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Simply Smiles provides bright futures for children, families, and communities. The organization partners with populations in need to create physical and emotional environments where suffering is alleviated and from which local leaders can emerge.

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Simply Smiles blog

Follow our blog and read insights from Simply Smiles staff, volunteers and other individuals whose lives are affected by our work!

Filtering by Tag: deworming

Field Notes From Mexico: More Than Just "Deworming"

Alex Gross

This latest edition of Field Notes comes from Simply Smiles President & Founder, Bryan Nurnberger. Bryan is currently visiting Simply Smiles program locations in Oaxaca, Mexico where he helped to staff a medical clinic.


In Oaxaca, Mexico, 2,504 people just received treatment for parasitic infection from Simply Smiles. At the same time, we distributed over 12 tons of food staples, began construction on 14 more latrines and announced the opportunity for children to be educated from kindergarten through the college level at our our new “Casa Hogar Simply Smiles Children’s Home”.

Efforts to treat populations for parasitic infection, or “deworming” programs as they are often called, are one of the most impactful and most common actions taken by governments and NGOs in impoverished areas. While deworming efforts are extremely common around the world, they are almost always done in a manner that is not in keeping with the principles upon which Simply Smiles bases our work. For example, in the village where our Director of Oaxacan Operations, Gabriela Chavez Hernandez, grew up, strangers would show up every six months, pass out pills to treat for parasites and leave. This “treatment only” approach is the global norm because it’s easy to execute and the relatively low cost of the medicine makes indefinite treatment possible - but it is clearly not a solution to the problem.

Treatment only perpetuates a system of dependency and is a disrespectful way to support individuals in need.

 

If the reader feels conflicted or unsure about the definitive nature of this statement consider this scenario:  If your own child continuously suffered with an ailment that left him malnourished, in pain, and at risk of death from blocked intestines would you rather A) provide temporary relief twice a year forever or B) address the root cause of the ailment and cure your child permanently? Treatment only approaches dictate that answer A is what parents want for their children. Simply Smiles, and every parent with a choice, chooses answer B - a permanent and respectful cure. 

Simply Smiles President & Founder, Bryan Nurnberger with one of the children he encountered on his first trip to the Oaxacan villages. At the time, Rigoberto was suffering from severe parasitic infection. Pictured here at Thursday's clinic (5/26/16) Rigoberto is healthy and attending one of the schools Simply Smiles built in the region.

Simply Smiles President & Founder, Bryan Nurnberger with one of the children he encountered on his first trip to the Oaxacan villages. At the time, Rigoberto was suffering from severe parasitic infection. Pictured here at Thursday's clinic (5/26/16) Rigoberto is healthy and attending one of the schools Simply Smiles built in the region.

Since 2009, Simply Smiles has been working in an extremely remote mountainous area of Oaxaca, Mexico. Here we encountered poverty that was nothing less than stunning. The globalization of the coffee market over the past decades left the population of Zapotec Indians, who have lived here for centuries, in a state of near starvation. During our first visit to the region, the ubiquitous distended and hardened bellies made it immediately clear that there was also an extremely high rate of parasitic infection. While our initial response to this humanitarian emergency was swift, Simply Smiles waited until 2013 to address what we soon learned was specifically parasitic round worm infection. Why? So that we could do it right. Because truly eradicating parasitic infection necessitates complete trust from, and partnership with, the population in need. And that takes time and effort to build. So for four years we built trust by focusing on other needs in the region including distributing over 2.5 million meals and building two schools. It was not until 2013 that we were in a position to begin our eradication efforts. 

(To provide a little more insight into why we waited four years to begin the eradication program, when an infected individual is treated for parasites the medicine kills the worms and they are passed out of the body through what is often quite extreme vomiting and diarrhea. Imagine if someone you didn’t fully trust gave you a pill that had this effect on you. Treating for parasites before we had earned the complete trust of the population would have surely prevented us from being welcome in the region and therefore prevented us from providing the support the population needs.)

