“If our hopes of building a better and safer world are to become more than wishful thinking, we will need the engagement of volunteers more than ever.” — Kofi Annan
Since March 2020 we have put a temporary hold on our volunteer program in response to the pandemic, and have been caring for our patients with a small crew of five to make sure food and medical supplies are distributed, our chronic patients are still treated, emergency cases are addressed, and the facts surrounding the spread as well as key health education is disseminated throughout our populations. We are also working closely with the Ministry of Health to monitor the virus.
After a year without full clinics, the medical need is building up and we are ready to begin accepting a limited amount of volunteers to help our patients, while following strict infection-control protocol.
As of March 28th, 2021, we will begin accepting a limit of 5 volunteers per week, so that each volunteer will be able to socially distance properly during training and meals, and will each have a dedicated bathroom space. Volunteers will need to provide proof of COVID immunization prior to traveling into the vulnerable Ngäbe communities, who may not receive the vaccine for some time.
Please feel free to reach out with any questions via email at [email protected]. We wish you all the best in your life and endeavors in the meantime, and look forward to having the opportunity to work with you someday soon.
As we close out August and what feels like the millionth month of quarantine from a novel virus, we’re looking toward what this season typically brings for most people: back to school and sporting events that either put us all in packed stadiums or crowded bars watching a screen. For those of us in the northern hemisphere, it’s the last hurrah before colder weather pushes us all indoors and flu season takes hold.
Flu season… and the debates over whether to get the flu vaccine. This year, we’re all also talking about the development of a vaccine for COVID-19. When will it be ready? Has it been tested enough? Will we get the vaccine if it shows to be “only 30%” effective at preventing COVID?
Well timed, August is also National Immunization Awareness Month in the United States. While we could share statistics showing the efficacy of vaccinations and the low risk associated with it, we’d much rather share some of the life experiences that explain why we support vaccination (all data aside.)
About 30-ish years ago, vaccination coverage within the Ngäbe-Buglé Comarca really improved (they were available earlier, but harder to access.) We even have a couple of patients in their early 40’s who were crippled by polio in childhood [for comparison, there have been no cases of polio originating in the U.S. since 1979.]
Despite massive trust issues between the indigenous population and any outside agency, there is pretty much zero vaccine pushback from the communities we serve, even from those individuals who otherwise prefer botanic medicine to western medicine. This is because many have a fresh, living memory of life before vaccines… and they remember all too well.
In our clinics, we ask all female patients how many pregnancies they have had, and how many living children they have, and believe us- the child mortality rate was not good. Especially when you look at women who were childbearing 30 years ago or more, you start seeing a lot more women who have had 8 or 9 or more pregnancies, but only 5 or 6 living children (or less), many of those dying in the first 5 years of life.
Then vaccines started to get out into the population and the children started living to reach adulthood– and the resulting massive population boom has actually caused all kinds of challenges for subsistence families living with no power, clean water, sanitation, or roads in remote jungle settings. Many Ngäbe feel these challenges keenly (feeding a large family, growing enough, earning enough, cutting down more jungle to build more homes…in some communities there are so many kids that half go to school on one day and half go on another day). Very real issues, to be sure, but the Ngäbe prefer to deal with those rather than expecting half their children to die by age 5.
Many we’ve spoken to here are puzzled that there is a movement by parents in the United States and elsewhere to not vaccinate their children. Their experience is that without immunizations, their children will likely die of communicable- and preventable- disease. The stories of those with first-hand knowledge of life pre-and post-immunization is extremely valuable to understanding important aspects of the relationship most of these communities have with the healthcare systems in their region. It encourages us- most of whom the population benefits of mass vaccination is removed by a generation or more- to pause and consider the question: Why would a population that has had such difficulty with the government in the past be so enthusiastic about receiving vaccines provided by this same government? The answer, to us, is clear- for them, it is literally a matter of life or death.
How is it the middle of August? With the way the past few months has played out for the world, it feels like time has stood still for months but at the same time a million years have passed. So little seems to be happening and yet SO MUCH is happening. It’s like botany–all the plants look like they are just sitting there but speed up the camera and you can see them growing, competing, striving furiously all the time, as though the world were frozen but with all the moving parts pushing against each other under incredible strain.
