Thursday, November 08, 2007

A Dental Hygienist's Experience with Tabasamu

When Dr. Trey Wilson approached me in May to go on a dental outreach with his team to Kenya, I apprehensively replied with an “Okay….” Little did I know that my feeble response would four months later turn into one of the most memorable experiences of my life.

Tabasamu, which means “smile” in Swahili, is a dental outreach project comprised of volunteer dentists, hygienists, and others. Each year, the team gears up for a trek out to a remote town in Kenya called Kitale, which is a ten-hour bus ride from Kenya’s largest city Nairobi.

When I told my friends I was traveling to Kenya for a dental outreach, many of them looked at me quizzically and asked, “What is a hygienist going to do at a dental outreach” To be honest, I wondered the same thing. A myriad of thoughts and scenarios ran through my brain, ranging from being chased by hungry lions, or being stranded somewhere far from civilization in the harsh savannah of Africa’s wilderness. Needless to say I managed to pack every possible thing I could need in two very large and very heavy suitcases, with enough food to feed an army.

After meeting the team at Newark airport, my apprehensions regarding the trip were quickly allayed by Tabasamu veterans—their friendliness and excitement about the upcoming adventure put to rest any fears I may have had. I knew I had little to worry about, so I hunkered down for the long flight to Kenya.

Upon arrival in Kenya the first thought that crossed my mind was “Wow! We’re in Africa!” Apparently I wasn’t the only one thinking that, because my thoughts were quickly echoed by two of my traveling companions Kaylyn and Erin. I was overjoyed that we were finally off the airplane, with only a brief 10-hour bus ride remaining.

I was immediately struck by the beauty of the landscape, and the native trees and grasslands that seemed to stretch on for miles and miles in every direction. It wasn’t uncommon to see baboons scattered around the side of the road. I certainly wasn’t in Manhattan anymore!

Early next morning, the outreach portion of my journey officially commenced. As a hygienist, my activities at Tabasamu can basically be simplified into two categories, Tooth Tour and Clinic.

The Tooth Tour

Dentists in Kitale are few and far between. There are only three dentists for the 300,000 people living in the area. However, even if more dentists were available the cost of dentistry is prohibitive for the majority of native Kenyans. As a result, preventive dental knowledge is generally inadequate among many Kenyans, who end up seeking dental treatment only for emergencies such as extractions and infections.

Therefore, the Tooth Tour provides a service to the young children of Kitale by bringing puppet shows and hands-on oral hygiene demonstrations directly to the local churches in the area. I certainly was not prepared for the overwhelmingly warm reception we received at each Tooth Tour stop. Even as we approached, each time we could hear the excited roar and cheers of the crowd of children gathered there. We felt like celebrities, with the children clamoring to get a closer look at us, or begging to have their pictures taken. They all sat in rapt silence as we gave our puppet show presentation about dental hygiene, and the dental dangers of eating too much sugars in one’s diet. I cannot begin to describe how amazing it was to see 1100 or so children sitting there in complete silence as we spoke—they treated us with the utmost respect, and genuinely wished to hear what we had to say! If only my patients paid so much attention!

Following the presentations we handed each child a toothbrush—perhaps only one or two kids out of entire groups of 1100 kids even owned a toothbrush. Needless to say the children were ecstatic. The tooth tours were by far the most touching and emotionally rewarding aspects of the trip.


With all of the dentists in the team constantly busy tending to the massive lines of patients waiting outside the clinic, it was essential for a hygienist (such as myself) to try to provide a basic cleaning and exam to those patients who did not need emergent care. Granted, the conditions were sub-optimal for a great scaling or cleaning (note exhibit A beach/soccer chair below), but I realized that their exposure to dentistry for that entire year consisted of, well, me.
It was somewhat disheartening to see dietary trends affecting the dental health of these Kenyans. With an influx of sugary sodas (Coca Cola is cheaper here than bottled water!), it seems inevitable that the children and younger adults face a growing risk of dental decay. I noticed that older adults appeared to show less decay than the newer generation. Many of the children who drink sugary sodas on a daily basis have no idea the harm it can cause their teeth. This just solidifies the need for earlier dental and nutritional education. With each patient, I felt like I was doing something genuinely good, because I knew that they didn’t have immediate access to dental care. It was not only rewarding to bring each patient to better dental health, but it was also touching to see the pure gratitude every patient exhibited after their procedure. The sense of accomplishment alone here was addictive.


Of course, no grand adventure would be complete without a love story. From the first time I laid eyes on her (yes, it’s a she—but Oscar was the first name that came to mind), I knew I was in love. Each morning I would visit Oscar, and she would suckle on my fingers (an indescribable feeling!). I managed to train it to come to me when I called out her name. On the last day, as we were packed up and ready to leave, I sobbed while Oscar moo’ed as we said our goodbyes.

As I sit here at my computer, nearly a month after my trip to Kenya, I can’t help but think about what all those children were doing… whether they were brushing, whether they had cut down on soda… and if the adult patients were doing the same. What were once feelings of trepidation are now feelings of fondness and reminiscence. Feelings of uncertainty have given way to feelings of love for the country, its people, and Oscar.

Would I do it all again? Absolutely!

Jessica Pao

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