Doing Good: Dentistry in the Dominican Republic by Susan Resh

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Categories: Public Health;
Dentaltown Magazine

by Susan Resh


It was November 15, 2019. About 11 of us flew into the Dominican Republic from three different states to attend a very special event -- the grand opening ceremony for a brand new Training Center at the Good Samaritan Hospital in La Romana. Although it was a culmination of nearly two years of work, it was really the achievement of just one more milestone in an ever-evolving vision to provide much-needed dental care to a neglected population.

Over the course of six days I had the chance to spend time with the drivers of this vision, hear in their own words why and how the journey has progressed, and participate in mission work. Upon returning home I also spoke with a number of other dentists about their mission experiences. I have discovered that a great deal more than just dental care is being provided in the DR. Genuine care and concern, friendship, training, a new perspective on patient care, and opportunities for better lives are all byproducts of the work underway in this underserved region of the world.

This article is intended to give you a small glimpse into the life-changing work your peers, their teams and others who work in dentistry are doing to help others in need. Moreover, I hope you will be inspired to think beyond your own community when considering your next “do good” project; a mission trip to the DR is an experience you and your team will never forget… nor will the people you serve.

A Shared Vision

The vision for the work in the Dominican Republic began in 2014 when Scheduling Institute (SI) Founder & CEO Jay Geier realized he needed to provide a head start for SI clients who accepted his challenge to be bigger than themselves. For more than a decade he has been teaching clients that true fulfilment comes not from making money, but by being generous with it; by leveraging success to positively impact those around you.

Geier forged an alliance between SI and World Mission Partners (WMP) – founded by like-hearted Director Patti Pease. For the first two years, dental missions were focused in Costa Rica. In 2016 they met Moises Sifren, Executive Director of Good Samaritan Hospital – a well-known and respected beacon of hope in the La Romana region where dental care is so desperately needed. This dynamic trio shared an intense passion for helping others and knew they could create something special. Since the beginning, 120 doctors and 817 team members have participated in dental missions in Costa Rica and the DR. They have served more than 6,775 adult and pediatric patients with treatments ranging from cleanings and fillings, to extractions and hospital referrals. Thousands more have received fluoride varnish, parasite prevention and reading glasses.

Sifren’s passion is deeply rooted, having been born to Haitian immigrants and raised in a “batey” – the villages throughout the sugar cane fields in which the workers live. Many of these unimaginably poor communities have no running water or electricity, no private bath facilities, no sewers, no schools, nor access to medical and dental care. Sifren is one of the exceptional few who made his way out of the bateyes to go on and lead a better life. Since 2001 he has served as Executive Director of Good Sam Hospital, the genesis of which was because his own mother died in childbirth after being refused treatment elsewhere. Opened in 1997, the not-for-profit healthcare facility is dedicated to serving the surrounding community, as well as the impoverished Haitian refugee population.

With the help of generous U.S. dental teams, SI training and Geier’s coaching, Sifren’s vision for the hospital is to not just provide care, but to teach staff to provide better care, and a better patient experience; to provide opportunities and training that help people build better lives for themselves and their families; to improve people’s environments; to bring out the best in people; and to foster a culture of giving back. Following are insights and reflections from doctors who have been a part of this journey over the past few years, and have helped bring the vision to life.

An Ever-Evolving Vision

Dr. Kirk Specht was one of the first to begin participating in missions through WMP, and has already done three to Costa Rica and the DR. He also told me, “I’ve probably done eight or 10 missions through other organizations; this is something I really believe in.”

He has helped with construction on many of those other missions, but said he prefers using his expertise in dentistry. As Dr. Specht explained, “Concern for patient comfort is not taught in dental school in the DR; it’s not part of the culture. It was rewarding to teach and demonstrate to their young doctors and dental students how we show compassion for patients, and to see the immediate change in their behaviors to provide a better patient experience. It was rewarding to know we were having a longer term impact than just the time we were there.”

Dr. Specht said he will continue to go regularly “because I’m trying to develop a spirit of giving back in my team within a bigger world picture. You can read about it. You can hear about it. But you have to see it, experience it, be a part of it to understand it.”

In contrast to Dr. Specht’s extensive mission experience, Dr. Rebecca Charpentier didn’t know what to expect. Nevertheless, she and her husband were among the first to sign up. She recalled, “My husband, who is not in the dental field, performed as my assistant. He came away with a changed view of what I do as a dentist, how we serve people in our profession, and what we are able to do even in such exceptional circumstances.”

