Cambodia… Open Wide !!

cropped lizardGroup PicA Honolulu Dentist on a mission to Cambodia

A lot of things have happened since November… here in Hawaii we get caught up in the holiday season, if you can imagine coconut trees strung with Christmas lights. 

As if the holiday season was not busy enough, I spent all of February off island.  I worked again at the Molokai Community Health Center, and then spent several weeks in Cambodia where I was blessed to participate with the Cambodia Health Professional Association of America (CHPAA) and their medical mission to Cambodia.  Cambodia is one of the world’s poorest nations.  The civil war from 1970 to 1975, the Khmer Rouge regime from 1975 to 1979, and the Cambodia-Vietnam War from 1978 to 1979 virtually destroyed Cambodia’s economy.  Although progress is being made, as of 2007 the latest year UN Statistics are available, 30% of the population falls below the national poverty level. Poverty in Cambodia is overwhelmingly a rural phenomenon.  Over 93% of the country’s total number of poor live in rural areas, 6.2% live in urban areas, with a tiny percentage in urban Phnom Penh. CHPAA’s mission is to provide medical and dental care to those desperately in need. 

Patients came from miles around, lining up overnight with the hopes of being treated

Patients came from miles around, lining up overnight with the hopes of being treated

In Cambodia, one of the free clinics was set up at the Khmuonh Health Center in Khan Sen Sok, a municipality of Phnom Penh and one of the most underserved areas in the Cambodian Capital.  Seen on a first-come, first-served basis, patients came from the surrounding areas, other parts of Phnom Penh and distant provinces.  The need for care is great.  In addition to this clinic, radio and television announcements brought many patients to outlying clinics where part of the medical/dental team travelled to each day.  It was a busy week.  By midmorning of our first clinic day, there were thousands of people lined up.  They came from surrounding villages, overnight and got in line.. hoping for their chance. 

There were 11 dentists total participating in this 3 week clinic.  About half of us stayed at the Khmuon Health Center, and the rest of us, travelled daily to outlying communities.  The day started at 6am with an average of an hour bus ride and each day, we would visit a different location.   I was responsible for making sure that all the equipment and supplies needed for the day was available, and was theClinic set up only dentist who was assigned to the travelling clinic for the entire mission. 

Once there, our first task was to set up the clinic.    

Dental chairs ready to treat patientsAgain, patients lined up with the hopes of being treated were triaged, and the dental patients were sent our way.  Many of the people had never seen a dentist, and were experiencing dental pain.  Unfortunately, most teeth were not able to be saved, and needed to be extracted. 

working on a patientIt was a truly humbling experience.  Poverty rates are high among those whose household heads have little or no education, dental education is non-existent at its most basic level.  Many patients were unfamiliar with the use of a toothbrush and still had fears that an extraction of a tooth would result in blindness.  My heart went out to them and I look forward to returning again.

ItCambodia agriculture is dry season in Cambodia.  It is beautiful and exotic.  On the way to the outlying clinics, we saw some beautiful areas which were dedicated to agriculture. 

Tarantula Dinner

True to form, I love to eat and found the food delicious and different.  Most exotic?  fried tarantulas… quite tasty actually.

             

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Honolulu Dentist does Molokai

I was on Molokai this week for the first time to work at the Molokai Community Health Center– Dental Clinic.  From Oahu it is a short plane ride, and incredibly beautiful, so I wondered why I never went before.  To get there I took a flight on Mokulele Airlines.  Small 9 seater.  It was fast- 20 minutes. No hassles, no long lines.   That should have been a clue of more to come.  

Molokai Community Health Center- Dental Clinic

The Molokai Community Health Center (MCHC) strives to provide accessible health care for the island of Molokai with respect and aloha.  Dental health services are provided by a full time Dental Director, Dental Hygienist, several assistants, and a Dental Receptionist.  Dental hygiene and patient education of dental care are among the priorities of the staff.   I was fortunate enough to be able to participate and see the good work they do first hand this last week by filling in for the director who was off island.  The dental clinic was busy attending to people of all ages, from children to seniors.  We were fully booked each day I was there!  One concern of mine was the amount of dental disease in the youngest patients.  One child at 16 months had the condition referred to as “baby bottle caries”.  This term refers to the pattern of decay in baby teeth caused by allowing infants to sleep with their bottle containing milk or juices etc.  Sadly, Hawaii has a higher incidence of this decay as compared to children on the mainland.

In the “State of Children’s Dental Health: Making Coverage Matter”, the PEW Center on the States gave Hawaii an “F” for its performance in the area of children’s dental health.   Hawaii was the worst overall performer among the fifty states and the District of Columbia.  Auwe!

I was proud to be able to provide care.  The Molokai Community Health Center- Dental Clinic’s priority of education and adoption of good dental hygiene habits, habits are so important to having good oral health.  As a preventative dentist, I also emphasize regular dental cleanings and exams, consistent home care, consisting of tooth brushing, flossing and rinses, and timely intervention for any dental issues.

Kamehameha V Highway (Highway 450)

Molokai is quiet, remote, and beautiful.  It is most famous for the Kalaupapa Leper Settlement, and Father Damien who recently achieved sainthood for the work he did for the people of Molokai.  There is a mule trip that you can take down to visit the historic Settlement that I did not take this time.  Instead, I chose to explore Highway 450 to East Maui.

We planned to head out to Halawa Park at the very end of the road.  Before the trip, we were advised to stop at the Saint Joseph’s Church in Kamalo, established by Father Damien, and sign the guestbook.  It is the second oldest church in Molokai, and worth a stop.  Thus fortified, we were on our way.  I was reminded of the ‘road to Hana’ another famous Hawaii road on Maui.  Highway 450 was curvy, narrow and scary with speeds of 20 miles per hour or less in some areas, and seemed to take forever.  In fact, the trip from Kaunakakai took an hour and a half, but was not very far! 

Highway 450 was scenic and definitely worth the trip.  Along the way we passed the Pu’u O Hoku Ranch which is a beautiful resort that you can visit and also stay at.   Keep on going though, and you will be rewarded with Halawa Bay.   This beach park was definitely worth the drive.  We couldn’t stay long as it was getting dark. Next time we will start early, and bring a picnic lunch!

Back to Honolulu

I enjoyed my week, but back to Oahu and my Honolulu dental officeI could tell that the need for dental care was great in Molokai and am so grateful for the opportunity.  It was such a great feeling to be doing what I love, providing dental care, in such a beautiful place.re almoana