Public Health Issue - Harvard School of Dental Medicine

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Courtesy photographPAHO Internships BenefitStudents and Communities“will be renewed in February 2013, created PAHO internshipIn 2010, HSDM signed an agreement with the PanAmerican Health Organization (PAHO), whichserves as the Regional Office for the Americas of theWorld Health Organization. The agreement, whichopportunities in international oral health for HSDM students.These internships offer the students valuable field experiencewhile advancing global oral health, particularly throughPAHO’s Caries Free Communities Initiative. In addition, theestablishment of an official relationship between PAHO andHSDM promotes awareness of oral health as an essentialcomponent of general health.To date, four HSDM students have served as PAHOinterns, with a fifth recently completing an elective rotation ingeriatric dentistry in Brazil and two additional interns slatedto participate in summer 2013. Below are reflections from thefour students about their experiences working with PAHO.Posing outside the Ministry of Health in Quito, Ecuador, in 2010were HSDM PAHO intern Jason Outlaw (DMD/DMSc 2016), right, andfrom left, Dr. Laura Ramírez (World Health Organization-Ecuador),Dr. Ximena Raza (chief dental officer of Ecuador), Dr. Hilda Gudiño(Ecuador Ministry of Health), and Dr. Galud Pinto (Ecuador Ministry ofHealth). All except Ramírez participated with Outlaw in the expeditionsto the 17 communities the group visited across the country.“My internship at PAHO was remarkable in that everyoneinvolved understood that oral health is everybody’s business,not just the business of the dentist. Instead of fightingprofessional turf wars, Dr. Saskia Estupiñán-Day, mysupervisor, focused on bringing together stakeholders fromacademia, public health, professional associations, clinics,government, and industry to create a vision for addressing theoral health needs of vulnerable populations in the region.While at PAHO, I assisted Dr. Estupiñán-Day, PAHO’sregional adviser on oral health, in designing and executing acommunity assessment for PAHO’s Caries Free CommunitiesInitiative. This project seeks to implement community-basedsolutions that improve oral health in communities that havenot seen the improvements witnessed more broadly in the Pan-American Region. After a summer in Washington, D.C.,I traveled to Ecuador as a WHO technical assistant to performcommunity assessments in 17 communities across the country.The experience fundamentally changed me. I came tounderstand that many innovations for health care delivery existoutside the United States, and that we must humble ourselvesand explore how other societies are providing affordable,accessible, patient-centered oral health care in the face ofresource limitations. Also, I came to discover that Ecuador hadonly recently implemented universal health care and placed oralhealth at the center of its primary care system (particularly inrural areas), something that has only happened on the marginsof US health care.Now that I am back in the United States, I cannothelp asking if we have a unified vision for oral health in thiscountry, particularly to reduce disparities for our vulnerablepopulations, which are growing in numbers. After myexperience at PAHO, instead of asking, ‘How can I get into thesystem?’ I now ask, ‘How can I improve the system?’”—Jason Outlaw (DMD/DMSc 2016), Summer 2009 PAHO Intern14 winter 2012–13 • harvard dental bulletin
public health focus““My primary objective as a PAHO intern was to develop anCourtesy photographeducational module for community health workers in Haition a neglected disease known as noma. Noma is an aggressivegangrenous infection that rapidly destroys orofacial tissuesand primarily affects children born into conditions of abjectpoverty. Surprisingly, little has been done to prevent thisdeadly disease, which kills 70 percent to 90 percent of itsvictims. Those who survive are left with grotesque facialdeformities that often lead to a lifetime of social alienation.Although it is most prevalent in Sub-Saharan Africa,with cases estimated by some experts at more than 140,000annually, noma was recently documented in Haiti. The urgencyof addressing the problem of noma there was compounded bythe earthquake that struck on January 12, 2010, which furtherdestabilized a precarious environment in which the risk factorsfor noma were already prevalent.My internship was based out of PAHO’s oral healthdepartment in Washington, D.C. To help me develop theeducational materials, PAHO connected me with experts onnoma from academic institutions, international health agencies,Abraham Itty (DMD 2013) with Dr. Saskia Estupiñán-Day, director ofthe PAHO internship program, and Anna Scharfen, a summer internfrom the University of California, Los Angeles.and the nonprofit sector. I had the privilege of working withDr. Cyril Enwonwu, the world’s premier noma expert, and Dr.Priscilla Benner, director of MAMA Project Inc., both of whomwere enthusiastic collaborators on my project.In just eight weeks, I was able to see how public healthpolicies are established on a global scale, befriend expertsin my field of research, and write a tangible educationalcurriculum that was implemented on the groundto prevent a noma outbreak. It was everything Icould have asked for—and more. The curriculumwas a succinct, interactive, and engaging moduleabout noma, which was incorporated into PAHO’sTrain the Trainer program. It was designed to buildawareness of noma and empower community healthworkers and families to engage in practices that willsignificantly improve maternal and child health. Thiscurriculum addressed an unmet educational need forcommunities at risk of developing noma and is beingused to prevent a potential outbreak of this terribledisease in Haiti.”—Abraham Itty (DMD 2013), Summer PAHO 2010 InternIt is common for rural communities in Ecuador to maintain 2-D and 3-D mapsof the community. These maps pinpointed the health challenges faced bylocal residents. The photo was taken in Penipe, an indigenous community inthe province of Chimborazo, during HSDM PAHO intern Jason Outlaw’s project. continuedCourtesy photographharvard dental bulletin • winter 2012–1315
Page 1 and 2: harvarddentalbulletinPublic Health
Page 3 and 4: From the DeanAs we reflect on the a
Page 5 and 6: alumni focusof Dental Medicine, dur
Page 7 and 8: alumni focuswaiting for their bunk
Page 9 and 10: public health focusInspiring Future
Page 11 and 12: public health focusMiddle-School St
Page 13 and 14: public health focusRishi Popat (DMS
Page 15: public health focusJan ReissElsbeth
Page 19 and 20: public health focusConference on Pr
Page 21 and 22: public health focusGender of OHPE A
Page 23 and 24: esearch focusNew Hope for Treating
Page 25 and 26: dental school newsCurrent State and
Page 27 and 28: dental school newsSurface Treatment
Page 29 and 30: dental school newsat the Western Un
Page 31 and 32: Back cover: Risha M. De Leon, senio

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