September 2/3--clinic is over, time to relax

REAL-TIME NOTE SEPTEMBER 11.   This post is from a week ago Friday, the last day of the clinic in the Cricket Stadium.  I neglected to publish it.  Sorry

Friday was another good day, except........

We were told that we would finish patients at 2pm, then break down the clinic and hit the busses at 4pm.  Well, I took lunch at 3:30, continued working till 5 and we got back to the resort at 6:30, our longest day of the week!

So many people to see, and all the providers worked till the very end trying to squeeze in all the patients that had been triaged during the afternoon.  No complaints from any of us, just very tired.  1000 Smiles was here for three weeks, and the total number of patients seen was 2,000!  We were told that is approximately 2% of the population.  We've got our future work cut out for us!

My 'highlight' on Friday was my 'last patient'.  He was the next to be called from the queue, I sat him in the chair and he told me that he was running last night, tripped, fell and broke his two front teeth off about halfway to the gum line.  Also, his lower lip was punctured and badly swollen.  A mess.  Yes, he was my last patient but it took me an hour and a half to rebuild and sculpt his teeth back to 'normal'.   Good result and very fortunate that we were in town the day after his accident to fix his teeth.  Otherwise, he wouldn't have been able to find, much less, afford care.  "things happen for a reason'...........

Saturday we were on our own.  We chose to take an island tour, visiting a chocolate factory, rum distillery, a 'famous' waterfall, and an ancient volcano caldera, now a lake.  Sounded good on paper, just a long day of driving around the island.  Kinda disappointing.  But, tomorrow we scuba dive!

Here is the 'dream team'.  Brittney and Gabe were my assistants 

for the week.  Brittney is a former dental assistant who got

her hygiene degree last year.  She admitted she enjoyed assisting

me after being a hygienist for a year.  Gabe, you remember is

the former ice dancer, now a college student deciding on a major.

They made my job easy.

This is Grenada.  Practically everywhere you look are homes

built into the side of the mountains.  Lots of very narrow roads 

everywhere.

September 12,11-----Diving and dining and final post

 So, Saturday and Sunday consisted of scuba, ocean time, pool time, hot tub time, eating time and to finish off the weekend, dinner with a VIP!

Finally, we were honored to be invited to Joslyn Whiteman's home for dinner.  He is 83 now but a Grenadian politician extraordinaire.  He was the ambassador to both China and the UK in the past.  He showed us around his house with pictures of him with the Chinese Premier and also the Queen of England.  Quite a guy.  Last week he had dropped by the Cricket Stadium clinic looking for the dentist whose office we worked out of this week and ended up getting a filling by one of the other docs.  I met him at intake to discuss his high blood pressure.  Such a gentleman, we enjoyed a very traditional Grenadian dinner prepared by his housekeeper/cook.

A successful two weeks of dentistry, diving, relaxing.  We are actually home for three days and do it all over again in Palau, Micronesia.  We'll keep you posted.

September 7-9---We did it! Or did we?

 Well, we just completed our week of'catch-up' days in Dr. Du Bois' office.  As mentioned, it is VERY small and we finally realized there is no air conditioning in the two operatories!  The small waiting room has air, as does her office, but not where all of us work.   (Long story there.) So THAT is why there are two fans roaring.  Their location blows the patient's bib over their faces so we have to use extra large paper clips to pin the bib to their shirt or blouse.  Can be a bit uncomfortable for me!  We also discovered on Friday that there is a 5th dentist that works in the office!  He is a Peruvian Oral Surgeon that comes in as needed to extract teeth for the other 4 dentists.  He used to work for public Grenadian Health for one month rotations, that didn't work so he comes in to Dr. Du Bois office to exctract teeth as they need.  Nice guy, interesting commute!

The front door of the office, 2nd floor at the 'mall'.  It is at the 

cruise ship drop-off, quiet now, crazy in the winter months.

The main clinic, the fan is out of the picture on the right.

Assistants are watchers and spit suckers, I 'assist'

myself with  instruments, etc.  Indeed, when I extract teeth

EVERYBODY watches.

This is our 'office', two boxes and my carry-on for 

our instruments and supplies.  Small hallway, that

is the mop bucket to the left!

