There were other teams at this site, mainly wildlife research people. Some of them from the States and a few Malagasies. They’d help us when they were free, and at night we’d all enjoy a good meal, some good music, conversation, and of course quality Malagasy beverages. Since we had little artificial light besides flash lights, we’d get to bed at a decent hour after chatting and being so tired sleeping on the ground wasn’t uncomfortable at all.

We did a few surgical extractions at Ankarafantsika, one endodontic procedure (with help from our Nomad portable dental x-ray unit), and even had a hypoglycemic incident in which I helped. Nothing like real, on your feet training. Granted, I’ve been training for that since I can remember (did I mention I’m an Eagle Scout?).

The following image was a highlight of school. We were doing a hands on exercise with Dr. Kucine, who I’ve mentioned before. It was a Friday and I’d get out early after my session. And since we took turns, I had the time to step back and capture this image.

A small glimpse into that which keeps me sane.

We packed up the clinic early and loaded everything up for the move to our next clinic site. No matter how hard you work to pack things up in an organized manner, there will always be challenges…especially with 10+ people helping to load up. Cornelia, the MAF CEO, and her Malagasy sidekick Benjy were invaluable on these days, not to mention the whole Malagasy team.

Upon return to the hotel we were instructed to clean up and put on our civilian clothes. MAF had planned a nice dinner for us as a swank hotel out by the water, complete with a pool. The meal was great, as were the drinks and the live music. Afterwards, a hand full of us stuck around and jumped in the pool. It was surprisingly cold, but refreshing after a long day in the hot sun.

Below is a video of one of our Malagasy team members showing us how it’s done on the vocals during dinner.

Our travels to Madagascar included a limo to JFK (thanks Dr. Wynn!) through London through Nairobi through Antananarivo to Mahajanga. Mahajanga is a larger port city on the eastern coast. We’d be staying in a hotel there for the first week. Having done an outreach in Uganda two years previous, I was surprised by the luxury of the hotel. Can you believe we had AC units in the rooms? Across from the hotel was the Madagascar dental school, and down the street was the water; nice views. Urban Madagascar was obviously better off than that which I had seen in Uganda. Take a look at the price of a cola: in Uganda it was approximately $0.10 USD and at least $1.00 USD in Madagascar.

Clinic

Each morning would we have breakfast in the hotel’s common room and then load into the vans to drive out about 45 minutes to the rural clinic in Berivotra. We used the existing school built by MAF as our clinic. There was also a teacher’s house, and down the road a bit the paleontology research station. Most of the first day was spent cleaning and setting up for the clinic; in the afternoon we saw a few patients. Here the third year students were asking for assistance from the doctors frequently. It was amazing to see their progress over the first few days. Everything rapidly sped up, and their competency grew quickly. Us first year sterilizers were stuck in the sun all day, but that’s better than inside a classroom with no windows!

Accommodations

Lunch during clinic days would be out of the van. Usually bread and toppings/spreads, and fruits. Not first class, but certainly nothing to complain about. After clinic we’d clean up and jump in the vans before sunset for the drive back to Mahajanga. We’d typically eat at a local restaurant. The cuisine has a heavy French influence; the eating was good. It was not difficult to find meatless options. Often after a THB (the beer of choice) or rum, we’d head back to the hotel for relaxation before sleep for an early rise the next morning and another long day of clinic.

This video shows part of our commute out to Berivotra from Mahajanga and a brief tour of the clinic. Towards the end you see Drs. Wynn and Willoughby contemplating radiographs taken with our portable Nomad radiograph system.

In removable prosthodontics we’re working our way through learning complete and partial denture setups. I’m still working through the complete dentures. It’s a frustrating thing to learn, but we’ll get there someday, right?

Some History

The Madagascar Ankizy Fund was started by our anatomy instructor, Dr. David Krause when a paleontology team of his noticed children observing their work in Madagascar. He wondered why they weren’t in school; in fact there was no school for them to be in. So the team chipped in, quickly raising the $500 it would cost to pay a teacher’s salary for one year. From there, MAF has built numerous schools in rural areas of Madagascar. Dr. Krause’s relationship with the dental eventually led to the beginning of dental outreach missions to the areas served by MAF’s schools. Today there are five schools in use (with a fifth under construction) and dental missions nearly each year since 1999. ¹

Dental Outreach, 2011

Beginning the previous year, two first year students were offered a position on the outreach team as the primary instrument sterilizers and organizers, as well as general assistants. I was interested in the outreach since I first learned of it, but was unsure if I would apply. It was unclear as to whether students that participated during their first year would be allowed to return third year to partake in the clinical experience. As soon as we learned that we would be allowed to re-apply, I was convinced I had to go. After writing an essay and a short interview, I was lucky enough to be selected as one of two first years to assist the team of six third years, and two participating faculty.

This year Drs. Wynn and Willoughby would lead the team, with assistance from Dr. Krause and MAF CEO Cornelia Seiffert as well as a team of Malagasi natives who were serve as facilitators, drivers, and translators. Our trip would span three weeks following the end of our first year (third years would be missing clinic) and we’d visit three different locations to provide treatment.

Over the next few weeks I’ll offer some thoughts and imagery about our experiences. For now, here’s a photo to hold you over.