Disabled dentist Lin Yi-chao is on a mission to bring care to rural Hualien

Disabled dentist Lin Yi-chao is on a mission to bring care to rural Hualien

2023-10-08

And now, we meet a dentist who lives with a disability and a mission. Lin Yi-chao is the only dentist in Hualien to make house calls, treating disabled patients who would otherwise have no access to dental care. Lin is disabled himself, having had a lame leg ever since he contracted polio as a baby. Growing up disabled in the 60s, Lin experienced considerable discrimination, but he defied stereotypes to carve out an impressive career. For 18 years, he and his dedicated team have focused on home visits in rural Hualien. The work involves a huge amount of travel up and down the Hualien coast, and specialist skills, to minimize the risks and address the challenges of care for disabled patients. Our Sunday special report.

This dental dream team – Lin Yi-chao, Lin Shu-yi and Pan Ting-chun – is scrupulous about packing properly. Today they’re preparing for a trip outside the cozy Hualien metropolitan zone, to make home visits in the countryside.

Lin Yi-chao
Dentist
This box weighs 30 kilograms at least. It’s really heavy. Sometimes it’s tough.

The trio takes dozens of kilograms of equipment out to the car. And as you might notice, Lin also has his walking stick in hand. Living with a limp, it takes effort just to walk down the street.

In the 1960s, 400 to 700 children in Taiwan caught polio every year. Lin caught the disease in the very first year of his life. There was already a vaccine for polio at that time, but it was prohibitively expensive for ordinary people.

Lin Jui-tung
Father of Lin Yi-chao
One jab was NT$300, and you had to get three jabs. How could we get NT$300? That was a lot. In those days, if you went to the doctor, one day’s worth of medicine was only NT$20. We didn’t have any money in those days. We were poor. Now, I’m going to get to a point where it’s hard to talk about it… We didn’t take care of him right. I feel so sad that we did that to him. There was nothing I could do.

Lin’s father can’t conceal the pain he still feels recalling that time. As a disabled child, Lin faced a great deal of discrimination. But he could not be held back. He defied expectations to excel at school, becoming the first student from Yuanlin City to be accepted by the hugely prestigious Taipei Municipal Jianguo High School.

Lin Jui-tung
Father of Lin Yi-chao
His grades were excellent. He went to Jianguo High School. He graduated first in his class at Yuanlin Junior High School.

Beaming with pride, Lin senior explains how his son’s studiousness paid off. His talent landed him in a job where he could sit at a desk in a safe and comfortable clinic. Ironically, now he prefers to get out of the clinic and tour the neighborhood, going out to remote communities and down into narrow back alleys, wherever a patient needs care. He’s the first dentist in the Hualien and Taitung areas to provide home visits.

Lin Yi-chao
Dentist
Many doctors think that home visits are bad value for money. You have to drive out, find the route, all the patients’ families are rather poor, and they’re out in the outskirts of the city or on the coast or in the mountains.

From Heping Village in Xiulin, in the far north of Hualien, to Yuli Township on the southernmost end of the county, Lin sees patients across a 200-plus-kilometer radius.

The first stop today is a care center for disabled people in Ji’an Township. The team has come to see Hsuan-hsuan, who suffered brain damage as a baby.

Facilities are limited in a home visit. And tending to exceptional patients like Hsuan-hsuan requires real physical strength. That’s harder when you, yourself, are a polio survivor.

Lin Yi-chao
Dentist
I have polio in my leg. As I said, my left leg is just for decoration. I can only press down with my right foot. And my right leg is where I put most of my body weight. So I often get lower back pain just from pressing the foot pedal.

Lin Shu-yi
Dental nurse
He wears a metal foot brace. So his body is being held up by a metal plate, and he also has to get into lots of different positions to treat the patient, and keep his body stable. But he never says “I’m so tired,” or “This case is so difficult, let’s not do it.”

And strength and mobility are not the only challenges posed by home visits.

