Saturday, July 19, 2008

Week 6 - Jose

The highlight of the week [or lack thereof] was my experience at the annual health fair conducted at Sunnyside High School in Tucson. The fair was open for anyone in the community of Tucson and its surrounding areas. Even people from Nogales, Arizona came to the health fair. The event was extensively planned; there were many different groups participating and volunteering at the fair. Employees from El Rio Community Health Center (where I am currently shadowing) were also there. The school had two gyms and a cafeteria that were full of volunteers and people from the surrounding community. There were groups giving away baby car seats, bike helmets, school supplies (by grade levels), doing pregnancy tests, and even conducting physical exams (including taking blood pressures and measuring blood sugar levels).

Having seen the flier from a fellow employee at El Rio Dental Clinic, I came to the health fair to volunteer at the dental clinic. There was practically no space for the dental clinic at the fair – we were doing dental screenings at the boys’ locker rooms since the cafeteria and the two gyms were occupied by different groups. It was really exciting even though we were only doing screenings, not exams. I was charting for Joyce, a retired dental hygienists in the Tucson area, who would look at the patient’s mouth and dictate to me whether the patient had previous treatment, needed treatment, had fillings, had cavities, and had/needed sealants. I helped her communicate to Spanish speaking patients by translating whenever it was needed. She knew the ins and outs of government-sponsored [health and educational] programs such as AXIS, Medicaid, Medicare, and even Head Start.

One Spanish-speaking woman brought her child for a dental screening because he was about to start Head Start and the program had required her to take him for a dental exam. After the screening, she showed us a paper that the dentist had to sign. Since we only had one dentist volunteering at the clinic, he oversaw what we did, but at the end, he decided he could not sign the form. The document asked for a comprehensive dental exam, not a dental screening; the former included x-rays and actual probing with the mirror and explorer while the latter was more glancing at the mouth and teeth to determine whether the child needed a referral to a dentist for immediate dental care (we could not use any instrument because we wanted to treat as many patients as possible, and we did not have sterilization machines at the school). Unfortunately, everyone including Joyce, the dentist, and I sadly saw her leave with her child and the document not signed. Before this, though, Joyce explained to her that Head Start was supposed to have given her a list of pre-selected dentists that Head Start had agreed to pay to cover the costs for the appointment. I imagine that the mother had decided to bring him to this health fair because it was a free dental screening, in an attempt to save some money, but in fact, she had the right and opportunity to take her child for a fuller dental exam. The heartbreaking part was that she did not know this; Head Start did not give her a list of dentist. Now, she had to go back to Head Start, ask for the list, schedule an appointment, and wait until that date to take her child to the dentist. To me it seemed foolish, unnecessary, and unfair that due to the fact that there was not good communication/understanding between the employee from Head Start and this mother, she had to run around the city to correct this problem. I wondered and still wonder today who is to blame for this issue – the mother because she did not speak English and/or because she did not know how this system worked; the Head Start employee for either not speaking Spanish or giving her incomplete information, or someone at a different level, perhaps at the governmental/policy level? Being interested in dentistry and volunteering at this health fair taught me a lot about how government programs work in conjunction with the health care system. Sadly, I learned about it through an undesirable experience.

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