Day 4: Circles, Circles!

Today we spent the morning packing up our supplies to leave at the friary for next year’s trip and then ventured out to the orphanage’s school to teach some oral hygiene and give out the rest of the toothbrushes we had left.  We gave instructions to about 500 kids in groups of about 150 – leaving Kakooge today we can say that we are a relatively sure that we taught half of the children in Uganda how to brush their teeth, and also how to say “circles…circles” and “up and down, up and down” with our hygiene talk. The kids loved it – and so did we.  We are hoping to be more active in the school next year, treating even more of the children who need help and making sure that all 931 of the students have toothbrushes and toothpaste, and know how to use it.  The goal would be to teach the staff at the school to give hygeine instructions and possibly simple procedures like cleanings and sealants and to replenish their toothpaste and toothbrushes as needed!

Dr. Farmer teaching some of the children at the school.

Marc teaching the kids our version of their "bonga" - HIGH FIVES!

Dan doing some hygeine instruction with the nursery class.

Katie teaching the kids to brush their front teeth in CIRCLES, CIRCLES, CIRCLES!

After the school, we toured the local hospital – which is really far from the villages that we travelled to, but close to the town.  The hospital is a Franciscan Hospital built by the friars and staffed by nuns and it is a really nice hospital compared to what we have seen in Kampala.  It is also much less crowded due to location and the fact that services are not free.  We visited the dental unit and met the dentist who pleaded with us to find her an amalgamator – she actually has a really nice set up in the clinic!  After the tour we headed home to provide some dental care to the people who helped us so much this week. 

We gave cleanings to Robert, Ronald, Marian (all three friars), and Sandy (the driver) and then with Dr. Farmer, performed fillings or extractions and made sure that everyone in the house had toothbrushes.  We really could not have done the work we did this week without them.  Overall, we are incredibly satisfied with how our first outreach trip went!  Not only did we gather really helpful information to be able to tweak our program and get Ugandan’s the maximum benefit from it, but we were able to provide treatment to over 300 patients, education to countless more and really learn some valuable skills.  Now we are headed back to Kampala to rest for a few days and head out on a safari on Sunday!

A last picture of the team before heading back to Kampala!

Day 3: Mitanzi (Wednesday)

We started off our last day of village outreach by stopping at a church that served as the village school and being greeted by about 40 kids clapping and singing.  We decided to stop for a little bit and give them all hygiene kits and instructions after Ronald (one of the friars) showed us the sticks that they are using to brush.  The kids LOVED it.  This was the first time most of them had seen a toothbrush/toothpaste and the coloring books that were in the hygiene kits and they really appreciated our silly performances. We looked at the children’s mouths and picked the kids with the 10-15 most severe conditions to take with us to the school to set up our “clinic” and helped some kids wiggle out loose primary teeth that were bothering them.  We headed about 15 minutes deeper into the bush to set up for the day.

Everybody brushing!!!

This location was by far the furthest out into the bush, or deep into the woods.  It felt like it took forever to get there on the bumpy unpaved road.  Once we arrived, we quickly set up shop and got started with the kids and registering the next patients.  We were joined for several hours by 4 dentists from the Uganda Dental Association which was really helpful in seeing as many patients as possible since this was also the location that the most people showed up for.  We were told later by the friars that the villagers thanked them profusely and told them that they often feel forgotten and hopeless because it is so far for them to travel for health care and they live in extreme poverty.

Our Team - UNC + Uganda Dental Teams, we cant wait to collaborate more next year!

Katie, Marc, Dr. Wandera (the president of the UDA), Dan and Dr. Farmer - Thanks to Dr. Wandera and all the dentists we worked with and look forward to working with again in the future!

We had to arrange our room a little differently in this village’s school since there was an abundance of bats!  Because of the large crowds and the fact that we wanted to just continue working, we decided not to allow them to prepare lunch for us on this day.  We did get slowed down temporarily by a huge thunderstorm which made us lose all of our light except our head lamps – the bats decided to come out and play during this little period of darkness and one even landed on Marc’s back and hung out for a while before anyone noticed. 

We treated and/or provided medicine, toothbrushes, and oral hygiene instructions to over 150 people in Mitanzi.  We all had our own personal struggles - Katie with a really young sad/uncooperative child, Dan and Marc with a patient who had not spoken in 2 months due to the pain she was feeling in her mouth.  Dr. Farmer was an amazing instructor, was able to work fast, and really helped us keep it together and learn to keep our confidence going.  Overall, we left Mitanzi exhausted but very happy to have at least given everyone we saw a toothbrush and help them learn to make strides to prevent the situations we saw from occurring again. 

Sayng goodbye to Mitanzi with a few favorites  before giving them a ride back the long distance that they walked in the morning to reach the clinic!

Day 2: Batuusa (Tuesday)

We were definitely successful in our goal of tightening the process and getting more patients in.  We all became much faster and more confident in our work.  We treated over 80 patients today and were able to provide almost 30 more with medication/pain medicine.  Of course, everyone also got oral hygiene instructions – which were necessary since we found out that most of the patients we were seeing were previously brushing their teeth with a stick!



