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Project Report Linus - Not only for dentists

A really worthwhile report from a young yet very experienced dentist with social aspirations
10 November 2024 by
Corazon de Cacao - Andreas (Lix)
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Dental aid mission in Santa María Cahabón from 21 March to 19 April 2024


Dieser Blog Eintrag hat wenig Bilder. Den gesamten Beitrag, inklusive der Bilder könnt ihr euch auch runterladen.

However, in another format (PDF), you can also view the entire story with images.. 

In mid-2023, I decided to undertake a voluntary dental aid mission following the completion of my two-year assistantship at a dental practice in Leipzig. Having successfully completed six weeks of aid work for the FCSM (Förderkreis Clinica Santa Maria) e.V. in Huancarani (Bolivia) two years earlier, I could very well imagine another mission in a Central or South American country.

While searching for suitable projects, I came across DIANO (Dental International Aid Networking Organisation) through ZAD (Zahnmedizinischer Austauschdienst) e.V., which has already successfully initiated projects in several countries in the Caribbean. Subsequently, I contacted several projects to find out which would fit best in terms of timing and organisation.

Through Tobias Bauer from DIANO, I finally learned about the relatively young project in Santa María Cahabón in Guatemala.

The project was initiated on-site by Andreas Degenhardt. He has been living in this small town in the centre of Guatemala for four years and is successfully growing cocoa and much more here. He originally had nothing to do with dentistry, yet his eye was keen enough to recognise that the Guatemalan population, especially in rural areas, has extremely poor dental health.

There is a particular lack of education and awareness regarding the importance of daily dental hygiene. Additionally, there is an extremely high consumption of sugar, whether in drinks like Big Cola from two-litre bottles (sometimes cheaper than water) or from other sweets like lollipops.

Due to the lack of access to dentists in rural areas, it is not uncommon to encounter (in Germany today) unimaginable oral health conditions.

In addition, there is the dilapidated healthcare system, as there is no statutory health insurance here that covers pain relief and basic treatment. The costs for an extraction, filling, or even dental prosthetics are often unaffordable for many, and there is sometimes a journey of several hours to the nearest practice.

Andreas (who is referred to here as Don Andreas) has also founded an afternoon school in the Communidad Chitzak, where he lives.

Here, children are now taught correct oral hygiene at an early age, so that their teeth do not, as is often the case here, have to be extracted at a young age.

Until my aid mission, only five groups of dentists had been present. The last group completed their aid mission in February 2024. There is a great need for treatment in this project, and dentists as well as students who are interested in supporting here are urgently sought!

Generally, arriving participants must bring a suitcase full of materials to the project (luggage with donations or aid goods is, by the way, transported free of charge by many airlines).

In my case, this was difficult as I had already been travelling through Mexico for two months before arriving at the project. The previous group therefore replenished the material supplies in February of this year to the extent that they should be sufficient for another project. However, I brought some essential items with me, such as four packs of XL gloves or a magnifying glass, as well as a headlamp (which I diligently carried around Mexico).

The journey through Mexico with my two best friends turned out to be a wonderful opportunity to recruit more volunteers for the project. At the beach of 'Laguna de Chacahua', I met Nava from Canada, who has 15 years of experience as a dental hygienist. She was also on her way to Guatemala and would arrive there at the same time as I would. Additionally, she had a great interest in a voluntary project placement and was ideally qualified for the role.

In Mexico City, I then met Francois from Belgium. He had already been travelling for a year as a cyclist on his way from Alaska to Argentina.

He would also arrive in Guatemala at the same time and was interested in helping. Thus, it happened that Nava was on site for the entire project deployment, and Francois also travelled to Cahabón for an extra week.

The journey to Cahabón is easiest from the nearest larger town, Coban. Buses depart from here to Lanquin, one of the tourist hotspots due to the natural spectacle of Semuc Champey, which is located nearby. On this bus, you simply stay seated and travel for another hour (through beautiful landscapes) to reach the final destination, Cahabón.



We were kindly picked up by Andreas in Lanquin on Wednesday and finally taken to our accommodation. The volunteers will henceforth be housed in their own house, which is not on the school grounds where work is done. Here, everything important for an uncomplicated stay is available: several rooms with beds and

Mosquito nets, a small kitchen, and a hammock to relax in after work. Next door lives Paty from Mexico, an employee of the chocolateria and the sweetest neighbour we could have imagined. She also shares her home with dog Negro, puppy Fozy, and cat Gacharro.


