Surgery and Healing in the Developing World - Dartmouth-Hitchcock

CHAPTER 24
Outreach Dentistry: A World of Wonder
Awaits in the Golden Anniversary of
General Dentistry
Glenn W. Geelhoed
It is very gratifying to be asked to address a subject that has been the focus of my
professional and personal commitment for several decades, and one I can attest to
be a communicable contagion based on the experience of a large number of young
professionals I have led abroad into adventure in developing world health care. None
of these idealists has made his or her “last trip” into such an environment! Further,
this is a highly appropriate way to celebrate the Academy of General Dentistry’s
“Golden Anniversary” with a heightened awareness that the professional skills and
approach to oral health are a trust to be further developed and passed along in a
humanitarian response to needy persons in environments less privileged than those
in which we have been beneficiaries. The challenge facing the next fifty years to the
century mark of the Academy will be one we will be less able to teach than to learn
from others in lesser developed parts of our world who have greater experience with
necessary skills we will have to master quickly: how to handle larger volumes of patients
with greater problems for effective outcomes using far fewer resources.
To accomplish this goal, we cannot turn in our usual recourse to higher technology,
but must rely instead on creativity and imagination for adaptation and improvisation
to meet the vastly larger human need with expanded ingenuity. The
overwhelming burden that sometimes confronts first-timers in facing the needs of
the developing world sometimes results in the paralysis of despair at responding at
all. Some of them may seek to limit their response to only a small boutique enclave
of patients most like us in socioeconomics, patterns of health, illness and language,
and in urban settings and facilities most nearly like those with which we have become
familiar in training and practice in the developed world. This limited response
strips the volunteer of the essential and rewarding experience of “sharing the burdens,
miseries and joys of the world’s majority citizens” and also impoverishes the
creative experience of adapting what one really knows of fundamental principles—
oftentimes stripped of power and plumbing, which were rarely present in the formative
evolution of the profession—and allows one the professional pride of “owning”
the concepts when applied in vastly different settings to the unique solution of human
problems.
A favorite phrase I have used to describe this process of adaptation across large
gulfs of socioeconomics, language, culture and technology is: we have no money;
therefore we must think. In the western world, reliance upon technology or pre-packaged
solutions—almost irrespective of the uniqueness of the problems—is often a
Surgery and Healing in the Developing World, edited by Glenn Geelhoed.