ISSUE
     
International Partners in Health
NYUCD Celebrates 15 Years of International Outreach
 


























































Photos by Dr. Roy Sonkin




In 1993, NYUCD introduced an international outreach program designed to provide students the opportunity to enhance their clinical skills while delivering much-needed health care to underserved populations around the world. Starting in the Dominican Republic, the program has grown to a total of six countries: Jamaica, Honduras, Nicaragua, India, Tanzania, and the Dominican Republic. The clinical services have also expanded from a focus on emergency care to a more comprehensive approach -- unique to dental outreach programs -- that includes restorative care, endodontics, pediatric care, and, most recently, a sustainability program.

NYUCD’s 2005 alliance with the NYU nursing program, which created a College of Nursing within the College of Dentistry, has added yet another dimension to the program. As a result of this alliance, we can more comprehensively address important challenges in international public health and healthcare delivery. To that end, nursing students joined the outreach program last year and have, to date, participated in four outreach trips.

The following is a summary of recent international outreach activities conducted by the NYU Colleges of Dentistry and Nursing.

Honduras
A team of 35 faculty, students, and staff from NYUCD and NYUCN conducted a joint outreach mission in March 2008 to the town of Copan Ruinas, Honduras, which NYUCD had last visited in 2004.

It was NYUCD’s third visit to the town and NYUCN’s first visit. Most of the area’s nearly 30,000 residents -- primarily indigenous people of Mayan descent -- earn between about $29 a month in rural areas and $47 a month in urban areas.

The dental team treated nearly 700 adults and children. Since Copan has no public dental facilities, the team transformed its city hall into a clinic, using portable drills to treat up to six patients at a time. Two residents and one faculty member from the Department of Pediatric Dentistry provided fluoride varnishes and sealants to 225 children, and trained teachers from a local school to reapply the varnishes every two to three months until NYUCD’s next mission, which is planned for March 2009.

A team of three residents and one faculty member from the Department of Endodontics performed root canals on teeth that otherwise would have had to be extracted. A 16-year-old girl who self-consciously avoided smiling in order to hide her extensive decay received four root canal treatments.

Dr. Donna Shelley, Director of Interdisciplinary Research and Practice, led a team of two nursing faculty members and three nursing students in an assessment of medical and oral health needs and resources in Copan Ruinas and surrounding hillside villages. Dr. Shelley and her colleagues found that infectious diseases, poor hygiene, environmental irritants, poor nutrition, and maternal/infant mortality were among the most pressing health concerns. They also found that almost half of the population has no potable water source, greatly increasing the risk for waterborne diseases; that 40 percent of the population has no access to health services; and that 55 percent of children under age 12 are malnourished.

Based on her assessment, Dr. Shelley believes that future NYUCD/NYUCN missions could have a greater impact on the underserved by identifying two or three rural villages with the greatest unmet need to receive basic oral health and medical care, and partnering with nongovernmental organizations already working in the area to provide the care.

Nicaragua
For the third consecutive year, an NYUCD outreach team traveled to Nicaragua at the invitation of that country’s Minister of Health to provide essential dental care to people living in Chiquilistagua, one of the poorest and remotest areas of the country. The outreach team consisted of over 30 people: DDS students; pediatric, oral surgery, endodontic, and general dentistry residents; and nursing students.

Chiquilistagua is a village of 11,000 people and no dentist. A major focus of the 2008 trip was on providing pediatric care to children from local schools, including children with special needs, such as hydrocephalus, Down’s syndrome, muscular dystrophy, and developmental abnormalities. A total of 285 children were treated. To view a video of the trip, please go to

http://www.nyu.edu/dental/news/nyucdtv/nicaragualarge.html

India
An NYUCD/NYUCN outreach team visited Mandvi, a rural village in Gujarat, India, for six days in December 2007. The mission was cospsonsored by the Shree Bidada Sarvodaya Trust, a nonprofit, charitable organization.

The dental team consisted of 16 predoctoral students, two residents from the Department of Pediatric Dentistry, two faculty members from the Department of Cariology & Comprehensive Care, and one faculty member each from the Departments of Oral & Maxillofacial Pathology, Radiology & Medicine; Pediatric Dentistry; and Oral & Maxillofacial Surgery. The team screened approximately 1,250 schoolchildren, providing 152 prophylaxes, 317 fluoride treatments, 802 restorations, 119 extractions, and 3,231 sealants.

Two students and a faculty member from NYUCN conducted a health-needs assessment at a dormitory housing local high school girls. Among the concerns they identified were female reproductive issues, skin infections, intestinal parasites, and stress. The nursing team performed 106 physical exams; conducted one-on-one health counseling that gave the girls an opportunity to ask questions in a safe and non-threatening environment; provided five educational sessions on female reproductive health; identified nursery schoolchildren at risk for malnutrition; and provided their parents and teachers with nutrition counseling and guidelines for charting the children’s progress through follow-up height and weight assessments.

Jamaica
In January 2008, an NYUCD outreach team visited May Penn and Ocho Rios, Jamaica, on a five-day mission cosponsored by Healthcare International, a nonprofit, nongovernmental organization providing essential health care to remote areas of the world. The team screened nearly 1,400 adults and children, providing 848 sealants, 774 fluoride applications, 283 restorations, and 794 extractions. The team consisted of 15 predoctoral students, two pediatric residents and one oral surgery resident, three faculty members from the Department of Cariology & Comprehensive Care, and one faculty member each from the Departments of Oral & Maxillofacial Surgery and Pediatric Dentistry. In May Penn, the team rearranged church pews and hung curtains to divide the building into triage, surgical, and restorative treatment areas, and lined the center aisle with tables piled high with dental supplies. At another church in Ocho Rios, the pastor invited the team to use the pews as makeshift dental chairs, and to return next year for a follow-up visit.

Dominican Republic
NYUCD returned to the Dominican Republic in November 2007 to provide 3,593 dental treatments, bringing the total number of treatments provided since NYUCD began its annual missions to the island 12 years ago to 33,427. In 2007, the team provided 684 full exams, 268 sealants, 245 fluoride varnishes, 949 restorations, 546 extractions, 11 minor surgeries, 570 X-rays, and 267 prophylaxes in Puerto Plata province, where residents walked through tropical downpours and ankle-deep water to reach the schools and clinics hosting the NYUCD outreach team.

The outreach mission was staffed by 14 predoctoral students, two students from the Advanced Program for International Dentists in Comprehensive Dentistry, two residents from the Department of Pediatric Dentistry, one faculty member each from the Departments of Oral & Maxillofacial Pathology, Radiology & Medicine; Cariology & Comprehensive Care; Oral & Maxillofacial Surgery; and the Dental Hygiene program; and one staff member from Central Sterilization.