hy Dwight Wayne Coop

The difficult things in life — to use the expression — are harder than pulling teeth. For Texan Philip Plunk, this has added meaning. Dentistry for rural Guatemalans is nothing you could painlessly imagine; and were it not for Dr. Plunk and others like him, the pernicious little bugs that rot teeth and gums would continue inflicting misery. Dentistry would not exist.

Dr. Plunk works on a patient at a rural clinic.

Well, almost not. There are “dental mechanics” whose practice predates Babel and whose qualifications are at best dubious. “Your village dental mechanic,” Dr. Plunk explains, “will be apprenticed to another village’s mechanic, who himself knows practically nothing.”

But even dental mechanics have a specialty: pulling teeth. They are good at it, since they do little else.

“As a rule, the first sign of a cavity is the cue for extraction. As soon as you notice a little black spot on your tooth, you know its days are numbered. Inevitably, the spot will grow. Eventually it’ll abscess, bringing severe pain.”

Since dental mechanics are neither trained nor equipped to fix cavities, the crude anesthetic (often rum) comes out. Then the tooth itself comes out in the old-fashioned way — sanguinary and unpretty. And that is only if you are lucky; often the “operation” is done with no anesthetic at all.

Dr. Plunk began his Guatemalan odyssey in 1984. Appalled by the dearth of dental attention available to Guatemala’s neediest, he resolved to return with a medical mission. But first he had to tell JoAn Dwyer about the Land of Eternal Spring.

Phil and JoAn were Sunday school chums, then sweethearts, at a Dallas Methodist congregation. She was a social worker treating victims of sexual and domestic abuse.

“Honey,” Phil told her, “you’ve got to see Guatemala for yourself!” But it was not so easy. Besides her own career, JoAn, a widow, had three teenagers to look after.

Patients waiting for the clinic to open.

“All right,” Phil proposed, “if I can find someone to watch the kids, will you join me [on an upcoming mission]?” When Phil found someone, JoAn assented; while keeping her end of the deal, she succumbed to Guatemala fever. After they wed, Phil continued coming down about twice a year, with Dwyer coming along on every other trip.

Phil’s life in 1988 turned left when he expected to continue veering right. “God called me to the ministry, of all things,” he recalls. “There was no doubting it. I was ready to drop my practice and preach full time, if that’s what He wanted.”

After two years of part-time but accelerated study — broken by missions — Phil took his master’s in theological studies at a Dallas seminary. “But preaching,” he says, “wasn’t exactly what the Lord had in mind.”

In 2001 the Plunks moved permanently to Guatemala and soon set about reviving two clinics that today operate under their stewardship, staffed by volunteers both Guatemalan and foreign. One is near Quetzaltenango; the other is on the road to Chichicastenango in a spot called Camanchaj.

“Then people started sending down equipment and supplies,” JoAn recalls. “And volunteers (some of whom are now paid) started finding us.”

One volunteer, Juan Toj, lived in Los Angeles for five years. Today, with his elegant command of Spanish, K’iché and English, he is, among other things, the Plunks’ chief interpreter.

“When we don’t have him,” JoAn explains, “our [Englishonly volunteers] must speak with patients via two interpreters: one translating English to Spanish; the next, Spanish to K’iché — and then back. Diagnosing a patient can be more than little awkward.

“It’s a little like that old whisper game,” she adds. “Someone starts a ‘rumor,’ then whispers it to someone else, who in turn whispers it to another and so on. When the last person retells the rumor aloud, everybody laughs.”

One volunteer who never needs more than one interpreter is Betsy Petersen, M.D., who “minored in Spanish because I knew that someday I’d practice in Latin America, probably for the rest of my life.”

Phil and JoAn always have a medical doctor in their employ; Dr. Petersen, a pediatrician, is here as an elective part of her residency. On Mondays and Tuesdays, she comes with them to Camanchaj; on Wednesdays and Thursdays, she accompanies them to the other clinic. Either way, they stay until they run out of patients, usually mid-afternoon.

“Occasionally,” Dr. Petersen says, “I still imagine having a nice little suburban practice back home [in Wisconsin]. But it’ll never happen.”

For Californian Elizabeth Rogolsky, “home” is Panajachel, from which she comes to give therapeutic massages. Another current team member is Ohioan Betty Palfi, a medical technician who is training Juan Toj’s wife, Manuela, to run the clinic’s laboratory.

“She’ll be able to do all the main tests,” Betty says. Manuela, attired in full K’iché finery, looks up from her microscope and smiles. She looks forward to a career Betty describes as “saving lives by helping physicians get early diagnoses.”

