Wednesday, May 23, 2012

Farewell from Coreen...

As I reflect on the past month of the Mexico field study,  a flood of immensely valuable experiences come to mind!  It was not just the clinical skills that I found beneficial but also the unexpected treasures that I picked up along the way as well.  For instance, getting to know the people of San Pancho instilled in me the importance of community!  Seeing how they interacted with one another really left a positive impression on me.  Also, their appreciation for what we had to offer touched my heart!  I was constantly impressed with how grateful they appeared with what we had to offer.  This was evident everywhere we went-from one-on-one clinical treatments to screening in the schools and teaching at the new moms group!  As I observed the way they interacted with one another it made me think of how wonderful it would be if our culture back home could be just a little bit more like the people of San Pancho.  On a side note…overall we found that the blood pressure readings were quite a bit lower in San Pancho than what they are in the clinic back home!  

When we first arrived to the small fishing village everyone greeted us by saying “hola” which means “hello”.  Although they were strangers, their faces lit up when we returned the gesture.  It did not take long before the people we interacted with would greet us with a hug and a kiss on the check-much like the French do.  As I observed the way that people interacted with each other,  it warmed my heart!  There seemed to be a sense of mutual respect towards one another and this trickled down to the children as well.

There was a restaurant that we frequented after the long days in clinic and while we ate together outside on the patio we had the privilege of seeing the children running freely through the streets-interacting with one another.  We would often see little ones riding on tricycles or chasing each other-laughing and simply being children!  It was wonderful!  I was impressed with how well behaved and patient the children were.  For instance, during the first week of clinic at the hospital several of the parents came in with their children and while they were receiving treatment the children waited patiently.  There seemed to be a mutual respect between the children and the adults. 

The clinical involvement was also an incredible experience for me as well.  I was very fortunate to have had the opportunity to see many clients who had tenacious calculus and this provided the opportunity to really deepen my debridement skills.  My clients were very patient and the experience was very rewarding.  Although there were times that my ergonomics “went-out-the-window” this provided me with a greater understanding of the importance of proper ergonomics and positioning for efficient calculus removal.  This experience also gave me a deeper appreciation for what we have back home in the clinical setting!

Overall this was an invaluable experience for me on so many levels!  It was hard to say good-bye to the small fishing village of San Pancho…they captured my heart and taught me the value of community!

Farewell from Merlita...

Good-bye San Pancho, you will be greatly missed. I think I was the only one who cried Friday morning before we left the hotel and the only who cried saying good-bye to our new friend Maria at the airport. I  really enjoyed my trip to Mexico. The last 4 weeks gave me a whole new perspective and appreciation for dental hygiene and it definitely re-sparked my passion for why I chose this profession. It also challenged me personally as I was immersed fully in the culture of San Pancho and make some really great connections with the people there, which I hope will last. 

Prior to leaving Victoria we were warned of “culture shock”, this definitely got me. I may not have been able to speak Spanish and communicate very well with the people but regardless I was able to connect very well with the Mexican culture. Mexico was my kind of place, I felt like I was at home in their easy, carefree, slow lifestyle. Being there I was never homesick, but the moment I left I was homesick for San Pancho…

Signing out, Merlita   

Friday, May 18, 2012

Until next time...

Goodbye, San Pancho. It's been another successful field school. The students have been recognized by the townspeople for the significant work that they did. The town has been very vocal in their appreciation. All of the students have been taken aback by their gratitude and their kindness. Last night, we sat down to a goodbye dinner and said thank you to folks who have helped make it happen. Thanks specifically to Glades whose efforts, hard work, and great attitude made the experience enriching for all of us.

The students gifted Glades with a beautiful dress.

