By Ellen Garnett
Since 2013, Harvard School of Dental Medicine (HSDM) and Northeastern University’s Bouvé College of Health Sciences have partnered with the Wampanoag Tribe of Gay Head (Aquinnah) on Martha’s Vineyard Island to combat oral health disparities within the Native American population. During their three years of collaboration, HSDM students involved in the program have learned that cultural competency is key in effectively treating patients with diverse ethnic and cultural backgrounds.
Under the instruction of HSDM’s Dr. Brian Swann, instructor in Oral Health Policy and Epidemiology, pre-doctoral students including Chloe Wong, Mindy Truong, Fiorella Candamo, Hannah Yoo, Sara Rosenberg, Samuel Lee, and others, volunteer once a month to share educational information about oral health with the Tribe. Through Martha’s Vineyard Hospital Dental Department, they also provide dental care, which has proven to be otherwise inaccessible institutionally, geographically, and culturally for the Tribe.
As a population that has lived on the island for more than 10,000 years, the Wampanoag Tribe has effectively maintained their values and traditions, including medicinal practices, despite Western influence. Therefore, HSDM’s approach to dental treatment must be respectful of the Tribe’s own view of medicine.
“It’s about how to be a trustworthy provider who is humble enough to find a balance between what your personal and professional goals are, and what the patient’s goals are,” said Chloe Wong, a third-year DMD student. “A big part of healthcare is empowering people.”
The Tribe has a holistic approach to medicine with their use of a medicine wheel and a Medicine Man. There is also an exercise called “fireball,” during which members of the tribe kick and toss a flaming ball, enduring pain to remove pain from their loved ones who are sick or dying. HSDM students learn about the Tribe’s spiritual idea of health and become “participants within the culture” to build trust and sensitively care for their patient’s needs.
For the past three years, HSDM students and Dr. Swann have attended Wampanoag powwows in Aquinnah and Mashpee to better understand the Tribe’s culture and break down any social barriers there may be in providing treatment. During the powwows, which are a sacred tradition, tribe members sing and dance and reconnect with one another.
“My biggest takeaway is to make it a priority as a provider to understand your patient as a whole, including their cultural beliefs because if you do that, it will increase their trust and the bond between patient and provider,” said Samuel Lee, a third-year DMD student who attended a recent powwow.
While initial grant funding for HSDM’s clinic on Martha’s Vineyard has ended, Dr. Swann and the students continue to work toward the expansion of dental care on Wampanoag tribal lands to reach more patients.
“Our presence is a success story in itself. We have one of the very few agreements between Harvard and the Wampanoag Tribe,” said Dr. Swann. “Many smiles have been restored, fears have diminished, costs have not been prohibitive, dentition has been saved and we have shared in bringing hope. Pre-doctoral students have also benefited by participating on a higher level than expected and have a greater understanding of what dentistry can mean from the clinical and psycho-social perspective.”
Photos courtesy of Samuel Lee