Training Log Archive: 'Bent

Day 6 The whole sick crew had recovered more or less. We headed over to the primary school section of Ak-tenamit and worked at the main dock.




It looked like the most civilized setup of all and I was in shade, but the deck had challenges. The generator was the loudest yet, and the lake had more waves with more patient traffic passing through my station, so it was harder than I expected. Mark was on dry land doing root canals. Our first case was a mom with challenging dental issues too who somehow got in.

Once we got into the rhythm with the kids it was fine. I did feel bad for one 18 year old, when I had to explain to him in my lousy Spanish that his cavity was actually a dead nerve, but we didn’t have the time in the endo chair for him so I had to extract it. We had fun with the kids, and got a few giggling nicely.



It was cool to see the schoolbus arrive later, an open boat with about 40 kids.




I heard a “Hey Richard” from the dock, and it was my extraction patient who yelled “Thanks very much” with a thumbs-up as he headed on the bus.

We only worked half a day as we had to break down the clinic, pressure wash everything and load it back in the water taxi boats.



We handed out all the rest of our toys and brushes, and that was that.



After lunch and some presentations from Ak Tenamit it was back up the Rio to town, and a pleasant surprise- a nice hotel with a pool!

All in all I was impressed with this mission. It was well organized, they had good contacts and the equipment and setups worked well, despite going into more remote and primitive areas than I have done before.
The group had a lot of fun but also got a lot of work done efficiently.
Everyone was able to solve problems and be self sufficient when needed, and took some nasty health issues well too.
I would have very much liked to see a preventive program implemented as well. Restorative without preventive is more of a band-aid. Even one hygiene chair and some counselling and instruction would be very important. There may have been more if we didn’t have a last-minute team member cancel.

The accommodations were primitive, but the on-site meals were excellent. The trips for dinner were a really nice break every day too.
I would definitely come back to the Rio Dulce team if I do another trip.

Day 5. Looks like the stomach flu swept through the team. Lacy and Stacey were up sick all night, Mark was still too ill to work, and Beth came down with it too. Elsbeth was also not feeling well, so we headed out with a much smaller team. Denis the Canadian nurse did a housecall and gave Stacey an IV.

The boat was moored far up another winding creek, in a very scenic and very jungly area near Lamantia.








Again kids trekked in a long way to see us, but at least it wasn’t through mud.


Nasha assisted me for a few patients,


then she and Tim had to leave for the village, so Martine worked with me. He doesn’t speak a word of English but he speaks Spanish and Quechi, which helped with the kids.



It took us a long time to get set up and explain how my material worked in my limited Espanol with Davy’s help, but he got it pretty well and we got working quite efficiently as long as I didn’t need something out of the ordinary, when the system would break down and I’d have to go rooting for stuff. Without Mark we did more extractions, but all went well and again the kids were outstanding. The bioactive material really let me do a lot more work than scheduled, working quickly but gently on areas that weren’t anesthetized.







Gerard was working with Miguel the dental tech, and he was a machine, seeing tons of kids.


Rob and Kristy were very efficient, as they were the original duo.


Kids heading home with Mom.

When we got back Lacy and Mark were well enough to come for dinner,


a guided tour of the caves and a visit to the hot springs.

Day 4. We were warned this would be a tough one. 25 minute boat ride to where the houseboat was moored as far up a creek as possible in a cattle field near Las Manianitas.







We set up the land station in slopping mud, with tarps over the Triage and surgery chairs. About 150 kids hiked over an hour in muck to see us, some in boots, most in flip-flops or bare feet.





The kids only spoke Quechi, and had never seen a dentist, but they were great kids despite lousy teeth. The whole team did a ton of work.
Dennis did Triage and got them numb, Mark was doing extractions under the tarps. The ladies got pretty dehydrated as it was hard for even the guys to find a place to pee. I think they got a tarp arrangement to go off the back of the boat.



My deck was slippery with mud. We took to lowering the kids over the side to wash their feet in the creek. We were all splattered with mud by the end, even though we kept the instruments clean. Tim said it was the messiest work site in 14 years.




Gang plank right to my deck operatory.

The team had brought lots of treats for the kids, and not a kid made a peep the whole time, even with lots of injections and extractions. Beth and I were able to do a lot of bioactive fillings, as well as a handful of extractions. We were rocking to Bob Marley thanks to Dr. Rob, and the gas fumes and noise levels were less as the generator was back in a field. The kids waited hours patiently, where back home they’d lose it after 20 minutes. I think we saw almost 100.




