Dominikanische Republik » Dominican Dental Mission Project (DDMP)

Dominican Dental Mission Project (DDMP)

Dr. Keith Phillips

World events — 1982: The British overcome Argentina in the Falklands war; Soviet leader Leonid Brezhnev dies; the first permanent artificial heart implanted in a human was placed in Barney Clark at the University of Utah Medical Center; Dr. Francis Serio, a young dentist just two years out of dental school, arrives on a flight from Miami to Santo Domingo to begin what ultimately would become the Dominican Dental Mission Project (DDMP). Today, the DDMP serves more than 44,000 patients and provides over $6 million worth of free dental services!
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Dr. Serio was initially motivated to begin this project when he observed the wonderful experience some of his high school classmates had while serving in Africa during their medical school training. He contacted the Catholic Medical Mission Board of New York, which directed him ultimately to the town of San Jose de Ocoa. His first four-week mission trip began with only a few boxes of instruments and supplies and plans to do a few fillings using hand-mixed amalgam and autocure resin, although he realized he would primarily be doing extractions.

The past 22 years have seen an amazing transformation in the DDMP. Dr. Serio continues to guide and direct the project. Teams of 30 or more dentists and volunteers from around the country — including dental students from the University of Mississippi, University of Maryland, and the Medical University of South Carolina — now contribute their time and skills to provide not only surgical care, but operative care, lab services for prosthetics, and even occasional endodontic treatment. The DDMP teams are now completely mobile and spend their time in different mountain villages each day. Schools, churches, and the occasional rural clinic can be converted into functional dental offices in about 45 minutes.

Dr. Serio attributes much of DDMP's success to the cooperative efforts of American and Dominican volunteers. Every year, American volunteers collect supplies and equipment, while their Dominican counterparts make arrangements for their transportation between villages. A well-coordinated schedule and on-site assistants ensure that things run smoothly.
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One of the highlights for Dr. Serio and the numerous volunteers over the years was the recognition by President Bush in 1991 when he awarded the DDMP and Dr. Serio the President's Volunteer Action Award. The DDMP is conducted under the auspices of the Catholic Medical Mission Board and is funded from a variety of private sources. Perhaps one of the most inspirational accomplishments is the opportunity Dr. Serio has had over the years to watch several Dominican volunteers become motivated to undertake dental training of their own. In addition, many volunteers have gone on to begin missions of their own in Jamaica, Belize, Vietnam, Cambodia, Venezuela, Mexico, Honduras, Ecuador, and Haiti. Dr. Serio sums up the entire experience by saying: "All who have participated, some many times, have been touched in some way by the dignity, hospitality, and joy of those who have little of the material goods the world offers."

The best time to plant a tree was twenty years ago. The second best time is today.
— Chinese Expression

I shall pass through this world but once. Any good, therefore, that I can do, or any kindness that I can show to any human being, let me do it now. Let me not defer it or neglect it, for I shall not pass this way again.
— Stephen Grellet, Alonzo Newton Benn

Dr. Keith Phillips maintains a private practice in Winston-Salem, N.C. He is president and founder of The Giving Hand Foundation, a nonprofit organization committed to the start-up and development of free medical and dental clinics. Dr. Phillips also serves as a teaching associate at the L.D. Pankey Institute. You may reach Dr. Phillips at keithp@ pprdds.com.

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he Dominican Dental Mission Project (DDMP)

The Dominican Dental Mission Project: The Dominican Dental Mission Project (DDMP) is a service-oriented project conducted under the auspices of the Catholic Medical Mission Board, Inc., of New York (see www.cmmb.org). The project, which is one of the most durable projects in the country, has been in continuous operation for 33 years (as of 2014). The DDMP was started in 1982 with one volunteer who spent four weeks providing care in mountain villages in the Dominican Republic. With rudimentary supplies, the volunteer performed exodontia in village homes, and limited restorative dentistry services (i.e., amalgams and auto polymerized composite resin restorations) were delivered in the local hospital dental clinic. Except for a dental unit with a creaky high-speed handpiece, equipment was lacking. A mortar and pestle and a squeeze cloth were used to mix amalgam. The volunteer returned from that first trip wondering whether he had done more for the Dominicans or whether they had done more for him.