Dr. Farmer, Dan, Katie & Marc in our "clinic" for the day.



Dan working with a helping hand from Sandy.



All of our backs may be broken.



Even though we expected a huge turnout and some bad conditions, we were shocked at the amount of people who showed up with severe infections, and in debilitating amounts of pain.  We were moreso shocked at the appreciation of the people for our work – even some of the kids who had a really hard time with some painful extractions would say thank you afterwards.  One woman told us to thank our parents for raising us and getting us to be the kind of people who would use our money to come and help people who were in great need – so shoutout to our parents!!! 

Marc doing some night dentistry.



It was a hard day full of abcesses and tears (mostly from children and not us) but we wanted to make sure that we saw as many patients as possible so we ended up staying until about 730PM.  We had to do dentistry in the dark for our last few patients…which was an interesting twist.  We did get to take a nice lunch break with a local meal cooked by the village for us.  We could not believe that they were using what little food they have available to cook us a huge meal of chicken, matoke, potatoes, g-nut sauce, and rice.  We all tried hard to eat as much as we could, with the looming fear of getting sick from using local water for cooking, and enjoyed what we could.  Robert, one of the friars, made fun of us for our weak appetites and told us if he comes to America he promises to not refuse food – so we agreed we would feed him to the point where he had no choice but to say no.

The lunch prepared for us.

Katie and Marc eating ALL THE FOODS.

Day 1: Kitansa (Monday)

We got up bright and early to eat breakfast, pack the car, and head out to our first village.  All of our outreach has been organized through schools, we were heading to the local primary school to set up.  When we arrived we were greeted by a school full of children ready to meet us!  They helped us unload our car, clear their classroom out and move our stuff in.  After about an hour of hard work – we were finally set up and ready to go!

Katie and her favorite, learning to floss.

Dan getting his first patient comfortable with some OHI.

Marc teaching a group of kids how to brush.



We left the house this morning thinking that our goal of seeing 75 patients was outlandish and insane, atleast Dan, Katie and Marc did – for whatever reason, Dr. Farmer was confident in us.  We were able to see 70 patients, send one patient to the hospital for a large growth in the back of her throat, and provide oral hygiene education for almost everyone that we encountered.  In addition to this – the patients we were forced to turn away got toothbrushes, health education, antibiotics for infection or medication for pain and were told to come to Wednesday’s outreach early to be seen if possible.  Overall – we felt really great about everything we were able to do today, and saw some people with very severe conditions.

Marc and Dr. Farmer suturing after an extraction.

"Walumi??" means something like..."where do you have pain?"

Katie was in pediatric heaven with all of the children from the school; the kids loved her oral hygiene puppet and got a kick out of her trying to use Lugandan to instruct them.  She even taught them some English words with her little talks.  Dan was a rockstar helping Dr. Farmer with “the African molar” and was eager to help with anything thrown his way – and everyone else’s way when they needed a break – and got very comfortable with assisting in extractions and anesthesia.  Marc got incredibly comfortable in his diagnostic skills and was able to get through a ton of patients and despite the language barrier was able to make everyone – even a kid with one of the worst infections we have ever seen – comfortable in our presence.



Uncle John doing some sterilization for us



We had so much help from local English speakers – the village heads – and the friars, especially Robert and Ronnie who are the up-coming friars we mentioned yesterday.  Even the man we hired to drive us for the week (Sandy) jumped in and became an amazing dental assistant and a key translator!  We solidified the little Lugandan we know and learned a few more words <please ignore the ridiculous spelling of these words if you are a Luganda speaker>– yasama noi (open more), wanda (spit), luma (bite), and of course bunira (close), and also learned some really helpful body language. 



Sandy (our driver) and Robert ( a friar) doing some translation.

We are looking forward to tomorrow, and are expecting more patients to show up at tomorrow’s village.  Hopefully we will be able to get our process down a little tighter and be able to add a few more patients and rounds of oral hygiene instruction into the mix!

Thank You for Loving Us! (Sunday)

We all got a great night sleep at the friary on Saturday; the boys were woken up by children letting them know it was “TIME TO GO TO CHURCH!” for the friars and Katie got an earlier wake-up call from the compounds German Shepard.  We were told the dog barks when it sees snakes or intruders, so you can imagine the things going through her head J.  After some amazing showers (the showers here are incredible compared to our Kampala showers), we got together to separate out our supplies and come up with a game plan. Our unpacking was accompanied by some local music a few of the school’s children played for us while they hung out outside the door, eager to meet all of us.  We were able to play for a little bit and get some pictures before we had to eat breakfast and get set up for the day!

Posing with our new friends, they wanted to "Greet the Lady"

Dan & Katie doing a composite fllling


We saw a total of 17 patients over the course of the afternoon – and it was definitely a learning experience.  With an amazing amount of help from all of the friars and people from the village who acted as translators, we all got the chance to do some work.  Marc, Katie and Dan all jumped right in and were all able to get the concept of extractions down, make sure that we had some of the basic language (yasama is open your mouth, bunira is close your mouth), place some fluoride releasing restorations, make sure that our oral hygiene presentations were up to par and most importantly – get some people out of pain and educate them to be able to care for themselves in the future.  For many of the children and even adults we met today, we were their first experience with a dentist.  Everyone was incredibly grateful for our presence and even for the small amount of help we were able to offer them - a common phrase used here is “thank you for loving us.” 

