Miles of Smile: SmileMobile provides dental services to the Spokane Marshallese community
Instead of looking forward to turning 6 on October 28th, Elje Mwejenwa, a child from the Marshall Islands, was in pain.
“She was crying and complaining that her teeth were really hurting,” said her mother, Bena Maneki.
Mwejenwa was one of the few pediatric patients who saw dentists at SmileMobile RV, a mobile dental clinic funded by Delta Dental and operated by dentists Sandi Walker, Paul Phillips and Karri Amundson.
Last week they provided services outside of the Spokane Tribe Casino on Airway Heights for four days, offering dental checkups, cleanings, and other treatments specifically for the Marshallese community of Spokane and other colored communities.
Amundson discussed the relationship between the community organizations and SmileMobile. In her role she should “reach BIPOC communities and populations”. BIPOC stands for Black, Indigenous and People of Color.
“We really believe in justice and everyone deserves access to oral health,” she added. “Whatever these barriers, we try to break them down and connect them directly to dentistry programs.”
The SmileMobile is affiliated with CHAS Health, Smile Spokane, Spokane Regional Health District and Better Health Together to promote and improve the dental hygiene of the local Marshallese.
From there, members of the Marshallese Congregation worked to inform their neighbors and coordinate transportation to the clinic, as well as providing translation services. Amundson also noted that many patients were unaware that Apple Health, Washington’s Medicaid program, covers both medical and dental services. Ronako Mejbon, a Marshallese and health worker at CHAS, served as an interpreter between the Marshallese and the dentists.
“I chose interpreting in March 2020,” said Mejbon. “I realized that COVID (logs) makes it so important to get information to those who don’t speak English.”
Flyers in English and Marshallese were created to reach as many people as possible. {%% note} {/ %% note} The Marshallese Restoration Church and the congregational United Church of Christ in the Marshall Islands also supported health organizations in collecting people and exchanging information. Doresty Daniel works for Spokane Public Schools and used her identity as a Marshallese and language specialist to make the SmileMobile project run smoothly.
She stated that American oral health practices are not common in Marshallese communities.
“We didn’t have toothbrushes or toothpaste. We just washed our mouths and were still fresh, ”said Daniel, who was born on Mili Atolla, an outer Marshall Island. “There is no tradition of dental hygiene in the Marshall Islands. It’s something we never knew was important to our health because we never thought it was important. “
Poor dental hygiene can be linked to heart disease, diabetes, and arterial blockages, other harmful health problems that disproportionately affect the Marshallese community. Amundson said many of the patients were adults with longstanding health problems including their dental hygiene. Amundson had to be careful with medication when Hemilen Robert, a 61-year-old patient, had four of her teeth removed. The surgery could potentially cause complications with her high blood pressure.
“Oral health affects your overall health, especially in the Marshallese population, where they have a very high rate of diabetes, so (SmileMobile) is seeing many Marshallese with diabetes (this week),” Amundson said. “We want them to get their overall health under control because it affects their diabetes.”
SmileMobile dentists were working in a mobile home outside the casino’s restaurant, Three Peaks Kitchen + Bar. Padded treatment chairs were installed to the right to diagnose problems. Additional supplies were stowed under the van. In light of COVID-19, ventilation panels are filtering the air from the roof of the motorhome. Space was tight for the three dentists, Mejbon, and the patients, but there was enough space to promote health in the Marshallese community.
Phillips has been an equity-focused dentist for more than 40 years. He also has a health contract with the Colville Reservation, and a tribe member was one of the first SmileMobile patients that morning. Phillips said he was happy to be transforming Spokane’s equity initiatives from “conversation to action” for the Marshallese community.
“The tread meets the sidewalk right here because I know there is a lot of networking going on in Spokane,” said Phillips. “But this kind of interaction, this face to face, person to person? This is necessary to help others in the health system. We have the interpreters and they helped us get in touch with the patients. As soon as (interpreters) feel comfortable, this feeling is interpreted to the patient. For justice issues, this (community effort) is required to get in touch with groups. “
He did a quick examination and found that she had to use silver diamine fluoride, a protective agent against tooth decay that would turn Mwejenwa’s teeth from brown to black.
“She has about three of her six molars and it’s important that they are healthy and that we seal them,” said Phillips.
After Amundson applied the fluoride, Phillips referred Mwejenwa to a pediatric dentist who would be better placed to assess and improve her dental hygiene.
With SmileMobile closing its dental clinic on Friday, they want to return and improve their reach in the Marshallese community. Many of the Marshallese live near Rogers High School. For those traveling without transportation or car pooling, the 30-minute trip to Airway Heights became an hour and 15 minutes by bus. An Uber trip would cost nearly $ 50 to and from the mobile clinic. Amundson said they hope to “provide services close to the communities they serve”.