DENTAL & HEARING CARE FOR AMAZONIAN COMMUNITIES
Dental, speech, and hearing health care services are extremely limited in this region of Brazil. We serve two locations during our two-week trips: Monte Negro and Calama.
Monte Negro is a small city south of Rondônia's capital, Porto Velho, with a population of 14,000. About half of the residents live in an urban setting, and the rest stay in rural areas. In 2002, we chose Monte Negro for our first expedition because our university has a research center for tropical diseases, ICB-5, in the city. The mission of ICB-5 is to develop activities and studies related to population health and biodiversity. The center provides us with housing and clinical space so that we can serve the people in Monte Negro and the surrounding communities. The campus has four dental offices and three rooms for speech and language evaluations and therapy. Our last trip in July 2019 was the 39th trip to Monte Negro. We usually spend two weeks in Monte Negro in January and one week there in July.
In 2012, we expanded our outreach services to Calama, an Amazonian riverine village north of Porto Velho. It has fewer than 3,000 inhabitants, and is only accessible by boat. There are no oral, speech-language, or hearing health care services in the community, and it recently lost its primary care doctor to the withdrawal of Cuban doctors hired through the Mais Medicos program. Each one-way trip to Calama takes about 12 hours. During the dry season, we usually travel up the Madeira River on a Saturday night with all of our clinical equipment (e.g., dental chairs and tools for clinical testing and earmold making). From Port Velho, the transfer is a challenging process since the tools and equipment need to be brought down the port (about four to five stories high) to get to the boat, and, upon arrival at Calama, carried up to the river bank, then to the clinic in the village. Our work starts on Monday morning, and the boat becomes our home for the week. In July 2019, we completed our seventh expedition to Calama.
VALUABLE STUDENT TRAINING
Student training is an important component of the expeditions. Faculty members supervise students from the university's dentistry, audiology, and speech-language therapy programs. Of note in Brazil, graduates of audiology and speech-language therapy get dual certifications. The students collect case history information, and perform speech, language, and hearing screening and evaluations. They also provide speech and language therapy, fitting of new hearing aids, and follow-up services to those who already have hearing aids. One of our team members is an earmold technician who makes custom earmolds for patients on site. Additionally, we provide counseling to family members and training for community health workers. We also refer patients who need long-term or more comprehensive services to tertiary hospitals in nearby states. We see an average of 400 patients during each trip.
In addition, we provide dental services—general dentistry, periodontics, endodontics, and dental surgeries—with a focus on preservation of the teeth instead of extraction. We educate patients on preventive measures and daily dental care practices. The dental faculty and students see approximately 600 patients during each expedition. Since 2010, joining the expedition has become an elective course for undergraduate and graduate students in the university's school of dentistry and the speech and hearing department. The students selected for the expeditions participate in pre-trip preparatory activities that address different aspects of providing services in rural settings, biosafety standards, and set their expectations for the trip. As of July 2019, 630 undergraduate and 220 graduate students in dental, speech, and hearing disciplines have participated in the expeditions.
In 2018, a medical school was added to the University of Sao Paulo, Bauru, campus. Faculty members and undergraduate students from the medical school will be joining our expeditions in 2020. With this wider collaboration, we look forward to providing integrated and interdisciplinary dental, medical, speech, and hearing health care services to the residents of Rondônia.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.