There are 12,000 school-aged children in the Toledo district of Belize – and only one dentist.
To say that Dr. Solomon Enriques has his hands full may be an understatement. But Dr. Charles Ramsey, clinical assistant professor of dental hygiene at the University of Mississippi School of Dentistry, and a handful of dental and hygiene students lent him their services this past May.
Up until this year, a mission trip to provide actual dental treatments to the poorest district of Belize would not have been possible.
Ramsey had approached Ruth McDonald, the deputy prime minister of health for the Toledo district, about bringing dental students to treat the children in her district two years ago. “She was adamant that it would never happen,” he said.
Ramsey said that not even medical missions are allowed in the district due to negative experiences with medical and dental groups in decades past. “This particular district is very cautious about who is allowed in to provide health care,” he said.
Since 2012, Ramsey has organized trips for dental hygiene students to provide hand-washing demonstrations, diet counsel, oral hygiene instructions, fluoride treatments, toothbrushes and toothpaste. But the need for dental procedures is great.
Ramsey was not willing to give up the fight so easily. Through Enriques, he reached out to the senior dental surgeon over the country of Belize, Dr. Raphael Samos. “We began to correspond by email,” Ramsey said.
Samos reviewed the complete dental curriculum, and in January 2016, he arrived in Mississippi for a visit to see the facilities and to meet faculty.
“He toured the school the entire morning,” Ramsey said. “We visited and had him ask any and all questions that he wanted to ask.”
Ramsey said that, after visiting the school, Samos was convinced he could assure the student’s entry into Belize. “He was very impressed.”
On May 8, Ramsey along with Dr. Amy Sullivan, professor of dental hygiene, and a group of dental hygiene students arrived in Belize. They traveled from school to school providing dental evaluations, instructions on dental hygiene, fluoride treatments and supplies, as in years past.
“We did about 3,000 fluoridations,” he said. “Dr. Sullivan was a tremendous asset to me.”
As they were fluoridating, the hygiene students would look for problem areas and would call Ramsey or Enriques over for a second opinion. Children who needed dental work were given a note to take home to their parents, telling them about the free clinic available the following week. Ramsey said the group handed out nearly 500 notes that first week.
The following Sunday, five dental students – fourth years Chelsea Barr, Blake Boleware and Bryan Rhoads along with third years Chauncey Craft and Andrew Sinclair – and dental hygiene student Hannah Hales landed in Belize City and made the five-hour bus ride to their hotel in Punta Gorda, the capital of the Toledo District.
Sinclair said that he was struck by the poverty before even touching the ground. “Flying in, I could see multiple wildfires through the area, pillars of smoke, uncontrolled,” he said. “It was the dry season, and they didn’t have the resources to manage the fires.”
He said that they passed families selling vegetables on the side of the road as they made their way to the clinic. Many of the people in the Toledo district are subsistence farmers. Ramsey said that the average yearly income is only about $250.
The clinic where the students saw patients is owned by a Methodist church and located in a village that is about a 20 minute ride from Punta Gorda. It is equipped with two dental rooms and two hygiene rooms – and no air conditioner.
“Driving up the first day, we didn’t really know what we were getting into,” Boleware said. “There was a huge line. We had a really good turnout.” Some people had risen before four in the morning to travel for two hours to reach the clinic early.
Rhoads said that it was not uncommon to see a whole family riding a single bicycle. “The dad was riding the bike with the mom on the handle bars holding a kid with another kid on the back holding onto the dad,” he said.
Barr, Boleware and Rhoads, the fourth-year students, were responsible for restorations. Ramsey said they completed 90 sealants and 80 fillings, more than they would complete in two years seeing patients in the dental clinic on the UMMC campus. Craft, Sinclair and Hales performed cleanings and checkups, sterilized equipment and developed x-rays.
They worked from Monday to Thursday, 10 to 12 hours most days. The students made the decision not to close the clinic for a full hour-long lunch and had the mission organizer, Wayne Sellers, bring lunch to the clinic for them instead. “We would take shifts and eat when we could. We just kept working,” Boleware said. “It went by quick. It was a lot of work but a lot of fun.”
The students rolled up their sleeves and worked – literally.
“It was very hot,” Boleware said. “I don’t think we really knew how hot it was going to be. I didn’t at least. We all had our scrubs rolled up and kind of made shorts out of them.”
Rhoads said that the experience in Belize gave him a lot more confidence returning to dental school. “We were all working together. If there was something we were unsure about, Dr. Ramsey was there, and he would jump in. It was definitely a confidence builder. He trusted us. He wasn’t over our shoulder checking on everything. He knew we were not going to do insufficient work.”
On Thursday, the team closed the clinic early to make travel arrangements and to take in some sites before heading home. “We finished on Thursday afternoon, and we took the students out to see a ruin. I got a phone call from Solomon,” Ramsey said.
Enriques was attending a conference in Belize City and had just watched a presentation by Samos. When Samos spoke, he showed a photo of Ramsey and himself standing in front of the School of Dentistry and told the attendees about the new relationship the country had with the school and all the work the group had done that week.
“He was very pleased with what the students accomplished,” Ramsey said. “I tell you, I was so proud of them. They did really well.”