A Short Productive Day

Though it's only 1:30, our day is complete. We started early and by noon had already seen well over 300 patients. Two-thirds of our patients only required fluoride treatment and one third required extractions, and often multiple extraction of teeth. Don't get me wrong, the two-thirds who only got fluoride had cavities too, but we had to make decisions regarding the overall best dental choice. Without the ability to place space maintainers,  the over-extraction of teeth could lead to severe malocclusions and their resultant problems. I feel a great deal of responsibility making these judgments, it's so much easier with X-rays. 

This village is known as Tall House Village. It is likely a reference to the stilts upon which these houses sit. Interestingly, these children have cleaner clothes and healthier teeth than the patients yesterday. It's probably because the patients yesterday were new to the program. 

As a group we are working well together. Each third or fourth year dental student is assigned to an experienced dentist. The non-dental volunteers are enthusiastic and enjoying getting to know the Khmer culture. Jamie and I are particularly proud of Michelle and Carol, who we brought with us. Michelle is both a friend and an employee. She joined us last year and is a skilled veteran. Carol is a newbie, but she is a quick learner. And as a part time camp counselor, she taught the children how to sing 'Head, Shoulders, Knees and Toes' while they waited to be seen. 

Though we are exhausted, we are feeling very satisfied with our efforts. I have said it before, the Cambodian people area beautiful culture and the children, in particular, are so deserving of our efforts. 

Returning to Prey Veng

It's 5 am and we have assembled at Smiles Restaurant which adjoins our hotel.

Yesterday, we completed our first day of work in Prey Veng Province, near the border with Vietnam. After work we travelled three hours to our hotel, heading north and paralleling the Vietnam border. There were many homes along the route, a major highway in this country, though it would be a secondary road at home. The houses were raised up high on stilts to protect them from the floods of the rainy season.

The roads, mostly paved, were filled with motorbikes and slow moving trucks.  Our caravan moved quickly though, with the horn constantly warning the slower traffic of our intention to overtake them. I had to suspend my concern for safety and convince myself that 'this is how it's done in this country.

In the van we talked a bit and dozed after a full day of work. We had returned to the monastery in Prey Veng where where we had worked last year. There were many familiar faces. Though the older monks had moved on to other monasteries,we did recognize many of children who attend the local schools. Returning children have paperwork from their last dental visit. It was encouraging to see their improving dental health. Yet some of the younger and newer patients had mouths full of cavities, making their teeth almost unrecognizable. 

Sadly, there are limits to what we can do. The need to make good treatment planning choices for the children is multiplied by the fact that there is little  follow up in the event a tooth doesn't react the way we hoped. Without drills, we are best prepared to extract  painful carious teeth and sometimes clean and patch small cavities. But we are also limited by aeveral things: knowing that baby teeth are important in preserving space for adult teeth; we can only anesthetize part of the mouth at a time; and we need to leave enough teeth for the children to be able to eat. 

Still, we rest assured knowing that the children have benefited from our visit. We have renewed our acquaintances and made new friends.