Clinics in Cape Verde
Today was a travel day for us. We awoke at 4:30 in Mindello, the capital city on the island of Sao Vincente. Though most islands have airstrips, Sao Antonio does not; thus we made sure to assemble our gear and make our way to the ferry terminal.
Sao Antonio is breathtaking. Desert mountains meet the sea. I'm told "it's like the Amalfi Coast without the tourists."
Our leaders chose this island because it is the most remote and the most in need of our care.
Our worksite today was a school situated across the street from the ocean. Though we travelled today we were able to schedule a half day of work. Of the 190 patients we were promised about 150 showed up.
The kids are great looking with beautiful smiles that are hopefully healthier when we finish our work.
Our team is top notch with both dental and non dental volunteers taking their jobs seriously.
Barbara and Cheryl handle sterilization.
Adam writing his case notes. (His patient gave me a thumbs up after this picture)
Kim is reassuring her patient after an extraction.
Jeff, who like me is an orthodontist, is finishing a procedure.
All in all, it's been a successful first day. 'Atelogo' for today. More about how we came to be in Cabo Verde in tomorrow's blog.
Today we visited the central school in Ribera Grande. The outer courtyard is covered with a beautiful flowering tree. Noticing that I was admiring the tree, a teacher brought me to the second floor to get a better view of its flowers.
And this is very much who the Cabo Verdians are....people who will go out of their way to show kindness.
Like this woman, who doesn't know her exact age, only that she is more than 80 years old. She was the caretaker for the school.
So, why are we here? Well interestingly, Bob and Purobi, the leaders of KIDS read about Cabo Verde on a TAP flight several years ago. This led to an assessment trip during which they found a moderate need for dentistry here. Oops! The need for dentistry here is much greater than that.
But as happens on many of the trips, fewer patients materialized than were promised. The new school directors forgot to spread the word. We were able to see 300 patients though, not bad for an "off" day.
Happily, we were able to negotiate the winding roads and made it home safely, ready for whatever tomorrow brings. Ok, a couple more pictures if this beautiful place.
Today we saw patients down the hill from our hotel in our adopted town where we've come to love the people, restaurants and the waterfront.
We are in the mid afternoon having seen some 433 plus children for preventative treatment and education and another 72 patients who required extraction and/or restorations in addition to preventative work.
We are seeing many fractured front teeth and my curiosity is piqued. I will have to bridge the language barrier to find out why this is so common. My best guess is this is a combination of protrusive teeth, physical activity combined with a lack of orthodontics and mouth guards. Soccer is after all, a national sport here.
Though I primarily do exams, I was able to restore two fractured front teeth on a 14 year old girl. She was extremely nervous at first, possibly not understanding the fuss over a couple of broken teeth; but she was very grateful when she realized she could smile with two full size front teeth.
When we arrived here by ferry we were greeted by a small proud puppy who could only be about 8 weeks old. He was thin and wobbly and his puppy enthusiasm did little to hide how sick he really was. Our lead dentist for the trip, Kim Baer, decided to rescue him. And he joined us for the ride to our hotel. Last night, after several days of waiting, Rocky, so named because "he was down and out for the count," was finally examined by the island's vet. Good thing he was, the little guy had 46 "live hitchhikers", not including common ticks, removed from his body. Over the past couple of days we've worked hard to fatten him up, and we're pretty sure that with the vets care and his medications on board he is on his way to a healthy future.
Antonio, a twenty something Cabo Verdean tattoo artist, who is raising a beautiful young girl has been our host for the week. Though he gets no compensation, nor has any formal position in the town, he and his friends have volunteered to help us providing translation and logistics for the week. He has also agreed to provide Rocky with a home when the vet finishes his treatments.
Our adopted town, Sao Antonio is an interesting place. We are sitting in the northern most peninsula of the northern most island of the Cabo Verdean chain. It's hard to imagine the vastness expanse of the Atlantic Ocean to the north and the west. The school where we are seeing patients today is only a quarter mile from the ocean. If you listen very carefully you can hear the surf as it meets the rocks. The cool breeze has a faint sea smell. It provides a natural air conditioning when you sit in the shade. When I moved my chair into the sunny courtyard on a break, the locals broke into laughter. No one here sits in the sun. It's far too strong.
It's hard to tell how the people here support themselves. Tourism may be the main industry, but it is minor by any standards. We have met fishermen, shop keepers, road repairmen and city and government workers.
But the roots in this community run deep. There are words of wisdom written on the school walls. "Alumni, take care of your school," and "Fathers, visit your school often." This good advice seems to be working.
Today we left the jagged seaside and drove up winding mountain roads into soft cotton clouds. I had wondered where the vegetables on the island came from, and it became apparent as we passed hillsides that had been terraced into farmable land. We marveled at the workmanship and effort that must have been put forth to built so many retaining walls. The terracing stretched on for miles.
Leaving signs of civilization behind, we continued on these cobblestone roads into the vista of bright sunshine and desert like greenery that awaited us higher up the road. Mountains that had seemed so tall from the seaside had peaks that barely protruded through the clouds that stretched below us. We passed solitary small farmhouses with goats, chickens and an occasional donkey.
Some thirty miles later we arrived in Lagoa on a dirt road that wound its way through one room homes with a regional school nestled between them.
Today is Sunday so some of the patients that we saw walked here yesterday and slept on small mattresses, unable to take the school buses that run during their regular school week. The mattresses sit this morning stacked in a corner of the room where we are doing dental exams and applying fluoride.
