Peru Experience

Thank you to everyone for your continued support with our Peru mission trip. We thoroughly enjoyed our entire experience. I must say that my absolute favorite part were the kids. The kids were so precious. They were so loving and always wanted to be touching in some way. They loved the coloring books and crayons that were donated. The people in Cascas were so happy to see us, we felt like celebrities. They hugged us and kissed us on the cheeks every chance they got. It was refreshing to have people be so thankful for everything.

Dr. Johnson Update

6/19-6/24/11

We worked all week from 8AM to 6PM.  We saw heavy decay and significant gum and bone disease.  On those teeth that were salvageable we placed restorations.  Many were not salvageable and needed to be extracted due to abscesses.  We saw and treated ages 2- 85 to my knowledge. 

Three patients stand out in my mind that I would like to share with you.  First was the young mother that walked all night and arrived after lunch with her 5 year old, 2-3 year old in tow with a  nursing baby in her arms.  She had never owned a toothbrush and her teeth were in poor condition.  All Dr. McArthur could do was attempt to save her teeth with some restorations.  One of our fine dental hygienists removed the massive tartar  deposits on her teeth with the ultrasonic scaler.  She left as soon as she could for the long walk back.

There was also a woman that rode her horse in starting early in the morning with one of her children riding with her.  I removed two teeth that were too badly decayed to save, following her hygiene appointment.

Last was the 14 year old boy that rode the same donkey, or burro, with his mother for 14 hours.  Sarah and I removed a badly decayed, infected tooth that had been erupted in his mouth only 1-2 years.  It was a very difficult extraction with bone removal and sutures, but he was a real trooper.  They had no money for food, so we fed him and his mother and they stayed overnight with friends.  Bright and early the next morning, he returned.  He hadn’t felt good so had not eaten.  We gave him a bowl of oatmeal, which he wolfed down.  Then, Sarah and I placed 8 silver restorations in his molars and premolars hoping to prevent further tooth loss.  We gave him and his mother toothbrushes and toothpaste.  Then they rode home.

I was angry extracting this last tooth because decay is such a preventable disease.  There is very poor knowledge about simple oral care.  Our dental hygienists, four of them, did their best to educate their patients to the best of their ability with the help of translators.  The favorite drink is “Inca Cola” which is a carbonated, yellow, very sweet, bubble gum flavored cola.  It is cheaper than bottled water.   I saw numerous kids buying this over the counter in the small corner stores or “tiendas”.

Our dental team of 2 doctors (with an occasional third local doctor) and four hygienists, along with about 10 auxiliary team, treated 455 patients this week and performed 1240 procedures in total.  The medical team that worked upstairs, from the Chico, CA area treated, about 1200 patients.  We all are very happy with our results and especially pleased that the number of extractions is down compared to the three previous years that this team has been going to Cascas.  We believe that we are making progress in the battle against oral disease!

Dr. Johnson's Travel Log Day 3

Sunday, June 19, 2011

Vegetarian breakfast early – oatmeal, raisins, barley “coffee” (tastes good but non-caffeine), locally made bread with peanut butter and jelly , bananas and oranges. 

As we walked up to the clinic, patients were already lined up waiting for us to begin seeing and treating them.  We began at 8 AM (Central time) and worked through until 6PM with about a half hour break for lunch. 

The dental needs are overwhelming!  There is almost a complete lack of  oral hygiene.  Rampant dental decay exists in both adults and kids.  Nearly all adults are missing teeth.  Virtually all have decay somewhere in their mouth.  If the decay is small enough and can be restored we placed silver fillings in the posterior teeth and white fillings in the front teeth.  Because it is difficult to keep the mouths dry enough, in our very basic clinic, white fillings were not possible to be placed in the posterior teeth. 

If the decay is large enough to destroy a tooth, then the tooth must be extracted.  I am the designated oral surgeon on this trip because Dr. McArthur prefers not to perform it.  I was well trained in my hospital residency to be able to extract teeth, but is something that I have not done much of since that time.  Very quickly, Sarah, Katy and I were immersed in all that we could handle.  I was tentative at first but soon got back into the rhythm of being able to rapidly diagnose what was needed and to get after it. 

Because none of the patients know how to speak any English, we needed translators to communicate effectively with them both before treatment and with post -operative care instructions.  During the procedures we were able to communicate the basics in Spanish but needed somebody more skilled to be effective in the necessary communication. It is frustrating to us that we have worked hard to learn Spanish via Rosetta Stone at home, but due to lack of use since some of the lessons, much has been forgotten and our communication is often poor. 

