for medical or dental treatment. All people who turned up for medical exams had intraoral exams performed by myself. Generally speaking, there were many dental and periodontal problems observed. Patients were booked for the following day at Obras Sociales de Hermano Pedro hospital. Because of limited resources, only those with emergencies (pain or infection) or urgent needs (discomfort or likelihood of pain or infection) were appointed. Patients were given an appointment form. Patients were told of possible complications. A list of the appointed patients was made for easy reference the following day.
Dental screenings are an excellent way of "reaching" needy people who have urgent dental problems. An interpreter is critical. With the lack of diagnostic equipment and objective testing, diagnoses are based much on subjective complaints. top
The Hospital Dental Clinic
On Feb. 3rd, the Hospital Administration and dental staff were informed that I was bringing in patients to be treated in the afternoon. The staff dentist and his assistant, Fernando, saw patients between the hours of 9 am . and 12 noon . It was only logical to see our patients in the afternoon. Every attempt was made to not interrupt the usual routine of the dental clinic and staff. Fernando was notified beforehand of incoming patients. Sundries donated to me were used and even given to the clinic to avoid depleting their stock. Patients were booked during regular hours. It was good to see a 100 per cent turn out for appointments. All nine patients booked from the previous day turned up.
It was refreshing to see patients who were patient and appreciative. To my knowledge all patients donated some money to the church to cover their procedure.
The San Rosa Dental Clinic- "Setting Up"
The dental equipment and supplies were stored in a room at Adventure Travel courtesy of Real. It was really disorganized. Every storage box was opened and all was basically inventoried. Everything necessary to start a basic dental operatory was there. Unfortunately there were spoiled items. The local anesthetics, some analgesics, and composite resin restorative materials were expired. There were plenty of disposables. There was an impressive number of instruments. However, when sorted, only the surgical equipment made up the excess. And this was only forceps and elevators. These numbered two hundred. Many were in moderate to poor condition, meaning they were rusty or had stiff hinges. These were set aside to be re-conditioned.
The following day, Tuesday morning, practically everything was transported, on top of
Real's van, to the Clinic. The Clinic building was at a good location. It had two rooms
in an open concept. It was clean and well lit. It took over four hours to sort and sterilize
equipment and prepare for patients, and final preparations were still required. The
compressor was placed outside the window with the air hose barely able to reach. There were
two autoclaves. The smaller one appeared bent out of shape and was not operating properly.
The larger one was working at this time. There was a lack of counter and storage space.
Some tables and chairs were borrowed from the other co-op building. On Wednesday morning,
furniture and garbage pails were bought and delivered to the Clinic. topThe day I laid eyes on the clinic facilities, I had a vision of that clinic up and operating. That is likely why I got things going so quickly. I was excited. Monday afternoon saw me sifting through the dental sundries and supplies like a kid opening Christmas presents. I was pleased and disappointed at the same time. Much of what I found was expired or rusting. At that time, I realized why Poco a Poco had went as far as to advertise for dental personnel. I was amazed at the variety of instruments. Essentially, everything was present to perform basic general dentistry.
We set up the Clinic with the intention of having one room used as the medical side. However, it became apparent that this was not going to happen. There was not enough privacy for medical exams and the other co-op building had tables for this purpose. Everything was present to mount the overhead dental lamps. The co-op plumber even volunteered to do the work. However, it was not done after considering how temporary our operation was. We were extremely lucky to find a cabinet/counter for the new clinic. It was beautiful with plastic surface for easy cleaning. Delivery was free. Even better, we even got a ride up to San Rosa. Only, I had to sit in the back of the pick-up. top
The San Rosa Dental Clinic - "Operation"Potential patients for the clinic were notified from various sources. Mercedes had informed schoolteachers in the community to bring children to the Clinic on Thursday and Friday mornings. On a more informal basis, "Blanca", the secretary of the co-op, notified others in the community and help spread the word. Others were referred by Poco a Poco physicians doing medical screenings.
Our dental team consisted of a dentist, chair side assistant, sterilization assistant, oral hygiene educator, and interpreter. Each team member had a defined role. The dentist stayed on the clinical side, behind drawn curtains, with the chair side assistant. The interpreter was also the administrator, who registered the patients. All patients were questioned about their medical health. The sterilization assistant received dirty instruments from the clinical side and returned sterile instruments. The oral hygiene educator demonstrated correct brushing technique, dispensed toothbrushes and gave out toys for good behavior after a dental procedure.
The response from the San Rosa community was overwhelming. The most memorable scene was the several classes of children waiting outside the clinic on the first morning. We were all excited. Everything was planned out before we started. To focus our energy where it was needed most, it was my sole decision to see children and people in discomfort only. I also realized that it was going to be difficult to set up such an operation again with such a large team. We had to see as many people as possible in a short amount of time.... and that's what we did! For such an inexperienced group, I must say we flowed very well.top
I estimate that we saw almost 300 Guatemalans for screenings and procedures. The screenings on the kids did not take long at all. They came into the room in fours. They were so relaxed in this way that they joked around with each other. For many, it was the first dental visit- and I believe the most significant one they will ever have. We impressed upon these kids so much, that they will now take their teeth much more seriously. The numbers are not as impressive as the fact that we did not turn away anybody who was in pain. Dental procedures included extractions, amalgam fillings and antibiotics and analgesics for infections. Some white fillings were done. A few individuals did try to receive free elective dentistry, including cleanings- but they really aren't hard to figure out. I found out that there was no denture service outside Guatemala City. This fact alone made people hesitate in having teeth extracted.
General Impression
All in all, the experience at the hospital dental clinic and the San Rosa Clinic was fantastic. The Guatemalan people were a pleasure to work with. Patients were patient and most appreciative of treatment. The children impressed me the most. Despite the fears that most children have, they were surprisingly cooperative. Of the 150 screening or operative appointments for children, we were only unsuccessful with two children. One two year old was too scared and another boy had been traumatized by a previous dental experience.
For other groups who wish to set up a similar operation...organization is the key. This is the only way to see a large number of people. Considering the effort to organize a team, I would not have it any other way.
Improvements in booking patients and reliable announcements of Clinic days would make a difference. Like the medical side, we had some misinformed patients. A reliable means of appointing patients is necessary. This applies to both the hospital and country clinics. I found that screening my own patients and booking the appropriate treatment time made things run efficiently at the hospital. top
Tim Lee