The first working week, we were therefore only on duty at the Clinica Dental on Thursday and Friday.

Our accommodation is located right next to the agricultural school 'Rax' Kicheh' where we are allowed to have breakfast and dinner daily with the boarding students. From here, it is a ten-minute tuk-tuk ride every morning for cinco (5) Quetzales (about 60 cents) to the other partner school 'Instituto Fray Domingo de Vaca', where the dental clinic is located.

 


The clinic is a large room with an elevated table as a treatment couch, as well as another adjustable chair. The chairs cannot be compared to German standards and do not have built-in technology, such as individual handpieces for drilling or integrated suction.

Therefore, mobile units are used. Water cooling is provided during drilling by a

Plastic bottle with a blunt cannula, with which the assistant sprays water onto the relevant tooth. The water collects in the mouth, and the patients must spit into a bucket as soon as their mouth is full.

There is also a hot air steriliser and even an autoclave and compressor, which have not yet been put into operation.

The equipment is sufficient for fillings, minor dental cleanings, and surgical procedures, primarily extractions.

So this has nothing to do with local conditions, but with a little bit of improvisation and spontaneity, most things can be wonderfully accomplished and provide great help to the people on the ground.


In the school, those responsible for us were Don Mario (deployment planning) and Doña Vilma (patient coordination).

After Nava and I familiarised ourselves with the available materials, instruments, and

Once we had familiarised ourselves with the circumstances, we finally got started, and in the first two days, we mainly treated students who were excused from fieldwork during their dental appointments.

However, a few patients from the surrounding area also came to us.

Oral hygiene has been addressed in lessons at the school for several years now, and most students are aware that they should ideally brush their teeth three times a day.

This is also evident in the examinations: The students (aged between 14 and 18 years) have generally experienced little tooth loss and mostly have smaller carious defects (especially fissure and pit caries). It is notable that all patients from outside show significantly worse conditions.

For example, at the age of 14, the premolars and molars in the lower jaw of a patient were so severely damaged by the second day of treatment that only extractions were possible.


After the first two successful working days, Diego, Sergio, and Josué took us to a nearby beautiful river, where families go to wash clothes and bathe.

In the first few weeks, we had over 40 degrees during the day at times, so any cooling was very welcome.

The three boys were very interested in our work, background, and the English language we spoke from the very first day. This led to a friendship, and Diego visited us almost every day during his breaks at the practice to learn something about dentistry or to ask about English words.

The second working week fell during Semana Santa (Holy Week), the most important Christian

Holidays in Latin America (in comparison to Christmas in Europe). Here, the entire country comes to a standstill from the middle of the week, as everyone travels home to their families in good time, before even buses stop running from Friday. The students have the whole week off and also visit their families in the Aldeas (villages in the countryside). Therefore, we only worked until Wednesday this week and carried out our first missions in the mountain villages.


On Monday and Tuesday, we set up our practice in the Aldea Chitzac. Here lives Don Andreas with his wife Mona and the dogs Nero and Frida. His plantations are in the immediate vicinity of the property; alongside cocoa, there are also cinnamon, cardamom, bananas, vanilla, and much more growing here. Andreas has also established the aforementioned afternoon school here. After regular classes, children from the surrounding area can spend the afternoon here. Oral hygiene is an important subject in the afternoon school.


As the house's open-air kitchen is best suited for it, we set up the mobile dental practice here for two days and treated patients almost at the dining table. The local people had already been informed the previous week that the dentist would be coming on Monday and Tuesday, so we had a "full waiting room" from the morning onwards.

In addition, Erica was available to us here as an interpreter, a teacher from the afternoon school. The people in the Aldea often speak only the Maya language Keqchi, so she kindly translated from Spanish to Keqchi (almost no one speaks English here).

After work, we had to take all the instruments back to the school's clinic room by car to clean and sterilise them, and they also had to be picked up again in the morning. On Wednesday, Andreas lent us his pickup for a mission in Aldea Chimulak, which is about an hour's drive away. Here, we received support from José, a staff member of the school.


He also translated for us, but above all, he navigated us for an hour along gravel paths through the mountains to the place where we were to work. Without a local navigator, it would have been impossible to find the location.

We generally always work at the homes of the cocoa farmers with whom Andreas conducts fair cocoa trade during activities outside of school, as relationships already exist here.

We were warmly welcomed in both Chitzac and Chimulak, generously fed at lunchtime, and experienced endless gratitude.


