We are home!

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Last night in Honduras... :(

Just wanted to clarify, there was electricity and water. However, there were times when it cut off with no warning or notice of when it would come back. --Noha

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"This is my first dental mission trip. Boy, have I been missing out! I was a bit apprehensive about going at first since Honduras is considered one of the most dangerous countries in the world. However, the minute I landed, I felt like I was home. Not home as in LA, but home as in Sudan, where i'm originally from. It was all too familiar to me. Both are developing countries with poverty, no electricity, no water, and malaria. Clinic was a great learning experience. I did a lot of restorative, a lot of extractions and an Endo case (on a cop!). I even learnt how to extract teeth with a single instrument! The patients were so grateful for the work we were doing. I would love to go on trips like this again. Maybe take it back to Sudan or Egypt? This trip was a lot of work; physically exhausting but mentally rewarding. Time to finally relax in Roatan. :)" --Noha

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Day 6

Today was our last day in clinic, definitely bittersweet. Half of us packed up the clinic while the other half did extractions. We eventually finished packing and had 5 chairs doing extractions. Our first pedo  case was really scared, so Dr. Espinoza treated her and we learned some good patient management tricks from her. It was pretty hard to manage and soothe scared patients because of the language barrier. 

Hayley and I paired up and did pedo extractions. We learned that kids who are scared will cry regardless and we have to differentiate whether they feel pain or pressure. An easy test is to see if they are crying even if you don't have any instrument in their mouth. We saw a 4 year old boy with a large abscess and needed 3 extractions, which was really sad because be was so young.   

We gave out a lot if toothbrushes and toothpaste, which they were really happy to get. I took a break and talked to the little kids for a bit, as much as I could anyway with my limited Spanish. Almost all of them asked me if I was chino, to which I responded yes. Understandable considering they probably have never seen an Asian before haha. 

In total, we saw 26 patients and did 32 extractions. It was gratifying to be able to take so many patients out of pain. 

We had lunch at the hotel and rushed to take a van to Valley of Angels.  The road started out very smooth and Hayley mentioned that she was impressed that they must have paved the roads in the last two years. Well, she was wrong, cause we were woken up and tortured with the bumpiest road full of a million gazillion potholes :( Two hours later, we stopped at Cafe de Los Angeles for a bathroom break and souvenirs. We played with the really comfy hammocks and Dr. Espinoza and Dr. Rima ended up getting some to bring home. Dr. Rima said she has always wanted one so was really excited to get one. Michael and Sami reconnected with their inner boy side and were mesmerized with machetes in leather cases and using them to play swords. Boys will be boys, no matter how old they are. For example, the other day Papa Espinoza found a caterpillar in the bag of mamones (really sour fruit) and put one on the table and started playing with it and poked at it with a butter knife while saying "caminar." :) Sami ended up buying two machetes, which goes in line with his ballsy extraction skills that he learned from Dr. Espinoza. We called him Dexter shortly after. 

We did some shopping and got some goodies, like coasters, picture frames, key chains ;), and super awesome selfish one person umbrella hats :) One of my favorites was a shirt that Reemon bought that said "I survived a Honduran mission." So interesting huh?

On the way back we saw fire flies, which were so cute, as Dr. Espinoza describes them. You have to look carefully for them, because they only flash their light sporadically. Almost like don't blink status. Eugenio played music and put on I'm sexy and I know it. Mama Espinoza started rocking out to it and was super cute. Mama and Papa Espinoza are such a cute and goofy couple :) Mama also noticed the moon and told Dr. Rima she mooned her without even knowing what it meant. Like I said, goofy! :)

At dinner Dr. Espinoza surprised all of us with bead bracelets that she got at the Valley of the Angels, which was very sweet of her. We all made a pact to wear them forever and ever and never take them off :)

We ended the night with inclusive quotes that we want to remember about our wonderful Honduran mission experience:

"Rule of the game: Yoonah is mafia"

"Eugenio, why are you such a stud ?"

"Yoonah, are you sure you're not autistic?"

