A Fish Out Of Water

A Fish Out Of Water


Today I went to Wentz Medical Clinic for the day to do dentistry in their “clinic”. I use that term loosely because there is one room with a dental chair and very few dental instruments. There is no dental assistant. Thank God, Dr. Ken, one of the part-time dentists there was there to help me. Bonnie ended up going back to the Loving Hearts Baby Home and as the day wore on I became jealous that I wasn’t holding those precious babies all day!

Dr. Ken is a fantastic dentist given the conditions within which he works. Although his accent was thick and culturally, Ugandans are very soft spoken compared to us loud Americans, we got along well. He warned me that they “improvised” a lot due to lack of funding and supplies.

This, of course, was the understatement of the year. This place makes the Free Clinic look like a state-of-the-art facility. There is an x-ray machine but I don’t know why, we didn’t take one x-ray all day. As far as I can tell, no one gets one. They even have a computer (I think the one I used to own in 1990- j/k) but I wouldn’t see a need for it since we didn’t turn it on.

There are few instruments and once they are used, they soaked in water in a plastic basin in the sink until we run out. Then they get sterilized. I wasn’t invited to see the sterilization area (hmmm…) but the instruments came out hot so something was done to them. There is no bagging of instruments, no wiping down between patients, no cold sterile and no patient bibs. In addition, we literally used the same handpiece and bur all day on everyone. He used my Lysol anti-bacterial hand foam to wipe it down between patients, I think mostly to appease me. We also used the same 3 plastic suctions tips all day (remember, there is no cold sterile so they just soak in bloody water in between patients).

There is no articulating paper, just bite and grind. There is no floss. There are no toothbrushes (only the ones I brought). The toothpaste I brought was prescribed as a fluoride treatment. Teeth that would have been surgically removed in the US are “man-handled” until they come out.

I did a root canal - there is no rubber dam and the endo files have caked on debris from previous use. If you feel pain during treatment, that’s too bad. There isn’t enough anesthetic for you to get more than one injection. In fact, you’re lucky that you got one at all. Many patients had work done without being numb (not by their choice).

Did I mention that the suction apparatus barely works. It’s more for looks, I think. The overhead light went out mid-day. Luckily, I brought a camping headlight to illuminate the working field. After lunch, the dental unit stopped delivering water to the handpiece and the air/ water syringe but that didn’t phase Dr. Ken and it didn’t stop us from doing fillings the rest of the afternoon.

Needless to say, it is SO DIFFERENT here. I asked Dr. Ken to alternate procedures with me so I could learn from him. He stated that he’d prefer learning from me but then acquiesced when he started to gather that, as a spoiled American dentist, I was completely out of my element.

In terms of the overall experience, I realized how wasteful we are in the US. They use EVERYTHING here, even when it’s unusable. The money just isn’t here to live or practice any other way. Dr. Ken loved the gauze I brought but used only one 2X2 until it was barely recognizable. I offered him more but he refused. Whenever I mixed IRM for him, which they use as a base under amalgam fillings, he told me I mixed too much. Mind you the mix I made was about ½ of what I would have mixed back home.

I find myself feeling guilty that we have so much and are so wasteful with what we have. Considering the treatment environment and experience, I also find myself awed at how grateful our patients were that we would see them!

Back home, we practice within medico-legal considerations. In Uganda, you get what you get and you wouldn’t even dare question the doctor. In the US, the doctor gives you all your options. In Uganda, the dentist tells you what you’re going to get and expects no crying or carrying on. We cater to our patients much more in the US.

Overall take home message today…thank God each day that you have access to the caliber of care that you do. Thank God that you have choices. Thank God that you live in the land of plenty and consider donating to those who are not as fortunate to have been born on your continent. We have it good!

Tomorrow we will take a 2 ½ hour bus ride to another town where there is a big pediatric AIDS hospital. We will be delivering blankets to the kids and loving on them. If you’re like me your probably wondering why they would need blankets in Africa. Isn’t it hot?!

The weather here has been great. It’s not too hot but very humid. Today it rained on and off all day and tonight was very cool. Bonnie and I both put long sleeves on!

We will be spending tomorrow night in the town by the hospital so, we won’t have internet access. I’ll post again in a couple days.

Thanks for following our journey!