In the first three days outside the dental clinic at the school, it became even clearer how much dental treatment need exists here. Most patients required not only conservative treatment but also surgical intervention, which meant that, unfortunately, we had to extract significantly more teeth here compared to the usual treatment routine at the school than we were able to save. However, with the extractions, we can free the patients from pain, inflammation, germs, and the risk of abscesses, which they often endure for years in their lives.

On Maundy Thursday, we were invited in the evening to a traditional Catholic ceremony. The Christian religion is often intertwined with Maya culture in many parts of Guatemala. The Swiss priest Padre Cristobal has been living in Cahabón for 30 years and speaks Keqchi perfectly. He invited Nava and me to participate in the annual foot washing, which the Pope also celebrates every year at Easter.

Here, the clergy wish to express that they do not stand above the believers, and they bend down before the congregation to actually wash their feet.

Although we understood relatively little from the sermon in Keqchi, it was still an interesting experience to sing with the small congregation and to be invited to a festive dinner.


The following weekend we spent in the next largest city, Coban. Here, large processions took place throughout the weekend as part of the Easter festivities. On the streets, for example, colourful images with floral patterns or even vegetables are painstakingly laid out.

A large parade takes place later, which all the spectators join and walk across the city.

A unique experience that we had not known like this from our homeland before.


On Thursday, Francois finally arrived in Cahabón and joined our team as an active helper. Fortunately, he speaks Spanish very well and was able to be deployed after a short training period in assistance, as well as in preparation and follow-up.

 

This also enabled us to carry out significantly more dental cleanings from now on, as Nava was no longer required in the assistance role.

On Saturday, we finally drove with a packed pick-up to Lanquin, where we would be working for several days in the coming week.


First, we visited the natural spectacle of Semuc Champey, where over the millennia, water and sediments have shaped natural swimming pool-like formations in the rock.

We spent the following weekend in our accommodation Tuqtuq’ilal, a Cacao Centre.


Here, cocoa is fermented, dried, and then processed into chocolate. The team at the accommodation welcomed us very warmly, and we felt at home straight away.



Cocoa Processing Next Monday, our first working day in Lanquin, the partial took place

A solar eclipse occurred, which caused great fear among the devout Maya population in the area. There was a belief that something terrible would happen on that day. This also resulted in us having no patients from the village in the morning, as no one wanted to leave their homes.

The staff of Tuqtuq’ilal were therefore lucky that we were able to carry out check-ups and filling treatments for them that morning.

After the solar eclipse had passed, fortunately, patients from the surrounding area also came.

As we identified such a great need for treatment in Lanquin, we even extended our stay there until Thursday.

The working week in Lanquin was quite special for us. The accommodation is located right by a mountain river, where we could regularly enjoy a refreshing dip during our lunch break or after work.

In addition, we were accommodated in our own cabanas, which were situated on a slope and had a great view. On a small hill, there was also a large terrace with a wonderful view over the landscape, which was perfect for morning yoga. We quickly formed friendships with the lovely people who run the Cacao Centre there. It was a great change from the previous weeks in our rather basic accommodation.


On the last weekend we spent together, Andreas took us around his cocoa plantations once more, and we learned a lot about his life and daily routine. 



Francois left us once again, and fortunately, Nava decided to complete the project together with me and extend it for another week. We ended up using all the materials in the last week; neither etching gel nor gloves in the right size were available on the final day. Even the last functioning angle piece gave up the ghost on the penultimate day. We were very lucky that the materials didn't run out before then and that the angle piece held out until just before the end.

All in all, it was a very successful mission in Santa María Cahabón, and we definitely want to return one day.

Overall, we were able to place 309 fillings and extract over 190 teeth and root remnants in four weeks of operation time!



The local dentist also offers dental prosthetics. In the future, Clinica Dental is to be continuously expanded. Next, for example, the acquisition of proper treatment chairs is planned, the installation of an X-ray machine, as well as the establishment of a dental laboratory.

 

 

Volunteers are currently urgently sought for dental practitioners (with at least two years of professional experience) for future aid missions.

Students are also welcome when accompanied by an experienced practitioner and have the opportunity to treat a lot here.

At least one person in the task force should have knowledge of Spanish.

The best way to get in touch is through DIANO with Tobias Bauer: Dental.aid.net@gmail.com or with Andreas Degenhardt: andreas@corazondecacao.com

Corazon de Cacao - Andreas (Lix) 10 November 2024
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