After the initial trip, several dental students learned about the project and expressed an interest in participating, so the mission board and local missionaries, who were approached about that offer, thought the students could be accommodated. A portable dental unit and compressor, along with more supplies, were purchased. In 1983, one dentist, one hygienist, and three dental students participated. Since that time, with the assistance of the local Dominican community, Catholic missionaries, as well as interested volunteers, the project has expanded to as many as 40 participants working at three different sites in the Dominican Republic annually.

The project has become completely mobile, so that each day volunteers leave the mission compound for remote villages high in the mountains. Preventive services, exodontia, operative dentistry (i.e., amalgams and light-cured composites), endodontic, pediatric (pulpotomies and stainless steel crowns) and prosthetic services (e.g., transitional dentures to replace maxillary anterior teeth and complete dentures using denture templates and monoplane teeth) are delivered in schoolrooms that have been converted into dental clinics for the day. The project incorporates a variety of portable units, compressors, generators, chairs, and other equipment to make the services a reality, and all of the dentistry is done in villages with no consistent source of electricity or running water. The local health committee of the town’s development association and local missionaries are responsible for scheduling the villages that will be visited, recruiting and organizing volunteers to help with registering patients, assisting dentists, cleaning instruments, cooking, and providing transportation.

After having treated about 250 people that first year, the first volunteer felt his efforts seemed like only a grain of sand on the beach. However, 33 years later, more than 60,000 people have received approximately US$18 million worth of dental services through the project. Eight Dominicans who originally worked as helpers have gone to dental school and have been partially supported by the project. Several of these dentists continue to work with the project. Preventive programs, including placement of sealants and administering fluoride, are in place in most of the local elementary schools, where each classroom has a toothbrush rack.

As the project evolved, some communities no longer had a great need for the visiting dental teams because Dominican trained dentists have been able to provide the necessary services. As some villages became more self-supporting, new villages were added to the itinerary. As the initial leaders of the project stepped away and then returned, other project veterans stepped forward to continue the work. In addition, several Americans who had volunteered for that project have subsequently developed projects of their own in other countries.

http://internationalvolunteer.ada.org/ge...ce-projects.php

by Kyle Patton, Associate Editor, Dentaltown Magazine

A house on a mountain
There is a house perched on the edge of a mountain. It is not easy to get to. In the Dominican Republic, the terrain is beautiful but unforgiving. For Dr. Francis Serio, the house is just another stop along the journey—albeit a special one. The house has no electricity and no running water. Serio has been to the house many times before to see Ramone, a young man who has cerebral palsy, a congenital disorder that leaves him mentally and physically impaired. The doctor stops by to check on Ramone and provide dental care, a service that the family could never afford or easily gain access to without the help of Serio's mobile dental clinic. For Serio, Ramone's story is the one that first comes to mind when he thinks back on the last three decades of charitable work he's devoted to the people of the Dominican Republic.

"We'd visit with the family often when we'd go back and forth over the years," Serio said. "One year, his father, as a thank you—and this family is literally dirt-poor—he brings us a whole burlap sack full of carrots. The thing is, while what we're doing might be worthwhile and have value, we are giving of our excess. This gentleman was so touched by the fact that we took care of his son, that he was thanking us from his substance. And it doesn't get any better than that. It just doesn't."

Humanitarian of the Year
Serio is the 2015 American Dental Association Humanitarian Award recipient, a cumulative recognition for his charitable and humanitarian work that spans more than three decades. The award recognizes those who have given at least 10 years to improving the oral health of underserved populations. On that basis, Dr. Serio qualifies three times over. And he isn't stopping.