Although the civil war was raging full-bore in Guatemala during Phil and JoAn’s early missions, they witnessed its denouement, then its ultimate closure in 1996. As health practitioners present when peace broke out, they found the name “Salud y Paz” to be an ideal handle for their project, now a tax-exempt charity. But as happy as they are about the Peace Accords, they note that peace has been a boon to — of all things — cavities and periodontal disease.

“The war kept people in total poverty,” Phil explains. “But now they have a little discretionary income.” Some even have enough capital to cut a hole in one of their adobe walls and stock a little store. Consequently, “tiendas are popping up all over … and their market is anyone in the village with a few spare quetzales.

“In some areas, during the war,” he adds, “it was barely safe to have a house, much less a business of any kind.”

“But now,” says JoAn, “everywhere you look, you see moms lugging babies, weaning them on cokes. Milk, too, but they lace even that with loads of sugar. And you see kids munching candy and junk food.”

Can anything be done?

“Yes,” Phil says, “though maybe not as quickly as we’d like. We need to establish credibility first. We can’t come in as outsiders and expect to accomplish change overnight.”

“It’s enough for now that we can fix teeth and deal with other maladies,” Phil says. “And as patients begin to ask what they can do, we can educate them. But if an occasional bag of candy is your sole luxury in life, then who are we — as people from an affluent society — to say you shouldn’t have it?”

“These people don’t even have clean water,” JoAn notes, “yet back home you see people soaking their lawns with water pure enough to drink. What a waste.”

“North Americans,” Phil laments, “may be the only people who flush their toilets with potable water.”

So that clean water is not just another unobtainable luxury, a Methodist geologist is surveying the Camanchaj clinic’s yard for the drilling of a fresh-water well. The aquifer, he estimates, is 600 feet down. To pay for it, Salud y Paz is enlisting sponsors — at the rate of $10 per foot.

Education at the clinics is presented passively. Wall murals as bright as highland huipiles illustrate a nutrition pyramid, a mouth full of besieged teeth, a river that people both drink from and contaminate. JoAn notes that children are often the eagerest learners.

“So I tell them to brush not just their teeth,” she says, “but their tongues, too. They think that’s the funniest thing they’ve ever heard.” Even so, some go on to do it. Phil and JoAn’s industries have loosed a swell of generosity from their denomination. The Camanchaj clinic has two operating rooms full of donated equipment. JoAn likes to show off the anesthesia machine stowed in a corner behind mounds of silvery bags containing sanitary curtains. With every imaginable bell and whistle, it resembles a robot prop from a sci-fi B-movie. But for the suffering, it spells deliverance.

Each clinic has a pharmacy walled floor-toceiling with medicines. The dental room boasts two chairs — one for “Doctor Felipe” and the other for the young Guatemalan dentist — not mechanic — he is mentoring. But all these assets would gather dust if care providers stayed at home.

“We’ve had pediatricians, surgeons and O.R. nurses coming down for years,” JoAn says. “But last year we had a pair of OB-GYNs. They fixed dozens of prolapsed uteruses.”

“Probably the commonest operation Salud y Paz provides is hernia,” Phil says. Volunteers have also fixed harelips and cleft palates.

This opportunity to serve will keep the Plunks in Guatemala; today they live in Cantel, near Quetzaltenango.

“Guatemala’s as beautiful as Phil said it was,” JoAn says. “But what I adore most is the people. I’ve seen a lot of the world — Phil’s traveled, too — but I’ve never seen people like the Maya. They have this inner peace, hard to define, in spite of all they’ve been through” — to say nothing of the peace that freedom from the agony of abscessed teeth brings.

“We can’t save every tooth,” Phil admits. “But here’s the difference in practicing here and back home. Occasionally, I’ll get a patient from whom I have to pull several teeth all at once. Then I put in the cotton gauze to stanch the bleeding. But then the patient gets up and gives me a hug and says, ‘God bless you!’ That’s unimaginable back home, where I might labor for hours to make a patient’s tooth look right, only to have him look in the mirror and say it’s still not perfect. But anything I do for these folks — anything at all — is greatly appreciated.”

When Phil and JoAn pack up each Tuesday, they leave something behind: hope.

“These people don’t have to suffer at the hands of dental mechanics,” Phil says, “or get too much done at once because they may never see another dentist. They know that, by God’s grace, we’ll be back.” •

To volunteer with Salud y Paz, or visit its clinics, write to pplunk@saludypaz.org, call 217-1985, or visit their website at www.saludypaz.org.