"Fried plantains, fried fish, fried bacon, fried chicken, fried fried fried Forest Gump"

"We're on a mission, nothing is ideal"

Leaving for Roatan tomorrow, the real vacation!!

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Day 5

Exhausted. 

It's definitely been a long week and it was hard to get up this morning. 

Today was pretty exciting though because Dr. Espinoza took Sami, Eugenio and Yoonah with her to the mountains to do extractions. They saw 25 patients and did 30 extractions. They shared their experience and said that the people who live there don't have running water. Yoonah also said that they don't have toilets, but instead have a hole in the ground covered by a toilet. Her story reminded me of what I've seen in Vietnam. They also said that many of them were really scared, more so than the ones we have seen at the clinic, probably because they have never been or even seen a dentist in their entire life. 

Clinic was super busy, we saw 38 patients and did 20+ fillings, prophies, the usual. It was the first day we finally had all four chairs operational at the same time. I was lucky enough to have two patients that came from the village who had never seen a dentist before. They were very scared, nervous and anxious. I used the counting technique, which worked very well. They were sisters and were so cute! It was really sad to see the younger girl's teeth, which were mostly, if not all, bombed out. She was already missing her four permanent maxillary anteriors and needed almost all of her lowers extracted. Seeing her teeth as well as others, some of who actually ask to have their teeth extracted, made me wonder if what we are doing will actually help them in the long run, considering their constant soda and poor oral hygiene habits. Well, we can only do so much and we tried our best to prevent caries from going deeper and taking them out of pain. I think the fact that we constantly come back is good though. The ideal thing would be to have dental care in Guaimaca be self-sustainable, of course. 

In the afternoon, I helped Yoonah with a class I composite. She was very good knew all the steps, which she learned from her awesome mentor Hayley. I also helped Eugenio with a composite restoration. He worked on a young boy and it was his first experience working on a posterior in a small mouth, which we all know can be difficult because the patient constantly keeps trying to close onto the hand piece.

We had dinner with Jenny's roommates Alisha and Helen, who are teachers at the girls' school that I previously mentioned. We had fun chatting with them about being in Honduras, bug bites, and playing mafia. In Honduras, it's not recommended for girls to walk alone after dark. So we walked them home and visited their house for a bit, which was very nice and home-y. They each have their own room and two bathrooms. They said they mostly stay at home on weekends watching tv, doing laundry, and cooking, because there is not much to do around Guaimaca. The house that they stay at is owned by the sisters, and they stay there for free because they work for the sisters. Jenny said her least favorite thing is doing laundry, because they have to wash it by hand, scrubbing it against stone, and she always gets soaked when doing it. They have the cutest and sweetest dog who was very excited to see us. 

 

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Our dental mission has come to an end. Our hearts were deeply touched and softened after seeing the great dental needs of children and adults in Guaimaca, Honduras.
I am so proud of this group of students. Aside from their impressive hand skills, their compassion and willing to serve is admirable! Their mutual support, and care towards each other is exceptional!
There is no doubt they will be great dentists, teachers, and mentors in the future.
I am proud and thankful to my talented group of students!
Our trip is not over yet. We are off to our well deserve rest/ vacation in beautiful Roatan. We will keep you all posted as to how our time there will keep bringing us togethere as a team.

Dr. Espinoza

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Michael, tired of trying to fix a chair to work on!

Laura hard at work!

Instruments and more instruments!!! Work, work, work!

Team photo prior to tuk tuk ride.

Off to do extractions at the base of the mountain. Some kids had never owned a toothbrush.

Dr. Espinoza, tired after a long work week!

Day 4 continued

Sad panda. Tony Parker is so good though. I think he needs to spend less time practicing and more time lifting so he can not be so scrawny and block the big guys. 

Oh! And I forgot to mention that the Eugenio's crush's letter mentioned his companero, or Michael who assisted him. She only mentioned him briefly, probably because she doesn't like chinos haha. 