Dominican Dental Mission Project
The bulk of Serio's charitable efforts has been spent founding and running the Dominican Dental Mission Project (DDMP). Serio will be recognized at the ADA's Opening General Session in November, where he will receive $10,000 to put toward continuing his work in the Dominican Republic. The DDMP, now a well-oiled machine, is approaching its 34th year. Since Serio began the DDMP in 1982, it has treated approximately 60,000 people and donated services worth an estimated $15 million, not including equipment and supplies. More than 520 volunteers have participated through the years, mostly dental students from American universities. The DDMP provides supplies for local dentists and works vigorously to raise oral-health awareness in the country.

The efforts and reach of the project have continued to expand. Each year, teams of dentists and American dental students travel to the Dominican Republic, where they link up with local volunteers to provide treatment and services to an estimated 1,000 rural poor each summer. At its peak, 42 people from the United States participated in the annual trip. On average, the DDMP brings 15 dentists, dental students and volunteers from the states. Its inaugural trip, though, was a solitary affair.



Mortar and pestle
"I've been very fortunate," Serio said. "Our family has always been service-oriented in many respects." Serio is from a big Catholic family—one of twelve siblings. His father was a dentist, and despite an initial disinterest in college, Serio eventually came back to dentistry.

"Dentistry had been staring me in the face ever since I was born. What attracted me to it, partly, was that my dad was a dentist. But the major motivation … I'd been exposed to it so much. I loved science and biology. I loved people and I loved working with my hands. So, what's not to like about being a dentist?"

Early in his dental career, Serio felt a need to use his skill set as a dentist to help underserved communities.

When he contacted the ADA in search of an opportunity, they gave him a couple of options.

"I originally wanted to go to Africa," he said "The Catholic Medical Mission Board out of New York said 'Great, can you go for two years?' And when I stopped laughing I said no, let's make it [for] a month somewhere else."

A while later, Serio was stepping off a plane in the Dominican Republic, despite not knowing a word of Spanish.

"The first year I was down there, these were the years the filling materials were mixed in two parts. I didn't have the machine to mix the amalgam, so I used a mortar and pestle. The only reason I knew how to do that is because my dad had a mortar and pestle in his study. One time, I had asked him what a dentist would need that for. And that's what he told me."

In 1982, Serio was teaching at the University of Maryland. He gave a lunch-and-learn presentation about the trip the previous summer, and several students asked if they could accompany him the next year. And every year since, volunteers have signed up. This year, 20 are on board to make the annual trek. Fortunately, no one is stuck using a mortar and pestle anymore.

A treatment day in the Dominican
The day starts at 7 a.m. sharp. It's an early start, and it's going to be a long day. Serio and his team won't wrap things up until around 10 p.m., and all the time between is set aside for a single goal: to help as many people as possible.

"We are a mobile clinic. We travel to a different town every day. So we take all of our stuff with us every day. The first thing in the morning, we get up, we have breakfast and we load the trucks. A lot of the places we go, there's no—or very limited—electricity, and sometimes there's no running water. We load everything we need. We've got generators, we've got portable dental equipment, we've got chairs and we've got dental units," Serio explained.

Then comes the travel, which can take as little as 15 minutes or as much as 45 minutes, depending on conditions. Much of the rural road system in the Dominican is—expectedly—unpaved and rough.

"We show up, and most of the time it's at a school," he said. "We take up one or two rooms and decide where we're going to do the oral surgery, where we'll do restorative, where we'll clean our instruments, do prosthetics and where we can put the generators."

Once everything is set up, Serio does triage at the door. It's an opportunity to meet everyone lined up outside, patiently waiting to be seen. In most cases, the team will meet people who have never seen a dentist before. Decay is common, especially among children. Serio has seen countless 1st and 2nd graders who showed up with their mandibular first molars already destroyed by decay. Early on in the trips, Serio was limited to mostly extractions and fillings.

"But over the years, we've done more than just fillings and extractions. We've done a lot of prevention. We do a lot of teeth cleaning, sealants and pediatric procedures. We do partial dentures; we make full dentures. On occasion, we've done root canals. We do a lot of different things and [will] continue to over the years," Serio said. "Last year I did full dentures. We made 14 full sets of complete dentures."

One of the hardest balances to maintain is time versus amount of treatment. Even working long into the evenings, it can be difficult to make sure that every patient is seen and treated.

