International Volunteer Dentistry: ICDImpactAround the World
A Presentation of the InternationalCollegeof Dentists USA Section 2024 Annual Convocation
Francis G. Serio, DMD, MS, MBA, Dr. Pub Service(Hon.),FACD,FICD,FADI(Hon.)
Founder and Director Emeritus DominicanDentalMissionProject
2023 USA ICDHumanitarianAwardrecipient 2015ADAHumanitarianAwardRecipient 2004AAPHumanitarianAwardRecipient Diplomate,AmericanBoard ofPeriodontology
InMemory of Dr.MichaelPerry,1973 2016
Commercial Disclaimer
Why is the ICD interested in these activities?
WhyistheICDinterested?
College motto is Recognizing Service and the Opportunity to Serve.”
Get the word out” to more locales regional meetings.
Complimentary to the efforts of the ADA and Health Volunteers Overseas.
Become a go to resource for those interested in getting involved but do not know where to start. Leverage the experience of Fellows of the College.
The Course
Who is in the room?
The questionnaire
A few words about conditions around the world
Sample projects
Volunteer opportunities
Q&A
Party time!
Who is in the room?
Letsgetstartedoral health conditions around theglobe…
http://issuu.com/myriadeditions/docs/flipbook_oral_health
http://www.fdiworldental.org/media/77552/complete_oh_atlas.pdf
Reorienting ourparadigm: Shifting thinking to the local context.
Other fluoride sources
Topical fluorides gel, varnishes, rinses. Need personnel.
Fluoridated water expensive. Where to the locals get their water?
Fluoridated salt inexpensive, effective, controversial.
Remember it’s context!
Cultural effects of facial deformities.
Cultural effects of facial deformities.
Majorsurgicalefforts
Global Health Outreach
Operation Smile
Smile Train
Others
Annual US dental careexpenditures: $142.2billion in 2020
Why Volunteer?
The reasons are as varied as the volunteers are.
Desire to give something back….or pay forward.
Realization that there is more than going to work, driving the kids to soccer practice, catching that trophy striper, or lowering that golf handicap.
Be part of the solution, not just part of the problem.
Interest in traveling to new places, meet new people, and do something worthwhile at the same time.
Why Volunteer?
Support a church mission or humanitarian service organization.
An interest in sharing knowledge, skills, and experience with international colleagues.
The desire to participate based on experiences related by someone with volunteer experience.
It
s just a fun thing to do!!!!
“From
everyonewhohasbeen givenmuch,muchwillbe demanded; and from the one who has been entrusted with much, much more willbe asked.”
Luke 12:48
The Nature ofVolunteer Activities
Traveling vs. touring.
Having a lasting positive impact on the community, whether at home (e.g. Habitat for Humanity, Missions of Mercy) or abroad.
“We” projects vs. “us and them” projects.
Engage the locals in any project. Key to sustainability.
Brocher Declaration
Brocher Declaration
Brocher Declaration
Brocher Declaration Principles
Mutual partnership with bidirectional input and learning
Empowered host country and community define needs and activities
Sustainable programs and capacity building
Compliance with applicable laws, ethical standards, and code of conduct
Humility, cultural sensitivity, and respect for all involved
Accountability for actions
Brocher Declaration
The nature of the volunteer
Leave some of who you are at home your ego, your impatience, you know what to leave in the airport parking lot!!!!
Remember that it isn t the first rodeo for many team members and locals, even if you are on a horse for the first time.
Preparation easy to be prepared for the project, more difficult to be prepared for the location.
Qualities ofDentalVolunteers
Culturally sensitive remember, it s context.
What if the power goes out?
Flexible be prepared for the what if s….
What if conditions are not as advertised?
What if the equipment does not arrive or does not work?
Patience.
Able to relax.
Think creatively.
Willing to share knowledge, skills, and experience with others.
A sense of humility.
Start young.
The nature of volunteering understand the contextyou are in,not the context from which you came.
Challengesonthehomefront
Preparing your practice for the project.
Make the project part of your practice.
Roles for staff members.
Preparing your family for the project.
It is your idea but the rest of the family has to be on board.
Could make it a family affair.
Being home but not present.
GetTheFamilyCommitted
Challengesonthehomefront
Returning from a project.
No one will mistake you for Mother Teresa. Plenty of others have done what you have even if it is your first time.
Don t be disappointed if people aren t as interested in your adventures as you expect or you think that they should be. Those most interested are those who have walked in your shoes.
Cross Cultural Issues
CulturalKnowledgeand Sensitivity
Cultural Similarities and cultural Differences
Cultural Values
Cultural Beliefs
Cultural Learning
Cultural Behavior
How do they see you and your culture?
Culture Shock
Initial euphoria at being in and functioning in an alien environment.
Irritation and hostility at the situation and conditions. This can be especially pronounced when tired or sick.
Gradual adjustment and comfort with the local situation.
Adaptation, or biculturalism, after having come to an understanding of the situation on local terms, not the volunteer s terms.
Cross Cultural Issues
Know something about the culture you are entering.
