PROJECT SMILE: A MODEL PUBLIC HEALTH PROGRAM IN BELIZE, CENTRAL AMERICA

Frances Kathleen “Kay” Riley Thigpen RDH BSDHed Armstrong Atlantic State University

History:

“Bridge of 1st world to 3rd world”

1992- Anglican Bishop Desmond Smith of Belize came to Augusta and was introduced to Dr. James Clark (professor of periodontal dentistry at MCG and member of the Episcopal church in Augusta). Dr. Clark then recruited another professor of pediatric dentistry at MCG. Dr. D. Stephen Acuff was then recruited by deacon Susan Harrison of Savannah, who was in Augusta at the time. (Dr. Acuff was involved in other outreach programs).

Fall of 1992- 1st fact-finding mission; 14 people: 4 dentists; 1 RDH; 1 CDA; 1 RD; church volunteers; 1 repairman; first had to obtain permission of Belizean government; they would allow only children to be seen and only preventive dental care (some restorative) and we could not charge a fee.

Philosophy:

“An ounce of prevention is worth a pound of cure” – Benjamin Franklin

Treat children ages 4, 5, 6; cleanings; seal 1st molars; Fl tx; simple restorations (nothing heroic); (other teams performed pulpotomies, extractions, large restorations and then left- problems with infections occurred which pt could not afford to fix); private organization; no fee for service/volunteer;

Hypothesis:

By doing preventive dental care on children ages 4,5,6 (cleanings, sealants and fluorides) we would decrease the DMF;

Funding:

1st trip was all “Dutch” treat; subsequent trips- Episcopal diocese of GA applied to National fund for religious development; 96/97 Dr. Clark left and Dr. Acuff then became leader; put Project Smile under umbrella of local Episcopal church and applied for grants from Stewart Huston, Rotary clubs and private/individual donations;

Findings:

A six year old in Belize was like a 4 year old in US; Belize children skinny, malnourished; may get only one meal a day at home; other food(s) included sugary Popsicles (called ideals), sugar cane, candy; brother-in-law of principal was selling children candy from cart in front of school-losing battle! children would either go home for lunch or not get any lunch at all; rampant decay!! would use primary teeth as space maintainers instead of restoring; 1996- 1st DMF: St. Mary’s 1.02; school not seen/control 1.43; 2008- DMF:

Adaptation:

Brought toothbrushes and toothpaste to Belize/school (St. Mary’s) and gave to teachers; kept them in a stand with name on them in each classroom and each child brushes after lunch;

Expansion:

Word spread about Project Smile and we now have team members from Southeast GA, Ohio, Wisconsin, England, Massachusetts; Fl program: powdered Fl brought down and instructions given to adult volunteer to mix w/ water, children swish weekly; new kitchen (refrig, stove, sinks, microwave) to cook lunch (rice, beans, chicken) daily for children, playground/swing set installed, computer lab w/10 iMAC computers (later Peace Corps came in to teach children), copying machine for school office; complete restoration of clinic in 2006: 7 portable dental chairs and units funded by Rotary club and Stewart Huston; cabinetry made by local Belizeans; painting. Lights/wiring and plumbing by NC rotary club; music program started and keyboard left at St. Mary’s;

2008-one week trip taken into western part of Belize (rain forest/jungle) to unused 2-chair clinic; after cleaning and renovating clinic Friday, Saturday, Sunday, saw 200 children during week.

Time Line: