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xcurmudgeon

Mission of Mercy - NoVa: a health care diary

by: teacherken

Fri Mar 12, 2010 at 19:17:05 PM EST


Today is a Friday.  Normally I would have just completed a day with my students.  Instead I have done something at least as important as teach.  I have just returned from a day of volunteering in dental triage at the Mission of Mercy event at the Medical College of Northern Virginia Community College in Springfield.   This is my third time, the first at a dental only event (those at Wise and Grundy were held in conjunction with Remote Area Medical).

Springfield is in Fairfax County, a wealthy jurisdiction of the DC metro area, a community very different from those of rural Appalachia in which I had previously volunteered.  

And yet, the need was just as great as in Wise and in Grundy.  

I ask that you continue reading as I share my impressions of the day.

teacherken :: Mission of Mercy - NoVa: a health care diary
We processed a bit under 400 patients.  We faced one problem basically not experienced in the Appalachian sites, that of language:  many of those we saw spoke little or no English.  A few had people who could translate for them.  Some of the dentists had fluency, and there were volunteers from the community who offered additional language services.  I experienced or observed the following languages being used:  Spanish, Vietnamese, Farsi, Korean, Amharic, Somali, Urdu, Hindi, and Khmer -  there may have been more.

Were some of those we treated undocumented aliens?  I am quite sure there were some, although that did not matter to us.

We treated no children.  The ages I personally saw were from 19 to 86.

We saw some who only wanted cleaning, others wanting dentures (we could not help).  We did root canals, fillings, extractions . . .

One of the questions on the screening form was whether there was a reason the patient could not see a dentist, health or otherwise.  The most common reason was that they could not afford it.

Some were unemployed.

Household incomes were usually less than 200% of the poverty level.

Our dentists were as varied as the patients, with the dentists speaking Vietnamese, Spanish and Farsi.  This is an area of great diversity, with members of many communities being part of the professions.  

Again we were confronted with having to have patients make a choice, as we could do only one service -  was it a cleaning, a root canal, a filing, extractions??

I was again reminded that many medical plans do not include dental.

One endo specialist who was in triage to evaluate had commanded Army Dental units before he retired 18 years ago.  He commented on how different the approach to dental is in Germany.

We were lucky -  the campus has a network that enabled us to do extras as online videographs that could be examine on computer - a positive use of technology.

A few patients had been screened previously by the staff at the campus.

And still, it was overwhelming.  So many people in need of basic medical care.

So many who do not have regular dental treatment.

Again, every dentist with whom I worked knew about Deomante Driver, the adolescent in nearby PG County who died of a tooth abscess where the infection spread into his brain.

We were in one of the richest counties in the US - not like in Grundy, which is in Buchanan County, the poorest in Virginia.

Consider:

Virginia's median household income in 2008 was, according to the Census bureau, $61,210

That of Buchanan County,  $26,571

and that of Fairfax, $107,075

And yet, in Fairfax and around the DC metro area (we saw people from Maryland, DC and WV), there are pockets of poverty.  Remember, what would be a median household income in Buchanan would be very much at the bottom in Fairfax.

Fairfax County has about one in four people born outside the US, and almost one in 3 speaking a language other than English at home.

What is clear is this:  community income, community racial composition, country of birth, home language, income - it does not matter.  In the US there are huge numbers of people who do not get regular dental care.

Dental disease can kill you.

Dental pain can distract you, making you unable to work or to study.

Today I was just outside the Beltway, that highway that demarcates the center of government and power.  Many of the people we served lived inside that circular highway.

As I write the Congress still struggles to put together meaningful reform of health insurance, of access to health care.

Whatever they do pass -  if they do - will still not address all the issues we were addressing today.

I am not in Congress.

I am not rich and powerful.

I know members of Congress, and I can try to persuade them how important this is.  But no House Members or Senators came to see how severe the need is, just as it is rare for them to appear at the free health clinics promoted by Keith Olbermann, at the events cosponsored by RAM and MOM.  

I know there are electeds who care -  I have been told that House Appropriations Chair David Obey uses his earmarks for free dental clinics.

I know, thanks to Sen. Bernie Sanders, that one provision of the proposed legislation is a major expansion of free clinics.

Meanwhile some electeds try to use their votes on health care as bargaining chips for other issues, like immigration.   Others attempt to block reform for political advantage.

And people lose teeth, and suffer.

So I do what I can.

I volunteer, doing paperwork to help the dentists in triage see more patients.

I write about what I do to try to keep attention on what is important - not the politics, but the people;  not the policy, but the patients;  not the philosophy but the suffering we can alleviate and prevent.

This is not much of a diary.  I am tired.  I arrived with only 4 hours sleep.  Tomorrow I will be back, this time with several of my students who also want to make a difference, for whom I will serve as a chaperone.

My words make no difference, unless they can help motivate others to action.

My volunteering is perhaps more important.  It reminds me of my connection with the rest of humanity.  It enables the dentists in triage to process a few more people.  

And yet, it somehow seems so little.  

It is so little.  

But it is more than those who obstruct in Congress.  My 8-9 hours of volunteering today did more good than the sum total of recent efforts of the members of one political party on the Hill.  That is shameful.  And I am not ashamed to point that out.

They want to kill health care.  Let's rephrase it.  They want to kill people.  They want to continue the pain and suffering of people.  That may not be criminal, but it is surely immoral.

Today I volunteered.  Tomorrow I will volunteer.  On 3/26 and 3/27 I will volunteer at a similar all-dental event in Roanoke.

Each time I will write, not because what I am doing is of great importance.  It is not.  And yet it is so much more than what many members of the House and Senate are doing for the people in America who are in need.

And I want to remind them - and myself - of that fact.

What about you?

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Just remember
All those highly paid people need the labor to run the city. It may be paramount to slavery in many cases. Of course, the best way to be wealthy is to spend frugally. Labor is still abused and especially so when English is not the language spoken.

Two Comments
First, the poor in our society are too often invisible to the rest of us. I remember visiting relatives in Reston more than a decade ago. As I waited to catch a bus into Washington for a day of sightseeing, I saw the maids and gardeners arriving for a day of work. Low pay...no benefits...not able to live near their work...a permanent underclass whose problems were invisible to their employers in Reston.

Second, the American attitude that dental care is a luxury that needs to be available only to those whose disposable income can pay for it is disgraceful and stupid. The fact that periodontal (gum) disease is one cause of heart disease was proven years ago. It is far cheaper to provide basic dental care to someone than to pay for open-heart surgery.


The invisible voted
in 2008 for Obama, or many of them did, and it totally discombobulated pundits, soothsayers, and most especially the Republican Party, none of whom has ever conceded and accepted that fact.

Every Republican I have talked with has an instinctive first reaction that Obama voters were illegal (many also consider that Obama himself was not "legal" either); when pressed, they may grudginly admit that most of the Obama voters were actually legal, but "they did't know what they were doing." In other words, all those people who did not look like traditional country club white voters were not real Americans, and the Republican Party is absolutely correct in stonewalling everything Obama wants to do... they cite polls showing the country does not approve of Obama's initiatives, especially "the government takeover of health care."

In other words, once Democracy worked, and heretofore invisible lower class people voted, suddenly the traditional leaders (or those who considered themselves the traditional leaders) no longer wanted to play within the system.


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