This trip was over 2 years in the making and was delayed by an incident with a Kangaroo.
[More about that one later]
I read an article about George Manos and Project Yeti about 3 years ago in Bite Magazine.
I had been looking for a while to find a volunteering project somewhere in the world where I could provide dental services to a community that desperately needed help. There are a lot to choose from!
My reasons are similar to most who wish to travel this path. I’ve been fortunate to live in a wonderful country and had a brilliant education. My career has been exciting, fulfilling and helped raise and educate my 4 children. And now I find myself at a stage in my life where I can give back a little.
My dental practice in North Adelaide and Millicent has been focused on providing a full range of services to as many people as possible. This attitude and commitment has lead me to extend my range of services into Special Needs, Aged care and Remote Communities.
It therefore didn’t seem to be too much of a jump to look at providing care in a 3rd world country as part of a voluntary project. I don’t claim to be an expert at Dentistry, but I consider myself to be competent and capable of adapting to new and unusual situations.
Providing dental Care in a Nepalese Buddhist Monastery at about 3000m above sea-level is everything…and more.
I should mention [and thank] my lovely wife Lesley who not only agreed to accompany me on this journey, but also agreed to train as a DA and assist me in the clinic. I could not have managed without her.
So after a number meetings with George and some gathering of materials and equipment, we finally made it to Kathmandu on Saturday 27th April 2019. We were met at Kathmandu Airport by George and loaded the 40kgs of equipment and gear into the back of the 4wd and set off for Kopan Monastery. The details of Kopan Monastery are well covered on their website and by Georges information on the Project Yeti website so I won’t go into it here.
We spent the first few days sorting out our gear and doing some maintenance on one of the Dental units before we were ready to set off to Chialsa in the mountains.
On Monday 29th we gathered outside the Kopan Dental clinic at 5.00 am ready to climb into the TATA vehicles for the 12-hour journey. Fortunately, we had already met Desirae and Vicky and our little team were well briefed on what lay ahead. The journey from Kopan [Kathmandu] to Chialsa [near Salieri] is arduous and tiring. We followed the main road [mostly bitumen] along a river valley roughly towards Mt Everest but it is a very narrow and tortuous route and the drivers are required by law to stop at checkpoints along the way to ensure they have adequate rest breaks.
NOTE; It’s a good idea to bring your own water and snacks [fruit] for the trip. There are meal stops and toilet breaks along the way but you’ll need local currancy to pay for the meals
We finally arrived at about 6.30 PM at the Monastery, just in time for a hot dinner and tea.
The following day we set up the clinic and met Pesang our translator. Pesang is a local man who was once a monk at the monastery but now helps out wherever he can. To be perfectly honest…without Pesang and his brilliant assistance we would not have been able to achieve anywhere near the outcome we did.
Each day we would see about 25-30 children and perform everything from routine examinations and scale and clean to restorations, silver fluoride and extractions. The children are the most rewarding aspect of the entire trip. It was a pleasure to go to work each day and be greeted by a sea of smiling cheerful faces. I can honestly say it has renewed my interest in pedodontics and I have established a strong desire to continue with the work we did in the mountains assisting these wonderful people.
The range of dentistry is within the grasp of any experienced dentist, but I was fortunate to be working alongside Deserae [Dental therapist]. Deserae and her DA Vicki have a wealth of experience treating our own indigenous population in remote areas of northern Australia. Their team approach and excellent organisational skills were helpful in enabling us to provide dental care to the children. She introduced me to the use and benefits of silver fluoride, and I was immediately a firm believer in this therapy.
The majority of the local children from the monastery’s boarding school and hostel have multiple caries affecting the deciduous dentition. I was often confronted with the decision to try to restore up to 6-10 teeth with large glass ionomer fillings or perform multiple extractions. Both of these choices would have caused a number of consequences to the child patient. Fear, discomfort, post-op pain and possible pulpitis/abscess formation after we had left for Australia. What on earth would they have done if they developed toothache or an abscess and we were no longer available?
The correct application of Silver Fluoride will result in the decay turning jet-black and eventually quite hard. The tooth is retained until it is naturally avulsed and hence space is maintained for the permanent dentition. Also, the therapy can often be provided without LA and only minimal preparation with a spoon excavator. A little research on the use of Silver Fluoride will help anyone planning to go to assist in any remote areas such as Nepal.
Sadly, however, some teeth needed to be extracted and although most children were initially reluctant, with a bit of careful explanation [+ Pesang interpreting] we were able to get the job done. As part of my personal medical kit, I brought along some Amoxil capsules and Flagyl. It was fortunate, because 2 of the children had developed abscesses and 1 with a full-blown facial cellulitis. I had to open up the capsules and roughly divide the Amoxil powder into approximate dosage and deliver it on a spoon [mixed with a little jam]. The flagyl was needed for some of the adult patients who presented with advance acute periodontal disease.
Once we had completed all the children fom our monastery and 2 others nearby, we started treating some of the local adult community. With no particular schedule, people would just turn up at the clinic requesting anything from routine dentistry, extractions, 1st aid for a broken bone in the foot and even a foreign body in the eye. My wife Lesley even helped a man with stomach spasm and gave him some remedial therapy.
I can heartily recommend being part of this project. George Manos epitomises the gentle caring dentist with a desire to help people who are in desperate need. The 2 clinics he and John Denton have created provide an invaluable service to their local communities and enable dentists, therapists, hygienist and dental assistants to experience a truly life changing volunteer program.
So….about that Kangaroo!
Well a few weeks before we were due to fly out to Nepal 2018, I was riding downhill past Cleland reserve in the Adelaide Hills. It was just around dawn and …well I missed the 1st kangaroo but the 2nd one hit my front wheel. I woke up with my wife arranging an ambulance retrieval. I sustained 5 broken ribs and a badly fractured collar bone. Fortunately, with some rest [pain killers] and excellent surgery I made a full recovery. I’m back riding again….a little slower. After returning to Adelaide from Nepal I was reminded how lucky we are to have access to such wonderful health care in Australia.
It also highlighted how a single dose of Panadol given to a small child in Nepal can reduce the fever and bring back a smile.