Dentist in the desert
In a normal day’s dental work it’s fair to say that getting up close to a giraffe and speaking Swahili do not feature prominently. But these are just two of the unique experiences I encountered when I took a month off work to volunteer in Kenya.
I have always believed that helping those in need is one of the most important things in life and I was keen to do something that could also make use of my skills as a dentist. It was this thought that prompted me to contact the co–ordinator of Gracepatt Ecotours Kenya, Patrick Karimi (who runs the company with his wife Grace), to find out more about their dental internship project. And, after hearing about the poor state of dental care in the deprived area of Malindi, I decided I wanted to help.
To prepare for my month–long trip into the unknown, I spent a few weeks gathering up as many dental supplies as I could. I was taken aback by the generosity of companies such as Wright Cottrell, Colgate and Oral–B and others who kindly donated items including gloves, masks, visors, filling material, disinfectant wipes, toothpaste, toothbrushes and scrubs as well as toys and stickers for the children.
With everything I’d need carefully packaged, it was finally time to set off for Kenya. I arrived in Nairobi after an almost nine hour flight to be warmly greeted by Patrick who took me to a transit house for the night where I hoped to shake off any jet lag. The following day he took me to the Sheldrick elephant orphanage and a giraffe centre where we had the chance to see these beautiful animals up close. It certainly made for an unusual and enjoyable introduction to Africa.
From there, it was time to go to work and a rather hot and bumpy seven hour bus ride took me to the town of Malindi on the country’s south east coast. On the bus I met hospital co ordinator George Mumba who took me to meet the family whose home I’d be sharing for the next month. Staying in a traditional African home really added to my experience with my friendly hosts introducing me to traditional African food and culture as well as teaching me some basic Swahili.
Once I’d settled in, it was time to go to the hospital dental clinic where my adventure really began.
Deprivation
I was given a position within Malindi District Dental Department leading a small team consisting of myself, a fourth year dental student and a dental nurse. As a government run hospital, the patients who came for treatment were unfortunately worse for wear financially as well as dentally. The majority came from nearby villages and I was surprised at the large number who presented medically with HIV.
The prime treatment we carried out was extractions – sometimes multiple in the same patient – and there were several patients with facial trauma seen in other departments who presented for dental review. More unusual tasks included providing treatment for prisoners or carrying out age assessments for patients involved in court cases.
Unfortunately, facilities in the clinic were limited. In addition to the dental chair being broken and the drill being inoperable, there was a lack of instruments, gloves and masks. The sweltering heat only added to the challenging environment. Despite the difficulties, I knew this was the best it was going to get, thanks to limited government funding.
Each morning, at least 10 patients would queue outside the clinic, mostly complaining of toothache that had kept them up all night. Around half the patients didn’t even own a toothbrush, never mind regularly brush their teeth. The dental student, Steve, acted as my interpreter as very few patients spoke English. I had learnt the basics in Swahili and could say things like open wide, extractions, pain, numb, filling, and bite together. Mornings were like a conveyor belt of patients but it was rewarding knowing they were leaving with the source of the pain removed.
Outreach
The afternoons in the clinic were quieter, so I arranged to promote dental health in the community with Steve. We visited three local schools, speaking to packed classes of 70 and 150 pupils, plus a whole school of 1,000 pupils aged 10 years or older.
With the aid of the blackboard, demonstration models, posters and Steve’s language skills, we covered topics including tooth structure, diet, brushing, fluoride, caries, periodontal disease and hand hygiene, both in English and Swahili. The pupils seemed keen to learn and we quizzed them at the end, offering prizes and samples for those answering correctly.
It can be difficult to know how effective these kinds of visits are, particularly as many villagers struggle to afford even basic dental supplies, but I was pleased to find out that several of the pupils we had spoken to visited Malindi District Hospital to get their teeth checked. During the visits, community health workers listened and took notes with the aim of continuing to deliver dental health education to other schools. I am happy to report that two more schools have been visited by these dental health promoters.
Looking back on it, the whole experience was a real challenge and took me out of my comfort zone. But, spending a month in such conditions has really opened my eyes to the problems of government run dentistry in Kenya and I would urge other dentists and dental students to consider volunteering.
I have made some cracking new friends for life and had the privilege of treating patients in great need of treatment, as well as helping to educate schoolchildren about the importance of prevention. The experience definitely enhanced my clinical skills as well as giving me a glimpse of the other face of dentistry.
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With thanks to Patrick and Grace Karimi ıwww.gracepattecotourskenya.org
ways to help the nations in need…
Gracepatt Ecotours Kenya
The tour and travel company operate medical/dental missions and internship programmes. It is looking for general volunteers as well as clinicians holding medical/dental qualifications.
http://www.gracepattecotourskenya.org
Bridge2Aid
This UK dental charity was set up in 2002 and works to improve dental care and access to pain relief for the people of Tanzania. It has trained more than 160 local health workers in emergency dentistry and continues to train a further 50 per year. Through its Dental Volunteer Programme, qualified dental professionals travel to Tanzania to pass on their skills.
http://www.bridge2aid.org
Mercy Ships
The UK charity operates a number of hospital ships, staffed by a volunteer crew, serving more than 150 ports in developing nations around the world. Its dental programme welcomes volunteers to treat dental and oral diseases and provide education and training for some of the world’s most deprived populations.
http://www.mercyships.org.uk/dental
Other useful links include:
http://www.christianreliefuganda.org
http://www.smiletrain.org
http://www.dentaid.org
http://www.dentalprojectperu.org
http://www.kausaywasi.org
http://www.fitfortravel.nhs.uk
Hari Lal graduated from Glasgow Dental School in 2010 and works as a dentist in Dedridge Dental Centre, Livingston
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