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Volunteering on the Downtown Eastside – “Word of Mouth” Blog

At the Marshall Dental Clinic in Vancouver, we have a strong belief in the importance of giving back to the community, and one of the ways we do this is through volunteering at the Vancouver Downtown Eastside Dental Clinic.

 Downtown Eastside Walk-In Dental Clinic

Vancouver Native Health Society

449 East Hastings Street

Vancouver, BC V6A 1P5

telephone: 604-254-9949

This clinic offers free dental care to the residents of the Downtown Eastside. The clinic’s focus is primarily on the relief of pain. The clinic is staffed with volunteer dental professionals and the hours vary.

The clinic is run by a dedicated team of volunteers led by Lynn Yankovoitch. Please read the attached message from her about her mission and some of the issues faced by the people who seek and provide the care.

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FREE DENTAL CARE-A SHARED VISION

DENTAL CARE IS A POVERTY ISSUE: The relationship between income and dental health is undeniable.

Few people need to be convinced that people with low incomes face undue hardships in obtaining necessary dental care. If the cost of a dental visit is the same as a month’s worth of groceries. What would you pick?

Without a PUBLIC HEALTH RESPONSE to the oral health needs of adults in Vancouver, the only other option is CHARITY.

Measuring the need for unmet dental treatment is difficult; however, there appears to be a consensus that there is a significant, urgent need for EMERGENCY DENTAL TREATMENT.

In British Columbia, there are significant disparities in oral health, with low income, ‘working poor’ and socially disadvantaged groups having a disproportionately high level of dental problems. These health disparities are linked to inequalities in access to oral health care. The current service structure creates financial and other barriers for many low-income adults who are employed, receiving minimum wage and no dental benefits, as we do continue to see deep and persistent poverty and rising homelessness.

The consequences of these interlocking access barriers is that low income adults are presenting at hospitals with sever dental pain.

Is it realistic to expect ‘Private Practice’, to fulfill the public oral health needs of patients? Studies found that Dentist professionals are willing to donate their time and charitable dentistry, however due to high overhead costs associated with running a private practice, it would be better to establish a dental clinic and request dentists to provide their free services there.

Throughout BC people are responding to this PUBLIC HEALTH NEED, by creating community-based dental care programs. Volunteer charitable dental clinics emerge from community-based processes.

The East Side Dental Clinic is a humanitarian effort and in part as a result of ‘Bruce Wallace’, a dedicated community-based researcher addressing the need to improve access to dental care for people living in poverty. His ‘Action Research Project’ raised awareness by focusing on poverty issues, access to dental care, homelessness, harm reduction and supporting role of in service delivery models to improve access to dental care for people living on low incomes.

To promote and organize charitable dentistry in our community is the role for COMMUNITY NON-PROFIT agencies.

From its inception in 2005, ‘THE EASTSIDE DENTAL CLINIC ‘, could not exist without the generosity of hundreds of volunteers and dedication of those who donate time, services and expertise, as well as the support of the Christian Medical dental Society, the BC Dental Association, Provincial Government, (Start up funds), and the donation of clinic space and utilities from Vancouver Native Health Society which also operates as a medical clinic and existing host agency. Currently we are partners working with other health care individuals and Mentorship Programs.

The East Side Walk in Dental Clinic operates with a relief-of-pain mandate, with a focus on extractions. Some hygiene services are available for oral health promotion. In 2012 volunteer’s donated $400,000.00 worth of services.

At this point, we don’t know how much time, money and resources we are saving our local hospital facilities by treating dental emergencies.

Dental problems affect people on a number of different levels-the most obvious one is the stigmatization that occurs. It effects people in a way that we have not even been able to properly gauge or assess because we probably don’t even see a lot of people who are not eligible for dental care and so they disappear and we only see them when their health problems become more complicated and then you see them when they are in real emergencies , if at all.

The inaccessibility of dental treatment for low-income adults and the urgency of the need is an ETHICAL & PUBLIC HEALTH ISSUE.

