Presentation at St. Alban's, Spirit Lake, on January 6, 2008
by T. R. Shively, DDSExperience in Humility and Joy
It was in December that I received a letter from a friend, Fr. Robert Kem of St. Anne’s Episcopal Church, Ankeny, Iowa. This letter was a follow-up of sorts to a conversation that we had during the Annual Convention of the Episcopal Diocese of Iowa in November of 2006. At that time, Fr. Bob informed me of his vision and that he was in the process of putting together a health care team for a mission to the Dominican Republic. He wanted me to design a dental component for that mission. I was excited and really “bought into” the vision.
However, because of the time lapse (very early November to later December), I quietly concluded that this trip was not “gathering wheels,” so, I put my thoughts and plans to one side. However, the letter informed me that the monies would be raised and we would indeed travel on this mission in May!
Thus started a three month process of research, searching, self-education, and the correspondence that was necessary. The research centered around designing and establishing a dental treatment area and treatment protocol without electricity, potable water, compressed air, or high volume evacuation. So, I went online to research all the possible sources of information to accomplish this goal. Many emails were exchanged with the resident missionaries and experienced health care professionals to determine the potential needs of the patients for which we would care. With the feedback, I concluded that triage would be the imperative of the day. This translated to oral surgery in its varied forms. It also meant, due to my limited Spanish language skills, that I needed a method to communicate. Especially important would be the post-operative surgical instructions. I located a source for pamphlets, printed in Spanish, about post-surgical instructions. These were then ordered. When they arrived, I started practicing.
Next, it was my blessing to make contact with an operating room nurse, Cheryl Allen, truly an angel for me and this mission. Our introduction was made possible by the acute thinking of missionary Ellen Snow, who was another important person to this mission. Cheryl advised me of basic surgical set-up needs. We decided on the use of cold sterilization solution procedure because other types of sterilization, without electricity, are practically impossible. She helped with treatment area suggestions, as well. It is important to note that she also advised the medical professionals of our team about the type, kinds and amounts of medications to purchase and ship.
The procurement of cold sterilization solution was a learning adventure in itself. Because it is considered a hazardous chemical, we were doubtful it could be shipped let alone brought in with us. We did find a willing flying service to transport these chemicals. However, the time frame for order, purchase and transfer to them was not going to work. Consequently, we had a number of discussions with the Health Department of the Dominican Republic. Following these discussions and with considerable effort, Ellen located the chemicals we would need from a clinic in-country. During her communications and at my request, she also located two portable dental chairs which were a wonderful bonus.
I was “pumped”. I sterilized instruments, established “lay outs” and sterile surgical packs. The locating of appropriate surgical instruments required weeks.
During this time, I was recruiting dentists and dental assistants. The excitement I felt of doing the Lord’s work was in me. Two other dentists responded positively. However, it was not long before they bowed out. I suspected the daunting prospect of triage dentistry caused them to eventually shy away. In some ways, I could not blame them. It was daunting.
It was at this time at I had a special conversation with the Lord. From this conversation, I discerned;
“I am only one,
but I am one.
I can’t do everything,
but I can do something
and what I can do
by the grace of God
I will do.”
To verify this revelation, God’s messenger, Cheryl, sent me an email:
“Things will be fine, just trust in the Lord, and remember you will be very limited in what you are able to do and this really is ok. You do what you can and the Dominicans will be grateful for your showing up. Peace & blessings.”Well now, that cleared my head, renewed my vision and charged me up for focus and action. So forward I trod, reminded of Luke 9:1-17: “take nothing for your journey, no staff, nor bag, nor bread. Nor money --- not even an extra tunic.” If the apostles took on that charge from the lord, what did I have to whine about?
Thus, work, research, and search more, I did. This meant connecting with every possible dental mission team or organization that had been confronted by similar circumstances and some very creative thinking. It was apparent, however, that “take nothing with you” literally was probably not going to work in this scenario. But I did get the drift: traveling light is a spiritual discipline.
As to staff, I recruited a friend who is a retired Lutheran pastor to be my dental assistant. He has a wealth of mission experience and was a very willing student, which is all I could ask.
Training sessions were held in my office. We covered required protocol. He learned the surgical instruments and assisting. We “role played”. This was admittedly “pie in the sky” but at least he had a base from which to operate. It also gave him an idea of expected demeanor during and after surgery and case management.
He later indicated that this was very valuable preparation.
During this time, I was working with a supply agent, Jeff Ellis, whom I had known for several years. We were negotiating cost effectiveness for supplies that we would need. He is a great guy and a wonderful Christian who really went to bat for this mission. We found, however, that the donation of such supplies to missions is not the same “ball game” as it had once been with large corporations. Thus, it became incumbent upon me to donate many of the supplies for this mission. Candidly, it was another way to serve the Lord.
Coinciding with this time, some women of my home parish, St. Alban’s Episcopal Church, Spirit Lake, Iowa, and the wife of the aforementioned pastor, volunteered to sew “medicine pouches” to give to the patients in the Dominican Republic. Into these we put dispensed medicines as well as toothbrushes and toothpaste. This allowed us to do some oral health education with parents and children. These wonderful ladies sewed 400+ pouches which turned out to be an absolute blessing. The “word of mouth” to fellow barrio residents (of Santo Domingo) was reinforced by these visible signs of God’s love, thus increasing the number of patients each day.