The AkTenamit boys showed up in a boat with grilled fish and fresh coconuts for lunch!








18 kids waited 5 hours and never got seen, but they all got gifts and promises to be front-of-the-line for the next team. One thing we were told was that we had to respect their privacy and not take any pics unless we got express permission, so I don’t have as many pics.

Dinner was family-style at the Finca down the creek from our place.


This time the concierge is the world’s most laid back rotweiller.


Unfortunately Lacey and Mark both came down with nasty GI issues.

Day 3. Darn rooster at it again early. It started pounding rain before breakfast, and the trail was a river.






We were at the school again today, and had tarps set up all over the place. The rain eventually stopped, replaced by steaming humidity. Odd feeling trying to see though foggy loupes while brown water rushes by in your peripheral vision and the boat bobs. We got a really solid day’s work in, as Beth and I got in the swing of things.








Her front teeth were stained and broken down before we started. One happy customer when we showed her the “after” pic.



Folks would paddle by casually in dugout canoes.


For dinner we got in the speedboat water taxi for a 30 min ride to Livingston via a deep canyon that connects the Rio with the Caribbean. We had time for a walk around town before dinner looking out on the ocean and a late night ride home.

Gerard spent time shopping for wood rasps to give to Joseph, a disabled craftsman with a hut at AkTenamit. What a decent guy!

Guatemala day 2


Early wake up thanks to a demented rooster who starts around 4:30.
We hiked over to the clinic at Ak Tenamit school and set up on the deck of the houseboat.



We were seeing kids while the generator and compressor roared. Some times there was a bit of a breeze, other times the sun would beat on my neck and prematurely set the dental fillings and the humidity was through the roof. Between the mask, headlamp and loupes we’d get pretty hot and my loupes would fog over a lot.
We managed to rig some shade, which blocked the sun a bit. When the breeze shifted we’d be breathing exhaust fumes, other times it was actually very pleasant.








Hike to the washroom

The kids had some pretty big decay but were really good, teenagers of Mayan descent from the local vocational school. Dennis would triage them and numb them, and Mark and Nasha set up a chair for extractions off the boat, bless them.

Mark’s surgical suite on land

It took Beth and me a while to get enough small tools and burs together at first, but we got rocking along.



Gerard and Rob were going gangbusters inside the boat on the actual clinic chairs with Trish and Kristy.

Rob’s office onboard


Gerard and Trish were really fast.

They were doing a *lot*of work, mostly amalgams, while Beth and I were doing more minimally invasive techniques with bioactive white fillings, and managing to avoid most of the extractions.

All in all a good day.



The shower sure felt great, and we took a boat ride to a surprisingly nice restaurant across the bay for dinner.




The concierge is a chocolate lab.

C • Looks like a job well done 3

Guatemala trip day 1
We stayed in a world heritage site town of Antigua, the old Colonial capital before it got hit with volcanoes and earthquakes. Lots of huge ruins of churches beside tidy haciendas and cobblestone streets with cafes, surrounded by volcanic mountains.














Bus ride took us through Guat. City, which is a bit scruffy and smoggy.
Very varied terrain on a good highway as we dropped from the mountains, through an area where they were clearing a big rockslide.


Local Chicken Bus


Garbage-truck-surfing.






We came down to the coconut and banana altitudes, with thick jungle canopy. It flattened out before the coast into farmland, and we passed huge rubber plantations.
We got to the river, transferred a ton of supplies, generators and compressors to a cargo boat, then had a late lunch before a 50 min trip by fast water taxi across the Rio.




Entire clinic in a pile.




The Rio widens out in places to the size of lake Simcoe, but we finally went up a jungle backwater to Ak Temanit and our cabins.











Simple bunk beds with a picnic shelter and a toilet/shower block.

Mosquito nets mandatory in malaria country.

Quick departure for the clinic, where we set up the little houseboat as the sun set.




Tim Lee, who started Health Outreach 14 years ago.

My fiddling talents were useful even though I’m a newbie to this mission. Nobody else had headlamps for setup, so my lights were handy when the generator died. Looks like my operatory is a wooden chair on the deck. Best view in the house! Beth and I got it sorted. Space is tight, and if I back up I’ll be swimming.






Quite a decent grilled fish for dinner, then a hike in the dark back to the cabins for a cerveza and a shower before setting up my mosquito net for bed.