1000 Smiles will want our conclusions after 'follow up' week.  They are mixed.  We saw a total of 15 patients (their goal) but almost that many scheduled that didn't show up.  Friday was our worst day.  6 were scheduled and only one showed up!  Half of the patients seen were not 'follow up' patients from the 3 week clinic at the Cricket stadium, but new patients.  Actual need for follow up procedures after 2000 procedures by all the volunteers?  Practically zero.  Hey, we do pretty good work.

September 5/6---Back to work

This is the 'follow-up' week. As mentioned before, new to 1000 Smiles is to have a doc stay after to handle any problems created by the last three weeks of Stadium Clinic.  We are working in the Chief Dental Surgeon's office downtown.  We were told she sees patients there in the afternoon so the mornings are available for us.  Three patients were already scheduled, starting at 9am.

Our taxi was to pick us up at hotel reception at 8:30 for the 30-minute commute downtown.  He showed up at 10:00!  So, a late start for the morning.  Also, to our surprise, our host and one other dentist were seeing patients when we arrived!  Only two chairs in the clinic, so the logistics were a bit messy.  We did end up seeing those three patients between 10:30 and noon, then a taxi ride back to Sandals for a free afternoon.

So, the photo below illustrates the two competing worlds in Grenada.  We have spent all week treating 750 patients who otherwise could not afford to see a dentist.  But we then retreat to Sandals where the truly blessed (and entitled) enjoy a 'bubble bath' in the pool.  Culture shock is whip-sawed every day.  Two worlds.

Tuesday saw us back in the clinic, now with a third doc! We were again picked up late by the taxi, just an hour, though.  We ended up seeing just one patient to pull a tooth, the second patient's blood pressure was so high that we sent her to a medical clinic for medication and told her to return on Thursday, she needs her four front teeth removed, (decayed below the gum line).  

So back to Sandals for a bonus dive of Grenada's Sculpture Park.  Created in 2006 to honor the history of Grenada, hence the history of slavery in the Caribbean.  75 sculptures in about 30 feet of water.  A good dive.  A few pictures are below.

September 4-----More time to relax, and diving!

 Chill day.  Scuba in the morning.  Good dives, not spectacular.  Good to get in the water again after 3 years, though.  Once I get our photos transferred to the laptop, I will post a few.  Afternoon, was a bit of snorkeling and pool time.  We really are relaxing!

Tomorrow, a taxi takes us to the city's/country's(?) Chief Dental Surgeon's office in town.  We will work out of her office this week 9-12 to see follow-up patients from the last three weeks.  Something new for 1000 Smiles, we'll see how it goes.  The rest of the day is ours to relax.  Lot's to do at Sandals so we should keep busy.

Below are pictures from Fort George.   Built in 1705 by the French.  The police use, what remains of the Fort, for a gym and a sewing room. Through time, neglect and hurricanes it is pretty dilapidated.  We had a self-appointed host when we arrived.  Quite the historian.    He told us to not question his facts because he is never wrong!   He asked for a couple of bucks from each of us as we left.  He earned it.

We also stopped at Concord Falls.  Nice falls and pond to relax, and cooler than Sandals.  Look closely at the top of the falls, this guy did a couple of these crazy dives.  Very brave.  

August 31/September 1--Am I Grenada's cosmetic dentist?

 Clinic, day three and four.  Interesting.  My first patient on Wednesday came in with a severely swollen face.  When seated, he said he had been to our clinic last week for treatment but they put him on antibiotics for 7 days and told him to return today.  Good call to get antibiotics in the bloodstream before any care.  When looking in his mouth he had a swollen abscess the size of a walnut on his right mandible with two broken molars causing the infection.  With antibiotics on board, I lanced the abscess and extracted the teeth.  My assistant almost got sick when the abscess cut loose!  We drained it, cleaned it and sent him on his way.  Probably the worst I'd seen in 20+ years.  Kinda remarkable, actually.  I took pictures, I'll spare you.

The highlight of both days were the twins!  Two 15 year old Grenadians with severe decay between their upper front teeth. We see this frequently in developing countries, and if left unrestored the teeth will eventually breakoff at the gum line leaving only the roots and a ruined-for-life smile.  Both girls were headed in that direction so I had my work cut out for me.  I worked on them for about 3 hours on Wednesday and another 2 on Thursday.  The smiles are below.  This work will probably change the course of their lives as they grow up.  Nice to be a part of that!  Definately the highlight of the trip.

Wednesday, getting started.

Final smiles!

Advertising for our clinic on city busses.  

BTW we are seeing 130-150 people a day.