Hunger and even poorer access to health care, as well as Covid19, have come to the Ngäbe-Buglé communities we serve. Our volunteer program is on hold, but a small core staff team have managed to ensure that our chronic patients (Diabetes, epilepsy, HIV, family planning etc) have managed to have continuity of their medication and we have shared a lot of PPE with our community and Ministry of Health partners. And as hunger becomes the priority issue, although most people in the world are experiencing financial consequences from Covid19, your INCREDIBLE generosity helped us raise nearly $38,000 for emergency food support. Originally, we calculated a food support pack to cost around $25 to keep a family of 5 fed for a week. Thanks to community and government partnerships, we’ve been able to locally source supplies for a fraction of this cost, and your support is going MUCH farther. We are partnering with local organizations like Rotary Club of Bocas, for food and PPE for the hospital, and with U.S. NGOs, like MATTER and International Aid, to bring in massive amounts of nutrient-fortified rice nutrient-dense vegetables from farmers in the US who freeze-dry their surplus vegetable produce and send it in 55 gallon drums.
Panama, unfortunately, continues to see an increase in COVID cases. It has made its way into the Ngäbe communities and despite rigorous infection control protocols, some of our staff contracted the virus (and recovered, thankfully.) Our uninfected staff are still under quarantine and we have put a temporary hold on medication and supply delivery until we are sure it is safe to resume operations in a week or so. In the meantime, we are taking the time to adjust our protocols to put even stricter infection controls in place during medication and food distribution.
Especially since Panama’s international borders are still closed to entry in mid-August and with caseloads rising there, we’ve decided to extend our hold on all incoming volunteers scheduled to join us for the remainder of the year. While it is possible that Panama may open borders and volunteers and staff could potentially travel to Panama, we feel that there cannot be an overabundance of caution and it is important to both protect our communities as well as our volunteers traveling internationally. Still, base feels pretty empty with our few staff rattling around the ol’ place like a few peas in a big bucket…we miss having our volunteers and look very forward to seeing all those faces from all over the world coming together to give their time and energy and vacation to once again climb into our 60’ hollowed out log canoe and drive through rain and rough seas and jungle rivers and continue providing care with our team.
Everything will be ok in the end–if it’s not ok, it just means it’s not yet the end. Things are definitely not ok, and we are definitely not at the end yet, but things will be ok and this will end. A very promising vaccine is starting phase 3 trials. A couple of revolutionary monoclonal antibody therapies are being rolled out. ICU death rates from COVID have dropped from above 60% to below 40%. The world will keep turning, we all just have to remember that it will and keep holding on.
A bad storm at sea ALWAYS feels like it will never end…and then it does. The storm takes all your attention in the moment because you are fighting to save your ship and shipmates. There’s no time to speculate on the next 5 minutes; your concern is the wave in front of you and the fact that after you navigate that wave, another will be along very shortly. And the lightning striking all around you is somewhat distracting. You lose all track of time and it seems like that’s how it’s always been, just you and your crew and the storm, locked in an eternal struggle together as time stands still.
And then there’s the moment where you suddenly realize the weather is getting better, not worse, and the wind seems to be dropping and each wave no longer seems like a potential game-ender. Usually you’re far too tired to even tremble and everyone who can be spared to sleep goes to sleep wherever they are. I once dozed off in the engine room during a prolonged struggle at sea en route from Honduras to Haiti during the cholera epidemic there, with my head resting on one of our 671 Detroit diesel running at full rpms. We nearly lost our ship (one of the two closest calls we had) but eventually managed to limp into Jamaica, battered and damaged…we all promptly slept and then the next day got up and began working to repair our ship as fast as we could and continue our mission to Haiti.
And that will be all of us. One day, this will end, and we’ll begin to work to rebuild what COVID-19 took away from us all. We’re a resilient, resourceful species when we need to be, and we need to be now. We are proud and grateful to everyone who during this has been able to look up from their own very real challenges and still reached out and made it possible for us to not abandon our post and continue providing the support we can to the communities we love and serve.
Thank you to everyone and remember: one hand for yourself, one for the ship and we’ll all get through this together.
Let’s Give Everyone a Way to Break the Face-Touching Norm
We’ve compiled a list of places to get a head net or veil (or ways to make your own!) Check them out here
MARCH 26, 2020 – Floating Doctors, an international medical relief group, today announced the launch of an interactive public campaign calling on everyone to do one seemingly simple thing: stop touching their face.
A recent study last year on hand hygiene and the global spread of disease through air transportation found that washing your hands at the airport could curb the spread of a pandemic by up to 69 percent. Further research has found that people touch their faces more than 20 times an hour on average. About 44 percent of the time, it involves contact with the eyes, nose or mouth.
