A Dental MASH Unit in Gwo Jan

While on leave in the United States, Dr. Trey Wilson ordered some dental supplies for Joseph Antony, one of the Haitian dentists who participated in the Tabasamu dental clinic and T3 training in May. I brought them back with me and called Joseph to schedule a time for him to pick them up. When he stopped by, Joseph mentioned that he was organizing a dental clinic in Gwo Jean during the third week of August. He had brought a beautiful young woman with him, Falide, who was also a dentist and his girlfriend. I was thrilled about the dental camp in Gwo Jean and asked if I could be of assistance. We decided to meet the following week and finalize all the details.

Joseph had already done most of the planning for the clinic. I made a few suggestions and offered to help on the first day. The only remaining concern was transportation (Surprise! Surprise!). I offered to contact one of the drivers who drove to Gwo Jan on a regular basis. However, Joseph assured me that he was pursuing some options.

In the course of the final e-mails the week of the clinic, I learned that the clinic was going to be held at St. John the Baptist Catholic Church. I envisioned providing important dental care amidst pews and altar, truly sacred space where God was laying his healing hand upon those who required it.

The first day of the clinic arrived. I had done all the necessary shopping, including the purchase of an Igloo and cooler (not easy commodities to find in Haiti!) and was ready to be picked up. Joseph’s friend had been unavailable to drive, so he secured a tap tap driver. I wondered if this driver was actually familiar with the final road to Gwo Jean- a decidedly steep and rocky climb. However, I decided to keep my thoughts to myself. As was the case with the reforestation initiative, we found ourselves about ½ to Gwo Jean when the chauffeur pulled over and began to negotiate for a higher wage. At this point, he argued that he had not been aware of the distance. His attempts failed and, soon, we were back on our way. As we made the arduous ascent to Gwo Jean, there were another 2-3 occasions when the chauffeur stopped and groused about the condition of the road, the challenge to his brakes etc. Ultimately, however, he continued to drive us to our final destination. He backed the tap tap up to a little incline to the left hand side of the road. A small group of volunteers appeared and, as we unloaded the supplies, willingly took items and started to walk up the hill. I was a little surprised that there was no road access to the church. However, I folded in and went along with everyone else, taking pictures along the way.

As we arrived at the crest of the hill, I saw before me not a bricks and mortar structure but, rather, a mission church created from woven palms and supported with small tree trunks. I had to laugh- I had lived in Haiti for 9 months and it never occurred to me to ask about the physical construction of the church. Silly me, I should have known better!

In approaching the church, I could see that the right front corner had been designated as the operatory. Volunteers had already created a sterile space with sheets. They had also placed a sheet over that section of roof to reduce the intensity of the sun’s heat.

Before Joseph and Falide set up the operatory, we added a second sheet to the ceiling. Though it was only 9:30 a.m., the sun was already beating down on the church. Joseph also switched out one of the sheets on the back wall for a sterile covering typically placed over a patient during surgery. Joseph and Falide unpacked and organized all the instruments and set up the collapsible dental chairs. Simultaneously, the registration volunteers reviewed the list of patients and created additional numbers for “walk-ins”. Within about 30 minutes, we were ready to see the first two patients.

Before receiving those patients, Falide stepped outside of the operatory and made some introductory remarks. I beckoned Joseph who introduced himself and shared a few details about the schedule for the day. I was taking pictures during their presentation. When they had finished speaking, the three of us started to re-enter the operatory. An older gentleman shouted out something in Creole. Joseph apologized and told me that the man wanted to know who I was. They introduced me and then it was time to begin.

My responsibilities included sterilizing instruments, providing patients with bibs (paper towels) & cups of water for patients and disposing of cups filled with spit. At the end of each cleaning and/or evaluation, I presented the patient with a toothbrush and two instruction sheets, translated into Creole, on how to brush teeth and general dental hygiene. Of course, I also documented the day with lots of pictures.

Around noon, a 3rd dentist, Francois, made the scene. He had spent the morning in his clinic at the hospital in Pernier. He would now spend the afternoon volunteering with us.

Despite the cramped quarters, everyone honored their own space and the operatory remained remarkably sterile. I kept thinking of “MASH”, one of my favorite movies and TV series. This experience gave me a glimpse into what it must have been like to offer medical care in what some might define as a “hostile environment”. Though the setting was rustic, the atmosphere was anything but hostile. There was a true sense of partnership and teamwork. Laughter and lively conversation filled the operatory. There was also important care given to each patient, including counsel on ways to improve their oral hygiene and more complicated dental issues that could not be addressed during this particular clinic.

Just before the last two patients, around 3:30 p.m., we took a break for lunch. The timing was perfect, as I was starving. We all ate quickly and then Joseph and Falide treated the final patients. We packed everything up and left most of the supplies in Gwo Jean for the next day. The tap tap driver arrived, loaded the few things we were taking to Port au Prince and we headed home.

It had been a good day. We treated about 20 patients. We might have treated more if we had not charged them. However, we felt it was important to set a small fee for the dental care that they received. This also helped to offset the cost of the program. Joseph and Falide treated about the same number of patients the next day. Since then, word of the quality care that the patients received has spread and there is a cry for a second clinic in Gwo Jean. Joseph, Falide and I hope this can happen in the next couple of months.

Joseph, Falide and Francois represent the wonderful spirit of Haitian people and the incredible ingenuity and determination of their generation of young professionals. I think it is very important to encourage their commitment and vision, for they are truly the future of Haiti. Joseph, in particular, has a contagious energy and important understanding of the need to lend a hand to serve the underserved while pursuing one's professional dreams. It is a joy and blessing to work with Joseph and all the special young adults that he brings to his initiatives.