Avoid the Ugly American persona.
Bafa Bafa cross cultural training.
Lonely Planet Guidebooks.
TypesofProjects
Service
Teaching collaborative
Combination
Givea persona fish, feed him fora day, Teach him tofish, feed him for a lifetime.” …but there is a caveat…
The idea ofsustainable projects.
WhatCanBeAccomplished?
Direct provision of care.
Teaching.
Making new friends.
Breaking down barriers…..in both directions.
Having a great time.
Meeting theneedsofthe community Being mobile.
Preventive, pediatric, periodontal, restorative, surgical, and prosthetic services. Support of the local dentists.
Sustainability, repeatedly visiting the same locations until the needs are met. Increasing the oral health awareness of local communities.
Servicesprovided
Exodontia.
Restorative composites, amalgams.
Prosthetic transitional partial dentures, complete dentures.
www.benchmarkdenture.com
Preventive and periodontal services, including scaling and root planing, sealants, and SDF. Includes OHI and toothbrush distribution.
Pediatric services pulpotomies, stainless steel crowns.
Occasional endodontic services.
Impact?
We know that because the dentists come back every yearthatGodhas notforgottenus.”
The People of Hondo Valle
42 Years of the DDMP
Over 67,500 poor Dominicans treated.
Approximately $22 million in dental care provided. ***Supported 8 young Dominicans to become dentists and take care of their own people.
This is the answer to development and sustainability. This project has evolved from being the only dental option to supporting the local dental care system.
42 Years of the DDMP
Approximately 900 American volunteers and countless Dominican volunteers dentists, dental students, community members.
1991 President’s Volunteer Action Award, 2001 Points of Light Award, 2004 AAP Humanitarian Award, 2015 ADA Humanitarian Award, 2018 UMSOD Distinguished Alumnus Award, 2021 Honorary Doctorate, UMB, 2023 USA ICD Humanitarian Award.
Theconceptof successionplanning keytoreallong term sustainability.
DDMP Board of Directors
Dr. Christin Mobley Director, new ICD Fellow
Dr. Aaron Nicholas Assistant Director, new ICD Fellow
Drs. Mark Costes, Olga Gil, Ryan Harris, Tiffany Harris, Shannon Minges
Dr.ChristinMobley
Dr. Aaron Nicholas
Training and EducationProjects
Dr. Steve Mackler in Moldova
Dr. Frank Serio in Vietnam
Matching the training needstothe local site.
Howtoprepareforteaching:
• Re-read current textbooks and pertinent articles
• Seek experienced teachers for help, advice and even materials
• As much as possible:
• Encourage active participation
• Give demonstrations
• Give digestible amounts of information
• Follow logical steps
• Communicate the “What?” and the “Why?”
• Make it personal and interactive
Howtogetstarted Jumping offthecliff andlanding softly!
Howtogetstarted
Jumping off the cliff and landing softly
Decide what type of project teaching or service, where you would like to work, how long you would like to go, and how much work you want to do preparing for the project.
Look around this room, do some networking before you leave.
Plugging into an existing program.
Selecting a Site
What is the political and social climate of the site? For example, is the location politically and socially stable? Is it friendly to Americans?
Can the country be reached by reliable commercial transportation?
Selecting a Site
Are special licenses, registrations, or work permits needed? For example, Jamaica requires all entering volunteers to have a temporary work permit issued by the Jamaican Ministry of Health. That requires the submission of professional credentials well in advance of arrival in the country. Treating patients without official permits falls outside the law, so a volunteer could be subject to criminal sanctions. Remember, volunteers are subject to local laws; the U.S. Embassy may not be able to assist if laws have been broken.
Selecting a Site
Are there appropriate logistics such as ground transportation, housing, ability to communicate with home via cell phones, Internet access, and food for the volunteers?
What health alerts or restrictions are there and what vaccinations are needed?
Selecting a Site
Has the dental project been developed? Have the specific dental needs been defined? It can be frustrating to prepare for a surgical project only to arrive on site to find out that restorative services are the primary need.
Are dental materials and equipment available on site, or does everything have to be brought in?
Selecting a Site
What are the customs restrictions regarding the transport of dental supplies into the country? How might materials be shipped before volunteers arrive in the country?
Is there a suitable facility in which to work? Will patients or professional colleagues be available at appropriate times?
Assembling theTeam
Do not overreach.
One person is ultimately in charge.
Delegate when possible.
You cannot talk anyone into going. The decision to go must be personal and independent.
Remember you want we projects, not us and them projects.
Assembling theTeam Using Locals
Organizing and registering patients. Crowd control. COVID screening
Assisting with restorative procedures and giving post extraction instructions to patients.
Washing, disinfecting, and sterilizing instruments.
Interpreting, cooking, and performing other tasks as needs arise.
Equipping theProject
Service vs. teaching some needs are the same, some entirely different.
Checklists, checklists, checklists.
Electricity 110, 220, something else? Plug configurations. Reliability.
Water potable sources?
Transportation roads, vehicles. Safety first, second, and third.