Most of us unknowingly touch our face all the time. In normal times, this habit isn’t necessarily problematic. But as COVID-19 continues to impact communities across the U.S. and around the world, face touching has been shown to be a method for transferring the virus.
The new and interactive campaign encourages individuals to secure, create, DIY, and wear—particularly when and if it’s absolutely necessary to be out of the home —a protective mosquito net or veil barrier to ensure mindfulness and awareness around breaking the habit. Be on the lookout for #dtyf (‘Don’t Touch Your Face’) in the days ahead.
It may sound silly, but Floating Doctors—a group that operates in coastal and tropical areas where mosquito nets are often prevalent—sees it as a chance to raise awareness, get people talking, and ultimately have an impact on our habits.
Floating Doctors Founder Dr. Ben LaBrot said,
“Look, we know it sounds strange. We acknowledge it. We’re asking people to wear a mosquito net or veil over their head if they have to go grocery shopping. But here’s what we also know. Touching your face has to stop—right now. Hopefully, those of us who aren’t working on the health care front lines or as part of an essential service are social distancing and in quarantine at this point. And if you aren’t, you need to be. We also recognize that people, to an extent, will have to go get groceries and participate carefully in essential activities.”
“So we’re calling on the public to try something out to knock out the face-touching habit. This is an experiment in reasonable action and behavior modification. But why a mosquito net or veil? Well, Floating Doctors travel by sea to provide free healthcare for people in remote coastal areas. We deal with tropical disease all the time. And we realized that by using one of the most simple tools at our disposal we can create a literal barrier of mindfulness.”
“We’re launching this campaign as soon as possible. And we encourage you to come along with us. Design your own, make it your own, and try it out—at home, at the grocery story, or even on a Zoom call with your colleagues.”
“The goal is to break the habit. Here’s an interesting way to do that.”In the coming days, Floating Doctors will officially launch and activate the ‘Don’t Touch Your Face’ campaign to reach the widest population set possible to remind them of the importance of not performing this common behavior.
Bill Harrison: [email protected]
Matt Pennacchio: [email protected]
…of our mission, that is!
Rest assured, we’re washing hands, surfaces, and just about everything else. 😉
With the need to put a hold on all volunteers at least through April, our operations are scaled back dramatically, but we are still committed to ensuring quality care for the people in our region and all over the world. Whether it is through delivery of medications to our chronic patients, responding to emergency calls, partnering with the Ministry of Health, or radio announcements highlighting necessary precautions during this time, we are still here bringing care to vulnerable communities.
Making sure we don’t abandon our patients while keeping our crew safe is our number one priority right now. We have always prided ourselves on the ability to keep our expenses to a minimum. The majority of our operations are supported by volunteer contributions, including important medications for patients with hypertension, epilepsy and diabetes, as well as contraceptive medication and maintenance of our equipment to monitor pregnancies. With no volunteers at the moment, and the reduction in volunteer contributions due to uncertainty for summer and fall trips, we need the support of our individual donors now more than ever.
We’re tightening our belts and have reduced our operating and program expenses by more than half; Many staff members are diverting their pay (which was never covered by volunteer contributions) in order to keep our program afloat. While we could close up shop completely and wait for this to pass, we feel it simply isn’t an option to abandon our posts, just as the healthcare workers where you are haven’t abandoned theirs.
You, our supporters, helped us provide care in Haiti following the 2010 earthquake and then again during the cholera outbreak. You enabled us to build our programs in Panama to reach thousands of people over great distances. Today, we are coming to you to keep us operational during this pandemic. Even better, please consider becoming a recurring donor, at any level, to help ensure we have predictable revenue throughout the year to provide care even when volunteers are unable to join us.
As with all crises, this too shall pass. We will come out of this and, as long as we work together, we will emerge stronger than ever. Until that time, we thank you for your support and being one of the (washed) hands keeping us afloat!
“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.” –Charles Darwin
This year marks 10 years of Floating Doctors operations. In 2010 after the earthquake in Haiti, a rag-tag band of us (aboard a boat we had rebuilt ourselves) sailed to Petit-Goave for our first mission. Weeks turned into months turned into years and we grew from just a few intrepid volunteers and crew members (whose exploits have since passed into legend) into an organization that hosts almost 1,000 volunteers annually from all over the world and operates a rural health care system providing services over more than 10,000 square kilometers of jungle-covered mountains, mangrove mazes, and open sea conditions in Panama.