Following a successful day that went by rapidly, we were exhausted.  We ate our meals  that were prepared for us at the church and walked back to our hotel, uphill, along a windy dirt road, showered and dropped into bed. 

Dr. Johnson's Travel Log Day 2

Cascas Blog

June 18, 2011, Saturday

Yesterday afternoon, after arriving, we set up our dental gear in the clinic.  We have  four brand new portable dental units with compressed air, suction and water delivery from a portable compressor- all in the size of a suitcase, but heavy- 50 lbs.  We will have lawn chairs for the patients to sit in and little round stools without backs on them for us to sit on.  The room is bright and airy- with windows and doors open.  We have 11 chairs for three docs- (one from the city of Trujillo), Dr. Bruce McArthur and me.  There are four dental hygienists, four dental assistants including Sarah and Katy, and a number of husbands, wives and two 12 year olds that are all support team.  Dr McArthur’s 80 year old uncle, Dr. Hollis Field and his wife were our triage team. 

This morning, we went to a four hour 7^th Day Adventist Church service, (which Dr. McArthur and his wife Cherryl and several of his team members are members of) which was very nice.  It was held in Spanish but had some of the Chico, CA church members translated into English. It reinforced the Spanish that I have learned to prepare for the trip.  The church was filled with local people as well.  Although they live in areas with  dusty dirt roads, they were all groomed and dressed very nicely in normal church type clothes- coats, shirts and ties for the men and nice dresses for the women. 

Following the service, we had a nice luncheon outdoors next to the church where the local ladies prepared a very nice vegetarian lunch, with local fruits  and vegetables such as passion fruit, avocados, tomatoes potatoes, rice and tangerines.

 Then we wandered around part of the town taking pictures of some of the local sites, people and the massive, beautiful mountains that surround the town.

Dr. Johnson's Travel Log Day 1

Friday, June 17. 

We made it to Cascas, Peru!  We got up at 3:30 Thursday morning to get to Denver International Airport  for check in- all 23 of us.  Katy and Sarah are my charges.  The first leg of our journey took us to Los Angeles and then we took our last flight to Lima Peru.  Going through customs in LA was minimally controlled chaos- a mass of humanity.  I took a picture after we got through the check, and was immediately admonished for taking photos in “security”.  I should have turned my flash off, which gave me away.  I did not know that it was a security concern.  This next leg took us 8 hours to complete in the air. 

Each of us were allowed to take a 50 pound bag of personal gear and a 50 lb. bag of dental clinic gear.  We waited and waited for our gear to come out in Lima,-which has a very nice- much nicer airport than LA.  We met about 60 people of a medical team from San Francisco and another 20 people from an evangelical team from Chico, CA.  All together, we went through and overwhelmed the security crew in Lima.  They wanted no part of checking each of us and backing up the process.  We sailed through and avoided some of the possible graft and need to bribe our way into the country with our dental gear.  After we got through security, I looked back and took another picture of the chaos and again was immediately and firmly admonished by a security officer not to take pictures in security!  Will I ever learn?  That’s all I need – to be sent to a foreign prison !

We had Papa John’s pizza at 3 AM and then settled down for a restful 3 hour sleep in the airport chairs until our next flight to Trujillo.  I did not think that I could sleep in the airport like I had seen others do at DIA, but I certainly did. 

Our next leg of our journey began with a 6 AM flight to Trujillo, which took about an hour.  Trujillo looks like the moon.  I was very surprised to see this because Trujillo is the second largest city in Peru, and sits right on the northern coast.  Almost no greenery in sight, except for a few isolated trees.  Several fires burning trash.  Rock, dirt and dust everywhere.  The airport has a single omega shaped baggage belt in a room that is only 20 x 30 feet long.  Everybody on the entire plane was crowded in to pick up their gear.  Chaos once again- took about an hour.  However, this time, I did not take a picture in security!  We finally loaded our bags on an old Greyhound-like bus and headed up a windy dirt road to Cascas which took about 3 hours.  We were told that the road is now better than it once was which has reduced the travel time by an hour.  We stopped at several isolated buildings along the way where vendors tried to sell us soda pop or popcorn.- not many takers.  Extreme poverty it appears in these sites and also in numerous small, dust -choked farms along the way. 

