12/02/2023
0與1 間的選擇
作為一個臨床牙醫師,能做的事情真的很有限。受制於資源的缺乏,面對源源不絕有需求的病人,在有限的時間內只能選出你有能力及有急迫性要治療的病人。
在史瓦濟蘭資源缺乏的地方,牙醫師幾乎只集中在首都墨巴本,但是在人口超過一百萬牙醫師數量稀少的狀況下,醫師與病人比遠超台灣的1:2000,讓很多有需求的病人無從求診。甚至很多病人因交通不便無法前往醫院治療,而到鄉村的巫醫接受傳統療法。
對一個牙痛來求診的病人,礙於治療的受限,一般來說當地的牙醫師只會進行拔牙的處置,而像我訓練背景在台灣的牙醫師,總會覺得可惜,但卻也無法改變治療的方向。在台灣,蛀牙牙痛可以做補牙可以做抽神經也可以做牙套保護,但是在這裡幾乎只有拔牙的選項。
今天是最後一天的聯合大義診,服務人數也是這幾天最多的。妳會希望你貢獻再多一點點、再累一點點、再待久一點點,可是現實是三位牙醫師儘管拼了命去做,能做的也只是冰山一角,非常期許史瓦濟蘭的醫療系統會繼續進步!
前幾天住所附近住了一群史瓦當地衛福部的官員,他很欣賞我們在做什麼,我和他們說,what you are doing is the most important thing, only by health system strengthening can help, we are just helping the rest.
This is the last day staying in the kingdom of Swaziland. Rains are still falling huge, they have never stopped, as our passion never put off.
As a clinical general dental practitioner, you were trained in a resources rich environment. You are able and allowed to perform complicated treatment in order to save teeth. Nonetheless, in resources deprived area as some faraway township here, you can’t do what you want. It’s a zero or one, save or extract.
Facing a patient with pain problems due to severe damage of tooth structure, your treatment option is limited. You wish you could have done better and more, but the reality is cruel. You feel guilty whilst you are in the meantime doing what you could do at the moment.
Always making decisions in this country. When making a treatment decision, you always ask yourself two questions?
1. Do you feel comfortable doing this treatment option to your parents if they were sick?
2. Do you have better treatment options?
These two questions struggled me a lot. You can’t find the right answer and it has been controversial.
Who can tell me what’s right or wrong? I dunno. And possibly no one knows. You may not agree with me that much. I am just an ordinary person and I am just trying my best to give. Hope in one day, the health system would be stronger and the people in need will be benefited.