They worked on patients in the bateyes in an old RV outfitted with dental chairs and less-than-optimal equipment. She confessed, “No matter how self-confident you are, you find yourself out of your comfort zone. You have to make do with what you have, solve problems, and use the skills and knowledge you have to get the job done. It’s enormously rewarding to overcome those challenges, and feel great about what you did for patients who so desperately needed your care.”

Having just started her practice several years earlier, Dr. Charpentier admitted they weren’t yet very involved with local organizations. As a result of this trip she said, “This inspired us to want to give back much more; impacting people becomes addictive!”

2014-2015

Alliance between Scheduling Institute & World Mission Partners to facilitate dental mission teams to Costa Rica

2016

Alliance with Good Samaritan Hospital to facilitate teams to Dominican Republic

Oct 2017

New Mobile Dental Clinic: Replaced old RV; put to use 15-20 times a year, helping several thousand children & adults annually in bateyes, instead of a few hundred

Jan 2018

New Dental Clinic at Hospital: 6-operatory, state-of-the-art facility replaced dated one-room, single-chair dental “clinic”

Nov 2019

New Training Center at Hospital: State-of-the art training facility with 3 high-tech conference rooms & a dedicated training room available to any group in the region

Dr. Ashkan Alizadeh and his team were among the first to benefit from the use of a newer, more modern and well-equipped Mobile Dental Clinic generously funded by Drs. Bob Matiasevich, Bob Lalor and Mary John. And while it was a far better resource inside than the much older outdated RV available to prior mission teams, that didn’t change the situation outside the RV. As Dr. Alizadeh put it, “Seeing the needs and living conditions of the children in the bateyes – the lack of resources, the lack of options, the limited future because they have no way out – was an almost overwhelming experience for me because I have three young children myself. And yet, they were playing and laughing and keeping themselves entertained. I’m proud to say that now every chance they get, my kids collect toys for needy children because they better appreciate what they have.”

He also said he was “blown away” by their expression of gratitude. One experience in particular is among his fondest memories – “A gentleman was told he would need to have all his teeth extracted, but I filled the cavities instead. He was so appreciative that he insisted on giving me a handmade bracelet – probably one of his few possessions. I was so moved, I’ve worn it almost every day ever since.”

Dr. Alizadeh admitted it was “refreshing” to not have to worry about insurance or liability or patient finances. He felt like he could “truly do what I thought would be best for the patient, which is at the core of why we went to dental school. There was no paperwork, just a handshake and a smile from a satisfied patient; that was the best payment and the best experience.”

To expose as many staff as possible, Dr. Dan Beninato took a team of 25 on his first mission trip, describing it as “a great team-building experience spending so much time together outside the office in an environment new to everyone. It really brought our team together. It’s hard to translate that to people; you just have to experience it.” They plan to do missions every two years, rotating people to ensure everyone’s lives are touched by the experience.

Working alongside dentists both in the RV and at the brand new Dental Clinic at the hospital, Dr. Beninato observed, “We got to see first-hand that the training they have down there is fairly minimal. We trained several dentists on some basic surgical techniques, which hopefully left more of a longer-term impact than what we were able to do in our few days.”

For certain, of long-term impact will be the funding he provided a student to get into dental school there. After successfully fulfilling specific requirements set by Sifren during his four years in school, Dr. Beninato will bring the graduate to his office in Omaha for a month of training, after which Sifren will expect this new dentist to role-model giving back by volunteering time in the bateyes.

Dr. Christina Kulesa and her team worked in both the bateyes and the Clinic at the hospital. She said she was somewhat surprised that “everyone was just so excited to see us when we came in; they made us feel so appreciated.” She thought “the doctors were great, but they laughed when I asked for the x-rays!” Adapting to the lack of what doctors here consider a primary diagnostic tool, she enthusiastically proceeded with an “Okay, let’s do this!”

She admitted that the decision to go to the DR was driven more by members of her team who had been on missions with other organizations, or were so moved by what they heard from others who had been. Thankful for having gone, she said, “The trip confirmed that being generous and charitable is in our hearts; it’s important to us. My staff are already arguing over who will get to go next time, and how soon can we go.”

In addition to the impact on those who went, Dr. Kulesa added, “I was surprised by how important our patients here at home and even our vendors thought our mission work was. They bragged to their friends, they donated, they helped with fundraising, they wore our T-shirts, they continued to ask about it for months. It created this great sense of community between our team and our patients. I underestimated the impact there, and here.”

