Reaching vulnerable populations in oral health care

Canada’s pluralistic society offers keys

In Pakistan, dentists are expensive and the poor go without oral health care, says UBC graduate student Abbas Jessani.

So it was an eye-opener, admits Jessani, to see that the same happens in Canada. “Before coming to Vancouver, I somehow had the impression that healthcare here was perfect.”

But what is reassuring, he adds, is Canada’s robust culture of volunteerism and social responsibility. “Here, there is a strong belief in the inherent value of each human life.”

Jessani has noticed this ethos at work at the Faculty of Dentistry through its different outreach initiatives. What drew him to UBC, he says, are its explicit goals to provide health promotion planning and ongoing care and maintenance to previously hard-to-reach populations such as Aboriginal communities, the working poor and the elderly.

This summer, Jessani left his hometown of Karachi and his one-year dental practice to pursue an MSc in craniofacial science with a focus on public health dentistry. His graduate research will look at oral health access among pregnant women, focusing on marginalized populations that include Aboriginal and immigrant moms-to-be.

Since his arrival, Jessani has been shadowing his thesis supervisor, Dr. Mario Brondani, whose research explores dental geriatrics, oral health and quality of life, community service learning, dental education and public dental health.

Once a week, Brondani practices dentistry at the non-profit Mid-Main Community Health Centre, where he was the first dentist in B.C., and perhaps in Canada, to offer HIV rapid screening testing to his patients.  As a volunteer, he has worked with organizations such as Health Initiative for Men, Positive Living BC, which represents people living with HIV/AIDS, and Boys R Us—Vancouver’s food and information program for male sex trade workers.

“I keep encouraging Abbas to think outside the box and always ask the ‘so what’ of his studies,” says Asst. Prof. Brondani. “It’s by experiencing the unmet needs of our Canadian society that he, as many others, can advocate for equality and inclusion.”

Brondani also advised Jessani to sit on a few classes of the Professionalism and Community Service (PACS) program, an engaging learning model that combines clinical skills and community services. In 2007, Brondani and other faculty team members helped to establish PACS through all four years of the undergraduate dental degree. The curriculum challenges students to move outside a controlled, on-campus setting into situations that call for cultural sensitivity, communications skills and compassion. Brondani organizes sessions where students can learn directly from community members on issues including addiction, sexuality and HIV.

Jessani observes, “Canada is a pluralistic society and I see how important it is to build trust with each community.”

A typical first-year PACS program sees undergraduates planning and delivering oral health education at different low-income neighbourhoods. In second year, students focus on geriatric patients in long-term care facilities, and in year three, on inner-city, elementary school children. By the fourth year, students are caring for special-needs patients, from psychiatric hospital residents to children with disabilities.

This contrasts sharply to his undergraduate years, says Jessani.
“My dentistry professors were a bit puzzled by why I would want to study public health. In their view, a profitable clinical practice is the sole career choice.”

Despite their advice, Jessani aims to merge academia and advocacy work. “In my family and Ismaili muslim community, there’s a strong emphasis on our humanitarian mission, our responsibility to help others.”

Before coming to Canada, Jessani was working with the non-profit organizations Aga Khan Health Services for Pakistan and Aga Khan Social Welfare Board for Pakistan. Between 2009 and 2011, he supported national “Substance-free Pakistan” campaigns that educated the public on health risks of addictive habits such as paan, betel leaf and chewing tobacco.

“My goal,” says Jessani, “is to be able to help countries like Pakistan move toward some of these models of grassroots community outreach. I hope that my studies at UBC give me the tools to shape evidence-based policy and practices to distribute dental health in an equitable manner.”

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