dental - 0710 tuesday

710 and breakfast is coffee like motor oil from the galley's huge silver drip maker and I'm down the gangway of the Anastasis with the keys to the gray Cherokee. I'm following the Mercy Ships dental team on their way to a village on stilts about an hour from Cotonou, Benin and the port where our floating hospital is docked. The plan, I'm told, is to pickup crates of equipment and supplies by the land clinic in nearby Godomey, drive to the river, pile into small boats, and setup shop somewhere in a remote stilt village to screen and treat as many people as possible.

I've got 2 camera bodies, charged batteries and all my lenses for this one and I turn off the main road towards the river and head into the marsh. Ten minutes and 47 potholes later our small convoy reaches the riverbank and we begin piling the equipment in two waiting dugout canoes powered by small outboard motors The dentists wear red and faded pink scrubs and unfortunately are taking too many pictures and ruining my action shots of them as they wave $149 digital cameras around but I suppose I'm being too harsh as we are passing white egrets, swimming fisherman, naked children running alongside the riverbank, intricate colony like structures of fish netting...

It's a half hour in canoes with motors and simply fascinating. As we enter the village, we see the houses are indeed built on stilts, hovering over the water, They are crudely constructed of thatch but surprisingly inviting. It's a makeshift Venice. A primitive network of canal-like waterways missing stonework and bridges - fine art and tourists but also that Venetian stench or sewage and refuse.

We're almost there and the boat's driver is hurriedly pointing at my head as I'm standing up taking pictures with my back to the quickly approaching bridge I duck under at the last minute. Ok so there's at least one bridge and my head was almost hanging from it. I must be more careful.

We arrive at a dock of sorts - a flat strip of riverbank with a few dugouts tied lazily to a pole in the ground, and head towards the building we'll be using for the screening. Now this "we" tense I'm using may sound silly to you as I'm just the photographer but I promise will make sense later.

We arrive and find 400 people lined outside a semi-dilapidated building I find out is the local medical center. It's surprisingly crude and we find it difficult to push our way through the crowd and enter.


Inside, there's certainly not much to work with. A few benches that look like church pews, a sink with barely running water, an old mattress littered with old syringes bolts and pamphlets. There's a surge of the crowd as Dominique, the dental team's tall, fearless, French speaking team leader tries to make order outside and I plan my escape route in my head. Too bad because there isn't one as I notice iron bars on the outside of all the windows and I just pray that everything settles down.

In a matter of minutes, the team has setup three stations in the room and laid a variety of shiny chrome and silver utensils out on a makeshift table in the center. By stations I mean wooden chairs set about 5 feet apart and pews arranged across from them to form a waiting area. I'm kicking myself for forgetting the flash, as the light is better in a medieval dungeon than in this clinic, so I head outside for better light and better air.

Past Dominique who has somehow brought order to the now peacefully waiting crowd, and as I walk backwards in the marsh, I take my obligatory establishing shots. I am again amazed at how vibrant the clothing is. The colors are vivid and unique and some of the ladies carry multi-colored umbrellas to thwart the blazing late morning sun.

Standing in the middle of the marsh, wearing western clothes and pointing my camera at 400 people, I'm not exactly inconspicuous, and the village children accost me. A lot of people practice voodoo here as some of the kids are camera shy (voodoo practitioners believe a photo can steal the soul) but once they see close ups on the digital camera back, they are Nikon's and mine. They love posing and drag me to a roofed but open cement structure down a narrow walkway through the marsh for better light and atmosphere. Soon they are taking pictures of each other, and with 15 children laughing, grabbing and twisting the camera buttons and lens I decide it's time to head back into the clinic before I need to replace the equipment.

Back inside and I shoot a couple of shots I'm still dissatisfied with because the light's no better so I put aside the cameras and try to figure out what's going on...

Turns out the system being used here was first tried by our very own Dr. Russell in a Guatemalan prison and is being perfected here. This is extreme dentistry. Although I can't confess to ever watching a full episode of Survivor, I'm sure if I had, a reference here would be found and quite fitting.

The patients enter after being screened outside and are given a number. That number is then written on a bib with a black Sharpie, which is hung around their neck. They are brought from the pews to one of the stations, and examined by a dentist. The dentist then will inject them with Lignocaine or lidocaine as "we Americans call it"- I'm shocked to find out noone's used Novocaine for many many years. Anyway, the patient then sits back down on the pews and waits for the anesthesia to take effect as the next person is brought to the musical chair. At each chair is a translator, who also holds a small flashlight (no electricity here) and the patient's hand or arm. A dental hygienist hands over the sterile tools, which are rotated in from big buckets in the corner filled with hygienic solution, and as they work without suction, blood, and lots of it too, is dabbed with cotton gauze held by tweezers.

Let me just say that I feel a long way from my last appointment in Dr. Pia Lieb's Park Avenue office where I comfortably watched Zoolander on Sony cinema goggles and chugged nitrous oxide.

There are so many people outside waiting I get bitten by the need to do something. I want to help and not just take pictures, and as we have 4 licensed dentists and only three stations, I grab the one on break, and we hurriedly setup a fourth station. Ten minutes later I'm playing dental assistant, aiming the flashlight, unloading syringes, cleaning equipment and dabbing blood.

Up close and personal and you realize how really thankless a dentist's job is. As many of these African patients have never been out of this stilt village, let alone to the dentist, and toothbrushes barely exist here, you can imagine the state of some of their mouths. The Mercy Ships work here is mainly limited to bad teeth pulling, and although I wish I could tell you it looks a lot more sophisticated than a yank with a clean pair of pliers, it's doesn't. But the dentist I'm working with is highly skilled, and after a few probIem teeth, I quickly see how difficult it is to get them to come out clean with the roots attached.

Some of the patients have come in extreme pain, some with terrible infections and open sores caused by these bad teeth. Although we're truly helping these people that have come and lined up hours before our arrival, they are not effusively grateful. It's with the usual dread that most in the west have always felt (although maybe not patients of Dr. Lieb's) that they sit down and go AAHH.

Everyone's running on adrenaline and it is a real rush being able to help with the removal of all these problem teeth. As we can only work on one side of the mouth at a time, patients with problems both left and right are given return appointment cards for free treatment at the land based Godomey clinic.

Quitting time is just before 5 and we've seen every patient waiting in that long line, treated more than 100, pulled at least 128 teeth (the count tallied on napkins), and scheduled another 210 at the land clinic. Another day in Africa for me and new found respect for the Mercy Ships dental team.