In the spring, following the Africa experience, a project was scheduled along the Amazon River in Brazil, but was cancelled at the last minute due to internal government wrangling. We were all hastily redirected to a site in the Yucatan in Mexico where an underserved Mayan population had been identified. For the third time I would find myself teamed with my colleague and now dear friend, Dr Mary Pergiovanni. Mary had begun to expand her personal involvement in foreign healthcare service by enlisting friends from home to help finance projects she was undertaking relative to third world families and orphanages. She would likewise expand the types of dental services she could provide by bringing more sophisticated portable dental equipment with her. While Mary worked out of our base camp, I continued with my usual “pain relief” clinic, performing extractions in a mobile van that took us out into the countryside.
Knowing in advance that were a significant number of untreated cleft palate patients in the area where we would be working, Mary made every effort to bring all of the laboratory supplies necessary to fabricate opturators (plastic appliance to create a barrier in the mouth between the oral and nasal chamber). Mary’s heroic efforts were stymied by the challenge of getting adequate stability of these bulky appliances in a patient’s mouth. When I returned from the outback I noticed Mary struggling in the dim light of a make-shift lab and marveled at her tenacity, yet observed her frustration. Seldom would a general dentist have occasion to design and shape a clasp to assure retention of the bulky opturator, however, clasp design is a part of everyday orthodontics so our collaboration led to the insertion of a series of appliances in patients who, now for the first time, could swallow a liquid without the fluid rising up into and being expressed out of the nose. If Mary had not had the heart to try to reach out to this patient population in the wilderness there would have been that many more people denied the opportunity to enjoy the simple human experience of swallowing as it was meant to occur.
Next, on to Nepal and the Himalayas.