Back in Seattle

Having now returned to the sea level oxygenation of Puget Sound, I can reflect with clarity upon the incredible week we had in what is called “Amazing Peru”. I would strongly support this characterization – and I didn’t even get to go to the pretty beaches (I’ll save that for my next trip). As I’ve said throughout my blog, there is much opportunity for us to collaborate between our Early Childhood Oral Health (ECOH) program and programs such as the First Lady of Peru’s incredible Project Sembrando. Dental disease in children is one of the few conditions that is just as severe, if not more severe, in developed parts of the world as in developing parts of the world. This fact enables the ECOH program to study and create solutions locally, and assist in their delivery both locally and internationally. We have already begun correspondence with Project Sembrando and will first learn how we can accurately assess the extent of dental disease in the children in high altitude regions of the Andes. Only then will we determine how we might work together to create prevention and treatment programs.

Had we not hired two talented faculty from Peru to work with us at the University of Washington (UW), none of this would have happened. Had I not met Lucho in years past (a UW alumnus now practicing there), this might not have happened. Yet, with all of us aligned in our thinking we can do what is most important in prevention of the most common chronic disease in children – tooth decay. What is most important is raising awareness of this essentially preventable but often devastating disease. We have only begun to truly document the morbidity of tooth decay. It is clearly much worse than we know, both in the suffering of the child and in funds spent by healthcare systems around the world. This is even more significant when one includes the medical management costs if the disease spreads beyond the tooth to the face, as it too often does when there is little access to care.

I have attached a few selected final photos as reminders of the trip, but we will update with more as this story gets told.

Final Pictures

Photo 1 – Drs. Seminario, Berg and Horruitiner discuss trip to Andes

Photo 2 – Beautiful courtyard at my hotel in Cusco

Photo 3 – Road in Cusco showing several types of materials, brick, stone, clay – some old, some new, but never cement.

Photo 4 – Child examined in Andes showing “chronic hyperplastic pulpitis” (pulp polyp) in lower left permanent first molar – evidence of chronic disease, and more commonly found in primary molars. Other teeth also badly decayed – this was a typical finding. (Taken without an intra-oral camera)

Photo 5 – Children gathered ready to learn about toothbrushing

Pictures from Day #6

Photo #1 - First Lady of Peru, Pilar Nores, and myself

Photo #2 - Pilar Nores explains Project Sembrando to Drs. Berg and Ana Lucia Seminario

Photo #3 - Examination of children in the village

Day 6: Traveling with the First Lady of Peru

This will be a day to remember. Woke up at 2:30 AM to catch a 5:00 AM flight to Trujillo. We met the First Lady of Peru, Pilar Nores, at the airport. We traveled several hours east into the Andes ascending curved, yet paved roads for the first 45 minutes, then extremely rugged and single-laned unpaved roads for the remainder of the ascent. At one stopping point, we were at 4,700 meters, higher than Mount Rainer in Washington. We eventually descended downward into a village center with an altitude of 3,800 meters, where we witnessed the incredible not-for-profit program that First Lady Pilar Nores is responsible for creating and maintaining.

Project Sembrando aims to offer a better quality of life to folks living high in the Andes who don’t have even the basic necessities of life. The program offers food, medical care, education in self-care and self-esteem, builds hygienic facilities and teaches how to prepare and cultivate food hygienically. It also brings together communities by requiring a certain presence at community meetings in order to receive the sustenance and important information. Today, we saw four communities, with a total of approximately 200 families gathered together, each proudly standing behind their community flag, waiting to learn what was to be presented to them this day. Pilar Nores gave an impassioned, articulate speech, explaining what was to happen today and the logistics of how it would happen. Families lined up to receive packages of powdered milk with supplements, many home care products, vitamins, and each family member took a pill for intestinal parasites. Liuva Horruitiner, a pediatric dentist from Lima who accompanied us, explained the importance of toothbrushing to the children. With Pilar Nores standing next to her animating, Dr. Horruitiner demonstrated the proper toothbrushing method.

I had the chance to examine the mouths and teeth of many children and quickly realized the high prevalence of dental caries in this population. One could be nothing but awe-inspired by the passion, the organization and the results achieved by all aspects of this incredible program, which is growing all around the high altitude regions of the Andes. We have already had preliminary discussions of how our Early Childhood Oral Health (ECOH) program might lead to significant oral health solutions within Project Sembrando, by utilizing its mission of developing local solutions and delivering them to distant sites. This amazing day is not over; there will be a lot more to this story, I am sure.

Day #5: Dinner in Lima

We toured Cusco in the morning and I realized just how much I want to return to this beautiful city and all of its architecture, culture and people. I flew back to Lima in the afternoon where I was met at the airport by Ana Lucia and her mother, who was visiting from the north. Went to visit the practice of Jorge Castillo (Lucho), my host and University of Washington (UW) Orthodontics alumnus – he trained in Pediatric Dentistry at Connecticut – our own Dr. Mariella Garcia practiced in his beautiful office with him prior to coming to her position at UW. We then went to dinner at Jorge’s home. He and his wife prepared a lovely traditional Peruvian meal, preceded by traditional snacks, and, of course, a pisco sour. Everything was offered with a “salsa huancaina”. It was a wonderful evening.

Pictures from Day #2-4

Photo #1 – Left to Right – Dr. Giovanna Espejo Arteaga, President, Cusco Society of Pediatric Dentistry, myself, and Dr. Jacquelin Camacho Claros, Pediatric Dentist in Cusco.

Photo #2 - Machu Picchu

Photo #3 - Machu Picchu

Photo #4 – En route to dinner in Cusco

Day #4: Machu Picchu

What can I say? If the Grand Canyon is one of Nature’s most incredible creations, then the ruins of the Incas at Machu Picchu must be one of man’s greatest achievements. Taking 100 years to build in the 11th century, the workmanship and results achieved are mind-boggling given the knowledge-base and technology available at that time. The photos I have attached certainly do no justice to the feel of being there. The only thing I forgot was sunscreen – at the high altitude and being close to the equator (and being surprisingly warm for 2,500 meters at 22 C), I developed a nice sunburn. It will serve as a great memory of an unbelievable day. The three hour train ride each way from Cusco crescendos with anticipation of what one is about to observe. My favorite technological observation of all the hundreds of amazing achievements was the way in which the Incas broke down stones weighing many tons eventually into small stones, some only a few kilograms in weight. They bored holes with special tools, jammed wood into the holes and allowed moistening of the wood to fracture the pieces. Their systematic and patient approach is one to be admired.