Everywhere we went, the weather was always changing…the wind and the sea have their own agenda and all we could do to reach that horizon is to trim the sails, batten the hatches, put the wheel over and press on. Living and working on the water means adapting yourself constantly to ever-changing conditions. The sea may be calm one minute, and a white squall may roll you over the next. Adapt or perish.
The health landscape is also always, always changing. Needs change, capabilities change. resources change. Governments change. Diseases rise and fall like empires. To survive and flourish, Floating Doctors has always adapted to meet change, but after ten years of flexibility and change I can still clearly see our original core ideals present in every aspect of what we do and who we are:
- Patients still count. One patient is still worth as much to us as a thousand patients.
- We align ourselves first and foremost with the groups for whom we advocate and serve.
- Volunteers matter and we create learning and growth opportunities to make the world they return to a better place.
- We believe there isn’t anything we’re ever doing so well we couldn’t be doing it better.
- We believe that compassion is the most important first element of any health care.
- We believe that when a goal for humanity is supposed to be impossible, we should try all the harder to achieve it.
- We believe that to be of service to others is a vital part of our own liberation.
- We believe that it is all a leap of faith: for a volunteer to step into the boat, for a patient to place their trust in one of our doctors, for a supporter to believe in us.
- And we still believe that to reach an impossibly far shore, you can’t save anything for the swim back.
In ten years, it seemed like many lifetimes passed. I’m STILL processing what we saw and experienced, especially in those early days. But I’m proud that in all that time we have remained completely true to who we wanted to be, and who we have always been, and who I know we will always be. It sure hasn’t always been easy…in fact it’s easily the hardest thing I’ve ever done, in every way. And it has certainly rarely been comfortable-after all, you can be comfortable or you can be growing, but usually not both at once…and we’ve been growing continuously for ten years.
But although looking at what we have now may seem extraordinary from our humble beginnings, don’t get too comfortable–everything you can see in Floating Doctors now may indeed be a monument to the efforts of those whose acts will write the history of their generation. But we’re just getting warmed up…wait till you see what comes next.
So gear up, batten the hatches, grab the wheel and prepare to trim the sails. There be storms and squalls ahead, but treasures far beyond gold and silver as well. The direction is easy–second star to the right, and straight on till morning. It only seems impossible until one day you look up to find yourself standing on a new world, and already looking ahead to the next one.
Earlier this month, you were teased with a picture of Jonathan, a very sweet boy who we had the pleasure of interviewing. Let me tell you about him and his family.
We first met Jonathan in 2011. He was bright-eyed and incredibly extroverted. Like many his age, he demanded we give him our attention, play with him, and hold him, which we were more than happy to do.
In many ways, making sure Jonathan has the support he needs to grow up healthy is the same as it is for all of our patients. He needs regular well-checks, dental care, access to education, and support for his parents to help him develop. Because he has Down syndrome, however, he and his parents need some additional resources to make sure he can reach his dreams. These resources exist, but they are difficult to access and the system is hard to navigate.
Floating Doctors has been working with Jonathan’s mother, Selina, since we first met them to ensure Jonathan has all the support he needs to grow healthy, strong, and fulfilled.
Now a 9 year-old second grader, Jonathan has grown so much. Like other kids his age, he’s developed strong likes- soccer- and dislikes- loud noises, and he likes art. He’s got big dreams, and we will do everything we can to help him achieve them.
Floating Doctors makes sure families like Jonathan’s have a chaperone to help them go through the systems necessary to obtain the support they need. We assist with access to occupational and physical therapy, provide regular eye and heart checks, and educational assistance.
We work alongside Selina to make sure Jonathan- and his 9 brothers and sisters- have access to the care they need. We make sure to see Jonathan every time we visit his community, to check on his development, assist with the paperwork Selina needs for specialist care, make sure he can get to his specialists for therapy, and spend time with this wonderful, playful boy. Down the line, we are looking at ways to help ensure some independence, such as adding a bathroom to the house (they currently don’t have one.)
We could not provide high-quality, ongoing, and complete care without your support. You are such an important part of the Floating Doctors community. With your support, we look forward to being there for every step of Jonathan’s development!