 

I have just arrived at our administrative office in Mexico after helping our team to host a medical clinic that treated 2,504 individuals for round worm infection. Treatment was the focus of this week’s work, but it is just one part of the Simply Smiles holistic plan to eradicate parasitic infection in southern Oaxaca, Mexico:

Partnership & Trust: When there is a line of 2,500+ people, you need a lot of help to manage a clinic of this size. My wife, Kristen, and I were the only Americans staffing the event. Our partnership with the local population means that we can help the people to help themselves. Villagers managed the flow of people through the clinic, translated Zapotec to Spanish at the registration table, helped to prepare and dispense the medicine, and distributed the 12 tons of food staples that are given at every clinic we host. 

Treatment: Twice a year Simply Smiles hosts a medical clinic where the population is treated for parasitic infection with the highest quality name-brand medication. 

Education: Because Simply Smiles built two schools in the region we are able to fold educational programs about how to prevent parasitic infection in the curricula. We’ve distributed thousands of informational pamphlets and hung innumerable signs. A doctor and/or nurse sees every single individual as they come through the clinics to explain what the treatment is for and why it is important. 

Prevention: One contracts round worm from contact with feces, either through lack of hand washing or as a result of open defecation. Each person receives a large bag of soap when they pass through the clinic along with instruction on how to effectively wash your hands. In an area without plumbing, construction of basic pit latrines is an economical and extremely effective way to provide sanitary facilities. To receive a latrine from Simply Smiles, a family signs out shovels and picks and then digs a 3 meter deep hole. Once completed, Simply Smiles sends our local construction workers to build a brick latrine on top of the hole. These latrines have an estimated lifespan of over 40 years. This week, we began construction of 14 additional latrines. 

Scientifically Proven Results: Simply Smiles has partnered with American and Mexican universities and pharmaceutical companies to formulate and execute our unique holistic program to eradicate parasitic infection. At the end of each calendar year, medical professionals including an infectious disease specialist, travel to Oaxaca and test stool samples from 10% of the region’s children. In 2013 the results showed a 48% infection rate. By 2015, that infection rate had dropped to 20%. Our next scientific testing will take place in November of 2016. We are hopeful that we will see an infection rate of less than 10%.

Simply Smiles, of course, will continue our efforts until eradication has been achieved and sustained. The children, families and communities in our care deserve nothing less.

 

For more information and photos, please visit our More Than Just Deworming webpage.

What Simply Smiles Means to Me: A reflection from Erin Scionti, volunteer & intern extraordinaire

Alex Gross

Erin Scionti first volunteered on the Reservation in 2013 and returned as an intern in 2015. She joined Simply Smiles staff members Zach and Sam and a team of medical staff during our fall medical clinic and food distribution program in Mexico in November. Below, Erin reflects on her experiences. 

I was beyond ecstatic when I was offered the opportunity to travel with Simply Smiles to Oaxaca, Mexico to help with the food and medicine distribution in the village of Santa Maria Tepexipana (SMT), and to assist Dr. Gil L’italien in testing stool samples to determine the prevalence of various intestinal parasites in that region. I am currently studying public health at Southern Connecticut State University, so this trip encapsulated everything that I had learned so far in the classroom. It made the classroom lessons tangible. I could feel and see the impact of the countless hours spent studying textbook material.

Erin, right, works alongside Simply Smiles board member and epidemiologist Dr. Gil L'italien to test stool samples for the presence of parasitic intestinal worms in Santa Maria Tepexipana and its neighboring communities.

Erin, right, works alongside Simply Smiles board member and epidemiologist Dr. Gil L'italien to test stool samples for the presence of parasitic intestinal worms in Santa Maria Tepexipana and its neighboring communities.

We arrived in Oaxaca as a spirited group of eight hard working and dedicated individuals, ready to take on the crucial tasks ahead. Coming into the week, I already had a strong understanding of what was expected of us as representatives of Simply Smiles. I served as an intern with Simply Smiles this past summer on the Cheyenne River Reservation in La Plant, South Dakota. There, I saw the attentiveness, flexibility and love put into each project and person by the staff of Simply Smiles. Though the tasks were drastically different in Oaxaca than those I worked on in La Plant, our mission remained the same: to inspire hope. 