Dr. Steve Pilipovich and his team of 16 comprised the first pediatric mission to the DR though WMP. He confessed it was a leap of faith that he and half the staff vacated the office for a week, but one he was glad he took – “It’s a leap of faith to leave your business behind for a week. It’s a great confidence-builder to see your associates and other staff perform so well in your absence. It makes you feel even better about your people.”

He also feels even better about the team who was with him, saying, “You work with what’s available and accomplish what you need to under less-than-ideal circumstances. You come back even more proud of the talents you have, and more aware and appreciative of the untapped and even surprising capabilities of your staff.”

While working at the Clinic, Dr. Pilipovich found it rewarding to be able to teach young dentists pediatric techniques they had never seen before. But most rewarding of all was the reaffirmation that, “I seem to have been blessed with a God-given talent for delivering great dental care to kids, along with my team. Being able to take that on the road, so to speak, and deliver services that those kids wouldn’t have gotten otherwise… it really makes a difference in how we feel about ourselves. We’ve been reminded that the heart of our practice, and the very reason we got into this business, is to help people.”

His team members echoed his sentiments -- “We have seen such a change in our team. You come back as more culture-minded, caring, compassionate individuals. You value the care you give your patients more than the paycheck you receive for the work you do. Interactions become more relational than transactional; you take more time to nurture individual relationships.”

The Ripple Effect

As the saying goes – “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.” There is such a ripple effect when people of influence are passionate about teaching others to be their best, and about doing good. Better yet, when they teach others to follow suit.

As Dr. Charpentier put it, “You can only impact so many people, but once you impact them, they can impact others. The vision for the Training Center is amazing because it’s about so much more than just dentists working on patients; it’s about other people who can be trained there to the benefit of the community.”

Like the Dental Clinic, the new Training Center is a state-of-the art training facility and includes ___ high-tech conference rooms and a seminar space. The Center’s primary use is for continuously improving the quality of care and operational efficiency of the Dental Clinic and the Hospital overall, and is also available to any group in the region who could benefit from such a facility.

Sifren expects to make maximum use of the facilty to build on everything they’ve learned so far. He explained, “We have already learned so much from American dentists and through SI training. We are learning about culture, team-building, communication, leadership, and standards of excellence. We are especially learning how to treat patients well.” He even lauds American dentists and SI training for already helping to change the culture in his country. For example, preventive care for children is now considered worthwhile. And, in lieu of excessive extractions, adult teeth should be saved when possible.

He went on to say that perhaps the biggest culture shift underway is that DR dentists are learning that if they treat their patients well, they will have more patients; if they have an assistant and a hygienist (which few there do), they will have more patients; if they volunteer their time and become known as a generous and caring dentist, they will have more patients. And ultimately, with more patients they will make more money, thus increasing their capacity to help even more people and have an even greater impact.

Sifren’s long-term vision is crystal clear: “Ten years from now when someone says they trained at Good Sam Hospital, people will know they are good because we’ll have a reputation for training good people. We’ll also be known for attracting students who want to learn, and who also want to give back.”

A Ripple Starts with a Step

Without exception, every doctor and team member with whom I spoke said they look forward to helping move the vision forward for better, more compassionate patient care through training and culture change in the DR, and by role-modeling the benefits of doing good. They also concurred with Dr. Alizadeh’s assessment that, “We all walked away thinking it was the best thing we ever did.”

Even so, many admitted missions can take a person well out of their comfort zone. In addition to (or instead of) serving in the bateyes, the new Dental Clinic and Training Center at Good Samaritan Hospital provide unique opportunities for dentists to use their craft to teach others, and for mission teams to have a longer term impact on a community and even a culture.

Make generosity and giving back part of your culture, and consider going beyond your community to have an even bigger impact. As expressed so well by Dr. Pilipovich -- “We’ve always done a lot locally, but this mission trip opened my eyes to the impact you can have at an international level that simply can’t be replicated at home.”

Dr. Charpentier urges others to take the first step – “Don’t let the logistics or other perceived barriers get so big in your mind that they derail your decision. Giving back at this level changes you not just as a dentist, but as a person; it changes you inside.”



Check it out!

To learn more about WMP, request information about mission trips to the Dominican Republic, or find out how you can participate in their life-changing work, visit worldmissionpartners.org or email info@worldmissionpartners.org.


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