Our Final Clinic of 2019…
by Gaurav Sikka, Floating Doctors Lead Medical Provider
Floating Doctors’ final clinic of 2019 was a multi-day at Ensenada, a community on the shores of the eastern side of Bahia Azul. Access to healthcare for this population is particularly difficult because, although located on the mainland, it is only really accessible by boat and the closest hospitals are expensive trips for our patients.
The clinic was run over two days. Our crew saw patients well into the evening hours and by the time we had the clinic equipment packed on Wednesday night, ready to leave the next morning, everyone was exhausted but in good spirits.
This being the last day of the final clinic for the year, however, there was sure to be some deviation from the normal end-of-clinic experience. Thursday morning started with a sudden awakening for Angeli, our Executive Director. The woman who had been catering for us during our stay was alerting her to a new arrival at Ensenada.
With a look of excitement and anxiety, she explained to Angeli that her daughter was in labour. Angeli came to wake up two Lead Medical Providers- Nisha and me, Gaurav- and Jess, a volunteer registered nurse. We all rushed to the scene and another volunteer, Joe, joined us a few moments later with the all-important emergency bag.
The walk to the new mother’s house was short but treacherous, stepping on half-floating logs and washed up debris from the sea, but we quickly made it up to the raised floor of the hand-constructed wooden house that stood on stilts.
There, in the corner of an empty room was an exhausted looking woman, with her legs open wide to accommodate her baby girl that she had just given birth to. Births are beautiful moments to witness, yet can occasionally be rather gruesome, even when there are no complications.
Upon entering the house we heard a loud, high-pitched, shrill cry. This was music to our ears- hearing the baby crying is the best indicator that it is breathing and expelling the fluid that fills their lungs while in utero. The baby’s colour was still blue initially, the umbilical cord was still attached, and the delivery of the placenta (also known as the third stage of labour) had not been completed yet either.
This moment in childbirth is critical and as we rummaged through the emergency bag to find the obstetrics kit I was reminded of how the simplest of pieces of equipment can prevent common medical complications. Two sterile cord clamps and a scalpel, for example, allowed us to safely cut the umbilical cord without introducing tetanus or other pathogens to the baby.
Then, with the placenta not yet fully delivered we encouraged the mother to breastfeed and offer skin-to-skin contact with the baby because this is known to speed the third stage up. We also coached the mother to push a final few times to complete the delivery.
The first priority after delivery of a newborn, even before attempting respiratory resuscitation if required, is to dry the baby with a towel and wrap it in another dry towel, then put a hat on its head. This is to avoid the inevitable increased rate of heat loss, even in the tropics, that a wet baby will experience due to an increased surface area to volume ratio.
Though certainly exhausted, with the labour over the mother seemed relieved and other than applying pressure for a short amount of time to restrict a small amount of bleeding we had little to do but offer moral support.
The surrounding female relatives rejoiced in the birth of a new member of their family and in the kitchen next door we could hear a chicken being slaughtered in preparation for the copious amounts of chicken soup the mother was to be served in the coming hours and days to help her recover after such a herculean effort.
Joe then kindly grabbed some more equipment for us from where we had been holding clinic- weighing scales, measuring tape etc. so that we could examine the newborn, just as we would in a high-resource setting. Thankfully, the baby girl was healthy and intact in every way; she even breastfed within moments of being born.
We, the Floating Doctors crew, felt privileged to have been at the birth of a healthy child in this community. We offered our assistance but thankfully not much intervention was required. In the process of the elder ladies in the family deciding a name for the new baby girl, Jessica was ruled out due to it being a common name there already, Nisha was considered but was just pipped to the post when one of the elder female family members found out Angeli’s name and decided it was the one that suited the newborn baby girl best.
by Jill Patel
Jill Patel joined us as initially as a global health student in the summer of 2018, and has been working on a research project focused on mental health within the Ngäbe-Buglé population. She will continue to work on Phase I of the project both in Panama and in the US through the Fall. Keep reading to know more about her initial time spent in Bocas, and be sure to check back in a few months with an update on her research!
Note: Written in summer 2018- future dates noted reference 2019
Words cannot begin to justify my experience in Bocas del Toro this summer with Floating Doctors. What I thought would be a simple medical mission trip turned into a life changing opportunity that has inspired my new path to global medicine. From the outside, I saw a beautiful landscape filled with lush green trees, tall mountains, and colorful houses. However, hidden behind this was a community that has daily contact with the jungle, high worm loads, untreated water, latrine sanitation, and wooden huts. Despite this, the Ngäbe-Buglé people welcomed me with open arms—they laughed, cried, and went on an emotional journey with me, never making me feel more or less than they were. I thought I would be helping them improve their health, but they gave me a whole new perspective on life that enriched my physical, mental, and emotional well-being. All of this may seem so abstract and good-to-be-true, and I would have agreed before coming here.
