Dental Project Peru – Trip Report
Trip 4 – 10th -17th September 2006
Sharon & Stephen
Day 1
I could hardly believe it when I met Sharon and Stephen at Cusco airport last week. It has been exactly a year since I met them both in Glasgow and we chatted about them coming out to volunteer with the project. A year can just fly by!
I went to Dental School with Sharon. She is a 30 year old dentist from Northern Ireland who has been living and working in Glasgow. I was excited when I heard from Sharon a year ago to hear she was interested in volunteering with DPP. We met in September during one of my visits to the UK. At that time, Sharon introduced me to her boyfriend Stephen. He is a great guy and I immediately knew we would get on well. Originally Sharon was going to volunteer alone but as the three of us spoke and I told them there could be a place for Stephen also (a non-dentist) – plans started to form.
Since then Sharon and Stephen have been busy! The final plan, and the one they are currently enjoying, is to quit their jobs and travel the world for a year! They flew from the UK to Peru and after a week of acclimatization and a bit of adventure, they joined the DPP trip. They have so much to look forward to in the months to come and so much to see and do – but I hope the volunteer trip will be something they remember and enjoy the memories of for a long time.
Fundraising was something else that kept Sharon and Stephen busy over the past year. They decided to raise money for the project by doing a sponsored run. But no ordinary run….. They ran the equivalent of 6 marathons and raised an amazing 6,700 pounds! This is the most any individuals have raised for Dental Project Peru – I am so grateful to Sharon and Stephen for the huge effort they made.
On the trip I was delighted to have the company of Yesenia and Leo again. We make a great team and all work so well together. So this morning we all met. There was a feeling of excitement and fun in the air right from the first minute – I knew this was going to be a good trip!
We packed up and set off early. On the road by 8am as we had a 10 hour drive ahead of us. It sounds like a long time but the truth is it passes quite quickly and with such beautiful scenery and changing landscape – it is far from dull!
The day passed with plenty of good chat, laughs and photos. We enjoyed lunch on the Apurimac side of the Apurimac gorge and were glad to get into the truck after lunch to get away from the sandflies. But the truck would not start! My heart sunk. What could be wrong? Leo and I tried for a while to see if it was the fuses or the starter motor but eventually gave up as the sandflies were eating us alive. So we bump started the truck with a team pushing effort. Off we went – but I was worried…..
We arrived in Tambobamba about 4pm. We still had another 2 hours of driving to arrive in Haquira but thought we might find a mechanic here. No luck. So we tried again to find what was wrong. This time we got lucky as we realized a simple connection had come loose on the bumpy roads. Two seconds fixed it and we were off again!
We arrived in Haquira in the dark. We got settled in at the house we always stay in with our friend Dino. Great to see him again. We were all so pleased to climb into our beds and crash for the night.
Day 2
Up and away by 8am. We all felt rejuvenated after an amazing sleep. Our first village, Ccocha was less than an hour drive. Beautiful morning and spectacular scenery. When we arrived I saw that the little foot bridge to the Health Post over the gully had collapsed. So the first challenge was to get all the equipment down one side and up the other side of this wee river bed. A good team effort had all the equipment in the Health Post and ready to set up in no time. Guido (the tecnico) went off to gather the school children together as we set up.
114 children arrived and Leo did a great Charla in Quechua. Yesenia and I got started with the adults who had been waiting since we arrived. Sharon and Stephen enjoyed seeing the first Charla of the trip and I love to see them taking it all in!
The morning progressed with lots of patients. We saw over 70 children. Their teeth are in a terrible state here – possibly the worst village yet. In each little mouth there was a choice of numerous painfully infected teeth to extract. So sad to see.
After a well deserved break at 2pm we then worked until 7.30pm. A long day. In the afternoon I saw a patient I remembered from last year. Roma (a volunteer from last year) and I performed a surgical removal of a huge cyst from his cheek/lip. It was a shame not to be able to follow up after the surgery but when I saw him today he told me the cyst had completely resolved and there was no loss of sensation. Full recovery! I was so pleased. Well done Roma!
Sharon really got into the swing of things as the afternoon progressed. It is always a daunting experience when a volunteer sees their first patients and realizes the difficulties with communication and quantity of patients. But after a few hours, Sharon was feeling more comfortable and confident and treating patients as if these circumstances were “normal”.
Unfortunately, the electricity was not sufficient enough to power the compressor. So we were limited to hand excavating fillings. Not ideal. Maybe by next year they will have the power sorted here?!
