DENTAL MAVERICKS MOROCCO 2013
Volunteer Dental Nurse Julie Richardson
Diary of a Maverick Jules Richardson. Jules won the competition at the Mavericks’ Ball in 2013 to be sponsored by Adventure Bug.
It all began in February this year when, after a difficult day at work, I saw an advert in the Dentistry magazine for Dental Nurses to win a chance to join a dental charity on a mission to Morocco.
“What a fantastic opportunity!” I thought, and entered my story, never in a million years thinking that mine would be chosen, and that I´d get that opportunity, one that would change my outlook on life forever! Here is my story….
My journey started on a flight to Amsterdam in the early hours of Sunday morning. There are no direct flights to Tangiers, that was my first discovery, so as well as going on a charity mission, to a foreign country, with people I’d never met before, I also had the daunting task of getting there alone!
My connecting flight to Tangier was on time, and was ready to board more or less as soon as I´d landed, so off to Morocco I went……
I met all the fellow Dental Mavericks at the Hotel in Tangier and immediately felt relaxed with them. We were all there for the same reason, to relieve as many children of dental pain as we could.
We would be carrying out 2 projects this year. The first 2 days would be in a village called El Jebha, where the Mavericks have visited for the last 3 years.
The 2nd project, also 2 days, would be completely new to the Mavericks, in a village called Merchekala in the Rif Mountains. Both projects were very different in many ways, but the aim to be achieved was the same.
After a 3 hour bus ride we finally arrived in El Jebah … What a beautiful village! We donned our “uniform” …. a tee shirt with the charity name and our name in Arabic on the front, and on the reverse was our name in English. As we walked up to the clinic, children read our tee shirts and shouted out our names, it felt like such a welcome!
I was amazed how everyone just mucked in with setting up the clinics. I was down to work with Richard Howarth, one of the trustees of the charity, on triage. The children were brought to the clinic in classes and as the children all arrived, suddenly it dawned on me that we were there, in the middle of it!
What also hit me was the amount of work that would need to be carried out to make the children pain free. A huge task in a country where there is usually just 1 dentist to 500,000 people.
We were working in an isolated fishing village with no dentists, a high sugar diet, no toothbrushes or fluoride toothpaste so it isn’t hard to imagine the levels of decay that we saw, but the dental neglect still shocked me. Many of the children we saw were living day to day with abscesses and pain, and there was nothing that they could do about it.
The interpreters wrote the children’s name on a card, and that was it! No medical history, no age, no consent, just a name, then they were examined. It took me back to the days of the old community school inspections! A bit of a conveyor belt … a quick look in their mouth, determine whether they were having toothache, and from which tooth, then write down the treatment needed. The level of decay was worse than I expected. Working in Community I was used to seeing neglected mouths, but these were different. The level of decay in permanent teeth was much higher.
The children were then sent to wait outside one of the 3 treatment rooms we had, the 3rd being the largest with 4 chairs in. When we ran out of waiting space, Richard and I went through to join the others and start treatment.
The first girl we saw, Romina, had a massive abscess on her lower molar. She sat on the chair, and pointed to the tooth. We numbed her up, and I comforted her by holding her hand, which she gripped tightly! Unfortunately the tooth was so badly decayed that it crumbled, leaving the roots still in the gum. It was only at this point that the little girl began to get upset. She was trying to talk to us, but we couldn’t understand what she was saying.
The interpreters were running from room to room trying to explain things to the children and I managed to get one to come through and help us. The little girl explained that she only wanted the one tooth from which she was having toothache taken out, and became upset because she thought we had already taken it, and were taking another. Once it was explained to her that it was the same tooth that had broken, she was fine. Poor thing. She must have thought we were going to take them all out! When we finally got the tooth out, she gave me a hug! She was so appreciative to be out of pain.
How humble something like that makes you feel. The rest of the patients were equally as cooperative, and equally as grateful. It´s amazing how you can manage to get by using thumbs up signs and high 5s! There was a lot of hugging going on around the rooms! It was after 6 by the time we finished and the team had managed to treat 61 children. Not bad going for 2 hours work!
As we walked back to the hotel, the children were out playing in the village square … football, an old bicycle, marbles and skipping ropes. Not an electronic game in sight! I actually felt quite pleased with myself, and was proud to be part of such an energetic and enthusiastic team. I felt that in those couple of hours we had truly made a massive difference to those children’s lives. I actually couldn’t wait to be back tomorrow!
We were up bright and early the following morning, and all were as eager as I was to get back to the clinic! Never have I known such enthusiasm. It was an amazing feeling!
We arrived back at the clinic and could start seeing the children straightaway. Some of the children must either have been resilient to pain or too scared to admit that they were in pain.
Totally shot teeth, down to gum level, but no pain? Unbelievable! But, as the child’s consent is the only consent we had, we couldn’t force them to have treatment.
All the children came on their own, the odd few speaking a little bit of French, but as their first language is Arabic, we muddled through with the few words we knew, and the help from the interpreters.
Fatima was, we guessed, about 6 years old. A little dot of a thing who came in pointing to her face. A massive swelling on the lower left. When she opened her mouth, every one of her teeth was carious, but she was only getting pain from the abscessed lower deciduous molar. It was oozing with infection.
She must have been in agony, but she was ever so good. She never even flinched when we numbed her up, but oh did she cry when we extracted the tooth. It was heartbreaking stuff. The infection was obviously so bad that we had no alternative but to get the tooth out. (It wasn’t like at home where we would have issued a prescription and got her back a week later.)