My most memorable and favorite moment was doing a community health project on mental health with children in Cayo de Agua. Nicole and I had brought coloring books and crayons, as well as prepared activities, from breathing exercise to hand-shakes, to teach children how to relieve stress We also created a simple questionnaire to better understand their emotions. Our activity started with five students. I used my broken Spanish, which was surprisingly better than I expected, to introduce myself. As more children joined our activity, our coloring circle grew from 5 to 30 students scattered, around us. Here I quizzed students on what they were coloring to practice my Spanish. The funny part was that I did not know if they were right—I was just asking to expand my Spanish vocabulary. However, I think they soon realized that and possibly taught me some inappropriate words because they kept laughing every time I repeated it—I wish I remembered the word so I could look it up.
This fun quickly turned upside down when I interviewed a five-year old boy. I still quiver every time I think about him. He was very reserved and would not look up at us when we spoke to him. At first, I thought his actions may be driven by socio-cultural factors and thus was common in this community. However, I soon realized that this was not the case. When we asked him what makes him happy, he said nothing, and he does not do anything to make himself feel better. He also told us that “ellos”—everyone—scares him; instinctively, I leaned in to give him a hug. He disclosed that a girl, who was present in the circle, was bullying him at school. My eyes watered up because I was no stranger to bullying myself. I was bullied up until high school for having thick facial hair, not shaving my legs often, and wearing long, oily braids- I know what it feels like to be different and to want to be a normal teenager. Before he left, I told him, “Tú eres muy fuerte y yo soy tu amiga.”
Mental health remains unknown and under-served in the Ngäbe-Buglé community, but the need is very large. From bullying at school to young mothers, children and teenagers are vulnerable to various mental health conditions as they are pushed into adult roles from a very young age. We all have been fearful, anxious, nervous, scared, and traumatized. Unfortunately, these communities lack the resources and support we receive here, and Floating Doctors has taken the initiative to address this issue. In January, a Family Therapist and a PhD candidate will come for a year to examine the mental health statues and needs of the community. I will join this team to further my community-based project in hopes of delivering better tailored care, and I encourage others to join the cause so no child ever has to cope with sadness and fear alone. Whether one is a volunteer, student, or professional, we can all make a difference in our unique ways as long as we have hands to serve, ears to listen, and a passion to help.
From clinic and beyond, I made many new friends and strengthened bonds with others. To continue Floating Doctors’ mission to improve the health of all, my group and I volunteered at Asilo, a nursing home in Bocas town, to address patient’s non-clinical needs—painting their nails, massaging their hands and legs, bringing water. When I entered the nursing home, I was surprised by the conditions of these elders- they were so frail and weak. My eyes watered up as I realized that many of them were either the same age or even older than my grandparents, who I am tremendously attached to. When I asked an elderly woman if she wanted to color or get her nails painted, she reached her hand out. As I held her hand in mine for a couple of minutes, her face relaxed and she closed her eyes. She reminded me of my grandmother, who would hold my hand as she watched TV or laid down because she loved having someone physically close to her. I sat with this woman for a while, just holding her hand without saying a word. This is the true power of a simple touch, something that many people may disregard but is immensely valuable.
Here I also met my new friend, Richard Garret from Queens, New York. I introduced myself and asked how his day was going in Spanish. To my surprise, he responded back in English—another lesson: never assume what one can and cannot do. From Turtle Beach to Summer, he gave me an oral tour of the entire town and listed all the places I should visit. When I asked if he goes to Summer, a dance bar, often, he enthusiastically said yes. Just like me, he loves to dance. We spent the next thirty minutes talking about our passion for dance. I shared with him pictures and stories from my previous dance competitions. Before I left, we took a picture together. He told me to show this photo to my family and tell them that I made a new friend at Bocas. He gave me a hug and told me to come visit him when I come back to town.