Anyway, forgot to mention dental stuff haha. Michael and Papa Espinoza spent the whole morning trying to fix the fourth chair/air compressor. Everyday we've always had only three chairs working for a period of time. But today we finally got the brand new compressor that we brought along with us to work! So if all goes well, we'll have four chairs working all day tomorrow, so hopefully be able to do more restorations on each patient and in general. Clinic was busy as always, with 15+ people waiting in line before we even opened. 

Today I did an RCT on #8 which was pretty cool. It was my first experience seeing real pulp, which bleeds! I also helped Sami with a composite restoration, which was exciting for him. He got a little discouraged, but who doesn't when it's their first time working with composite :)

In total we saw 36 patients today!

At dinner, Dr. Espinoza let us vote about whether we want to work half day Saturday or not. Our other option would be to go to Valley of Angels to do some sightseeing and souvenir shopping. Dr. Espinoza and Dr. Rima both voted no with a thumbs down to working Saturday--we have a cute picture of them :) But really they have both worked so hard this whole week so who can blame them for wanting to go on vacation early :) We really have been so grateful to have them both on this trip, from Dr. Rima's esthetic restoration tips to Dr. Espinoza's ballsy extraction skills and sooo much more. 

Dr. Espinoza also told us she's going to the mountains tomorrow with the priest to do extractions. She drew out of a hat to pick who would go, and she picked Yoonah twice. We told her she should buy a lottery ticket since she's been so lucky, esp being mafia all the time. Yoonah, Eugenio and Sami volunteered to go with. Can't wait to hear about their experiences tomorrow!

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Day 4

One word: tired. 

Today we took the tuk tuk around town, which was pretty cute and awesome. We stopped at Marie Pusipan (I think), which is a girls boarding school associated with the church/mission. We usually reserve the afternoon to only treat these girls, so it was pretty cool to see where the girls we have been treating live, eat and sleep. Their school was very nice and Rima got some pics of some interesting fruits/plants. Hayley and Noha bought some jewelry that the girls made to support them, which was sweet. Eugenio also got a special letter from one of the girls that he treated today with two class one composite restorations. She said he was "paciente y carinso," but I think she forgot muy guapo ;) She ended the letter with "I LOVE U!!" Super cutes!

Jenny, the missionary nurse from Nashville, who also picked us up from the airport, joined us for dinner at the hotel. She stayed to play mafia with us and turned tomato red when accused of being mafia, which she was :)

We ended the night watching the finals game, thank goodness for cable in Honduras! Rooted for my Tom Duncan the wholeee time :)  

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Oh! And courtesy of Michael, Sami did the cutest thing when he walked into the smaller room I was working in and asked if there could be no more patients anymore and if we could go to Roatan now, cause he was tired, and it was only 3pm! We should give him benefit of the doubt though, cause he was assisting Noha on her RCT case, which can be pretty boring :)

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Day 3

Last night our water shut off before bedtime, so we had to brush our teef with water bottles, which was pretty interesting. By the time we woke up for clinic, the water was still off so we had to go to the local store and buy water bottles to fill the bottles for clinic. By the time we opened, we already had at least 15 patients waiting to be seen. So it was a really busy morning. We even had a couple of the police militia come in for some restorations and an RCT. I was pretty flabbergasted when I saw one of the police woman's gun on the clinic counter near the sink. Uhhhhh

My first patient was a young woman who needed an FML on #9. She asked if I could also restore #7, but Dr. Espinoza said we could only do one urgent restoration on each patient because we had so many patients to see. So we told everyone who needed more restorations to come back on Friday or Saturday. 

Dr. Espinoza screened a patient for me for an RCT with x-rays. I get to do an RCT on #9 tomorrow, pretty exciting!!

Then Dr. Espinoza gave me a patient who needed #11, 12, 14 root tips and 15 extracted. She was an elderly woman who was already missing most of her teeth. They were pretty hard to luxate so I asked Dr. Espinoza to help me. It ended up being a pretty difficult case, involving bone trimming and sutures. 