Thursday, May 17, 2012

Last activity of the field school. Oral health presentations and caries screening at the Escuela de la Primaria

Yesterday, we saw 98 children for our second visit at the Escuela de la Primaria. Of the 98 children, 39 exhibited caries, largely on their primary teeth. Each year, we are seeing improvement in oral health status in the children population as well. In 2007 (the first year of the field school), almost all of the children that we screened had decay. This year, only 40% of this population group showed signs. What was also clearly evident was their cognitive understanding of how to prevent caries. They practically knew our presentation by heart, having seen it for the last 5 years! ;-)

We waited outside the school gates as there were award presentations that morning.

A view from across the street. Michelle was feeling a little unwell this morning so she decided to sit down until we were ready. She was back to normal at the end of our presentations.

This is a grade 4 class. While the four students set up the screening kits, Meryl held up the presentation booklet for our presenter.

A few of the Grade 5 students joined us for a group photo at the end of our session at this school.

Taking care of paperwork at the end of the day. Such focus inspite of the surroundings!  ;-)
According to Leandra, "best one-on-one debriefing ever!"  How can we do this back home?

Last day of clinic @ Entreamigos

On our last day, Michelle continues to be focused.
Ada and Leandra taking inventory of supplies.
Xipatzin is a regular and has been coming since 2007.
Last year, he was Shannon's patient. This year, Katie was the lucky one.
Yuliana and Coreen after completing treatment.
Another view of our makeshift clinic...we have already dis-assembled three dental units as we near the end of the day.

Meryl channelling Dianne Gallagher.

Yay! We are done!


Queen lift.

A stop at the Alianza Jaguar office to get an orientation of this organization's  conservation efforts.
Erik Saracho, director of Alianza Jaguar talking to the students about what the organization is all about.

Gone fishing...

Last Sunday, Michelle, Coreen, and Katie asked the best fisherman in San Pancho to take them out to the ocean to fish. They caught a few and left it for the fisherman to make ceviche. Apparently, there were lifejackets on board, but none visible. Hmmm..They all made it back safely. ;-)

On the following Monday, the students made presentations to two separate daycare centers (ages 0-3)  in town. Here, Coreen and Katie are speaking  to about 8 moms, while Leandra, Michelle, and Meryl spoke to about 20 parents at another center. They drew from their experience and knowledge from their community course presentations and they were very well received by all parents!

Tuesday, May 15, 2012

A post from Coreen...

This past week was our first stretch of 8am-6pm full-day clinics! It was incredibly rewarding. The operatories were considerably less ergonomic than what we are used to at the college. However, what lacked in up-to-date equipment made up for in our clients! Each and every one of my clients was very grateful for what we had to offer. One of my clients even gave me a hug after her many hours of treatment! This experience so far has been very rewarding! 

However, it is not just during our clinics that provide an opportunity to learn and grow, our days off have also been a rich array of opportunities as well. For instance, on one of our days off I had the opportunity to take surfing lessons and surf for the first time! I have always wanted to experience this but did not think it was possible until now. Initially I was afraid of trying because I did not know if I could do it and if I did how would I get off of the board without falling? To my surprise I found the whole experience exhilarating...and yes, I did fall off the board...many times, but I did learn how to surf!!! The lesson I learned about this adventure is that in order to achieve a goal you have to be willing to risk falling...If I had been too afraid to fall I would have never learned to surf. This also applies to other areas of life as well...I am still learning!  Some of the other excursions and extra activities that we have taken part of is a bike tour. That too was a bit of an adventure! It was a lot more rigorous than I envisioned it to be. We found ourselves cycling through rocks and sand...up and down small hills out in the countryside of San Pancho. The scenery was beautiful. We even saw horses, cows and goats. Initially, I was nervous about cycling through terrain that I was not use to but I took the plunge and it proved to be a wonderful experience! Some of my classmates also went horseback riding on the beach one day! The natural beauty and simplicity of San Pancho makes up for the long hours of hard work in the clinic setting!  One thing we did that was a little less adventurous yet still fascinating was the bird watching tour...I was not sure if I would enjoy it, however, our tour guide was an incredible source of information on the local birds and his knowledge and joy for birds was contagious!  It made me realize that if I stop and take a longer look at the things around me there is more than meets-the-eye.  I would not normally notice many of the beautiful birds that he pointed out to us.  This principle can be applied to other areas in my life as well.  If I take the time to really notice the things around me, I can see the beauty within. 

