Helping hands abroad

Green River Registered Nurse Cornellie Squires, Dentist Bryce Castillon, Dental Assistant Ashley Castillon, and Volunteer Myron Kippen recently completed a medical mission trip in conjunction with the organization Joshua Mission in Negril, Jamaica.

The trip, lasting seven days, consisted of four and a half clinic days and a day and a half to set up and tear down.

Squires, who was on her third trip with Joshua Mission, primarily assisted with wellness exams to acute injuries. In four days, the medical unit saw 492 patients with a variety of illnesses.

"Medical wise, we see that there are many people who have high blood pressure, high cholesterol or blood sugar issues," Squires explained. "It's not uncommon to see a person in their early 20s who has already had a stroke. We do tests for all as well as ekgs for heart issues.  Joshua Mission brings prescription medication that is given out by health care providers. This year we had one orthopedist, one internal medicine, and five nurse practitioners and one mental health counselor. Other staff consisted of nurses, EMTs, as well as other help."

When asked what the biggest challenge they faced while working in the clinic, Squires said there never seems to be enough volunteers to help the people. 

"Such an underserved area with little access to health care, let alone free health care," she said.

Squires noted significant differences in health practices compared to our healthcare here in the United States.

"It's hard for people to get specialty care or testing," she said. "Patients have no money for physician visits or follow up. They wait for us to come back the next year to access help.  Patients line up for hours before we open to get care."

Squires said the most surprising thing she learned about the local culture was that religion is a huge part of their culture. As an example, it's rare to find someone who smokes because it is against their religion.

Squires also noted that while most Jamaicans speak English, there were some individuals who are deaf, so it would be helpful to have someone who knows sign language.

Squires said she had many memorable interactions with patients.

"This is my third year going," she explained. "They remember you and your name and seek you out to tell you how grateful they are for the care. They are so proud to show you how much they have improved."

Squires also mentioned that the most rewarding part of connecting with the local people was the gratitude they showed.

"It's such a humbling experience to see so many grateful people," she added. "Most rely on rainwater in their homes, no running water or inside bathrooms. Yet they are very clean and dressed in their best clothing to be seen. In Jamaica lingo, they say 'No problem' when it takes hours to be seen."

Reflecting on the overall experience, Squires said that serving a medical mission makes her want to learn more about different cultures and medicine to help better understand people and their needs. She also discussed how important education was as part of the trip. 

"Education is huge, teaching people about how to control their disease process when they run out of medication," she explained. "The Joshua Mission gives them about three month's supply of medication, and they figure out a way to make this last until next year."

Green River Resident Myron Kippen also attended the trip for a second time, volunteering to set up and tear down, and acting as a runner to get supplies. Squires stressed how important Kippen is to the mission overall.

"Most important, he is the greeter outside that encourages people to come inside," she explained. "We could never do this without him."

On the dental side of Joshua Mission, Dr. Bryce Castillon and Dental Assistant Ashley Castillon spoke about the primary needs of the patient they saw.

"Their primary dental needs were extractions," they explained. "Patients had toothaches and abscessed teeth. Many of the elderly patients needed their necrotic teeth extracted so that they could get dentures in the future."

Ashley Castillon said the dental clinic saw 150 patients and extracted nearly 300 teeth in four days. Three of the four days they worked approximately eight hours, and then had a fourth day of 11 hours.

"There were 35-40 patients each day," she said. "People would be lined up before we even arrived, and some would wait all day in hopes that we would have time to squeeze more patients in. We typically saw the children first so that they could get to school."

As for qualifications, Ashley explained that dentists and hygienists had to be vetted and cleared by the Jamaican government, submitting the necessary documentation months in advance.

The Castillons also said that it was important for the Joshua Mission volunteers to support the local economy.

"As a volunteer group we supported local restaurants, walked along the beaches, had locals who would drive the bus for us and who also worked at the clinics," Ashely said. "We were able to experience Jamaican cuisine and music. Upon completion of the week, the Joshua Mission provided the group with a dinner/reception where they shared the accomplishments of the week with the medical and dental teams. There was also a Rotary Club group with us who were able to paint a local medical clinic throughout the week and help reorganize the clinic."

Ashley also explained how the Joshua Mission tries to ensure the sustainability of the dental care provided beyond the mission trip, but that it can be difficult.

"The dental hygiene team returns to the clinic three to four times a year," she said. "We can't continue to follow up with the patients once we are gone. Many do not have phones or ways for us to get in touch with them. However, as the patients would leave antibiotics and pain medication were provided as needed."

When asked about the long-term goals of Joshua Mission in Jamaica, Ashley replied that main goal of the program is to assist the Negril locals with basic medical and dental care, also explaining that this was the first year that dental teams had joined, and the need was great.

"The goal is to care for patients who are unable to afford care with their local providers," she explained. "Next door to where we were housed for the week was a free clinic for wound care, basic primary physician needs, etc., and every day there was a line of people waiting to be seen."

One of the ways that the Castillons were able to make a lasting impact was by providing other dentists with information on how to make things more efficient not only in Jamaica, but on dental mission trips as a whole. They were also able to work with the Rotary Club to donate the Joshua Mission group some money to buy a handheld x-ray unit. Dr. Castillon was also able to assist with purchasing of the unit and getting it to Jamaica.

Anyone interested in more information on the Joshua Mission can visit thejoshuamissioninc.org.