My next patient was also an extraction case, also an elderly woman. We had some trouble getting her numb, so ended up giving her several carpules. Right before we extracted the first tooth, we noticed that she was shaking and was cold. Dr. Rima said that can happen after giving a patient epi.  We took her BP, and it was 140/90, expected to be high after receiving epi. We then extracted #22-26, and I extracted my first tooth, which was exciting! The patient wanted 30-31 extracted also, so we told her to come back on Friday as well. I don't think I like extractions that much--too bloody and gory for me haha. 

Mama Espinoza got us lunch from the hotel and it was the first lunch we ever had that was actually satisfying. We had chicken, rice, potatoes and salad with banana soda. 

After lunch I did a #14 MO amalgam, which was pretty easy considering #13 was missing :) Then I did a #7FM with the color matching pretty well. I ended the day doing a prophy on a patient who had #14 extracted, taking one for the team. 

Noha did an RCT on a mandibular canine and Reemon finished his RCT from the previous day. Yoonah did her first injection today as well as four fillings. Sami extracted four teeth! And Eugenio got his feet wet with extractions and prophies. And last and least, Michael did 7 fillings, but only because he stole all my cases, literally. 

We made the boys clean up the spit cups and headed to dinner at the hotel. On the way, we stopped at the market and got some chips and Bacardi to snack on while playing Mafia later. We had dinner while watching a telenovela.  In recap of the day, we saw 41 patients, did 28 restorations, 24 extractions and 10 prophies. Can't believe our time in Guaimaca is half over!

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Day 2

Today Michael and I were responsible for making breakfast, but couldn't because the kitchen was locked and we didn't have the key. Hayley and I walked to the clinic and found the dental assistant, filling out the medical forms for the day's patients. There were already about 5-7 patients waiting outside the clinic to see us at 7:20am, even though we didn't open until 8am. She quickly rode to one of the sister's houses and got the key to unlock the kitchen for us. We didn't have much to eat besides cereal and the toast and PB&J from the previous day because no one came to give us food to cook for breakfast. Nonetheless we ate quickly and went to see our first patients. 

Clinic went really well, definitely a lot smoother than yesterday. We had some problems with the suction on one of the chairs, but were able to find a replacement with Papa Espinoza's help. He's really been a HUGE help, especially with sterilizing all the instruments and making sure we have them to use. In the morning before clinic started, Sister Maria told us she is leaving for  Massachusetts. She expressed her thanks for us coming to the mission to provide free dental care and asked about Stephanie, who started the affiliation between them and ASDA at UCLA. We were able to get a picture with her before she left. 

The morning started smoothly, with Noha pairing up with Sami, me with Michael, Hayley working by herself finishing her RCT case, Reemon  with Eugenio, and Dr. Rima with Yoonah. We were pretty much able to pick up where we left off yesterday, with the only big problem being Hayley unable to find any denatured alcohol. Dr. Espinoza ended up going to the local store and getting some for a few dollars. 

Our first patient was a 9 year old boy who needed a COAD on #30. Dr. Rima told us she wanted us to clean out the decay first to see if it was savable. Seeing how deep the decay was, I asked Dr. Espinoza if she thought the tooth could be saved. She then suggested an x-ray to find out. Taking the x-ray showed all of us that we needed to always make sure to count and identify teeth, especially in patients with mixed dentition. The tooth with the deep caries was actually #Tso we decided to extract it. Upon luxating #T, #S became loose as well, so we extracted both. Michael delivered #S easily, but had some difficulty with #T, whose roots were not as resorbed. With Dr. Espinoza's help, he delivered #T successfully. He did make me nervous when I heard something crack, thinking it was a root tip. After learning about all the things that can go wrong during extractions during our OS course last quarter, I think my biggest fear is losing a root tip and it possibly being forced into the sinus or submandibular space. Overall, I thought it was pretty exciting and can't wait until I deliver my first one. Michael also got scolded for showing the patient the needle, considering he was only 9 years old. The patient was super cute and surprisingly calm for his age. He taught me how to say "tingling," or "dormido." I always knew it meant sleeping, but didn't know I could use it in that dental context. I used it with the rest of my patients throughout the day and found that it was a good adjective to use when determining when patients are numb. 