The Asilo opened my eyes to the struggles of the elderly in Panama and more significantly, the importance of addressing a patient’s non-clinical needs to provide holistic care. Sometimes medical mission trips get caught up in providing preventive and surgical care but forget that health encompasses much more than the physiological. Floating Doctors is unique and successful because it improves health at the clinical, social, and personal level. And this is what has, is, and will always pull me to Floating Doctors
As my story comes to an end, I want to leave with a final lesson: Dr. La Brot always says that in order to serve, we must learn from those that we serve. No matter how superior my knowledge or skill may be, I can never provide the best service or obtain the best outcome if I do not listen to my patients. While living in an open church and eating with locals in wooden huts at Cayo de Agua, I witnessed the lack of infrastructure and services. But through these activities, I also learned about the community’s lifestyle, needs, and wants. This helped me understand why certain medications and preventions were utilized in situations that we normally wouldn’t in the US. Learning and applying these social, cultural, and economic determinants of health in practice has been a humbling experience. I remain driven by the knowledge that easing the service gap can mean drastic change for neglected populations, which motivates me to continue my path in global and community medicine. I cannot wait to return back in January to help further the Floating Doctors mission! Thank you to Dr. LaBrot and his Floating Doctors’ team, the Ngäbe-Buglé and Asilo communities, and my wonderful colleagues for making this a memorable experience.
By Dr. Kevin Lan, Dental Director
“You can never cross the ocean unless you lose sight of the shore.”
Now more than ever, we face a rising epidemic of dental caries in the teeth of children from the indigenous Ngäbe communities we serve. The combination of their inability to afford basic oral health products such as toothbrushes and toothpaste, poor education, lack of access to healthcare, compounded by a sharp increase in consumption of refined, sugary hot and cold drinks, has resulted in many children with decayed and broken down teeth, especially in their newly developed adult teeth, ones that will not be replaced.
2018 saw the Floating Doctors dental program explore new horizons and greatly increase our services provided to the communities of the Bocas del Toro Archipelago. We established our first mobile dental team, held independent dental clinics, provided continuous oral health education and prevention, recorded dental health in the communities for research and we have hosted dental groups from the University of California Santa Barbara and the Dental Humanitarian Outreach Program (DHOP) of the University of Southern California.
14 undergraduate students from UCSB and 3 dentists visited and stayed in the communities of Nance de Risco and Cerro Brujo, where 156 patients were seen and treated. The challenges faced by this team were numerous; it was our first dental only deployment away from the medical team, the first time we had stayed in two communities and worked 4 days consecutively, whilst setting up and packing away our equipment in between both communities and working the same day. The success of this group can only be measured by the amount of hard work put in by our FD staff and the UCSB group where despite being constantly pushed outside of their comfort zones, numerous students embraced the opportunity to learn and be part of a positive life changing experience where they sought to give to those who had less, rather than how their time with us could benefit them.
DHOP held 6 clinic days from the 9th -14th December in Bocas del Toro. A total of 90 dentists, dental students and FD staff, worked tirelessly each day from 7am – 7pm in temperatures above 85°F, providing dental care to over 700 patients from 20 communities in the Bocas del Toro Archipelago, where some were transported 3 hours by our boats. The DHOP clinic was a very emotional experience to work alongside such a dedicated, skilled and high spirited group where it was heartwarming to see people from communities that we know, receive high quality advanced dental treatment, like Root Canal Treatment which we could not normally provide when in their community. This is the difference between saving or losing a tooth. I will never forget the family of 4 who had traveled the whole day to attend our clinic, where a 10 year old girl had fallen and broken her upper front teeth 3 weeks ago and required Root Canal Treatment. Due to the required treatment time and inability for this family to return home that day, they were given accommodation as they were unable to afford this themselves. The next day, her father could not express to me without tears in his eyes, how grateful he was for the care and compassion we had shown to his family.
For me, it is not the numbers of patients that we can see that drives our ambition to care for the Ngäbe people, but it is to be present for those who have been forgotten or unable to access healthcare and being able to make one little girl smile again without losing her front teeth. Floating Doctors is proud to host groups like UCSB and DHOP so that we can try and inspire the next generation of healthcare providers to educate and improve the lives of others, so that we can leave our communities and world better than we found it.
Walt Disney once said “All our dreams can come true, if we have the courage to pursue them.” 2018 saw Floating Doctors take big steps towards continuous and sustainable dental care to the communities we serve. 2019 will see huge development and partnerships being established as our family grows with increasing support from Europe and America. 2020 is still unknown for what the future holds, but I can predict that we will continue to work hard in providing dental care and education for the people in the communities who need our time, compassion and support against the challenges we will face together.
Through the courage of our team and those supporting us, our dreams are not far away from reality.
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