Volunteering dental services to the very poor in Guatemala, working under raw conditions, is a humbling experience.

“It keeps me grounded,” Dr. John Burkett said.

“I realize there’s a difference between things I need and things I want. I’ve even changed my vocabulary. Instead of saying, ‘We need a loaf of bread,’ I say, ‘We want a loaf of bread,’” the Salisbury dentist said.

Burkett is one of several local physicians, students and assisting health care professionals who have volunteered time and effort to help those too poor to afford care.

Early this year, Burkett was in Guatemala with Christian Medical Missions, Inc., working with others including an Army dentist.

“We go to rural areas where people don’t have access to medical care or very little,” he said. There might not be any electricity or water.

Volunteering doctors are taken to schools or buildings to work in makeshift clinics. Burkett only extracts teeth, he said, describing a typical patient, who might be sitting in a school desk instead of a dental chair, spitting in a plastic bag taped to one side.

“It’s very austere,” he said, relating that some townsfolk get trickling water only from a PVC pipe in the middle of town.

“We see a lot of infected teeth, things like that. We take local anesthesia with us and we remove bad teeth,” he said, estimating he pulled 75 teeth a day for four days.

He was based at a hotel in Panajachel City, and driven to towns about an hour away to provide care.

A dentist for 25 years who’s fluent in Spanish, he has been volunteering since 2006.

Orthopedic surgeon Dr. Pasquale Petrera spent a week in Managua, Nicaragua, this month, replacing hips and knees through La Merced, a Salisbury-based nonprofit that provides medical services to the poor.

In four and one-half days, he replaced 15 hips and 15 knees.

Patients paid nothing, and wouldn’t have been able to have the surgeries otherwise. “There is no charge. They just show up and show us their hips,” he said, with a laugh.

“The government is so poor, if someone can’t afford the surgery to have a knee or hip replaced, they will never get it. The doctors are limited by economics, so we go down there and everything is free for the patients. We pay own way,” he said, estimating the cost at $2,000 per person.

Petrera traveled with a full team including his partner, scrub tech Patrick Smith, physician’s assistant Katelyn Whitelock and representatives from the companies that donated artificial joints.

Donating joints were Stryker Corp., which sent representative Ryan Mault, and Zimmer Corp., sending representative Jesse Tailby.

About $200,000 worth of equipment was donated, and the local team took about $2.5 million in additional equipment, including extra implants and surgical materials.

“I did it last year alone. I did 17 hips. This year I had a lot more help, but I’ll tell you, I smiled the whole week last week and couldn’t wait to get back this year,” Petrera said.

“We were doing what we’re supposed to do, which is to take care of patients. The OR there is actually very nice, It’s air-conditioned, but on the wards where the patients are there is no air conditioning. It’s 100 degrees. I don’t know how they put up with it,” he said.

He credited scrub tech Patrick Smith, of Pocomoke City, for teaching fellow scrub techs in Nicaragua and keeping the team laughing with his sense of humor, and said students learned skills including suturing.

“It was so satisfying for us,” he said.

Dr. Vincent Perrotta, a Salisbury plastic surgeon, has volunteered for many years, performing surgery on cleft palates and deformities including those caused by elephantiasis.

He was more interested in the spotlight being on the less-publicized who volunteer, like anesthesiologists, students and scrub techs.

Salisbury orthodontist Dr. James Crouse traveled to Guatemala with Burkett a couple of years ago and recalled removing 300 teeth in three and one-half days.

“We went to a school and set up a clinic. People lined up and said what tooth hurt. We had several chairs and we numbed them up. Mainly we were trying to get these people comfortable,” Crouse said.

“They have so little and we have so much,” he said.

“To be able help these people gives you a really good feeling. I went for one full week and I’m looking for another opportunity.”

Reach Susan Canfora at scanfora@newszap.com.