Our next patient was a young woman who had caries on 8 and 9. She also wanted her diastema closed. I prepped #8, which had a pretty big carious lesion. I then prepped #9, which had an old composite with recurrent decay on the mesial. #9 also had decay on the distal, which I also prepped. Opening the distal of #9 showed me that the mesial of #10 had caries, but I was not able to restore that lesion and other lesions I saw in her mouth because of the long line of patients we had. I was not entirely happy with the final case of restoring 8 and 9, as I think the color match could have been better and I was unable to completely close her diastema given the time and material constraints. 

Michael saw the next patient. The first was an older woman who needed an ML on #27. She originally thought we were going to extract it, but we told her it was a good tooth and could be saved. 

Then we went to lunch and had tuna sandwiches with tomatoes and cucumbers. Several of us stayed to eat the sandwiches while others ventured to the hotel. Shortly after eating my sandwich, Natalie said she saw a worm in hers. I didn't dare look to not lose my appetite. Thankfully none of us who ate the sandwiches had any stomach issues  *knock on wood.* 

The next patient we saw after lunch was a teenage girl with lingual decay on #18. She jumped when we touched the lesion and reported sensitivity to cold. Luckily it was only large carious lesion and she didn't need an RCT. It was difficult getting her numb at first, which we thought was because of the existing infection and inflammation. Dr. Rima helped us get successful anesthesia, saying it may have been because we didn't do the long buccal nerve block. 

Our last patient of the day was a girl who needed #18 O, #19OB, and #20 PRR. Her caries were not very deep and prepping her teeth was almost like prepping virgin teeth. I think it is definitely harder to prep small decay than large decay, because there is more good enamel structure that needs to be removed in the former. It was a fun and easy case. 

For dinner Mama Espinoza made us papusas, which were muy sabroso y delicioso!!! She set up a skillet on top of burning wood in the backyard of the mission/church. She even got us Honduran donuts, which were very sweet and warm just out of the oven. We really are so blessed and spoiled to have Mama and Papa Espinoza on the trip with us. 

Dr. Espinoza also went over our progress for the day: we saw 33 patients, and did restorations, another RCT, sealants, prophies, extractions and varnish. I'm really proud of how much more efficient we have become compared to yesterday. We had a really good time begging for seconds on the papusas and talking about Eugenio and how we want to put him on match.com :)

Of course, we ended the night playing Mafia with Dr. Rima and all of the Espinozas this time.  We had good laughs when we killed off Papa Espinoza for thinking he killed his wife. I hope I'm as cute as them when I'm old :)

Here's to seeing 7 patients tomorrow! :)

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Day 1

Today went surprisingly well for the first day of clinic. It took us awhile to set up because we had a lot of trouble getting the compressors and vacuum/suction to work. The whole experience of setting up chairs really made all of us thankful for having these simple dental necessities back at UCLA that we usually take for granted. But somehow we managed to get them to work, thanks to everyone's help, especially Reemon and Hayley, and started seeing our first patient at 10:30 am which was really exciting. 

Michael and I teamed up and saw an elderly woman who seemed very nervous and anxious. She wanted us to extract all of her remaining teeth, which of course we refused to do. Instead, we restored two class 5 lesions on her lower premolars. Since it was our first patient outside of school, we decided to each do a prep. We anesthetized her via mental nerve block and local infiltration. Michael did the first prep on 28, which was minimal because it was a lesion due to abrasion. I did the second prep on 29, which had some decay. The decay was deeper than I expected, and when I hit a deep part, she winced, which told me she wasn't numb. I then gave her more anesthesia via infiltration and asked her if anything hurt, to which she responded no. I even had Eugenio and Ginny translate for me, but she insisted that she didn't have any pain. A little shortly after she sat up and walked away from the chair. At that point, Michael and I just stared at each other dumbfounded. After talking with one of the nurses, she decided to come back. Dr. Espinoza overheard what she was saying to the nurse and came and helped us with the rest of the procedure. While this was disappointing and somewhat lowered our confidence in our newfound clinical competence, it really made me realize how difficult it can be to treat someone with a language barrier. In retrospect, I think I would have done an IA block just to make sure that she was definitely anesthetized. 