Overall, dentists recognize the need to better address the needs of individuals with low incomes. Many already offer charitable dental work. However, to incorporate a certain amount of charitable work within their own schedules challenges dentists, as they balance their role in providing an essential public health service, operating a private business with high overhead costs while also operating within a professional association.

BC’s health care application system is not working as it discourages delays and denies people who need help and many experience harm and homelessness as a result. The BC Benefits system is extremely complex and difficult for people to access. There are barriers at every step of the way, because even if a person gets benefits, the fee schedule is so low that they may be refused access to services.

There are a lot of good dentists, but is it financially desirable for dentists in private practice to accept patients facing multiple social and personal challenges, creating frustration with scheduling challenges and other limitations? Dentists routinely refuse to treat patients in need, due to inadequate funds and discrepancy between fee-guides.

Obviously, charitable dentistry is a limited response to a fundamental basic health need, but should be supported as an important COMMUNITY RESPONSE to the need to improve access to dental care.

The gap in health policy and programming that leaves many low-income adults unable to access dental care has widened and the resulting disparity in dental care problem is spreading, particularly among, multiple access barriers patients and with immigrant and refugee populations. There is virtually no dental care for our clients who are not on social services. Clients are most often adults who cannot afford private treatment and or do not access treatment for other reasons such as mental health, addictions or homelessness. The predominant barrier to accessing care is the related issues of availability, physical access, cultural acceptability and discrimination.

The services are limited due to limited resources. It is relief of pain by a compassionate person, that is the bottom line and that gives a different flavor to the whole office. According to one clinic organizer, “The dentists get the most gratifying experience out of it.”

THE VOLUNTEERS need to be aware of the issues that the clientele deal with on a daily basis and knowledge of HARM REDUCTION PHILOSOPHY. Even if a person can’t afford the cost of dental care, it cannot be ignored. They still need to take care of urgent dental needs-like painful problems. Just think of the consequences of having narcotic pain relief medications prescribed on an ongoing basis. It is amazing to know what people have been living with, that we see. One dentist stated that their role “is to solve the pain and dispense a little love, understanding and respect.” “Often times, if you can give them just a little support, these people are capable of carrying on as responsible citizens in the community. A lot of people probably have awareness of the need to take care of their teeth, but they have just lost hope of ever being able to get treatment. They are often quite capable people who are just in a real bind and when you have dental pain, it almost takes you out of your mind; it is so severe that you can’t think properly. You really become quite incapable. A lot of people just need to get past this incredible pain and then they are ok. “Being able just to see a Dentist when in Pain is an untold psychological benefit”. Although the compassion demonstrated by the volunteers is key, the service is vulnerable, as access to care is dependent on the willingness and commitment from the dental profession. If we lose the volunteer dentists we lose a vital content of the whole spirit of the service. Most significantly, dental professionals must continue to want to volunteer, for these clinics to survive. We really need lots more volunteer dentists and the rest will take care of itself, through a network of common energy as they recruit participants.

Outcomes from a clinic: reduce spreading of communicable disease, an improvement in the general health of the Downtown East Side, increased employability and self-worth and self-esteem and above all harm reduction and a reason not to use drugs to control pain, especially for patients who are currently undergoing drug treatment and in Recovery Programs and an end to toxins leaking into their system.

This clinic has a reputation for the outstanding level of commitment, dedication and expertise it requires to treat our most neglected. “PAIN is perfect excessive misery and overturns all patience.” –Marcel Proust

The clients of these services are extremely grateful, not just for the relief of pain, but also grateful that people care enough to volunteer their time and services. The work our volunteers do changes the lives of patients as well as our own. Their enthusiastic dedication and heartfelt compassion demonstrates the very best attributes of mankind.

Thanks to everyone who is working to improve the health of people living in poverty. Your contribution cannot be overstated!

“Never doubt that a small group of thoughtful, committed people can change the world, indeed it is the only thing that ever has.” Margaret Mead.

EAST SIDE DENTAL CLINIC-455 East Hastings St. Vancouver-604-254-9900

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