Day 11 Final Thoughts

Why We Fly

Gloria and I have been going on overseas dental service trips for almost as long as we have been practicing dentistry.  Many ask why. 

We have joined or led teams all over the world.  In China to provide dental care for older citizens who survived Mao Zedong’s Cultural Revolution.  In Cambodia treating local villagers at orphanages of children whose parents were killed by Pol Pot’s Khmer Rouge.

In Vanuatu, blue water sailing among the islands to provide care to islanders that have never had access to dental care of any kind.  In Peru, joining a team of high school students drilling fresh water wells for families and communities in the Amazon Delta.

In Thailand, working alongside a group who trenched and laid a 2-mile pipe line for freshwater so that the village girls weren’t enticed to Bangkok’s sex trade.  Other trips to Mexico, Belize, India and Tonga to learn from the villagers how “simple life”, when without pain and disease, will impact generations to come.

And now the Philippines.  A great country consisting of 7,641 islands and over 100 million people.  They speak 150 languages and hundreds of dialects.  In many parts of the country medical and dental care is sparse or non-existent.  Since the trauma of WWII, I believe, this country has changed.  Many Western luxuries have become curses.  Specifically sugar in the diet. 

As people are waiting to have decayed and infected teeth to be removed they are drinking sodas and sucking on hard candy.  In conversation and confrontation, we are told that this is their “culture”, it is “who they are”.  I disagree.  Prior to the introduction of fast and processed foods, these people’s diets weren’t causing the pain and disease I see today.  They have, for generations, been surrounded by fresh fruit and have grown vegetables in their family garden plots.

We discovered that many parents aren’t aware of the relationship between sugar and tooth decay.  Others, unfortunately are, but because sugary foods and drinks are so prevalent; succumb to their child’s begging.  Additionally, parents frequently don’t model good oral health themselves.

One example:  As I was ready to pull seven infected and decayed teeth from a cute 8-year-old girl, I called for her mom to help calm the child.  When she came over, I discovered she was my last patient from whom I had just removed eight teeth!  Most people in their 40’s have already lost the majority of their teeth.  We saw few grandparents, for they have no teeth.

Further, we saw about 150 patients in 3½ days, pulling around 300 teeth.  In total, I saw three fillings, three stayplates, (small partial dentures to replace a few missing front teeth), and two “swedge crown”, more like mouth jewelry.  In other words, except for those 7 people, none of our patients have either been to a dentist in their lives, or may have gone, but just to have a tooth extracted. 

So, dentistry is either inaccessible or unaffordable.  So what can we do? Prevention.  What’s to stop us from encouraging these fine people to reduce or eliminate processed food and sugars from their diets.  They grow or raise most of their food now. All villagers have a small garden and pens for chickens, goats and pigs.  Fresh fruit grows on trees everywhere.

Education is a priority in the country.  I have seen many more schools then churches.  Perhaps this is where we start.  Provide the means and training to educate the teachers and students in the importance of diet and how it can affect their health and future.  The Filipinos need and deserve this.  It is the least we can do.

The Future?  Our vision is to pursue working with the local town leaders to introduce the children at school to a better diet and oral care.  If successful, our new friends will lead healthier, happier and longer lives. 

Day 10 Repositioning to Laoag

Graye and Mike left last night on an all night eight hour bus trip to Manila.  They needed to catch an early morning flight to Tokyo, then on to either Denver or Seattle.  We had the luxury of another night in Bangued to clean up, then a 5 hour drive to Laoag today.

Also, it is Palm Sunday.  Everyone is bustling around.  Lots of floats are being readied for the parade and lots of "palms" are being created from bamboo shoots,  Beautiful and creative.

Half way we stopped in Vigan for shopping and lunch.  It's known for its well preserved Spanish colonial and Asian architecture.  A great place to shop for Filipino souvenirs and enjoy a meal.

Inside the Jeepney. 5-6 hours on a given day.  A little tough!

A 4:00pm arrival in Laoag, check into the hotel and enjoy a swim in the ocean.  Tomorrow we flight back to Manila, then home.