Our next patient was a young male with two recurrent class 3 carious lesions on 8 and 9. They were fairly large lesions under already large restorations. They were fairly straight forward, but it was difficult to achieve good isolation because of constant bleeding from the gingival papilla. Dr. Rima helped us with better isolation by using a cotton pellet with hemodens.  Dr. Espinoza took before and after pics, since it was an esthetic case. 

The last patient we saw was a young girl who needed restorations on incipient caries. Although I would prefer to not restore these, Dr. Espinoza explained that there are no such things as incipient caries here, because they will only grow bigger and we are unsure when they will see the dentist next. All in all it was a good day, but I'm hoping we'll be able to see a lot more patients tomorrow. 

After our long clinic day Dr.  Rima treated us to dinner at the hotel down the street where is is staying , which was so nice and sweet of her. Some of us had chicken, while others had fish. It was definitely the best meal we had all day, since we only had ham sandwiches for lunch. Dr. Espinoza recommended the plantains at dinner, which were AMAZING!! We also talked about what each person did that day, and how we could improve the next day. In recap, we saw 21 patients today, and did restorations, prophies, sealants, varnish, and one RCT. Hayley treated an autistic child, which she said was challenging but a good experience. She said she learned good ways to deal with such anxious patients with Dr. Espinoza's help. She also got the opportunity to do the RCT on a mandibular molar. She also paired up with Yoonah, who got to remove some decay. Reemon and Eugenio paired up and did restorations, with Eugenio taking the operator chair at times doing a class II and local anesthesia. Sami paired up with his mom and did three restorations on 18, 19, & 20. Natalie also got her hands dirty with applying fluoride varnish and assisting when needed. Noha got to do several extractions, explaining that it was exciting, a good experience, but also stressful, saying she she needed a fan multiple times :) 

At dinner, Dr. Espinoza explained that she had been fighting with the nurses at the mission all day because they had neglected to tell the community we were coming to provide free dental care. They had only opened it to the people of their church. We were not happy to hear this because we want to treat as many people as possible, especially those who need urgent care. Hearing this, Mama Espinoza spent the day going around and trying to pass the word around town. We are hoping the nurses will be more open to us treating anyone who needs our care, even if they are not part of the church. 

We ended the night playing several rounds of mafia and had some good laughs. Yoonah was our resident mafia :)

Can't wait to see what tomorrow brings!

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History of the Mission

HISTORY OF THE HONDURAS DENTAL MISSIONS 


The Diocese of Fall River created the Honduran Mission in 2000. The mission is in the town of Guaimaca which is located two hours from Tegucigalpa, the capital of Honduras. Through the health clinic, girls' school programs and other events, the Diocesan Mission aims to help the poorest of the poor in rural Honduras. UCLA ASDA (American Student Dental Association) students will be providing dental treatment to thousands of patients between the June, and September trips we have organized for 2013. The treatment will include, oral health instruction, prophylaxis, restorations, extractions and more. Most of the people we will be providing care to have never had any dental treatment and many do not even have the resources for or understanding of the importance of preventative care. Our goal is to provide treatment to as many patients as possible, but even more importantly, to educate them on proper oral health care. This will enable them to bring what they learn back to their families along with the toothbrushes and toothpaste we will be handing out. Our UCLA mission groups are very excited to be able to put our skills to use for such an impoverished community.
Last year we sent two trips of 14 dental students and dentists each to the clinic in Guaimaca. The 2012 trips were the foundation for our current efforts to improve the clinic, the mission trip organization, and our fundraising efforts. This year, we have received lots of donations from various companies such as P&G, Johnson & Johnson, Brassler USA, Medical Protective, Patterson Dental Supply and more!
Stay tuned for updates while we pack the supplies and prepare for the June trip departure!!!

If you would like specific information about the mission, how to donate money or supplies or possibly participate on one of the mission trips, please email Ryan Brennan, at HondurasDentalMission@gmail.com.