Throwback Monday... Is that a thing? Well for me - I am going to call in Mwanza Monday and throw back to another one of the posts I wrote when I visited Mwanza in Tanzania a few years ago. As you may remember, I worked with a dental charity there, and this is a snapshot of some of the work that the charity does. I have been thinking about this a lot, as I really sort through my thoughts on healthcare, and so I thought I would share with those of you who may not have been reading my posts then, some of how I spent my time in Tanzania when I was working with Bridge2Aid. I hope you enjoy it. I will have the link to Bridge2Aid at the end of this.
Well I have been asked by a near and dear friend to stop writing War and Peace, and send shorter more frequent updates. I think we all know that is not going to happen! (Sorry) However this post may contain images of dentistry that some of you might find disturbing – especially if you are partial to pristeen surgeries and modern dentistry. For those of you who are non dental – you can look away now, although its pretty interesting overall.
I have mentioned in previous emails the charity that I am working with and some of the stuff they are doing. A big part of what they are geared up to do is enabling the local health community (where there is one) to be self sufficient for the area when it comes to dental treatment. There are 4 teams a year that come out to train local clinical officers in rural areas, and this is done in conjunction with running several rural extraction clinics. We drove about 25K’s out of Mwanza to an agricultural centre where the training was taking place over the past couple of days before they move onto another area. The local clinical officers are just that – they are not dentists or doctors, but they have been taught basic clinical skills to help them cope in the remote communities where they operate. They are taught by the team of volunteers to give local anaesthetic and take out teeth safely. They then return to their various areas where they can serve their communities. There was a great team there: On the local side Dr Nyrobi is the district dental officer, and he himself travelled from about 25K’s away on the bus (he came from the opposite direction that we did) and then a half hour or so walk off road to get to the centre where the training takes place. He helps with the teams, and has a great deal of experience taking out teeth in the local community. There are then a number of clinical officers being trained, and then the UK team. The team that I went out to visit today had Dr Neil Marshall as clinical lead (and to show you how small the world of dentistry is – he used to work in a practice next door to the ortho practice where a good friend of mine worked! Small world). You can see the pictures that I have attached for a bit more detail. When we arrived, there were lots of people waiting to be seen by the dentists. Some of them had come from far! One lady in her sixties had taken a bicycle taxi (yes) before sunrise in the morning to travel to the centre to have 4 teeth removed that had been paining her for 5 years! The charity announces where they are going to be either using a tazango (a notice sheet stuck up on buildings or trees) alternatively one of the locals who works for the charity John Simba goes around with a loudspeaker and makes the announcement a few days before. The patients are given a number and a record card, and then they are seen first by the dentist who does the assessment. The dentist from the UK team show the clinical officers how to give local and this is supplied in 50ml bottles to be drawn up into syringes which are used. The patients have their extractions done, and anyone who runs into trouble calls Dr Nyrobi! They see about 70 or 80 patients a day and at the end of the 3 day training, the clinical officers are presented with an extraction kit which contains a range of luxators and forceps, and a pressure cooker (that is what is used to sterilise the instruments over a kerosene stove – boil at high pressure for 20 minutes!)
The clinical officers then take their kits and the anaesthetic is supplied by the dispensary, who is also in charge of the kit – in case the clinical officer moves on to another area. So in this way they are able to see a lot of patients as well as provide some training. This is important – its easy for dentists from the UK or the States to go into these areas and provide treatment but once they leave, a void can sometimes be left, and the charity is trying to avoid this. It also means that locals with local knowledge and the language are able to treat the patients. Secondary education and university education is taught in English, but in some of the remote areas, tribal languages are still spoken so having locals go into these areas is very helpful. So its been a long day!
Above are some photos of the team having a go at some extractions and some of the kit they are using. They make every effort only to use kit that the clinical officers will have access to once they have left, so cryers are contraban!!! (although one of the volunteers brought a set which I understand have been used once on a difficult case). This is the reason why they draw up the local anaesthetic into syringes, as these would be more readily available at the dispensary. They have seen a few interesting cases – one of the teams saw a giant ameloblastoma yesterday and so that patient could be taken to the hospital. The teams try to do about 3 lots of 3 day training at different sites, so they are pretty exhausted by the end of it.
Well there you have it! Not sure how this works in terms of length, but it was an interesting experience and the team finds it very rewarding – several members have been out 5 or 6 times already! Of course there is some fun and games too – last night the taxi bringing them back from dinner ran out of petrol and they had to push it up a hill. (I have yet to get some decent photos of some of the worse roads around here). We are also going on that safari this weekend, and apparently staying in a nice hotel – which the volunteers thoroughly deserve after their long days of training and extractions in the heat. Me – I am just going along for the ride!! So I will hear you when I get back! There are so many other things that the charity does, and over the course of the 3 months, I should be involved in every aspect, so there will be a bit more “off road dentistry” to come. Until then – have a good weekend guys and take care. Big love from sub Saharan Africa xx
Ps Here is the link for Bridge2Aid