Good trip, good group, great country.  Final blog tomorrow.

Day 9 Church then heading back to Bangued

Stayed in "The Elder's" house. Not sure of his name, but he is the pastor to the small church in Malapaao, and he helped translate for us yesterday.  Nice man, nice house.  Services were in their small church still under construction.  They are very proud of it and it will look very nice once it's finished.

We slept upstairs, the boys downstairs and the girls next door.  In front
of the house in the dining room.

After church we had a traditional Filipino "budu fight" lunch.  Everyone had great fun eating with their fingers.  The family dogs waited patiently until we were done.

Graye, our leader.

After lunch and goodbyes it was back into the Jeepney for the 4 hour drive back to Bangued.  We got stuck, again.  This time no truck came around, so we had to dig and dig, jack up the rear wheels, and put rocks under the tires.  Five times....it finally worked.

Back at Bangued, we had a choice go to a local river to swim and eat dinner with our hosts, or McDonalds.  Sorry, it was unanimous......McDonalds.  Hamburgers, fries and ice cream just seems the "right" thing to eat after the last few days of bumping around in the Jeepney and sleeping on the floor, no showers and challenging toilet usage.  Well, not really McDonalds, we went across the street to Jollibee's.  The Filipino equivalent.  (McDonalds was too busy and we wanted to compare).  We weren't disappointed!

Day 8 4th clinic day

Early start today, we got up at 5:45 to hit the road for 3 hours. Although we actually didn’t get to our destination, Malapaao, till around 10:00.  We got stuck on the road once and had to get pulled out by a passing jeep.  It is basically going up the seasonally dry river bed.  Real bumpy.  Very adventurous. 

Very narrow streets/roads where ever you are.  After seeing this packed Jeepney, we
stopped complaining about our ride.

This is a rather remote village in the mountains.  Not a lot of modern conveniences, but very appreciate residents.  Short clinic day today, 5 hours.  Evening was at a local house, dinner of rice, eggplant from the garden, noodles and the requisite goat and chicken.  

Getting ready for the festival.  We couldn't wait to watch the serious preparation,  But we did learn a lot about taking the hair off of a dead pig with a sharp knife and a blow torch.

Now this is a "family moment".  Greg holding the head, and Lacey 

the tray of instruments for Gloria's patient.

The outdoor kitchen at the home we stayed at in Malapaao.

Commuting in Malapaao.

Day 7 3rd Clinic Day

REAL TIME NOTE:  Just returned from Malapaao.  Quite primitive with no WiFi.  We'll catch up with the blog tonight.  Heading to Laoag tomorrow.

Dinner at Pastor Bert's.  Patio dining, and a table of great choices.

Clinic today was about a 45 minute drive from our hotel in Bangued.  We think it was in a small church, although more open-air then church.  We set up at the “front”.  Plenty of people were triaged for the Filipino doctor, the pharmacy and us.  We ended up working till 5:30, seeing around 40 people and pulling about 90 teeth.  I hit my personal best for the trip today, removing 13 teeth on one lucky lady!

We all wearing our "Septodont" bandannas.  This is a multi-national supplier

of dental anesthetics, based in Europe.  Gloria sent them a request

for donated anesthetic and needles.  They were VERY generous

with their donation, and included bandannas that they asked us to wear for 

a picture that they could put on their Facebook page!!

Lunch was special  We walked a block down the road to a church member’s house.  Routine rice, veggies, chicken and mango. But, we all agreed, the best chicken we have had since we came to the Philippines, and some in our group said it was the best chicken they have ever had!  Fried and seasoned just right!  Pollo Loco look out.

Kids always watching, always too close.

Meanwhile, the students back at the school were painting, making and installing a basketball backboard, building bookshelves for the library and painting a ‘four-square’ for the playground.  Real busy and real hot, probably our hottest day so far.

Why our backs hurt each night!

No Walmarts in the Philippines.  The vendor comes to you for all your needs!