We set up our “kitchen-dining” area in the health post and had dinner. We then found a machine to listen to our hearts (a baby monitor). We were all pleased to hear our own but were worried when Leo’s was nowhere to be heard…….. This caused us much hilarity.
Day 3
Today was record-breakingly busy! We started early – actually before we had even had breakfast! So from 8am through to 6pm we saw over 200 patients.
It was the secondary school children who came first. Yesenia did a great Charla while Sharon and I got started with treatments. I managed to do one nice anterior filling on a young female patient before the flow of electricity became so low as to not power the compressor. Nice save of that tooth though.
Mid-morning another primary school came. Leo did the Charla and about 1pm I went to do the screening. Unfortunately, the teachers in these communities were not very helpful and they children were running wild! Stress levels rise quite rapidly as I try to organize the children and keep them all in one place as well as screening and treating. It was exhausting. When I went back inside, Yesenia was feeling the same as me – exhausted. She works so hard. So I told her to take a break while Sharon and I finished the secondary school childrens’ treatment before lunch. Sharon worked on like a trooper. It is typical – we thought, “only 7 more”. But it turned out to be 7 burly school boys with multiple molar extractions! Thank goodness for Stephen and his deliciously prepared lunch!
After lunch we started on the primary school children as they had walked about 2 hours to get to us and still had to walk home. But there were also a lot of adults waiting so we got to work on them too. One lady came with an extremely swollen right side of her face. She had a serious infection and by extracting the appropriate teeth and giving her antibiotic treatment, we probably prevented a very dangerous situation.
We had a very welcome laugh and comedy moment towards the end of the day. Sharon had a female patient who seemed very anxious when she first came in. Sharon extracted 4 of her lower teeth gently and painlessly. She was so happy. As she jumped down off the chair she started giggling. And she could hardly stop. The laughing was infectious and before we knew it everyone was laughing – Sharon, Yesenia and me. The other 2 patients, Leo and Stephen. No-one really knew what we were laughing at but the female patient continued and we all kept up. After she received her medications from Leo, she came back and told me she felt like she was eating wool (she had cotton in her mouth to stop the bleeding) – this started us all off again. She then took the blanket from her back and dished out toasted corn to Sharon in thanks for the treatment. It was the perfect release of tension!
We got packed up and headed back to Haquira and Dino’s house in the dark. Sleeping on beds rather than the floor is wonderful!
Day 4
We arrived in Llac-hua this morning to hear that they had no idea we were coming. I do not understand because all the other Health Posts have received their letters and word of our schedule. But I did not worry. Victor is the Tecnico in Llac-hua. I have worked with him for 3 years now and he is the most motivated and influential person I know in the area. He truly cares for the people of his community and they trust, listen and respect him. So when he told me he would organize the people and get word to the communities I believed him – he did not disappoint.
By 11am we were hard at work filling and extracting. The crowds were gathering outside and both Directors of the primary and secondary school had come to speak to me and to make a plan of how best to tackle the treatment of over 300 children! Charlas and screenings were underway and with the teachers co-operation we managed to see all the primary school children and waiting adults. We planned to treat the secondary children early tomorrow morning before the schools from the distant communities arrived.
Mid-morning, a 7 year old boy was taken in by his mother. He was blind and was moderately mentally retarded. All our hearts went out to his mother. She was a tiny little lady, yet she still carried her son on her back – he was almost as big as she was. She clearly cared so much for him and desperately tried to comfort him as Yesenia tried to examine him. His permanent upper incisors were erupting over his still present deciduous incisors and so were all out of alignment. A simple solution would be to extract his milk teeth – but this proved impossible. He was too frightened and confused to let us anywhere near his mouth. We all just wanted to relieve some of that mother’s burden. But alas, it was not to be.
Everyone worked hard all day and we finished just before the sun set. Yesenia and Stephen were delighted to finish so they could join in the volleyball game that had been set up on the road outside. Llac-hua has a great community spirit and the people are warm and welcoming. We spent the evening in their company as we talked, played and danced the Hokey Cokey with the children. Stephen was a great hit! He danced and sang with the boys of the village and they followed him around and copied his every move and breath for over an hour. Stephen has an infectious personality and is such a likable person that no language barrier exists when he interacts with people. He entertained us all that night!
Day 5
There was a lot of laughter last night before going to sleep as we tried to catch moths and bugs before they settled down to sleep with us in our sleeping bags. We were lined up on the Health Post floor in our bags – quite a sight.
Up and ready for another busy day by 8am. The secondary school children came as planned and we got to work straight away. A lot of them needed their first or second molars extracted. It is very sad. But we did manage to save a lot of anterior teeth with fillings – that really is a wonderful feeling. Although there were a lot of patients here, there were a lot less multiple extractions than Ccocha!
