Sunday, September 10, 2017

Maui's Brightest Smilers




Maui's Brightest Smilers is the Maui based team that is reaching out to collect the Voice of the People on dental needs in the community.  We chose to work with a group from just about every demographic.  Every group was racially diverse, each also having 
  • a dominant demographic 
  • a dominant subculture
  • an offset minority to the group
For the last 6 weeks, we have been focusing on those who do not reach out or attend such community meetings and events.  Although the results are as expected, the community at large was thankful that someone is thinking about their smile and confidence thereof.

So to get back to demographics, we feel we have reached out to the variety of cultures, age brackets, financial statuses, disabled, elderly, youth and homeless/houseless populations.  In surveys we only managed to have approximately 100 returned, however in verbal feedback, we were able to reach a larger multitude of people, having talked story with about 250 people total.

Starting with the 2 smaller islands Lanai and Molokai, there is scant resources at best to cover anything more than a cleaning and possible emergency pull.  We were unable to find anyone on these islands to talk to who had sufficient insurance coverage to get any further in dental care. There seems to be a total negligence in these 2 islands altogether.  Whereas we can understand the population and lack of sufficient population demographics for these 2 islands to have a lot of options, we feel as though a total disregard of those places create a disparity level too high to ignore.

On Maui, we were able to speak to a much wider array of demographics, which provided the insights of where the disparities lie.

Whereas some people could vaguely name how their recent ancestors have handled dental issues in the past, most old enough to remember an older past, remember that their elders had more teeth at an older age than the elders of today.

Dental habits haven't changed much since then, except people simply don't have access to affordable dental care these days and insurances get skimpier by the year and age. As living expenses continue to rise, insurance values and monetary values continue to fall and wages continue to remain stagnant, things like dental care often sit on the back burner until they can no longer be ignored.  Many times they wait too long and under such politically oppressive circumstances, the only option is extraction at that point.

What further impacts the situation is the fact that teeth are among the first thing people notice when looking at you.  They are the first part of a person's appearance that employers look at when conducting an interview. It is important that both customers and clientele feel comfortable talking to a person and sadly, people judge.  And their judgment affects business.  It is a quiet kept and wide spread corporate practice to look for these things. Teeth are crucially important to break dependency upon the system.  If we want more people to find substantial employment, get off the system and be healthy, we will take care of their teeth.  

Socioeconomically speaking, the system feels as though taking care of its constituents is too costly to do.  Of course prevention is our ultimate goal, but in order to stabilize our economic future as one community, we will have to think outside the box and solve multiple issues with the most impactful, cost efficient solutions that we can muster.

After consistent brain storming, we came up with one idea.

There are multiple economic reasons that the people are being denied such crucial care to their health and well being.  While some of those reasons are not a subject for today, one set of reasons should be brought up. That reason is the overwhelming amount of assistance programs that goes out each year and the fact that so many entities compete for the same grants, that nobody gets anything substantial enough to meet all the needs of our communities.

One cost effective way to meet the needs of our community while opening a new market for employment, commerce and education, would be to create one five year plan, broken down into five stages:

 - Apply for a grant to open and operate a 3D printer and operate the print shop from Lanai or Molokai, in one of the health system complexes there. This provides future sustainable jobs for upto 5 people in the beginning.  They will have to learn 3D print technology and their main objective is to print dentures that are low cost and effective for use in public arenas. This print shop will function to serve all islands, while providing sustainable and friendly place of employment.

 - Expand community dental clinic hours and utilize graduate year dental students at internship stipends for a fraction of the cost to state and federal programs. Med-Quest, non-insured, under-insured and the likes thereof may participate in the program during the hours of 5pm-9pm as not to affect normal daily operations.

 - Extend scholarships through the First-to-Work program to solicit employees to handle the 3D stations at dental clinics.  Require them to attend these clinics to get their teeth fixed prior to graduating program, so they can present themselves to their communities as models of how this system will work.

 - Understand that this is going to open doors to a confident Hawaii with gainful employment and better hope for the future.  Plan actions accordingly.

 - Record the journeys and follow up with people, everyone.  This may be a breakthrough for our people to open doors that have long ago closed. For many, this would be a cost effective solution.  For the system, perhaps the newfound confidence and gainful employment will lead to less dependency on the system and Hawaii can be a pioneer in 3D technology and the concept of aloha, for the world to see.

This time around, when we talked to people, there was a desperate hope that we could find one solution.  People want to do better but they see who has the good jobs.  They see that their appearance doesn't stand a chance in the world today, and there's nothing they can do about it.  Many have other struggles, such as "alternative coping" that stem from the very core values and emotions we witnessed on our journey to capture their voices.

We spoke to people who have had temporary parts painfully stuck in their mouths for over 30 years, and others who couldn't afford the co-pays or procedures.  Then there were those who struggle so hard to get an appointment, that they don't even think about routine maintenance because their teeth are so bad, work simply has to be done there... and there is no hope for the work to get done.  Those are the people who end up costing the system a lot more in medical expenses and assistance over time.  How beneficial a few small solutions would be.  Thank you for your time and attention.





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