Day 6 Settling in to Mala-pao Abra

Another 5 hour drive to where we will stay for the next two days, Mala-pao Abra.  While we put new tires on the pick-up (!) we spent some time in the local mall at a city between Laoag and Mala-pao Abra. (sorry, can't keep all the city names straight).  What a mall!  Next door they were building an extension probably 3 times as big.  Stores very similar to malls in America.

In the mall was a good size supermarket.  Gloria and I like to roam these looking for unique teas, coffees and spices.  We were successful.  More interesting was the focus we found on MILK!  This store had milk wired.  Three different isles of milk!

Another interesting sight in our travels today was a funeral procession.  Several police cars with light flashing were slowly leading the procession.  Very solemn.....and slow.  The traffic behind was stacked way up.

In addition to five of us in the pickup and a jeepney full of people, three more were in the back of the truck, Graye, Chase and Kim, the local pastor's daughter.  Kim stayed under the umbrella to keep the sun off and for easier texting on her phone!

Lunch at Filipino fast food.  Not sure what everything was.  Although chicken-on-a-stick was recognizable.  Desert was great, can't remember the name, except it had ice cream, beans, nuts, potatoes and something like flan.  Delicious!

We spent the afternoon at the school watching precision marching (!), getting a tour of the school, meeting the faculty and playing with the kids.  A great time.  Tomorrow, while we have a dental clinic about 40 minutes away, lots of construction will take place at the school.

Day 5 Re-positioning to Laoag

We are at a very nice hotel tonight.  Thanks to Graye our leader!  Nice to get a hot shower and a more familiar toilet situation after the last few days.  However, tomorrow, we head back into the hinterlands of Philippines to continue with our building projects and dental care.

Today was a bit of driving, great to see the country in the light.  When we arrived last Friday, it was dark for much of the drive.  For me is looks like Hawaii maybe 75 years ago.  Beautiful, green, but no real western influence.

So, below some pictures of the day.

Our last breakfast.   Cooks have been great!  Real, authentic Filipino food.

A couple of the great kids we spent time with.

These Jeepneys are everywhere.  They originated after WWII with all the
left over Jeeps the Americans left.   Now they have become a Filipino cultural
icon.  The more outlandish and Kitsch the better..

These side care-motorcycles are also everywhere.  They are the taxis of the Philippines.
We have seen as many as 7 or 8  people pile in the sidecar and behind the driver.

BONUS CONTENT:

For those who are still reading, and because I have decent bandwidth, some pictures of a typical Filipino bathroom.  First the toilet.  Note, no toilet paper, the trashcan on the left and the bucket of water on the right.   For Americans, we bring in our own paper and dispose in the trashcan.  No paper in the toilet.  Once you are finished, one to two ladles of water the complete the job.  Different, but it works.

Next, the "shower".  First, no hot water, and no water.  Note the drain in the floor and the soapdish in the wall.  So.......... you sit in the chair, ladle cold water on yourself in the corner, soap up, then rinse with said cold water and it drains into the floor drain.  No "turn off the shower, you are wasting hot water" in the Philippines.  (we actually bathed in the river!)

Finally, extra credit:

With Americans using the facilities, one has to expect a few problems.  Unfortunately, the traditional toilet plunger isn't to be found.  So, a home made one.  Not the 1 gallon container on the top, a tube ending in a bisected soda bottle.  It worked perfectly......several times!

Day 4 2nd clinic day

REAL TIME NOTE:  Those who have followed other blogs in the past note the brevity and just a few pictures in this blog.  Two reasons.  by the end of day, we're exhausted.  We try to make it to the river to bathe, then back for a meeting with the kids, another with the adults, then it is time to sit down, ponder the day and look at photos. 

Secondly, the WiFi is very slow.  It is tough to upload what I have here.  

So, I hope you still enjoy the update.

Today, we exercised with the kids at the elementary school.  Great fun.

OCS students also got into the classrooms to work with the kids on crafts and projects, including setting off model rockets.

