by Gary A. Rabinowitz, DDS
In the aftermath of the earthquake in Haiti, justifiably the focus on dental care was blurred. Tabasamu cancelled its previously scheduled mission which was to happen in April of 2010, only a few months after the quake. What Haiti needed at that time was clearly beyond the scope of expertise of Team Tabasamu.
However, this summer, our colleagues and friends in Haiti, the dentists that we call the “indigenous volunteers”, headed by dentist, Dr. Joseph Antony, requested our return. Much help is needed as the population of 9.5 million continues to have little or no access to dental care, and the maladies of dental decay and gum disease run rampant. Team Tabasamu’s return was scheduled for 5 days over the Columbus Day weekend. With an emerging and expanding emphasis on education, we set out to empower the children with our educational “Tooth Tours”, to create partnership with the teachers of Haiti in our newest program “T3” – “Teach The Teachers”, and to work along side the Haitian dentists in clinics in Mirebalais and Las Cahobas.
So, why has Tabasamu shifted its program more towards education? Tabasamu originally provided only clinical care to the underserved. Well, if Haitians or Kenyans, for example, have no access to dental care, then the only reasonable choice they have is the prevention of dental disease. If they can prevent the need for dental treatment by a dentist, then lack of access is a greatly diminished issue.
The T3 program, a four hour seminar, was developed to compliment our educational Tooth Tours. The thinking behind T3 is that we ask the teachers of the primary and secondary schools for their partnership in combating dental disease in Haiti. Then, we impart the knowledge necessary to these teachers and empower them to be catalysts of change, “ambassadors” of oral health. With the teachers as our partners, our message becomes their message forever forward in their classrooms and communities. Thus, reaching and educating the people of Haiti in oral health care grows exponentially.
In one of three modules, the fundamentals of dental science and disease were taught at T3, by Dr. Gary Rabinowitz along with the Haitian dentists, Antony Joseph, Francois Lintz, Roody Beauboeuf, and Falide Macillon. A projected Microsoft PowerPoint presentation set a professional tone matching the teachers’ ardent desire for continuing education. Close-up intra-oral photographs and diagrams were a vivid means of communication and stimulated much dialogue with the teachers.
Dr. Trey Wilson, along with one of the Haitian dentists, gave a live demonstration. Using one of the participants they applied a special stain which turns plaque and tartar fuchsia red on the surface of teeth and gums so it becomes visible. A prophylaxis or cleaning was then performed comparable to a dental hygienist visit here in the States. Twelve heads at a time maneuvered to see inside one mouth for a unique new learning experience, something they had never seen before.
Otho Kerr and Kyle Evans taught and demonstrated the components of an effective Tooth Tour: the Puppet Show – “How Tooth Learned to Be Healthy”, the basics of self care including how to brush and floss, and the elements of a proper diet. Having seen our performance of the Puppet Show at the start of the day, narrated in Creole by team Tabasamu’s Rebecca Baum, teachers in this module staged mock run-throughs giving them a chance to make the Puppet Show their own, and have a few laughs.
We used the following example to illustrate the value of preventive care, and to define the challenge we face in Haiti:
If we identify a Haitian child, 4 years old for instance, and that child never eats sugar, ever. And, that child brushes his or her teeth every morning, after every meal, and at night before going to bed, always. And, that child flosses his or her teeth daily. It is extremely likely that child will have little or no dental decay and little or no gum disease throughout life. And, that child will rarely, if ever, need the services of a dentist. And, that child will have dental health and all of his or her teeth for a lifetime. “Teeth for a lifetime”! This would be ideal.
But, can we realistically step into Haiti and ask the teachers in the schools to effect a change in the culture and habits of Haitians? Can we ask a population to stop eating sugar when it is customarily served at home? When sugar cane is habitually chewed and thought of as healthy? Or, when it is a major part of their sustenance? Can we expect to elicit brand new habits of brushing, flossing, and rinsing after meals that require time, energy and discipline by the individuals? After all, only 2% of Americans floss. Tabasamu acknowledges that though what we are suggesting is quite simple, it is far from easy.
At this T3, for the first time, each teacher received a lengthy seminar evaluation form. To our delight, consistent with their level of engagement throughout the day, these 65 teachers took more than the allotted time to thoroughly complete the evaluation forms. It is the insightfulness of the Haitian teachers and the sensitivity to their own culture that will help us to hone the Tabasamu program. Our common goal is for it to blossom to its greatest potential and maximum effectiveness. This is the partnership we asked for.
We consider this mission to Haiti to have been extremely successful. 526 children and adults were educated via the Tooth Tours. 65 teachers received certificates in T3 training. 50 children received fluoride treatments. 125 patients were treated for dental disease. 2900 toothbrushes were distributed. One of the Haitian volunteers, Bernard Elma, who functioned as a translator, is also a manager of an IDP (Internal Displaced Persons) camp. As a result of what he learned by assisting the Tooth Tours and T3, he decided to take a Tooth Tour to his IDP camp, and will distribute 700 toothbrushes there. Our program is working.
One final memory captures the enthusiasm we have for this particular mission to Haiti. Upon completion of the T3 seminar, a graduation ceremony was conducted. Each teacher was called to the front of the room and received a personalized certificate, along with congratulatory handshakes, a Tabasamu t-shirt, mirror and tooth brush. Upon exiting the building, Tabasamu member Kyle Evans suggested a group photograph. Spontaneously, and without direction, all of the teachers put on their Tabasamu t-shirts for the photo. They are the Tabasamu T3 Graduating Class of 2010, prepared to carry the message of prevention of dental disease and the importance of oral health to their communities.