Working

Jan Budo, RDH, BS, and Judy Shimamoto, RDH, BA

A career in dental hygiene can take practitioners to many different places. For Judy Shimamoto, RDH, BA, and Jan Budo, RDH, BS, it brought them to Kwajalein! Kwajalein is a part of the Marshall Islands, a group of islands located about 2,100 nautical miles southwest of Honolulu, Hawaii. The two women work on a military base for government contractors, providing dental hygiene services for military and contract workers and their families.

Shimamoto and Budo didn't meet until coming to Kwajalein. Budo learned about the opportunity at the Annual Nevada Dental Hygienists' Association meeting, from a friend who could only stay for three months due to other obligations. Budo had always wanted to work in a foreign country, and after some phone calls, she relocated to Kwajalein four months later.

Shimamoto began looking for an overseas position after her sons were grown and out of the house. Her youngest son graduated college in 1997, and she began looking shortly after that. She looked long and hard at various resources, but if it hadn't been for a friend spotting an ad for this opportunity in a local St. Louis paper, she might have missed it. However, the friend knew she was looking, and informed her right away.

"As it turned out, the ad was premature and the hygienist who was scheduled to retire did not," she said. "The chief dental officer and I remained in contact, and when the hygienist did retire a year later, he called me. It was close to two years from the time I sent a resume until I was here. In the meantime, I was looking at other overseas opportunities."

With such a move came a lot of adjustments. For one thing, the island is five hours away from both Hawaii and Guam, the two closest large destinations. Also, because Budo and Shimamoto are on an army base, they must obtain military travel orders and deal with a lot of paperwork in order to get permission to leave.

"The biggest adjustment for me was moving so far away from my family," said Shimamoto. "But I wanted to work overseas, and I knew I couldn't do that and be near my family."

Because they are in such a remote location, it can often be difficult to get new supplies in an orderly fashion.

"Requests for something new go through various levels of supply requisition and then to a buyer who places an order," said Shimamoto. "Supplies are placed on a barge in the states that goes to Guam before coming here, where supply personnel receive them. Then we request them from supply--often takes about 3 months."

Despite some of the adjustments, both women agreed that the rewards of this type of work are immense. Being able to provide quality care for their patients and having the time and resources to accommodate each patient's needs are valuable aspects of their work there. Their patients consist of children and adults, but not geriatric patients. They also speak very highly of the Marshallese people, including one of the clinic's dental assistants in particular. Daleiana Chong-Gum has helped the dental hygienists learn Marshallese phrases, and also helps translate when they need to communicate with community members. Budo and Shimamoto cannot provide dental hygiene care for the Marshallese population due to government restrictions, but they can offer oral health education. Both women said, "Working with the Marshallese through education has provided us with a great deal of joy and satisfaction."

Being in such a small community also allows them to create relationships with each patient. Because most members of the population come through their dental clinic, Shimamoto and Budo have become familiar with almost everyone who lives and works on the island. The population on Kwajalein is made up of military personnel and their families and contract workers and their families; there are more contract workers than military on this island. They go to community events, even school plays, to support patients they have gotten to know over their time there. "I love being able to say, 'Tessa, that was a great piccolo solo the other night,' or to tell Elizabeth that her science project was fun and exciting," said Budo. "Because of this unique situation, I'm much more involved in the community than I was back home."

Shimamoto added that friendships often form due to common interests. "It isn't unusual to get together at the beach to eat sashimi caught by the hospital's surgeon and the local butcher, or to go scuba diving with a school teacher, an Army sergeant and an engineer from MIT." This type of interaction leads to an unconventional relationship between the dental hygienists and their patients. "We don't just treat our patients as we would our friends," said Shimamoto. "Our patients are our friends."

Working in a military base has more perks than many might think. Because they are employees of a corporation, they have paid holidays, paid vacation days, a retirement plan, health benefits and the option to go through the company to pay for continuing education. They are also provided with housing, most utilities and food in a dining hall. "Because we live in an Army base we have access to all the recreational activities at minimal cost: bowling, golf, organized sports, movie theaters, and island water activities like scuba diving, snorkeling, sailing, et cetera," they said.

Both women plan to stay in Kwajalein until they simply don't want to anymore. Budo said she is enjoying her work and the opportunity to take part in so many activities; Shimamoto has so far stayed more than twice as long as she intended, and said she will leave if she finds a similar opportunity in another location. For dental hygienists in the States looking for a similar opportunity, they recommend networking, reading dental hygiene journals, being active in your association and letting others know you're looking. Most importantly, Shimamoto and Budo said, "You need a sense of adventure, flexibility and an open mind."

If you are interested in contacting Jan Budo, RDH, BS, about her position, please email JeanM@adha.net

This edition of Working was prepared by Meghan Washington