On our first day in Oaxaca, we visited Casa Hogar Benito Juarez, the children’s home that first inspired Simply Smiles. I was a bit nervous at first that I wouldn’t be able to connect well with the kids because of our language differences. But, I learned quickly that language was the smallest of barriers standing in the way of children and fun. The kids warmed up to us immediately as we colored, ran around and enjoyed multiple servings of their favorite ice cream. Seeing the way the kids at Casa Hogar interacted with us reassured me that a language barrier wouldn't stop me from connecting and building relationships with the other children I would meet throughout the week. 

The next day, we departed on an eight hour drive through the breathtakingly beautiful roads of Oaxaca up to Santa Maria Tepexipana, a small village in the remote mountains. When we arrived, I was expecting to see a town in despair but instead I saw quite the opposite. Though poor and many stricken with illness, the people of SMT were some of the warmest people I have ever met. I was so fortunate to meet these kind-hearted individuals, which reaffirmed that happiness is not a measurement of material worth, but rather, a reflection of how one values life.

People in SMT are simply happy to give love and be loved. Families took pride in their home and their culture, they looked out for one another and willingly took less to give others more. Their generosity never ceased to amaze me. One family cleared out an entire half of their home so that we would have a place to sleep and eat during the week. Like the children at Casa Hogar, the kids in SMT instantly became our best friends, hugging us, and holding our hands upon moments of our arrival. I was pleased to see that, once again, despite our language differences, we were welcomed with open arms and smiling faces. 

During the three days of the food distribution and the medical clinic, I worked closely with Dr. Gil Litalien in examining stool samples to track the prevalence of intestinal parasites in the SMT region. We looked specifically for Ascaris, Trichuris, and hookworm. We gathered samples from 113 children who came through the food distribution program with their families.

After careful examination, we found a 21.2% prevalence in the entirety of the region, compared to a 31.4% prevalence in 2014. This 10% decline is a remarkable confirmation that the work Simply Smiles is doing to treat and prevent the spread of infection is noticeably working. By distributing Abendezol at each food distribution and educating the community on the importance of hand washing and wearing shoes out side, the prevalence of intestinal parasites in the SMT region has drastically decreased. 

Erin, during her time as an intern on the Reservation in 2015. Her positive attitude, willingness to lend a hand wherever needed, and sense of humor are among her many qualities that make her a favorite in the La Plant community!

Erin, during her time as an intern on the Reservation in 2015. Her positive attitude, willingness to lend a hand wherever needed, and sense of humor are among her many qualities that make her a favorite in the La Plant community!

As the week continued to run with ease, thanks to the hard work of our energized and committed team, I grew more and more attached to all the smiling faces of the children and their families in SMT. The people I met in this one small village in Oaxaca, Mexico were so thankful for the help we brought them, but I feel what they gave me in return was an even greater gift. They gave me their friendship. Though our work here is not complete, I returned home knowing that the people we helped this week would continue to grow healthy and remain happy. 

Interning for Simply Smiles has taught me a great deal about myself and the world around me. I’ve learned how to be a valuable part of a team, how to be a strong leader, how to love and care for everyone I meet and most importantly how a simple smile can go a long way.


Tell us what Simply Smiles means to you! Respond with a comment below, post to our Facebook page, Instagram a photo, or tweet @simplysmilesinc using the hashtag #SimplySmilesmeans.

Field Notes from Mexico: More progress made in our public health efforts

Alex Gross

This Field Note is brought to you by Simply Smiles Senior Program Manager Zach Gross, who recently returned from our Mexico projects, where we held our third medical testing and fifth treatment of parasitic intestinal worms.


On November 9, I returned home from a fantastic week in Oaxaca, Mexico working with our Mexican staff members and a team of volunteers to carry out our latest medical clinic to treat for intestinal parasites.

I am pleased to report that our latest round of testing shows that the infection rate is now at 20% across this region—down from 48% just two years ago!