A group of people brought an elderly man in on a stretcher. All the women were crying and the man’s head was covered by his hat. He had fallen from a tree and had suffered some severe injuries. Victor and his wife were on it straight away. I said to Victor to let me know if I could help – but he seemed to have everything under control and is very capable. The diagnosis was a broken back. The poor man had no movement or sensation in his lower body. They made him a neck and back brace out of cardboard boxes and padded it with cotton wool. He was taken to Haquira where a doctor could further examine him. What a tragedy – what kind of life did this man now have to live?
We continued to see our patients. After the secondary school children were seen, we started on more primary school children who were starting to arrive from a community 2 hours walk away. Victor did a great job of getting the word out in such a short time. Only the children who knew they needed treatment and were in pain had come. No teacher accompanied them – they simply came to us themselves. Amazing.
The drill was going all day as we filled and saved all the teeth we could. We did a record breaking 40 fillings in 2 days!
By 5.30pm all the patients were seen including the two girls that worked with Victor. We got packed up and were sad to say goodbye to Llac-hua. Stephen was given a salute by all his new friends – “Good Morning Doctor”.
Back in Haquira we had a quick and simple meal of Ravioles. Leo showed us a trick how to open a beer bottle with a kick of your foot – we will be sure to practice, very impressed! Lots of laughs and happy to be back in our comfy beds!
Day 6
Early start in Haquira – 5.30am! We had the “Curca Challenge” before we could even start work so we had to get a good start on the day. The Curca Challenge is the adventure of getting ourselves and all our equipment down to the Health Post where the road does not go. We arrived where the footpath starts but there was no-one there to help. But it did not take long before we could see people leaving Curca and walking up towards us. Also, people came from another community and helped with the equipment. So we were all loaded up with lots of helpers and set off down to the Health Post.
It is about a 45 minute walk down and really not too difficult. We are at 3,900 metres so we have to take it easy. It is the uphill we will do tomorrow that is more challenging……
Arriving at the Health Post, my old friend Alicia gives me a big hug. I have known Alicia since I first came to the Apurimac alone in 2002. A good friend! We got set up and were pleased that there is now electricity in town. So fillings were the order of the day!
All the people that helped carry the equipment were first to be seen. They were eager for their turn and we managed to see a lot of adults before the children from the local school arrived. Leo did the Charla for the children and for their parents – this was great. It is so important to teach the adults about oral disease as well as the kids. It is after all, the parents who give the children fizzy drinks and sweeties!
We worked constantly again. I thought we were going to get hammered but we kept things going steadily and everyone was seen by 5pm. We did a lot of fillings and had some nice saves of upper anteriors. I always get great satisfaction from saving these teeth in particular because I really feel losing your smile can affect your life.
Leo headed off before dark to take the truck to the nearest town and sleep there. We have been told it is not safe to leave the truck on the road all night. I’ll take no risks with “Juliana”.
We had a fun evening playing with the local children again. A lot of them were with their parents in the Health Post until 10pm. The government is introducing a new plan whereby women of child bearing age can get “seguro” (health insurance) for basic medical and dental procedures for free. But this was the final night they could do their paperwork. And there was a lot of paperwork! And it is the same the world over – we all leave things to the last minute……
So we played for hours with the children. I almost forgot how much fun a simple balloon can be! After everyone left, we set up camp! Yesenia got a bed, Stephen and Sharon were on the floor, and I attempted to sleep on a birthing table (interesting!).
Day 7
Happy Birthday Stephen! Our first DPP birthday – and one that none of us will forget!!!.....
It was a beautiful morning and Stephen and Sharon took a moment to open cards and gifts outside with one of the most outstanding views. A pretty cool place to start your 33rd year.
We got to work quickly as we realized lots of patients were gathering. My first patient was a wee 6 year old girl. Her entire dentition was shot. All her teeth were black and rotten. She had 6 abscesses in her mouth! She had been here yesterday with her mother but refused treatment – today her dad had taken her and she was much more co-operative! I managed to numb her up and extract all 6 of the infected teeth. She resisted a little but her father managed to persuade her to sit still. We were able to find out the cause of the gross decay. The wee girl had an auntie in Lima who would send her and her little sister big bags of sweeties. They would eat them all! The father brought in the little sister next and her mouth was exactly the same! We managed 2 abscessed teeth for extraction. Explaining to the parents the reason for their childrens’ pain and infection seemed to hit home. Hopefully there will be a change.