As we climbed toward the pueblo of Cascas the agricultural fields became larger, more organized and more green and lush. Outside of town,  an entourage of about 20 dirt bikes-some with two or three riders, were waiting for us, beeped their horns and led the way into the little town’s square.  A small musical band of young people played drums and trumpets, enthusiastically, through a variety of songs that all  sounded about the same.  The little town square was filled with people waiving , some holding signs of welcome.  The mayor gave a passionate speech of welcome and spoke of how much help and good we would bring to the people of the area, in Spanish but translated in English.  We were then all urged into a government office building, up the stairs into a small auditorium with a roof but without windows.  Again more ceremonial speeches of welcome, translated, by different government and church officials.  They also expounded on the virtues of the wines of their region and trays of wine samples in plastic cups were distributed to each of us.  The success of our visit was toasted with the flavorful red, but very sweet wine.  

Dr. Johnson's Updates via Email

We hear from Dr. Johnson pretty much every day.  He is becoming quite the surgeon down in Peru, extracting teeth with the best of them and doing it in not so great conditions.  Here is an excerpt from one of his emails:

Hard day today.  4-5 surgical extractions with sectioning, bone removal, sutures.  Getting to the point where I don't fool around as much- I now get after it.  Am enjoying the surgery.  The positioning- bending upside down due to immoveable and poorly positioned chairs, poor light, compressors that lose suction frequently and usually at the most critical time- all make it difficult.  My back is really tired, therefore the rest of me is too.  I probably removed around 20 teeth today in total. Could have seen more people today if the conditions were better.
Kate and Sarah are doing well.  They went out to a local plaza with a number of the others from our group this evening after dinner.  Seems very safe here.   Katy is progressing really well as an assistant.   Weather's great, very temperate.  Food's good, lots of it.  Sleeping well. 

And here is an excerpt from Dr. McArthur's Blog:

Towards the close of the day, Dr Johnson had a very challenging extraction on a boy of about eleven. He was our last dental patient for the day, and Dr Johnson finished about 6pm. The boy and his mother had ridden a donkey for 14 hours to get here! They were obviously not able to go home then, so we fed them dinner and got them back to the town square where they could get a place for the night.
As usual, it was dark when we walked back up to town. The occasional car that would pass us would stir up so much dust it looked like fog in the street lights. I didn’t get a really good picture of that because it didn’t seem good to pull my camera out in the dust storm!
As I was in my hotel room typing this, I heard a band playing outside, getting louder and louder. Ran out front to see a marching band go by our hotel, up to the corner, turn, and march off. Turns out it was just a school’s marching band out practicing. At 8pm.
So pretty much just another normal day here in Cascas!

First Days in Peru

Hi, it is Kristine here and I wanted to let you know that we heard from the team.  Dr. Johnson, Katy and Sarah spent all day Thursday traveling to Lima and then getting transported to Cascas.  By the time we heard from them, they were just really tired from 24 hours of travel!  On Friday the teams from both offices set up the clinic and got unpacked and organized.  Yesterday, they started their clinical treatment.  Dr. Johnson said they saw about 35 patients and some of the people were in pretty rough shape.  He had to extract a lot of teeth.  The type of dentistry they are doing in Peru is the type of dentistry where they want to help either a) save teeth or b)get people out of pain.

I have not received any pictures yet, but I have borrowed some from Dr. McArthur's blog. and will include them here.

Exerpt from Dr. McArthur's Blog:


6:00 am Thursday, June 16: 18 dental team members met at the United counter at DIA. It was time to check in and get going! Most of us had one personal bag, and one “clinical” bag, loaded with dental supplies, instruments or equipment. We flew to Los Angeles, where we met more team members and prepared for the LONG flight to Lima. It was really pretty good; a comfortable plane with lots of entertainment options- but eight plus hours is still a long time to sit on a plane!
We arrived in Lima shortly after midnight, and got all our bags rounded up and through customs in less than 2 hours… that might not sound impressive, but that’s better than previous trips, and we had to pay no duty or customs fees. We then checked the bags for the next leg, up to the oceanside city of Trujillo. Spent what was left of Thursday night sleeping on chairs in the airport. Friday morning at 6:30 was a one hour flight that I can’t tell you anything about – I slept like a rock. Once in Trujillo we transferred our bags to two buses, and settled in for a three hour trip up into the mountains. Our buses had a police escort the whole way, which probably had our driver performing a bit more sedately and carefully…
Near our destination of Cascas, Peru, we had our escort supplemented with several motorcycles, and even one in the lead with a flag. As we pulled into the city square, around noon, we were met by firecrackers and a large band playing! They further welcomed us with a reception with the mayor and city officials.
We then unloaded all those heavy bags, and set up the dental clinic. We have 13 chairs in our portable dental clinic!
Dr. McArthur's blog: http://gorgeoushealthysmilesdenver.com/


I will keep you posted as information arrives.  I am hoping to get some updates from the team today.  Thank you for your interest and continued support.

Kristine