Equipping theProject
Portable equipment what do you need? Where can you get it?
Supplies checklists, checklists, checklists.
Where to get them.
How to pay for it all?
Private donations.
Foundations.
Government grants.
Other.
Aseptico
Nomad Pro
Theproblem of “YES”
Newfunding possibilities
ICDandHenrySchein
ICDandHenrySchein
http://www.osap.org/?page=ICOralHCMissions
Pressure Cooker Sterilizer
SeeChristianDentalSocietyInfo
Immunizations Oh no, notthat!
Hepatitis A
Hepatitis B
Influenza
Measles, Mumps, Rubella
Tetanus Diptheria
Poliomyelitis
Yellow Fever
COVID in country and traveling
Local First Aid
Ciprofloxacin
Hydroxychloroquine
EpiPen® other epi forms easier is better in an emergency
Diphenhydramine
OraQuick®
Percutaneous exposures HIV primarily
Isentress® raltegravir
Truvada® emtricitabine and tenofovir
COVID testing BinaxNOW Abbott, others
Word of mouth professional groups, church projects, friends.
www.internationalvolunteer.ada.org
Directory of volunteer organizations. www.hvousa.org Listings from this presentation.
CDS
ChristianDentalSociety
www.christiandental.org
Volunteer opportunities.
Equipment rental or purchase.
Clinical instruments.
Portable patient chairs.
Dental Missions Manual.
Volunteer training sessions.
Globaldentalrelief.org Dr.Cunningham
beckyb@globaldentalrelief.org
Flyingdocs.org Dr. Fritz
azdacares.org
Dr.Myers Fineberg
flyingsamaritans.net
Dr.Myers Fineberg
Somosamigos.org Dr. Castillo
Smile Outreach International
Dr. Mark Costes, Dr. Aaron Nicholas
Smile Outreach International Dr. Aaron Nicholas
Local Opportunities
Why VolunteerLocally?
For those who seek to volunteer, but find it difficult to travel outside the country, Mission of Mercy type opportunities and other smaller scale events are available
Volunteering locally, or within the U.S., affords you the opportunity to address tremendous need in a location that is more accessible
Mission of Mercy Clinics
What is a MOM Clinic?
A MOM Event is hosted by the state dental society and its foundation in partnership with America s Dentists Care Foundation, ADCF (The parent organization of Mission of Mercy)
A MOM events consists of up to a 100 chair, portable dental clinic, complete with central compressed air, vacuum & water…instruments and sterilization
What is a MOM Clinic?
Extractions
Fillings
Cleanings
Pedo (which you may be surprised to learn accounts for under 15% of our event patient treatment Parents will always make sure that their children receive care first and more programs are available to serve children s needs)
A lab will provide treatment partials and in some states, Benchmark Dentures
Limited Endo
Patient Education/Social Services
What is a MOM Clinic?
Strong support from the local community and state and local dental society for preevent assistance, event assistance and follow up care, post event
A 25,000 Sq. Ft. facility to host the event with adequate parking
An adequate electrical, water, and lighting supply
Byvolunteering,we combine our desire to giveback withour greateststrength:our dental skills!
Volunteers are most touched by those patient experiences that conclude with,
Now I Can Smile. and/or, Now I Can Apply for a Job.
Benefits for the Individual and ourDentalCommunity
No surprise, you will experience a remarkable sense of accomplishment.
You are able to volunteer and share your greatest strength your dental skills.
The opportunity to work closely with your colleagues is exciting and inevitably, a tangible and inspiring Esprit de Corps develops.
An event will draw attention to the importance of dentistry, the contribution that dental professionals make, and recognize all of the good work that dental societies provide.
Bringing hope, perhaps the greatest gift of all.
Operation:StandDown
Purpose to provide for veterans who are needy and have slipped through the cracks.
Locate the veteran service officer in your county VFW will know.
Approach local dental association and secure volunteer dentists. This should not be a problem as many have served or are in the reserves or National Guard in many areas.
Posters at VFW and American Legion posts.
Screening at community health center on a Saturday morning.
Operation:StandDown
Dentists then reviewed charts and assigned 4 5 veterans to each of the volunteer dentists.
Each dentist saw the vet in their office providing all types of care free of charge.
Veteran eligibility
Copy of their DD214 (discharge papers)
Driver’s license to show residency in the county.
Lack of dental insurance.
No current dentist.
Income less than $25,000.
Honor system.
Remote Area Medical Clinics
Dr.JohnOsborn
RAM atSouthernVirginia University
RAM atSouthernVirginia University
Other Resources
Other Print Resources
Steffes, B, Steffes M. YourMission:Getready!Get Set! GO! www.s3ministries.com. A comprehensive guide to traveling overseas from a Christian perspective. Companion guide to Medical Missions;GetReady!GetSet!GO!
Palmer D, Wolf CE. Handbook of Medicine in Developing Countries. Christian Medical and Dental Associations.
Dental Mission Manual Christian Dental Society.
Volunteer It s the mostfunyou ll ever haveworking!
