09 July 2011

My (not so) Nightmare Third World Dentist Experience

I got off the taxibe 165 as if I was going to The Cookie Shop, a little cafe in the capital that is the closest thing you can get to America this side of Africa. Unfortunately, as soon as I neared the shop, I had to ignore the little latte fiend in my brain and turn down a side road instead. This road heads past a strip of chop shops that leads to an informal market surrounding the “stinky lake,” the most foul, putrescent cesspool of a pond in Tana (and people fish in it). I did this because I was headed to the dentist, having ejected a filling from a lower incisor and subsequently swallowing it while therapeutically biting my nails the week before. I think I should take up smoking instead - it would be better for my teeth.

Now, Im not a particularly terrified dental patient. I’ve always had an innate trust in the being with the starched coat, latex gloves and mint green facial mask, the purr and whiz of the drills, the metallic glint of sterile probes, and  the laughing gas that I habitually requested as a juvenile, not because of pain but out of enjoyment. Yet still, I was a bit apprehensive about having to go to the dentist in this oh-so-poor country. All sorts of gruesome “Sweeny Todd: Dentist Rendition” images popping into my usually placid mind.
The Santé Polyclinique is a small medical complex, barricaded behind high walls and a big gate, in the chaotic Behoririka neighborhood in the center of town. It is clean and modern and everybody wears smocks or lab coats.
When I first arrived I was a bit early so I had to wait in their waiting room - leather seats, glass table, bubbler in the corner (You’ve infected me Wisconsin) and brightly painted miniature tables and chairs carved with fruits and animals for the kids, a speaker playing, what else, but Celine Dion’s eternal hits. In other words, it was like any modern waiting you that you would expect in the states, except it was strangely bereft of any reading material and off the side of the complex in its own separate building, giving it a somewhat surreal, liminal feel, like I was in purgatory. Or, I would have felt like I was in purgatory, except that I had my faithful Macbook and was able to distract myself from that reality like any good postmodern, consumerist American.
30 minutes later, I was escorted into the Dentists office, which was a wood-paneled room with large windows, a desk in one corner, an x-ray machine in the other, and a single 21st century dentist chair right in the center. The chair had an instrument cart and beautiful clear glass spittoon with water fountain, a spotlight and a large flatscreen monitor all attached to it.
Everything was as it should be, at least in my coddled western mind, even the fact that the Dentist was a cheery, sharp 30-something woman rather than the stodgy old Gasy mind that I pictured. My filling replacement and cleaning progressed without dismay, though there were several reality eliciting anachronisms in this otherwise surreal experience.
For one, she began the drilling without a moments hesitation, including hesitating long enough to give me anesthetic. Not until I yelped did she ask if there was any pain and then, somewhat dismissively, as if it wasn’t the pain of her drill sending shockwaves down my nerve. This is understandable given many Malagasies' horrid dental conditions; rotting blacked stubs of broken teeth all too common and there is a nearly constant state of tooth-ache the island over. Her drill probably send waves of soothing bliss through the mouths of some of her clients so my discomfort was probably a source of some amusement for her, though eventually she did offer me anesthetic, which I gratefully accepted, knowing full well that such medicine is not as easy to acquire here as elsewhere and that it is expensive and saved for situations of serious dental surgery that this most certainly was not.
Another point of interest to me as I reclined in her chair was the absence of an assistant who uses a sucker thingy to control all the water. Despite the fact that she had all the fancy equipment I would expect and an assistant, there was no sucker thingy. Instead, the reason for the glorious spittoon became quite clear. Every minute or two I was commanded to rinse, and I would lean over and take the mysteriously filled cup and rinse-and-spit. I must have done this over 50 times rather than the two or three times I am used to, and it took me half the appointment to figure out how the cup was being filled. I kept stealing glances at the mechanisms during my few seconds of rinse-and-spit and couldn’t find the sensor that knew when I returned my cup and filled it to the brim, simultaneously sending up a little spray of a fountain to wash the spit from the spittoon. Finally I realized that the assistant was controlling this, and it wasn’t just a magical chair, though she was on the other side of the dentist, away from any levers that I could see, busy handing the dentist tools and cotton swabs.
One tool she handed the dentist was a small piece of sandpaper. This one surprised me. I mean, she had just been using all sorts of high-tech tools to build and buff my new porcelain tooth, why ever would she use sandpaper to finish it off?
Turns out that going to the dentist in Madagascar is neither a nightmare or an ultra-modern experience, but a curious amalgam of Malagasy practicality and transplanted western aesthetics and understanding, like much else in this capital if you have the money for it (thank you Peace Corps!). Im not sure Im ready to visit a tooth doctor in the Malagasy countryside. 
Leaving the dentist, I headed off to the Cookie Shop to put a literal cherry on top of this expat experience, and ordered a caffe latte and a brownie sundae.