Another memorable excursion was a trip to Puerto Vallarta for a food festival which was a fundraiser benefitting a number of non-profit organizations and appeared to be a success as over 1,500 tickets were sold! There were musicians and dance groups that volunteered to make the event entertaining. The food was presented by many of the fine dining and other food establishments from the surrounding area of Puerto Vallarta. Overall the food festival was a beautiful display of talent and goodwill!
 I would normally not notice on my own one of the non-profit organizations benefiting from the fundraiser is Entreamigos, which is a non-profit community centre situated in San Pancho! Entreamigos is where we have set up our dental hygiene clinic for the remainder of our clinic time here in San Pancho. It is an incredible community centre that provides a plethora of activities for the community. Its mission statement is: " increase learning opportunities for children and families through the implementation of educational programs based on principles of integration and collective community action.” and its vision is: "to provide the children and families of San Pancho with the skills needed to contribute to their changing communities in a positive way.." It is quite the success because it is funded primarily by private donations and also relies heavily on the support of volunteers

So far this field study has been full of learning experiences both inside and outside of the clinic setting.  It has also reminded me of how important it is to give back to a community, whether it be volunteering or sharing one's passion!     

A post from Katie...

Our experience in Mexico providing dental hygiene services to the local residents has been a journey to say the least.  I knew that I was signing up for an opportunity that was out of the ordinary which will test my  adaptability, cultural competence, clinical skills and, as Ada reminded us all, our flexibility.  Needless to say, this opportunity definitely challenged me both personally and professionally. 

Ada forewarned us of  the meaning of “Mexico time”, and that although it sounds nice, it took some adjustment to accept and go with the flow of Mexico. My days in Victoria revolves around knowing exactly what time it is at all times and the idea of "time" has been, and continues to be, a personal challenge for me – especially since not everyone seems to adhere to the concept as I know it. 

Professionally, this experience has challenged me to stay focused regardless of the working conditions.  Poor lighting, scratched mirrors, mis-shapened instruments, less than ideal ergonomics and of course the language barrier are just a few of the hurdles that our team has faced.  The most challenging and frustrating part, however, is coming to terms with the fact that I can’t do more for the people that I am seeing and that we have to turn people away because our clinic days are booked solid. It’s hard to see such a caring and cohesive group of people suffer from a lack of resources.  

For instance, the other day I screened a young 14 year old girl whose lower 6-year molars had been completely "bombed out" with decay and both pulps were exposed.  She didn’t complain of any pain, but as a high school student she was concerned about the large cavities between her top two central teeth that were clearly evident when she smiled.  I helped her understand how cavities developed and how she could prevent them and showed her how to effectively remove plaque from her teeth. I also gave her a fluoride varnish treatment to help make her remaining teeth more resistant to decay Her needs were definitely beyond my scope of practice, but hopefully the knowledge that I shared with her gave her the foundation to make positive behavioural changes for a healthy future.  

Monday, May 14, 2012

A post from Michelle...

Upon reflecting on my time spent so far in San Pancho, I feel that my skills have improved significantly over the weeks that I have spent here. We have been immersed in clinical practice for the majority of long appointments during our long days at the hospital and the community center. This has been a rare and rewarding opportunity to receive a great deal of coaching, and to be able to apply new skills immediately has been extremely beneficial for me. The first time I realized what a fabulous opportunity this field school is, and that it was the right decision for me to have taken part in it was when I completed a class 3-2 client in 4 hours. The jump from taking up to 6 appointments to finish a moderate to difficult client, to finishing one in less than half that time was a major confidence booster. 

