Do we make a difference?

THE TIKAL AREA OF NORTHERN GUATEMALA HAS GONE Hollywood. The TV reality show Survivor has changed some of the last untouched villages of the world by bursting in and introducing Western values and lifestyles to the indigenous inhabitants. Native life will never be the same.

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In February and March 2006, I found myself in El Quiche, northern Guatemala on my ninth or tenth Kindness In Action (KIA) dental mission. Our group consisted of 28 dentists, dental assistants, dental hygienists, translators, and "go-fers." Working out of a newly constructed concrete one-room medical centre, the week consisted of helping long lineups of people in dental pain. Basic-needs treatment consisted of extractions, simple restorations, and gross scaling dental cleanings using a portable ultrasonic scaler and hand instruments. With the help of four other volunteers and one giant green dinosaur hand-puppet named "Dino," we spent a day and a half at the largest school, implementing basic tooth brushing and dental health education to over 320 kids (K-Grade 7). Trying to find the right local volunteers to teach tooth brushing and to set up a fluoride varnish program for children was a little harder for me this year--especially after discovering I had only two tubes of Duraflor! (I do need to find out just how Jesus fed thousands with only five loaves of bread and two fishes.)

Sometime during the week of kids crying, extracted teeth flying, and souvenir buying, I began wondering about the impact KIA has had over the last 13 years. Has KIA done the same damage as Survivor? Honduras, Guatemala, Nicaragua, Belize, Peru, Venezuela, Mexico, India, Thailand, and the Philippines have all been touched by KIA. We have provided instant pain relief, passed out a few shoes and clean clothes to those in need, and taught a few kids how to brush their teeth. Has it just been a nice thing to do? Or has there perhaps been either damage or real benefit from our helping?

Statistically, there cannot be much of an impact on the people when you have helped only 500 out of a population of 2 million. On the other hand, specific individuals receive pain relief through dental extractions, restorations, and dental hygiene cleaning. As well, the volunteer gets to experience warm feelings from giving to another human being.

In 1993, the very first Kindness In Action dental mission was born when Dr. Amil Shapka and three other Canadian dental volunteers joined an American contingent in Honduras. "Bright eyed and bushy tailed" best describes our early years of KIA. "No game plan, no portable equipment or supplies, and minimal dental tools," said Amil Shapka, head of KIA. "Horrible, horrible, working conditions from sun-up until sundown and a never-ending lineup of people in pain. Now we have lots of dental personnel and volunteers, a dynamic evolving organization, lots of supplies and instruments, new portable dental units for restorations, and preventive community programs in place. We had a huge learning curve."

I sat and reflected on my first dental mission in 1998. Memories included fighting my way out of mosquito-netted dormitory bunk bed and hand scaling what felt like ancient two-foot-thick calculus on a grandmother with only two teeth left (she wanted one on the top and one on the bottom to chew her corn tortillas). On my most recent mission, I used a portable ultrasonic scaler with a separate water supply and gave dental health education to 320 kids in school. Times have changed!

But what stays the same is a location that is usually very remote and difficult to get to, incredibly long lineups, and superb views. KIA, like its many dedicated volunteers, is growing up and maturing as an organization. The original mandate of "putting fires out" (immediate pain relief) has now progressed to include pain prevention. Kim Penner, RDH, is responsible for formalizing and developing a community-based preventive program and a basic oral health program for grades K-6.

As I talked to Amil on the telephone, he repeated the word "spin-off." Wikipedia defines this as a new entity formed by a split from a larger organization. "Okay," I said. "What spin-offs have come from our KIA dental missions that have had a lasting impact on the regions we have touched?" Here are some examples ....

Dr. Brian Palmer's KIA group wanted to make a bigger contribution in northern Honduras. They decided on a five-year project, thus providing both consistency and time to establish the project. The first objective was to establish a fully equipped, permanent dental clinic in Santa Cruz and to pay a local dentist to work part-time and deal with emergencies. "Dental emergencies from the surrounding mountain villages are shipped down to the clinic," said Brian. The second objective was to establish and support a toothbrush program in four schools in the villages of Balin, Buenos Aires, Cipres, and Las Flores. Now 1500 kids brush twice daily at school. Yesica, a local volunteer, was originally taught how to teach the kids to brush; she now is in charge of the school program. In each classroom, toothbrushes are stored in a pop bottle with each child's name on it. Teachers instruct the students to brush twice a day. "Don't you remember? You were the first volunteer to start dental health education and fluoride varnishes in these Guatemala schools in February 2003," said Brian. I had forgotten. The final goal was to support 10 youngsters from local villages to go to technical school where they can become marketable as nurses or electricians. Education after grade six is free, but it costs $300 per student for bus, books, uniforms, and extras. "One fellow literally begged us to send his kids to tech school," said Brian, "because otherwise the kids go directly to work in the local rum factories at 12 years of age." This team funds these three programs from monies raised at their annual golf tournament in Sundre, Alberta. In February, when Brian's team goes to Honduras, they keep the excitement up by working in the clinic and travelling to the mountain villages about two hours from Santa Cruz.

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Dr. Gordon Huff was another name mentioned. "We left behind knowledge by teaching the government-funded nurses how to do simple extractions, surgery instruments, and a school," said Gordon. "We brought dental care to a very isolated group of tribal people who have never had any type of dental care ... For three dental missions, we would travel two days (in 45-foot dugout canoes) up the Rio Coco (river) heading to our final destination and headquarters of San Andres in the Bosawas Biosphere Reserve (northeast side of Nicaragua). Thirty-five hundred indigeneous people from the Miskito and Miagma tribes live around the river.

In the beginning, everyone was curious and they would come running down to the river and stare as our two large canoes went by. Our MASH unit only did emergency dentistry. Multiple perio extractions were easy--the teeth were loose and falling out. Over the years, the dental IQ has changed. Now, healthy dentitions make the extractions more difficult! The nature of procedures has changed, with requests for fillings, orthodontic, and other elective dentistry. In our first year, the old generator gave us only three hours of light a night. Last year, it seemed strange to find people watching Rambo. In just three short years, solar panels have allowed satellite television into the solitude of the jungle.

Last year, Dr. Jim Guild in Urubamba, Peru, left behind a portable compressor and equipment to entice local dentists to volunteer dental services to the area. Jim, as well as many other KIA volunteers, has sponsored youngsters to go on to higher education in Guatemala. Roger and Bonita Marchand raised funds at home to sponsor a teacher for the new school in XIX (pronounced sheesh) in Guatemala. Dr. Bob Dickson, MD, largely funded by KIA, built the medical clinic where I worked in El Quiche, Guatemala. This went along with a medical lab, computer centre, and playground for kids. The list goes on and on ... all spin-offs.

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I began to see that KIA dentistry is just a foot in the door for helping others. We plant the seeds of self-sufficiency and leave behind a great deal of knowledge and material things such as schools and medical centres that were not there before our arrival. The impact on the recipients is huge. But the impact on the volunteer is like no other experience you have ever had. Leaving the comfort zone of our North American cocoons to work from the heart is foremost a transforming experience and arguably the most important thing we do. As Gordon Huff said, "You are the only ones ... no one else can help. You know why you are here!" Now my head is spinning. What kind of an impact can I make this year on my trip to Venezuela? The fluoride varnish will help many children and I want to train a local volunteer to repeat this procedure at least twice more this year.

For further information, visit our website at www.kindnessinaction.ca or contact Dr. Amil Shapka at [e-mail].

by Donna Kittle, RDH