As we have seen over the past three days, fewer children are requiring treatment this year than last year. The worst teeth were removed last year and the fluoride and education programs are beginning to bear fruit. We actually hope that we will not be needed here in another three to five years.
But volunteer dentistry in foreign countries is a complicated thing. We had high hopes for Mongolia and had predicted a similar timetable for success. But the same government that had invited us back for a second year after an incredibly successful first year changed its mind two weeks before our departure date and cancelled our trip.
That's why we visit so many countries and why Purobi and Bob spend so much of the year scouting third world countries for places that need our help.
Today we saw 146 patients for preventative treatment and 46 for restorations and/or extractions. And that will be it for these kids. God willing we'll return next year, renew our friendships and take them out of pain!
This morning we returned to the mountains. But following a different route today, the majestic Acacia trees of yesterday were replaced by small banana and sugar cane plantations. I made a mental note that this would heretofore be called the "sugarcane valley" when, in the future, I remembered the day and told stories of our experience in Sao Antonio.
The road was less steep and the rocks and terrain had a lighter brown color than the majestic rust/grey peaks that rose around us yesterday. It was no less beautiful, just different.
The children today are also no less beautiful than the ones that we saw yesterday. They have African and Portuguese blood. And it's as if God said to them 'you have to live in a barren place, therefore you get to choose the most beautiful facial features that you want for yourselves.'
But there is a significant difference in this community versus yesterday's village. Living in a less remote valley, that serves as a conduit to the other side of the island, there is more commerce here than in yesterday's village. And it shows, the uniforms are cleaner and the girls have more intricate hairstyles; many adorned with beads.
But nevertheless, the caries rate is still high here. Too high. It's 11 am and we've seen 231 patients. 51 have required restorations and/or extractions giving us about a 22% caries rate.
Upon arriving here, as I waited outside for the clinical room to be assembled, I sat next to a 7 or 8 year old girl who was drinking from a bag of sugar water. Not that this doesn't happen at home. Rather, the counterpart to the plastic bags that we see here are fancy cardboard boxes and aluminum cans in the US. But here, and even sometimes in the US, this combination of sugar, poor access to dental care and inadequate home care, are a recipe for disaster.To combat this, we have recently begun bringing parents and educators into our patient education room in the hope that we can break this cycle.
And somehow we now find ourselves at 2:30 pm. We have seen a total of 411 patients, 84 of whom required extractions or restorations. The caries percentage remains too high at 20%. But we are hopeful that we can make a change. Bob just met with the assistant president for this part of the island. He explained the numbers. By weeks end we will have provided about $750,000. work of dentistry to the children of Sao Antonio, Cabo Verde. The assistant president was astonished at first, but with a bit of explanation he came to understand how fortunate he was that KIDS has chosen this region and these children to benefit from our efforts.
One more day to go and we'll return to the comfort and chaos of our regular lives. And as always we'll be happy to see family and friends and of course, our dogs. But we'll soon start counting the days until our next dental volunteer adventure.
Yesterday was our final day of seeing patients. I had hoped to write about our experience last night but the local government threw a small party for us and by the time we returned to the hotel, we were completely exhausted.
The party was fantastic though, allowing the locals to express their thanks and pamper us with their local dishes. We were told how the Sao Antonians could not believe that outsiders would come and provide service like this for them.
Somehow, as has happened before, I was asked to speak on behalf of our group. I blithered on about the people, the beauty of the country, etc. ... at some point Eli Davidyan whispered to me "enough already, tell them thank you for trusting us with your children!" Of course, I dutifully followed his advice, received a round of applause, and in the process made certain that by using his words my role as team spokesman would likely be renewed.
When we treat children, it is never about the numbers. But I would be remiss if I didn't discuss what we accomplished yesterday. Our small team saw 659 patients with 118 requiring restorations or extractions. And it was hot. For those of you that have joined us in Cambodia, it was Cambodia hot.
As you'll see in photos below, our patients arrived in very large groups and had to wait to be seen. Our last group were teenagers around 14 to 16 years old. Unbeknownst to us, these kids had breakfast at 7 am, no lunch, and exercise class before their afternoon appointments. Likely dehydrated and overheated, two of the girls began to faint after their dental procedures. A big thanks goes out to Giel a 22 year old Cabo Verdian, who was celebrating his birthday yesterday. He sprinted across town and bought fruit juice for our patients.
It did its job reviving the girls and was used as a preventative measure on the remaining kids. Had we known, we would have fed them, we've certainly done it before in other countries.
Yet despite this bit of excitement, it was a terrific day and a fitting end to a special week. On all of our trips we encounter challenges, yet with a team of like minded dedicated individuals, problem solving fills us with with pride and not regret. And that's one of the many reasons that I am drawn to KIDS.
Special thanks have to go out to Antonio, Ivan and Giels, our three 20 something Cabo Verdian organizers, translators, heavy equipment movers and humorists. They are three very special people. And also thanks to Isabelle and Manuela, two women from Lisbon, who helped in patient education, logistics and anywhere else they were needed. And, thanks of course to our team, and specifically Bob and Purobi! As Adam said during our final team meeting, KIDS is successful because Bob and Purobi set a standard of excellence at the top that challenges the whole organization to be just as good. I couldn't agree more.
And recharged from our experience, our KIDS team will disperse and re-enter our lives anxious to tell stories about this trip and apply our recently learned life lessons to our daily life.