Dan & Dr. Farmer doing a filling

Tomorrow we will head out into “the bush” as Marian calls it, and go to our first village outreach.  We are all bracing ourselves for a long day – as Dan, Marc, and Katie felt like they got hit by a bus after just 17 patients today – but are incredibly excited to meet everyone and be able to make some small impact on their lives and are hopeful that with growth of the project we will be able to make a lasting change.  We are so thankful to Dr. Farmer for coming along with us and teaching us and again – thanks so much to everyone who donated supplies, this could NOT have happened without you!

Welcome to Kakooge!!!! (Saturday)

First things first - all of the patients we saw at Makerere and in the villages have consented to us taking their photos and them being used/posted by us, and if they did not...we didn't take pictures! :)





Now back to Uganda: Leaving Kampala on Saturday afternoon – we had no idea what to expect.  We had heard that Kakooge was various distances and that it would take anywhere between 1 and 30 hours to get there.  Father Marian, one of the friars who works at the Greyfriars Mission Uganda and Marc’s Uncle Johnny, who is also a friar, were meeting us in Kampala so that we could caravan with our minibus and our driver, Sande.  They were only meeting us because they needed to go to a grocery store….which made us think if they have to drive ALL THE WAY to Kampala for groceries – what were we in for!

Playing in Kampala before heading out to Kakooge

We met the friars at Garden City after having lunch and checking out the craft market and buying souvenirs – including Muzungu T-shirts of course.  Father Marian told us to expect simplicity, which is something that we had very much gotten used to at The Edge House in Kampala.  When we arrived, about an hour or so later, at the Friars’ compound, we could not believe how nice of a set up they have!  It is right outside the heart of Kakooge and living inside the compound are three friars, a few up-coming friars, and a cook.  The children that the friary supports live on the adjacent land belonging to the school in dormitories and we got to take a tour and meet all of the children!  The friary has set up multiple side projects to get income for some of the families in their villages – they grow bananas, pine trees for wood, and many other healthy fruits and vegetables.  They also have a well with clean water that they allow village members to use, since children and women are responsible for supplying water to their families. 

The group meeting some kids from the school!

Expecting that we were missing American cuisine, Marian and Johnny asked the cook to make us spaghetti and got us treats like Oreos and Snickers and then….they asked us to eat ants, a Ugandan treat. Marc, Dan and Dr. Farmer say they taste like sunflower seeds – Katie and Uncle Johnny ate theirs more like a pill, so they may not be sure how they taste.  After a delicious snack, we settled our plans for the rest of the week and heard from the Uganda Dental Association that they would send SIX dentists and supplies to help us with our outreach in Wednesday’s village!!! THIS WAS GREAT NEWS! We had been warned about the multitudes of people who will show up this week and are incredibly excited to have help and support as well as to be able to see as many patients as physically possible with so many hands to help!  We also decided that we would see 15 patients on Sunday to have a run through of what would be happening the rest of the week and make sure that we were all up to speed on all of our skills. 




Uncle John savoring his ant, and Katie grabbing a chaser



The men being really manly and enjoying their ants.





THE LUGGAGE CAME!!!! (so did dr. Farmer)

After our awesome night with our housemates, we got up nice and early for Oral Surgery Theatre (which is the OR). It was really cool to see the prep, anesthesia, how they manage the operating room.  It was all very similar to things that we had seen in the States with a Ugandan twist; we particularly enjoyed the wardrobe.  When you enter the surgery ward, you take your shoes off and leave them at the door, change into hospital scrubs, and once you enter the surgery side you select boots to wear. 



Katie, Marc & Dan in our OR outfits!


Marc and Katie had to leave before the surgery started to meet Dr. Farmer and get him to campus for his lecture, but Dan got to stay and see an amazing jaw resection and reconstruction due to an ameloblastoma - there is a picture of the resected section of the mandible at the VERY bottom of this post for those medically/dentally oriented folks. Marc and Katie took Dr. Farmer to get some Indian food for lunch, which was AMAZING, and then made the trek to campus where he gave two lectures on Oral and Systemic health and Local anesthesia techniques.

After Dr. Farmer's lecture with students, the dean, and the president of the Uganda Dental Association.

The students and faculty really enjoyed the lecture and we discussed future collaborations in which we will hopefully be able to assist some Ugandan students in coming to visit UNC, as well as having our students spend more time at Makerere! When we came back to the guest house - WE GOT OUR BAGS!!!! We are all super excited to have clothes that we haven't worn for 5 days straight. We celebrated with a nice dinner at Mamba Point, and came back to hang out with Ellie, Deria, Ben and Nasa (he lives at the house, works there and keeps us all entertained) for the girls' last night. We said goodbye to the staff at Edge House today, and were sad to leave our little home.  We are heading out to the villages and our internet connection here is slow - we will add more pictures to this post when we get a better connection!

Posing with Nasa right before we left!

The resected mandible and the wire they were reconstructing it with!