Incredible past two days of work alongside Haitian dentists, doctors, nurses and students. Yesterday we worked in a location in Carrefour where Dr. Marabishi Jasmin is trying to start a clinic. The people of the town had been expecting us for and were all very friendly and appreciative. We set up in a church. Registration and triage in the fron, dental in the back of the triage area, optometry a little further toward the back. Our dental team say about 17 patients, all extractions and cleanings. Worked through lunch as usual, but ate at one of the Haitian's house across the street, which was delicious. Chicken and rice, very well seasoned.
At the close of our clinic, Dr. Marabishi Jasmin gathered everyone, Haitians and Americans, in a circle outside the church. Hand in hand he said a prayer thanking us for our work and for the future of Haiti and those in need. He spoke sentence by sentence, the translator echoing his words in English. In those moments I knew what it meant to be connected, compassionate and genuinely happy. Afterwards I spoke with a Haitian who was volunteering in Spanish and that was really great. I had been adding random Spanish into my Creole unknowingly, so being able to just speak Spanish was great. He expressed such grace and gratitude toward our work, that all I could do was thank him and pull him in for a hug. I knew I wouldn't be able to find the words to say that they have given me so much more than I could give them. He has dreams of becoming a doctor to serve his people and initiate change. I told him I hope I can be right there with him when he does.
Ryan and I carried the Haitian's dental chair down a muddy, rocky Carrefour street along with the others carrying supplies. We piled into the bus with the translators for the ride home. Spent the night on the rooftop of the hospital with the team with a couple guitars. Perfection.
Today clinic was held right at the Hopital Miracia in Merger. A bunch of us decided to take a hike up the hill but it ended up being much longer than expected. Got some gorgeous views though, and got a little bit of exercise. We did make it back in time for clinic, but time is always a scarce resource. The "Clinique Dentaire" had two operatories with actual dental chairs, however they were electronically nonfunctional, so no restorations today. While setting up I noticed the long line outside of about 30 people awaiting registration. Never a dull moment in Haiti. I worked with Dr. Timote and Dr. Noel who were very helpful and I really felt more empowered by their comments and teaching than I was empowering them. Dr. Noel was an amazing teacher, showing me exactly how to position the elevators and how to anchor the mandible with your free hand to get more leverage. Ryan commented to me about one maint difference of dentistry in Haiti vs. the US being the future planning. In the U.S. we always seek to restore missing teeth, whereas in Haiti the primary concern is removal of the diseased tooth, and prevention of infection. This allows them to be a little more aggressive with extractions than we may be here. Nonetheless, I still admired their ability to get these teeth out quickly and entirely.
Ryan graciously took the time that night to teach me the method in which we write prescriptions, so that I would be able to manage patients in future clinics more independently. He also will be leaving a day earlier and missing the last clinic so the dental team would be me and the Haitian dentists and dental students, who are not familiar with the American pharmaceutical code. The template is as follows:
To prescribe Amoxicillin, the directions are to take one tab every 8 hours, for 7 days. We write this "1 tab q8h x 7d." Then we calculate how much to dispense, 24/8=3, times 7 =21 tablets. So the script would be:
Amoxicillin: 500mg
Disp: 21 (twenty-one) tabs
Sig: 1 PO q8h x 7d
"PO" = "by mouth".
Sig = Instructions
Disp = Dispense
For Ibuprofen we used:
Ibuprofen 800mg
Disp: 42(forty-two) tabs
Sig: 1-2 tab PO q4-6h PRN
PRN = as needed for pain
If patients had allergies to Amoxicillin, we had clindamycin. If they were irritated by Ibuprofen we used aspirin. Of course dosing would change based on the patient's age, weight and height.
Tonight it's hitting me that I'll really miss all this. The morning ginger/citronelle tea, breads, incredibly creamy avocadoes, the children that despite their poverty smile so brightly and always made my days; The dentists who guided me hand in hand and built me up, singing Haitian songs on the bus with the translators, and most of all the genuine kindness and good nature of the people. Astonishingly, almost every patient, except 2-3 had any sign of distaste, discomfort, or wincing. They were the perfect patients. I know a few months down the line I'll be bogged down with work but I can only hope that I keep in mind that dentistry is so much bigger than what we see and think.
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