After these months and over 300 hours of preparation, word came that the medical doctors on whom we had planned were dropping their commitment. Then, on the heels of this disturbing news, came an email notice from the in-country missionaries; “no MDs/no mission!” This really hit hard. Had we met these challenges just to see the vision of our mission come to a cold slap in the face? After reading this email, I pushed back from the computer monitor and started praying, “what does this mean? What would you have of me Lord? Am I focusing so intently on the immediate needs and plans of the dental component of this mission that I have not listened to your intent for us? “Please show me the way.”
After many minutes of prayer and silence, into my consciousness popped a name. When I tell this story verbally, I snap my fingers vigorously, for that’s the way it felt. The name was of a physician friend of mine from previous mission experience. But wait, Ginny did not travel with us to Africa the previous year as she had just found out that she was pregnant with their first child. This young one would now be less than a year old. So, it would be unlikely for her to commit to our mission with those family circumstances. However, she had indicated that her husband is an M.D. With mission experience. While not exactly a “road to Damascus” revelation, it was worth a shot. “Yes,” came the reply. Her husband was indeed an emergency room “doc” at the University of Iowa hospitals. He has lots of mission experience. Would he be receptive to our invitation and “bail us out”? Let’s ask and pray.
After personal contact from Fr. Bob and I, he agreed to commit if we could change the mission schedule dates, which would allow him a window of time to get away and join us. Alleluia! This occurred about sixty days prior to our planned departure.
Now back to the in-country missionaries. Would they be able to adjust the schedule and salvage the mission? The missionaries replied; “because the health care mission was badly needed, especially for dental treatment, it would be worked out”. All right! So, everyone; our trip coordinator (who came on board as another angel), travel agent and our entire mission team retooled. The blessings were many. The extra time was not the least of them. This meant a little “breathing room” for the transport of dental surgical instruments, equipment, and supplies to Fr. Bob’s church in Ankeny, Iowa. This is an eight hour round trip from my home.
I was directed by the circumstances and the Lord to “bring everything we would need for dental treatment and surgery. Also, it was necessity to establish a manifest of the instruments, equipment and supplies with the Iowa customs agent. It took me several additional hours to establish the manifests and assure absolute accuracy for transport permission from the USA and the Dominican Republic. Included in this time was establishing a list of medications. Earlier I was required to forward copies of my license to practice and meds. Certification with the health department of the Dominican Republic, which took a fair amount of time in itself. I organized the secure packing of the instruments, supplies and meds.
We also weathered the hassle of Fr. Bob’s passport renewal. But that’s another story.
Now we were ready for departure. This occurred from the Des Moines, Iowa airport on May 31st.
Our first day in the Dominican Republic consisted of orientation to the area and our mission, which was to establish the “clinic” at San Felipe Episcopal Church in Las Minas area of Santo Domingo. Shortly after we arrived at the church on our first day of clinic, it was discovered that the bags of dental equipment, instruments & supplies did not make the trip from our lodging. Is this yet another challenge on this many obstacle fraught journey? Again, it was time for prayer. We joined together and offered our request to the Lord. “Please locate and bring to us these precious bags”. The answer came after many anxious minutes. Security at the facility informed us that they had been placed in another secure holding area and had not been loaded on our van before we left for the barrio, but it would be possible to get them to us soon. This arrival happened. Another moment of joy and thanksgiving.
So, with the proper instruments, etc., we initiated the set up of our dental clinic. It was placed in the corner of the nave of the church, just in front of the pulpit. We established a sterilization area set up in the sanctuary. Thus, the only place for the instruments, in sterile packs, was on the beautiful stone altar! Being so busy and committed to set up and care for the patients, the fact that my instruments were on the “Lord’s table” had not occurred to me at first. During a short break between patients and surgery, I was profoundly struck by the fact that these instruments of care were laid out before the Lord in front of a beautiful and simple stained glass window of the cross. Again, maybe not the overwhelming experience of Saul of Tarsus, but certainly a dramatic one for me. My thoughts privately verbalized as I viewed this scene in the midst of caring action were; “here I am Lord your humble servant with my talents and abilities as bestowed by you. Thank you for this blessing”. Luke 24:36a – 48 came to mind: “look at my hands and feet, see that it is myself.”
Each time I recall this experience, I am still hard-pressed to restrain the tears of joy.
What Christ Jesus has sacrificed for us and is now with us.
We went on to examine, treat, and serve about 500 of God’s children. We were able to dispense nearly $160,000 (comparative USA value) worth of medications and supplies. Many surgical procedures were accomplished in the Lord’s house.
Finally, I can see the meaning of all the struggles and frustrations of bringing this mission to fruition by the guidance of the Lord’s hand. It is apparent that God is presence. Thanks be to God.
Faithfully,
Dr. T. R. Shively, Humble Servant of the Lord.