We were delighted to be able to give out some DPP-NBPs (DPP New Baby Packs!). Last year a little baby was born in Curca when we were there. The mother had no clothes, only rags to wrap it in. Since then, one of the volunteers on that trip (Murray Kerr) has had his wife and her friends knitting furiously so we can provide warm, clean, beautiful baby clothes to the infants that need them. This trip was no exception! Twins were born only days before and were in the Health Post for a check up. They were gorgeous – a wee boy and a wee girl (possibly now called Sharon and Stephen!). We helped to dress them and another month old baby. Wonderful to see the wee toots cosy and clean. We also left some clothes with Alicia to use at her discretion.
After lunch we treated the final waiting patients. We had got the word out that we could only work until 4pm because we then needed to pack up and get the equipment up to the truck before dark. Leo had gathered some kind people to help us with the chore!
Women, children and men were loaded up. 2 men rigged up the compressor to a wooden beam and carried it up the hill – no easy feat! Leo was ahead with the helpers but the rest of our team was last to leave as we waited for the sterilizer to finish. But by then all the people were away and we still had 4 heavy boxes left. We searched for more people but with no luck. So as needs-must, Alicia “acquired” a horse. The owner was nowhere to be found so we loaded up the horse with 3 of the 4 boxes. It seemed very “tranquillo” and did not flinch as some expert ladies from the village tied the boxes on with Mantas. We headed off – Alicia guiding the horse, Yesenia, Stephen, Sharon and then me.
Everything was going fine until about a third of the way up the mountain the horse went crazy! It reared up and started fighting to get free from Alicia’ grip. She released it and it kicked and bucked and started down the hill. It was coming straight towards Sharon, Stephen and I. On the narrow path there was nowhere to go but we all dived to the left just as the crazed horse tore passed us. It was a very frightening moment. Somehow the horse managed to smash the plastic boxes into pieces with its hooves in an attempt to get free of its load. So as I watched it gallop down the mountain I saw all of my equipment from the 3 boxes fly from behind the animal. I could do nothing but hold my head in my hands as I saw my dental tools get smashed and strewn across the mountainside. It was a disaster!
The 5 of us were all in shock. We had gotten a real scare but were all unharmed – that was the most important thing. But the next thing was – the equipment. We pulled ourselves together and spread out down the path to collect and salvage everything possible. Amongst shards of plastic boxes we found filling instruments, filling materials, metal containers, salami, tea bags, cotton wool rolls, etch and bond, and many many more parts of our artillery.
Unfortunately, some of the larger (more expensive) pieces of equipment were smashed into pieces. The light-cure machine was destroyed for example. There was nothing to do but pick up all the pieces. Once most things were gathered together, most of the village was out helping. But I was still missing 2 handpieces (these are the drills that cost about $500 each). The people were all so concerned and wanted to help. So before I knew what was happening, they had decided to clear the mountain side of the bushes that were impeding our search – they set it on fire!
Within minutes the side of the mountain was ablaze. These men are very experienced with dealing with and containing fires and so we stood back and let them do their thing. There was a moment that it seemed like the flames were spreading out of control and so the nearby adobe wall was dismantled and the dried mud hurled at the flames to douse them. Very effective!
As the flames died down, we all got in amongst the smoking remains and continued our search. It was a fruitless effort but it warmed my heart to see the people of Curca so determined to help us.
We conceded the loss of the handpieces and decided to head up the truck. It was dark by the time we got there with our bundles of smashed equipment. The rain started and so we loaded up quickly and set off to Tambobamba.
We had lost all our remaining food at the same time as the dental equipment. So there was nothing to eat. But the perfect solution was to have a birthday dinner for Stephen of fried chicken and rice. Yesenia and I arranged for a local lady to prepare us some food and we celebrated with beer and a tiny birthday cake Sharon had carefully taken all the way from Scotland. It was a great night with, as always, lots of laughs and great relief that we were all unharmed after our final adventure!
Day 8
The team agreed to get up early and head back to Cusco in order to get the cleaning done today. But unfortunately the fried birthday chicken was to take its toll! Without going into too many details, let’s just say that by the time we got back to Cusco, there were too many fragile tummies to even think about taking on another challenge. But the drive home had been beautiful as always and we all had a joint feeling of incredible accomplishment after treating almost 600 patients, extracting over 800 teeth and doing about 70 fillings!
This was a wonderful trip. The team quickly became close friends and worked so well together and were able to meet the huge demand from the villages we visited. Even a crazed horse destroying our equipment could not dampen this teams spirits!