Although I have found the time limitations that Ada has placed on us to be very challenging, I am really proud of myself for managing to keep up with them. When I compare the hours I might be spending completing a single client at home and the schedule that we need to conform to here in Mexico, I am glad that I came because I think it is helping me to be more prepared for private practice settings. Aside from the skill improvements I have been able to gain, I believe that seeing how in need some of the locals are here in San Pancho reinforces that I have made the right decision to participate as well. Although in our clinic back home we do see people in need, we have seen some very complex cases here and since these people have much less access to care, I feel really good about being able to spend my time and energy here where it is clearly needed. Our patients have all been so grateful, and it is so rewarding to be able to feel as though you are making a positive impact on the lives of those in need.

A post from Meryl...

Giving back to communities that are in need has always been something that I have been passionate about, which is the number one reason why I chose to come on this field school in the first place. Dental hygiene services is not available in San Pancho, so to come here and bring this service to the people of this town has been amazing. 

After being here for a few weeks, I realize that most of us take our oral health for granted, but here the people are so grateful for the work that we provide for them. I don't want to take away from the great clients I’ve seen back at Camosun who appreciated my work, but here it’s a whole other vibe. It’s an amazing feeling to hear that everyone is so grateful for our work, but I’m equally as grateful just to be a part of the community and doing what I can to help.

Not only did the above indicate to me that I made the right choice in coming but also the improvement I’ve witnessed in my own clinical skills has been a huge indication that I made the right choice. Even after the first day working at the hospital I could see the change and after nine grueling days of debridement, I have definitely honed my skills and picked up my speed. Can I just say, hello private practice, here I come!

50+ clinical hours at EntreAmigos Community Center

Unlike the very first field school, this year we saw a greater variety of “patient types” in our clinic, ranging from simple to very complex. We saw this as a positive change, as that meant that many of our returning patients have shown improvement in their oral health status. We also saw an exponential jump in the number of young adults lining up to take up any available chair. Was this coincidental or was it a case of increased awareness and valuing of oral health? Whatever the reason may be, we were more than happy to accommodate as many as we can.

The clinic sessions provided good learning for our students. They were able to hone their instrumentation skills on the more “difficult” patients, as well as their time-management on the simpler ones.  Additionally, they learned to adapt to the challenges of working in an environment that was ergonomically difficult accompanied by soaring afternoon temperatures. In the end, they showed their true mettle and forged on. Each day was exhausting, but emotionally satisfying. Each day we all learned something new that we will take back with us and each day we found that progress comes in waves. Overall, everyone is most impressed with our students work ethic, compassion, dedication, and good humor. Camosun should be proud!

Today, we start our last week in San Pancho with commitments for one more clinic day at Entreamigos, presentations at two day-care centers, and the primary school.

Set up time. We used whatever resources were available to us. The HUGE spider that jumped out of one of  the plastic chairs during the set-up scared Michelle enough for her to leave the building until we were able to "take care" of the scary arachnoid.

Michelle recovered. Here she is still red-faced helping Meryl out setting up one of the tables.

With Glades help, we did it. We are ready for our 5 days of clinic. 
The "Smile Project" is one of the activities at  Entreamigos in the month of May.

A new puppy!

A new baby!
Nutrition break. Our host coordinator does it all.

While waiting for mama, she fell asleep.

Lunch break!

Tania and Meryl. Rie: I took this picture for you! Tania is now 10 years old and doing very well. 

Closing time. We were responsible to make sure everything is locked up as we were always the last ones there.

Well, at least Leandra's back is straight! 

Get out of that position quick, Coreen!

Yes, you have to complete your paperwork, Leandra!

At the end of another day. Everyone was still in good spirits! Work it, Meryl!
Yoga pose by Leandra. Fashion pose by Michelle and Katie. Just take the picture already pose by Meryl and Coreen.
Sterilization center. 

We lost many.
One of the many young children that came in on their own accord wanting to be seen.
Coal miners? No. Charlie's Angels? No. It's Meryl and Katie ready to start another day.

Michelle found the smallest chair in the building and made it work.

Had to join in on the fun!

It is 7pm Saturday night and the last of our 5 day session at Entreamigos! Well done, Camosunites!