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Offering help to those who suffer pain without hope

30 October 2019

Dr Jeremy Keating, a dentist in Perth, Western Australia, looks at the work of Bridge2Aid Australia

I first heard about Bridge2Aid Australia three years ago. What stood out to me immediately was how it differed from the other dental volunteer opportunities I had seen previously. Its unique approach was to focus on training rather than treatment and, in doing so, create a sustainable solution.

The idea is to train local clinical officers in emergency dental care. They already have basic medical skills and are effectively the GP doctors for their local community. They deliver the babies, sew up the wounds and dispense the medications. By training these clinical officers in emergency dental care, the work can continue long after the volunteers leave and help thousands more people than the volunteers could ever hope to help with their hands alone.

In August this year I travelled to Tanzania, East Africa, to experience the programme first-hand and it overwhelmingly exceeded my expectations.

Tanzania is one of the poorest countries in the world. They have a population of 61 million and there are only a little over 100 dentists. The gap between need and the ability to service that need is hard to fathom. Outside the cities there is simply no access to dental care.

While Bridge2Aid has been operating for 15 years, its sister organisation Bridge2Aid Australia is much newer and the August trip was its first programme. We assembled a team of volunteer dentists and nurses from across Australia and together we flew to the Tanzanian capital of Dar Es Salaam.

Waiting for us at the airport were Dr Graham Stokes and Dr Kiaran Weil from the United Kingdom. Graham and Kieran were our clinical and assistant clinical leads. They have been involved with Bridge2Aid since the beginning and we were privileged to benefit from their skill and experience. In addition to being a general practitioner in the UK, Graham Stokes also sits on the council of Medical Protection and the board of Dental Protection.

Here in Dar Es Salaam we also met the team from Education and Health for All (Eh4all). A large part of the exceptional volunteer experience was due to this team. They are Tanzanians and as such understand their country in a way a visitor cannot. They managed all of the details of our programme, and our safety and comfort was always paramount. They provided our transport, they organised our accommodation, they organised our food. They spread the word of our trip before we arrived, so that on our first day there was already a queue of people waiting.

The team complete, we travelled to the rural area of Lindi in the south eastern corner of Tanzania. In this region there was only one dentist, the district dental officer Dr Rwanda, with whom we worked closely. Over the course of nine days we treated 750 patients, but more importantly we successfully trained six clinical officers. They each care for their community of around 10,000 people, so collectively there are 60,000 people who now have access to emergency dental care.

In addition to providing training in emergency dental care and perhaps even more importantly, we were also teaching prevention of dental disease. The people we saw don’t understand the consequences of sugary foods and the importance of cleaning their teeth. We were able to speak with several school groups and to pass our programme the clinical officers needed to demonstrate proficiency both in treating patients and teaching prevention.

Our days were long but rewarding. Each morning we would rise with the sun and after breakfast travel about an hour to the clinic where we would work that day. The clinic was essentially an open space where we were able to set up tables and instruments. Despite the challenges of an environment without electricity or running water, we were able to treat patients in a sterile and safe manner. As we were primarily treating patients with advanced caries and infection, the management after careful diagnosis was usually extraction of a problem tooth under local anaesthesia.

One of the most significant challenges of the experience was managing the emotion. Most of the people we examined were suffering with dental pain. It was usually measured in years rather than days or months. For some that pain had been a constant source of suffering for more than ten years and, until we arrived, they had no hope of relief.

Each person we met had a story of how significantly a simple dental infection had impacted on their life. One sadly common story was shared with me by a young man named Mwamedi. After years of pain he was desperate and, not aware of our arrival, chose to seek out the help of a witch doctor. It is hard to imagine, but without anaesthesia the witch doctor attempted to remove the painful tooth. Mwamedi presented to me three days later as the problem was worse rather than better. The untrained person had increased Mwamedi’s suffering and to relieve his pain I not only had to repair the botched extraction but remove extra healthy teeth that had been unnecessarily damaged.

For the small price of two weeks of my time, I return home knowing that there will be fewer stories like Mwamedi’s and I have added to a legacy that empowers people much less fortunate than me. I am already planning my next trip.

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