”Dental Safari“ in south-western Africa
Namibia in the south-west of Africa is a popular travel destination for tourists wishing to go on safari, be it armed with a rifle or with a camera. With its diverse flora and species-rich fauna, the endless expanse of desert, savannah and scrublands, as well as rugged mountains and ravines, this sparsely populated country offers exactly what adventure-seeking visitors from all over the world appreciate most about Africa. But there are also those who focus their attention, beyond these attractions, towards something entirely different, and who make best use of their stay for the benefit of the local inhabitants. They include, for example, the dentists volunteering for aid missions to ensure that dental care is made available, especially in those regions where there is no – or only limited – provision being made by a state-run healthcare system.
Given the major urban-rural divide, the increase in extreme poverty and growing social problems, large parts of the population have no access to medical services, and a nationwide healthcare network simply does not exist. To name but one example, the whole of the country with its 2.4 million inhabitants is served by just 120 dentists, almost half of which have their practice in the capital Windhoek. Whereas wealthy patients in the few urban conglomerations are offered high-quality dental treatments, the rural and difficult-to-access areas lack adequate dental care. Those in need either have no local points of contact or are not able to afford even the bare necessities when it comes to treatment. The teeth of those affected are mostly in a correspondingly poor state. Help is thus needed – and comes in the shape of aid workers from abroad.
DWLF on duty in Namibia since 2012
Founded in 2004 and meanwhile providing services in nine countries worldwide, the German charity ”Zahnärzte ohne Grenzen“ (Dentists Without Limits Foundation, DWLF) has been organising aid missions to Namibia since 2012. Since then, and true to its motto ”Manpower is more important than Moneypower“, it has sent several groups of dental professionals both to the north and to the south of the country. Their tasks for the usually two to three weeks of their stay are clearly defined: to provide basic dental care free of charge to those in need, as well as dental health and dental hygiene education at village schools, and to carry out fluoridation treatment. The charitable foundation works in close cooperation with the Namibian Ministry of Health and Social Services, and with the local authorities. Whereas at first, the relief workers from DWLF only looked after Grootfontein and the surrounding area in the Northern region of Otjozondjupa, they have also been working in Bethany and in the area surrounding Ketmanshoop in the southern region of Karas since 2013. Both in Grootfontein and in Bethany, permanent dental stations have been established at local hospitals.
For their work in the surrounding outreach areas, the teams of relief workers use mobile treatment units which are transported by off-road pickup trucks to the respective locations where they are set up for a few days. This is hard work, alongside the actual tasks of the aid mission, which usually focus on patients who have never before been seen by a dentist as it was not possible for them. Conservative treatment may be the main focus, but the relief workers often reach their limits, as they frequently diagnose deeply destroyed teeth, which leave them with no option but to extract. A further problem that many patients have is that of malaligned teeth, which would really need to be treated urgently by an orthodontist. In addition, the quality of the water in some areas results in the teeth of many patients being affected by pronounced fluorosis. Due to the immense demand for treatment, DWLF is looking to increase its activities in Namibia during the anniversary year 2014.
Outreach service travelling in mobile dental station
One relief team working in the north of the country in July / August 2013 using material donated by VOCO was also confronted with the particular challenges of a dental aid mission in Namibia. Dr. Anne Kempf (from Dettingen), Dr. Isabel Maier (from Illertissen), Dr. Christian Krawitz (from Bremen) and dental assistant Bianca Roth (from Neu-Ulm) started their assignment at the Grootfontein State Hospital and found themselves faced with a true rush of patients on their very first day. With treatment in progress at the local hospital, preparations for the first mobile mission to the backcountry were made, which would lead the aid workers to the Berg Aukas primary school, where mainly pupils from the people of the San are taught. The German dentists found considerable need for treatment amongst their patients there. The diagnosis for almost all of the children included caries-ridden six-year molars, which often left no option other than extraction. Due to the large crowds of patients and the extent of the need for treatment, it was agreed to come back for a further visit the next week. The first step was again an assignment at Grootfontein State Hospital, where the necessary provisions and equipment were also collected for the new outreach visit. The second Berg Aukas mission was just as successful as the previous treatment day they had spent there.
Next stop of the dental safari was St. Isidor Primary School at Maria Bronn near Grootfontein. Thanks to the active support from the school’s director and teaching staff it was possible to examine and treat all first-year pupils. ”What was remarkable here was how patiently many of these children endured even long treatment sessions. Treating up to four teeth in one go was usually no problem at all“, Dr. Christian Krawitz reports about his brave patients in Africa. The last backcountry assignment led the team to a small school called ”New Hope“, approximately 150 kilometers east of Grootfontein and in close proximity to the land of the Bushmen. All 80 pupils here had to go through a check-up, which found that the children’s teeth on the whole were in noticeably better condition than those of the patients treated previously. This is largely due to the fact that simple means are used under the teachers‘ supervision to provide good dental hygiene for these pupils. ”During the breaks, children of all age groups can be seen regularly frequenting the tap to clean their teeth. This is reflected in the good teeth almost all of these children have“, notes Dr. Christian Krawitz.
For the time being, it is unlikely that nationwide dental care will be made available equally to all sections of the population of Namibia, particularly as this is additionally complicated by some characteristics of the country. ”On the one hand, this is due to the size and low population density of this country. On the other hand, it requires academic training in dentistry, which to date cannot be offered. In addition, the increasing influence of civilisation on nutritional issues will continue to make the problems and tasks in regard to prevention of dental disease and provision of dental care very demanding“, explains Dr. Anne Kempf. The teams of the DWLF will continue to be faced with the particular challenges of this country, but will thus also be given the chance to experience and develop a completely new perspective with regard to their work and the appreciation given to it by the local patients.