On 14th June 2015, a group of dentists, oral health therapists (OHTs), dental assistant and dental students set off from Singapore to Siem Reap, Cambodia for our now-annual dental mission trip. In total, there were 25 volunteers, with 16 dentists and 3 OHTs. The mission was held in conjunction with Republic Polytechnic’s(RP) Overseas Community Involvement Project(OCIP), where as part of their OCIP, the students will participate in our dental mission as volunteers.
On arrival at Siem Reap, we were warmly received by our host for the duration of the mission, Mr Bun Kao. Mr Bun Kao is a survivor of the Khmer Rogue regime, a period of genocide from 1975 to 1979. Educated Cambodians like scientists and doctors were targeted to suppress resistance. Effects from this period is still felt till now as the prosecution of educated citizens resulted in stagnation of progress in Cambodia. The official average monthly wage for a Cambodian is USD80 a month (a doctor earns USD100 a month, so imagine what a villager will make every month!) while the cost of an extraction in a rural village cost USD10.
As a result of his experience during the Khmer Rouge regime, Mr Bun Kao has endeavoured to better the lives of his fellow Cambodians, often participating in local mission work projects to villages as well as hosting and helping mission teams from overseas at his family-run guesthouse.
The following day, we set out at 6.30am in the morning for Village. This is the second time we visited the village since we started our mission work in Cambodia. We were informed that the villagers were very appreciative of our visit 3 years ago and requested for our presence once again.
Upon arrival, we were met by the RP team and we immediately got down to setting up our equipment and treatment area. Setting up is usually the most chaotic part of any mission trip, however, thanks to the presence of many well-practised old hands in our team, the setting up process, which can often result in angst and the odd harsh word, was smooth and efficient. Soon, we were welcoming the first patient of the mission.
Supply table neatly laid out
The “polyclinic” where we worked at
For this mission, we were working in the “polyclinic” of the village. It was a standalone, one storied building the size of a basketball court, divided into a few rooms. We were informed that baby delivery was carried out there as well, at a cost of USD 0.30. One of our dentists was delighted upon hearing the price and enthusiastically climbed onto the delivery bed, keen to take advantage of the good exchange rate.
The other benefit of working in the local polyclinic, beside very affordable deliveries, was the participation of the local doctors and nurses. They were crucial to our triaging of patients, highlighting patients with medical conditions, as well as helping to attend to patients who experience anxiety and vertigo post treatment.
After registration and triaging, the patients were funnelled into the respective waiting areas for restoration and extractions. From previous experience, we expected a long queue and requested for a tentage to be set up so that the patients will not have to wait in the sun.
Patients waiting in the shade of the tentage
At the restorative section, patients lay down on our made-shift “Kavos” and “Sironas”. We were fortunate to have portable rotary motors and handpieces as part of our mission equipment and hence, were able to perform restorative treatment just as if we were in a proper clinic in Singapore. Focus was mainly on preserving the teeth for function with our guru, Dr Vijayan, doing a few dentures for selected patients.
One of our restorative units
Spot the denture! Hint: #12 to #21
Extraction section was naturally the busier of the two treatment areas. Chairs were arranged in a row with one attending dentist to each chair. Cambodians are very tough and hardy people, and naturally, their teeth were just as tough to extract. Our dentists were sweating under their gowns in the hot weather trying to extract multi-rooted, badly carious, 8s and even doing surgeries to remove fractured roots.
Our team of OHTs, led by Dr Noeline Tan, were not to be outdone as well! Due to the language barrier, coaxing and voice control were of limited use and at times, the Cambodian kids proved to be as tough as their parents, fighting tooth and claw against the dentists and OHTs. However, the crying kids usually end up smiling at the end of their treatment under the very capable and caring hands of our pedo team.
And of course, no mission can be carried out without the all-important sterilization unit. The sterilization unit is akin to the engine room of the dental mission, critical to the success of the mission, has to be well-oiled and efficient, hot and stuffy, and often overlooked in favour of the more exciting extraction and restorative sections. Proper sterilization protocol was followed, with instrument washed and soaked in disinfectant before sterilization in pressure cookers.
Around 500 patients were seen over 3 working days. As always, even though we had to tough it out in the hot weather and less than ideal working conditions, all of us felt very satisfied and contented with our effort. Personally, this trip has served to remind me to be appreciative of all the simple things in our everyday lives which we often take for granted. As clinicians, we can do more than simply treating diseases. We can literally bring a smile to these impoverished villagers.
By: Dr Lee Bingwen Jon