Nurse Bernarda Lopez Ordaz helps us to distribute treatment to children in Santa Maria Tepexipana (November 2015)

Nurse Bernarda Lopez Ordaz helps us to distribute treatment to children in Santa Maria Tepexipana (November 2015)

Over the course of three days, 2,173 people from the remote villages of southern Oaxaca came to our food distribution in the town of Santa María Tepexipana and received a month’s supply of food staples. Everyone (except children under age two and nursing or pregnant women) also received a dose of albendazole, which rids the body of intestinal worms and their eggs.

Our method of collecting demographic and qualitative information from participating families allows us to target areas with the highest incidence of intestinal parasites.

Simply Smiles board member and epidemiologist Dr. Gil L'Italien tests stool samples to determine the effectiveness of treatment. Gil has spearheaded our approach to eradicating parasitic intestinal worms in the region. (November 2015)

Simply Smiles board member and epidemiologist Dr. Gil L'Italien tests stool samples to determine the effectiveness of treatment. Gil has spearheaded our approach to eradicating parasitic intestinal worms in the region. (November 2015)

The infection rate on our final day of testing was 0%—meaning there were no positive samples among children in those villages.

These latest results are certainly encouraging, and they prove that our multifaceted public health initiative is having a directly positive impact on the health of children and families in Oaxaca.

But we still have work to do. A 20% infection rate is not 10%, which the World Health Organization deems the level at which treatment can occur on a case-by-case basis. And it’s not an overall rate of 0% — which is our ultimate goal, so that soil-transmitted intestinal worms are no longer a reality for families in the region.

Until that time, we will continue to treat the entire population. We will also continue working with the local schools to implement health programs, passing out informational literature on methods of prevention, and building more latrines and hand-washing stations—particularly in villages with the highest infection rates.

While the test results are a reliable, scientific method of measuring the impact of this public health initiative, other, more “subjective” methods are perhaps more telling of our overall impact in this region.

As soon as we first visited this remote part of Oaxaca in 2009, we saw the distended bellies, vacant stares, and malnutrition spots — all signs that intestinal parasites were plaguing the children and families there.

Rather than coming in as outsiders with microscopes and pills, we knew that in order to have long-term success in this region, we needed to form friendships first.

We needed to build trust and prove ourselves worthy of that trust and friendship through our actions. Because of these foundational relationships, we can continue to effectively implement all of our initiatives and measure their effectiveness,

Over the past few weeks, we have collected responses from various supporters and friends at our project sites about what Simply Smiles means to them. We asked our friend, Matea Figeuroa Santiaguez, from Santa María to explain how she sees Simply Smiles. She made note of our “humanitarian support,” referring specifically to the our distributions and school construction, but she really focused on the relationships she’s made with Simply Smiles staff and volunteers over the years—on the people behind the projects.

We appreciate all of the people who make this work possible, and we hope to maintain our friendships with those who visit us in this tiny corner of Mexico. We admire everyone we’ve met from different countries, and we in Tepexipana feel so proud to have made so many new friends over the years. We cannot thank everyone enough for all of their support — especially for the personal energy and sacrifice that each volunteer makes just to be with us in our town.
— Matea Figeuroa Santiaguez, resident, Santa Maria Tepexipana

 

The willingness of our volunteers to give up a week of their lives to spend time in Mexico and on the Reservation will never cease to amaze me. Our volunteers are the hands that distribute food & medicine and build latrines in Mexico, but they are also the encouraging role models and friendly faces that solidify the Simply Smiles dignity-first, relationship-based philosophy.


Field Notes from Mexico: Treatment and infection rate updates

Timothy Nurnberger

I’ve just returned from my third trip with Simply Smiles, Inc. to the mountains of southern Oaxaca, Mexico, where I have been spear-heading an effort to eradicate intestinal worms among a population of 3,000+ individuals...  www.simplysmiles.org/blog/2014/11/11/de-worming-update

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I Am A Bag: Zach’s Whirlwind Summer (So Far)

Zach Gross

In the past three months, I have: made a cross-country road trip to the Cheyenne River Reservation on our big red bus; flown home for a two-week stint in the office to help launch Simply Smiles Coffee; flown back to South Dakota for two more weeks on the Reservation; flown down to Mexico for a medical clinic to treat thousands of people for intestinal worms and to host two volunteer groups; and flown back to South Dakota for the final six weeks of the summer.

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