Bringing Dentistry to Honduras
by Meghan Bastin
The School of Dental Medicine at the University of Pittsburgh has traditionally encouraged students to be well-rounded, active community members both in school and after graduation, and over the past several years a new tradition has started among the students. Each year, a few dental students step forward and independently envision, organize, and execute two to three separate international mission trips to less privileged areas of the world. Dental students have provided care in many countries over the years, but one of them is becoming a traditional favorite: Honduras.
Thanks to the leadership of Matthew Cooke, D.D.S., M.D., who accompanied three separate groups of students to the country in 2013, mission trips to Honduras have become more frequent. His friend and colleague, Honduran dentist Adan Arita, the leader of the Transcultural Dental Brigade in Honduras, coordinates dental outreach mission trips three times a year for various rural communities. Most recently, from December 15 to December 19 this past year, a total of 25 members from the School of Dental Medicine—one Periodontics resident, one Anesthesia faculty member, and 23 third-year students, including myself—volunteered their clinical services and skills in Honduras, a region without access to dental care.
Our group, traveling via three different airlines, all arrived safely in San Pedro Sula airport, leaving behind the snowy and cold northeastern United States and landing in 84 degrees of humidity and heat. We all climbed into one small Honduran tour bus and began our five-and-a-half hour journey to a coffee cooperation in Capucas that would become our home for the next few days. A late-night dinner awaited us as we crawled out of the bus and into our respective cabins. The next morning, we awoke to the surprisingly cold climate that accompanied the altitude of 7,000 feet above sea level. Having only packed a few warm clothes, we all shivered over to the common area to eat breakfast before we began our commute to the clinic, a trip that took 55 minutes each way.
The first day of our mission felt like controlled chaos. Upon our arrival we discussed team roles, envisioned how the clinic would ﬂow, unpacked our supplies, and then opened the gate. Nobody looked back as we welcomed 144 patients for dental care that day, more than any other Pitt group had seen before. Arita and the other Honduran dentists expressed how impressed they were by the efficiency and maturity of our group. We all left the clinic feeling a bit jet-lagged, yet accomplished. At the end of each day, we ate dinner in a common eating space—part of our home base complex—and recapped the successes of the day while discussing areas for improvement.
Although Spanish speaking skills varied within our group, we were all able to connect with the people who came to the clinic in different ways. We brought pamphlets, brochures, and print-outs in Spanish to help the patients learn about dentistry and their individual diagnoses. We provided the children with coloring pages and game sheets which they animatedly enjoyed, but their favorite part of the clinic was “Feyito,” a large orange stuffed animal with big teeth that we used for brushing and flossing demonstrations. We even gathered groups of kids and, with the translating help from Arita, taught them about the importance of a healthy mouth. Many children were under the false impression that they should not brush their teeth without toothpaste, and consequently when they ran out of toothpaste, they stopped brushing their teeth. We used Feyito to convincingly debunk this myth in their minds, teaching them that the physical brushing action of the toothbrush was the most important part of keeping their teeth clean and that it could not be skipped in the absence of toothpaste.
It was obvious that patients were grateful for our attention to their oral health. Some patients thanked us verbally, others smiled, and a few exchanged hugs. A few patients are prominent in my memories. I remember seeing a five-year-old girl and her grandmother for tooth extractions. The granddaughter, acting bravely, was treated first. After the anesthesia set in, I extracted two of her primary molars that were badly decayed. At the end of the procedure she proclaimed, “Senti nada!” (I didn't feel anything!) and “No duele!” (No pain!) to her grandmother. A weary and proud grandmother congratulated her and then sat down to have her remaining twelve teeth extracted. At the end of the procedure, unable to speak while biting on gauze, she turned and gave me a hug. Serendipitously, somebody snapped a picture. After extracting a root tip from another patient’s mouth, I asked the gentleman, “Puedes leer?” (Can you read?). He replied no, so I read the post op instructions to him in Spanish.
We know we changed the lives of the patients that traveled to see us in our clinic, and they know that they changed ours. We forged friendships, established trust, and embraced cultural differences. Our Pitt Dental Team treated 625 patients (12.5 percent of the county’s population), completing 875 procedures: 223 full mouth cleanings, 425 tooth extractions, and 227 restorations. However, the volunteers, organizers, and patients of Capucas provided us, the 25 missionaries, with priceless personal experiences, limitless gratitude, and timeless memories.
Although not a formal part of our education, the dental students that participate in mission trips highly value the opportunity to provide high quality and standard, ethical care to people in underserved areas year after year. It is an informal tradition that forever changes the perspective of dental medicine for those who participate. I was part of an amazing team of people on this mission and I could not be more proud of the positive impact we had on that rural community. Going forward, I know I’ll be a participant and leader of mission trips for the rest of my career.