"You can't spend all day taking care of one person because then you'd only see a small handful of people," Serio said. "But at the same time, you don't want to just run them in and run them out and only work on a couple [of] teeth."

Serio focuses first on ridding patients of pain and infection, and then he always tries to give each patient at least one side of his or her mouth to chew with, while doing extractions, fillings and restorative treatment on top and bottom.

Support
Serio will be the first to tell you that he could never have done any of this alone. From the support of a strong family to having the financial backing to keep the DDMP running smoothly, there is a lot to remain thankful for.

"Nobody does anything by [himself]," he said. "And certainly without the love and support of my wife, Cheryl, who is also a general dentist—without her, there's no way this project would have lasted as long as it has. She went for the first time a month before we got married. She knew what I was about, she knew how it was going to be important to me. She's been on the trip a handful of times, while the other times she stayed home to take care of our children."

The project itself is entirely privately funded. Participants buy their own plane tickets and contribute $300 to help offset the cost of housing, transportation and food. The Serio family considers the DDMP one of its major philanthropic projects, giving it the rest of the backing and whatever else it needs to continue to serve the communities that have come to rely on the dentists coming back each year.

As a charity, the DDMP is able to generate a value of $10 in service for every dollar spent on the project.

Years to come
A few years ago while in the Dominican Republic, Serio came across a newsletter from one of the nearby churches. Inside the pages he was surprised to come across a bulletin that mentioned the DDMP.

"It said 'We know that because the dentists come back every year, that God has not forgotten us,'" Serio recalled. "And the first time I read that, you could have knocked me over with a feather."

Sometimes you can go through life not knowing what kind of impact you're having on people, he said. "The fact that we can give hope to people who literally live at the end of the road, the hope that we're coming back—that is probably the most impressionable thing that's ever happened to me.

"You get to a point where it becomes a fabric of your life. You've always got to pay it forward. You can't pay it back. The only way you can try is by taking the gift [you've] been given and then using it to make somebody else's life a little better."

Several things keep him going. One, the need is there. Despite the work his team has done in helping several local Dominicans become dentists, there will always be future generations to take care of.

"I speak enough Spanish now, I can goof around with the patients. I can make them laugh. When I first started I wondered if I'd do it the next year, then the next year rolled around and we did it again. Now I don't even think about it. We've been doing it for 34 years. Someone asked me if it was sustainable. We've been doing it for 34 years. I think that's long enough to call it a sustainable project."

Every year is another reason to go back for the doctor and his volunteers, he said.

In three decades, Serio has never lost his desire to return the following year.

Pay it forward
In 1982, the access and amount of resources dedicated to finding charitable and humanitarian outlets for dentistry were rare. Today, the information is closer at hand than it has ever been. There is no excuse to not help out in some way, Serio said.

"A lot of times, dentists worry about what's going to happen to their practice," Serio said. "Nothing bad is going to happen to [your] practice if you leave for a little bit of time. Patients will even see you in a different light once you're involved in projects like this. I have patients asking me all the time if I've gone on my trip, or asking about how it was. It becomes a part of the fabric of the practice." Serio's recommendation is that dentists interested in charitable opportunities join well-established projects and organizations that have a close working relationship with the host community. But everything starts with the feeling of wanting to give back.

"As they say, to whom much is given, much is expected," Serio said. "And I think my family and I have tried to live up to that."

For volunteer opportunities and more information, visit InternationalVolunteer.ADA.org, and USA-ICD.org.

About Dr. Francis Serio
Serio's humanitarian projects extend beyond his work in the Dominican Republic. In 2012, he coordinated the dental arm of the Project Homeless Connect in Greenville, North Carolina. He has also served on many Mission of Mercy and Remote Medical Projects in North Carolina and Virginia. Serio is currently a national presenter for promoting volunteer activities within dentistry. Outside of dentistry, Serio has worked with Habitat for Humanity for 15 years. He works in a community health clinic in Greenville, North Carolina. He and his wife, Cheryl, have two children. He can be contacted directly at francisgserio@gmail.com.

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