As soon as the tooth was out, she gave the biggest smile, and another hug. Inside I was cry-ing. This little girl was so relieved to be out of pain. She must have been living with daily pain for months!
And so the children came, and continued to arrive until the last child who had said that they had toothache had been treated. A total of 185 children relieved of toothache.
We went back to the hotel to collect our things and onto the long journey back to Chefchaouen. We arrived back in the evening. Everyone was shattered, both emotionally and physically and ready for a day of rest before we would leave for our 2nd project.
Today was a much needed rest day. A day to reflect on what had been, and to discuss what may lay ahead. Time to recharge the batteries.
We were taken on a guided tour through the village by one of the elders of the village, and it was interesting to see a little bit of the country that we were staying in, and hear a bit of the local history.
We set off bright and early for the journey further into the Rif Mountains. Today was Day 1 of our 2nd project. A completely new entity to every one of the Dental Mavericks. No-one knew what to expect as we set off to the village of Merchekala.
Although the journey was shorter than the one to El Jebah, it seemed a lot longer as the majority of the journey was off road! There were some hair-raising moments where we were perched precariously on the cliff’s edge. Seemingly donkeys and goats had the right of way on THIS path!
When we arrived at the Gite, we were made to feel like royalty! Fresh bread, with honey and the sweetest ever mint tea! (Obviously the reason we were here!)
We quickly set up the dental chairs, 3 in the store room, 2 outside on the courtyard and 2 in 2 of the bedrooms! How bizarre to be treating patients in the rooms we would be sleeping in later!
Very quickly word had got round that the dentists were in town! In no time at all there seemed to be hundreds of children, clambering over the gates, through the bushes, and getting in through anyway that they could!
It soon became apparent that the order we had experienced in El Jebah wasn’t going to be the same here. There was no shouting out of our names like before, perhaps because these children couldn’t read?
This village was far more run down than the other we had visited. Children with no shoes and children who were dirty. We were very much back to basics here. Two teenage boys took it upon themselves to “work the gates!” It was a case of one in, one out as this was the only way that any kind of order could be achieved!
The children in El Jebah knew what was involved when the Dental Mavericks were in town, after all, it was the 4th visit, but to these children, they had no idea what to expect. Excitement of the unknown soon passed when the first few children had been treated. Some of these children had never experienced going to the dentist, and at first it was a novelty. Every child who was seen got a toothbrush and toothpaste, regardless of whether they needed treatment or not. We think that word had got out that you got a gift, regardless of whether they had a tooth extracted or not.
After lunch, the boys working the gates were given a Sunderland football shirt each, kindly donated by one of the Dental Mavericks, and their faces lit up! Something so simple had probably been the best gift they had ever received!
Mohammed came to see us with totally shot molars. I’m guessing he was about 13. He had been triaged to have 2 extracted today, then come back tomorrow for the other 2 extracting. He was so good, but obviously so scared of the unknown.
The language barrier is so difficult. Then there was Redoin. A young boy aged about 7 or 8. He’d obviously suffered some kind of trauma as his upper central had been knocked out, he had a stitch in his lip, which looked like it had been there for months, and his upper deciduous premolar was broken.
We numbed him up, and he grabbed my hand tightly. He didn’t let go all the time that we were treating him, and he stared at me the whole time too. I wonder what those eyes have seen in his short life. There were high fives going on around us, and lots of thumbs up coming from every dental chair!
The buzz of getting through the patients and seeing them smile afterwards when they knew they would no longer have to live with toothache was immense! It was a roller coaster of emotions with lots of highs and a few lows. The last patient was seen at 7pm. Time had gone so quick, and everyone worked so hard. Fluoride varnish was applied to as many children as possible, toothbrush demonstrations were being given, and those in pain were relieved of that pain.
The day had been a success, with over 200 children seen and treated.
My journey was so worthwhile. I felt honoured to be part of such a fantastic charity and such a worthwhile project. Yes there’s still a lot of work to be done, but Rome wasn’t built in a day as they say! If even one child’s life was improved then that’s a start.
We had no policies or procedures, nor was there a tick box in sight!! Everything really was back to basics. Sterilisation was cold sterilisation, but we managed. If we didn’t have the right equipment, we improvised.
I know that this will change me completely as a person. Too often we take things for granted. I will take a lot out of my week in Morocco, but most of all I felt valued. I felt that we did something worthwhile. I made new friends, who are good people, who give. I aspire to be like them. We gave something back to a society who have very little.
As I was leaving, Redoin, the little boy with the stitch, was waiting by the Land Rover, and he gave me the biggest smile ever. I knew he was no longer in pain. Goodbye children of El Jebah and Merchekala … I hope to see you all again next year!
The Mavericks are a team of special people, the likes of I’ve never met before. Each and everyone of them gave their time for free to try and spread the message of better oral health, and relieve as many children of pain. Why do they do it? They do it because they are human and because they know that every human being deserves the same rights as each other.
If you can get back to basics, get your hands dirty and make a difference then please try and get involved in a project like this. I can guarantee that amongst the madness, lack of order and frustration your heart will be opened, and you will have a beaming smile on your face at the end of the day when you know that because of your team, hundreds of children will no longer be in pain.
These are the people we should hold in highest regard. Many thanks to all the Dental Mavericks for their inspiration and help, but mainly for giving me the chance to help make a difference.