This is the second blog about our second dental outreach trip to Jamaica. Here’s the first blog, wherein I mainly talked about preparing to go down and how much better we were at it (compared to 2015!). Now, in this blog, I’m going to be telling some stories about what happened in the clinics. The good, the bad, and the really ugly stuff… And how we had to adapt to keep going. In the next blog, I’ll talk about some of the funny things that happened in and outside of the clinics. In the fourth blog, I’ll discuss some shock and awe that we experienced. And in the final blog, I’ll talk about reverse culture shock.
Background
By way of background, our Canadian contingent was pretty much divided into 3 groups: a small resort clinic (which had 1 dentist + 1 hygienist + 1 assistant and who worked on resort staff); a clinic at the Town of Little London and another clinic at the settlement of Grange Hill. The latter 2 clinics had about 12 or so volunteers.
Team Little London!
Team Grange Hill (with community volunteers!)
Clinic Set Up
Each clinic had 7 chairs. 2 of those chairs were used for hygiene. 1 chair for a dental student. And the remaining 4 chairs for dentists. We had a sterilization room with 2 autoclaves, ultrasonic bath, etc. In terms of sundries, we would initially set up the clinic with what we thought we needed and then make a supplies list every day for things we needed. Then we’d just go to the supplies room back at the resort and pack up what we needed for the next day. That’s how we got through the week. Our supplies were pretty well organized at the clinic.
Equipment Failures
Over the course of the 5 days that we volunteers, harsh working conditions coupled with equipment failures made it difficult (but not impossible) to work. Over at Little London, here’s how dental hygienist Jazz Chohan described it:
“Where do I start? Ergonomically, this was the worst week of my life. I’ve worked the hardest I’ve ever worked. My arm was killing me by day 3. My chair stopped going back. I couldn’t use suction. I didn’t have water. So no cavitron. The next day, they sent me a cavitron that didn’t work. I was doing hand scale the entire week. I do hand scaling at home; but I’ve never done anything this. Our compressors kept failing; we only had 1 sterilizer for most of the week until we got a second one. The second one came was taking too long (old autoclave); took a long time to get things cleaned vs. the 30 minutes for the other one. There were set backs with the availability of the equipment and also the use; assistant wasn’t trained so he wasn’t putting things into the autoclave strategically.”
Typical work station over at Little London
Dental Hygienist Jazz Chohan
Over at Grange Hill, we had cavitrons stop working, compressors fail (due to fuses being tripped), equipment not being available (we were waiting a few times for syringes to get sterilized). On our first day there, our saliva ejectors weren’t fitting properly into our adec units! Oh no!
Here’s the key thing to remember: be prepared for things to stop working. When they do, try your best to fix them and when you can’t, call in the experts. There were a few guys like Oshane and Roshane and Richard who worked with Great Shape! Inc. and who were sometimes available to help us with our equipment problems. But when they weren’t around and it didn’t look like we were going to get a working cavitron, we had to IMPROVISE. In our case, when we didn’t have syringes ready, I put all of our hygienists to work doing cleanings. This gave the dentists a break. Only 2 cavitrons were working and we typically had 5 hygienists, so I would send the little boys and girls to 3 hygienists to do hand-scaling and the older folks would go to the hygienists who were using the cavitrons. Then, once we got the syringes working again, the hygienists went back to assisting the dentists on extractions and fillings. Like I said: ADAPT! And when we noticed that the saliva ejectors weren’t fitting, we made some ‘adapters’ by cutting other surgical saliva ejectors to make it all work. And it did!
Another way in which we had to adapt involved registration. At first, it was just me doing registrations alongside DJ of Great Shape! Inc. Then we decided to get Dr. Christina Bodea to do triage. And her husband Stefan Atalick started helping out with the ticketing system. Things were going slow, but people were getting registered. But because we had a huge lineup outside our door on the first day, we needed to speed things up. So we decided to set up another table and have more people help with registration. This helped ease the tension and it definitely sped things up. I would register people on Mondays through Wednesday and DJ would register on Thursdays and Fridays. I only wish we would have done this from the beginning!
Grange Hill Set Up
Team Grange Hill getting instructions from Oshane about equipment
Over at Little London, they also had to adapt to their environment. They had a hygienist named Carla (their team leader who had done this mission trip before) who was able to freeze patients so the doctors would simply come over and start their treatment. She was trained in the U.S. on how to do this; apparently, Canadian hygienists aren’t allowed. This helped speed things up at their clinic. Another way in which team Little London got ahead of the 8 ball was by dividing the roles of patient intake (Jonathan Borrelli, DMC LLP) and patient flow (Anthony Archer, Henry Schein) after the first day. This helped speed things up tremendously.
FYI, here’s a cool time lapse video I took of us working a FULL day at Grange Hill.