Another busy day.  Fewer patients but more teeth.  We saw around 30 people, but pulled 86 teeth.  We worked till dark, around 6pm, and unfortunately we had to turn away 25+ people.  We are moving to our new location tomorrow and just ran out of time, and light.

An unsettling lifestyle emerged.  First decay is rampant in the local people.  The most sad was the kids who were 7 and 8 years old who's 6 year molars were already decayed and broken at the gum line.  Also, the 12 and 13 year old kids who had already lost there 6 year molars (only roots remained and were now losing their 12 year molars to decay and infection.

Lacey, Greg's wife, setting up our instruments while one the the students is doing
sterilization behind.

But worse still was a very pretty 20 year old girl, (she looked 15), who's 4 upper front teeth I had to extracted because of severe decay.  Three of the four had broken off at the gum line probably years ago, the last remaining tooth was severely decayed but not sheared off.  Another example:  I extracted 8 teeth on a middle aged lady, (probably that many were already gone), she then brought her daughter to see me and I pulled 7 of her teeth.  

Here is the kicker: after we pulled the girl's teeth we watched her go the the roadside stand to buy candy and soda THREE TIMES in the afternoon.  The problem?  SUGAR.  Many of the kids in line to be seen had suckers in their mouths. Discouraging.

Now this is one brave gal.  She could still muster a smile after I just finished pulling all
of her upper teeth, eleven in all.  All badly decayed, many decayed below the gun line.
She spent over an hour laying on the table to her left while I worked away.
My awkward position driven by my sore back from bending over her!

Now, many of you are reading this blog who want to know what the rest of our team is doing.  I apologize for not keeping you up to date.

Our kids have stayed extremely busy hanging out with the local kids.  Sports, crafts, visiting the local schools and just having fun.  The building where we are staying is loaded with kids all day and half the night.  Everyone is having a great time.

For all of you OCS followers, lots of pictures of the students will follow on your website.

Tomorrow we do move on,  So much more dentistry we could do.  We would love to educate the kids and parents concerning their diet, but that will have to wait for another day, I guess.

Day 3 1st day of clinic

OK, we are up and running.  We are setup with medical and pharmacy at the covered basketball court right in front of where we are staying.  Probably 75-100 have cued up to either see the dentist or the Filipino physician that has joined our team.

Fairly routine for Gloria and me. Once patient has been triaged with blood pressure and chief complaint, we start pulling teeth!  OCS students helped all day, some for the whole day, others floated through as they helped elsewhere.

Busy day.  We saw about 50 patients and removed around 70 teeth.  Very grateful patients.  At the end of the day, we sent about 20 home who we hope will return tomorrow.

NOTE:  These posts are a bit brief, due in part to exhaustion (!), and our internet connection is very, very slow.  A few pictures of clinic.

This is our routine setup.  5 patient chairs.  Gloria and I numb teeth for each other and pull
teeth as people are ready.  Each of us has an assistant to hold instruments.  Next table contains
all our instruments and the closest table to the camera is sterilization.





For those interested, Gloria or I will loosen the tooth and let an OCS
student finish the job.  Great fun for all!

Day 2 Rest and Relaxation

REAL TIME COMMENT: Just finished our first day of clinic.  WiFi connection here is very slow, will try to catch up, if not we will do so in two days.

Rained all night, not a downpour, but a gentle rain encouraging you to sleep!  Breakfast was eggs, rice, french fries and mangos.  Mangos at every meal, delicious.  Off to church a few blocks away.  We walk through the village and the government school grounds, all well-kept. 

 

The new church in Tanglagan Apayao

A special day, the first time the locals are meeting in the church!  Grand opening.  Full house with our team and the locals.  All are very proud of the church that was Graye’s project from the very beginning of his work here.

 

Where we are staying the next couple of days

After lunch of vegetables from the garden, chicken, goat and mangoes, the afternoon was either relaxing or playing with the kids and swimming in the local river.  Tonight, planning for the week of building and dentistry.

The sign is up, we will be seeing patients tomorrow