The team squeezes its way through a home full of stuff to the patient’s room. This is Hsiao-fan. Now 27 years old, he suffered a brain hemorrhage caused by a traffic accident in fourth grade. Before the home visits of Lin and his team, getting dental care was virtually impossible for Hsiao-fan.

Lin Yi-chao
Dentist
He had phlegm in his throat just now. We were afraid that cleaning his teeth would increase the risk of him choking. So our nurse Shu-yi removed the mucus from his throat, following her professional judgment.

The biggest risks the team faces on home visits are a patient choking or being asphyxiated. The only way to minimize those risks is by having a dental nurse present.

Lin Yi-chao
Dentist
Look, see how dirty it is here? Dr. Lin is going to clean it for you. Then it won’t smell bad. Okay, we’re done! Dr. Lin is going to go home now. Get well soon, okay? Wake up soon.

It’s nearing 7 p.m. and the sky is darkening. The camera crew has been following Lin all day and we’re getting exhausted, but the dentist is still full of energy. He needs to make it to the final patient of the day.

Liang Ching-chuan, aged 72, was painting the house four years ago when he fell off the roof. He entered a six-month coma. His wife Liang-chen Chin-hua told us what a wonderful, loving husband he is.

Liang-chen Chin-hua
Wife of dental patient
I hope for a miracle. I hold onto that, even though I know it’s impossible. I hold onto that hope.

Liang-chen hasn’t left her husband’s side in the four years since his accident. The farthest she goes is to put the garbage outside the front door, not trusting anybody else to come and watch over him. The only time she gets respite is when Dr. Lin makes a visit.

Liang-chen Chin-hua
Relative of dental patient
We really feel reassured when the doctor comes. Reassured emotionally. And normally he’s so compassionate. He has mobility issues but he always comes to see us, and he praises me. And instantly I feel reassured and happy and moved – really moved. I’m going to cry saying this.

Liang-chen manages to smile through the heartbreak. What the dentist brings to families is not just medical treatment. It’s emotional and spiritual support.

But if he’s now the picture of dedication, he shared how in the early days he was deeply reluctant to go into dentistry.

Lin Yi-chao
Dentist
Actually, I wasn’t sure about dentistry, all through my six years in college. Because in a medical college, it’s doctors, then dentists, then pharmacists, nurses, technicians. We always felt we were one rank below the medical department. So we didn’t think it was some kind of honor to be studying dentistry. And in those days we weren’t so optimistic about the career prospects of dentistry as people are now.

In his fourth year of college, Lin joined the university’s medical service team. It went out to patients in remote locations. That’s when Lin realized the real value of dental care. That early volunteer experience gave him a longing for remote country environments and a lifelong mission to serve isolated communities. It led him to sell his house in Changhua 18 years ago, and close his successful clinic, to move to Hualien.

Lin Yi-chao
Dentist
In 2006 there were only about 120 dentists in Hualien County. The county is more than 200 kilometers long from north to south, and has a population of more than 300,000. Now it’s been 18 years since I came to Hualien and there are still just 140-something dentists here. So basically one more dentist has come here each year.

Lin Shu-yi
Dental nurse
We’ve been doing home dental visits for five years now. We think many people need it, but few people are doing anything.

With almost two decades of experience serving Hualien, Lin also makes occasional visits to New Dawn Educational Center. Providing care for the more than 100 disabled students at New Dawn presents some similar challenges as home visits. Treating a disabled patient may require considerable restraint, and four professionals need to be present to help. So taking the students to a dental department in a hospital is an impossible task.

Lin Yi-chao
Dentist
When they take a student to the Mennonite Christian Hospital, they need three teachers to go with one student. They might thrash around a lot during a simple dental hygiene appointment or a filling. I’m a disabled patient too, so I can really relate to how it feels for them.

Hualien is a beautiful, rich county with a remarkably long and narrow shape. It’s the largest county by area in Taiwan. Making home visits here is a herculean task, but it’s one that Lin takes up gladly, walking stick in hand. He hopes that one day soon more colleagues will join him, to bring care to every patient who needs it.

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