Dental charity Bridge2Aid provides emergency dentistry to those who need it most. Founded in Tanzania, Africa, Bridge2Aid’s Dental Volunteer Programme (DVP) allows dental professionals to pass on their skills to local Health Workers in East Africa’s rural communities, providing safe and sustainable access to dental pain relief.
After eight years, 260 trained local Health Workers and emergency dental care provided to more than 2.6 million people in East Africa, the first ever DVP was carried out outside of Tanzania, in Rwanda.
It is reported that there are currently only 11 dentists living and working in Rwanda – equating to approximately one dentist for every one million people, so providing dental care is vital.
Jeanette Grimley took part in the Rwanda pilot programme as a volunteer Dental Nurse. Jeanette had previously taken part in a DVP in Tanzania – the volunteers had to be confident in what they were doing so no first timers took part in the pilot.
The team set up camp in Kirambi, a rural area whose road from Kigali becomes completely impassable during rainy season, making it totally isolated during those times.
“Clinic is just a short walk away which is a real treat; no long journeys in 4x4s over dust roads means our training time will be longer [which is] an added bonus. As we approach a small group of buildings we are greeted by the staff of the health centre singing a welcome song to us; their voices the only music, the velvet choral tones completely harmonious. A spine tingling moment if ever there was one.
“We are located in the health centre which is a busy place with vaccination and baby clinics going on around us as well as blood tests and nutrition clinics. Imagine if you will a small cottage hospital without any of the technical equipment, a couple of four bedded wards which consist of just that; four steel framed beds with plastic mattresses in a bare room, a small window the only light. The floors appear to be concrete but I’m not sure if they are hard baked clay/mud.
“We quickly set to building our clinic. Volunteer dentists Judy, Peter, Barry, Graham and Neil organise the treatment room whilst Janine, Sarah and I organise the decontamination room and stock the stations with local anaesthetic, bite packs etc. It’s a slick set up made easier by the fact that we’ve all done this before.
“The rooms we use for treatment and decontamination are separated by a courtyard and initially I find this challenging. Having the two rooms apart makes it more difficult to assess what is needed in clinic in terms of support and head holding and stocking the stations but we soon work out a system, carrying clean and dirty boxes of instruments (CQC would be impressed!) between the two rooms whilst keeping an eye on the clinic needs. We work on a rotational basis as scrubbing instruments and putting pressure cookers on kerosene burners in a confined hot space can become intense after a while. Different personalities and high running emotions add to the challenge and we all work hard to achieve a calm working environment and support each other when necessary.
“As part of the training I was asked to deliver a perio seminar to the trainee health workers. This proved to be quite interesting as translation into French, Kinyarwanda and English was necessary. My French is abysmal, my Kinyarwanda non-existent and my Lancashire English accent didn’t do me any favours either! Luckily we have Neil, the Site Clinical Lead, whose French can only be described as fluent and eloquent and we also have a translator.
As well as delivering seminars, the volunteer Dental Nurses teach during the programme. During Jeanette’s turn to teach she says: “Being the hygienist the general consensus is that I should teach the oral health education section to the trainees after which they would deliver a talk to the waiting patients. It goes well and I’m so proud of the speed at which the nurses learn, they deliver the talk and one lady stepped forward to say something. I asked Innocent to translate and she said 'we like this education very much; it is so good, now we can go and tell the others how they can avoid the painful teeth.' I felt so elated.”
At the end of the programme, the trainee Health Workers take their exams after being taught by the volunteer Dentists and Nurses.
“As the papers are marked we nurses set to with the final sterilisation and packing away of instruments, counting and monitoring the condition of each so they can be readily identified for future trips. The pressure cookers are scrubbed of soot for the last time and the group of children that have been watching us all week help to carry the water. I will miss them all so much.
“The results are in and each of the trainee Health Workers has successfully passed the training programme in emergency dental care. Shouts of excitement echo around us, hugs and tears of joy! They are each presented with a kit of instruments, provided by Bridge2Aid, including the pressure cooker and kerosene burners for sterilising and beam with huge smiles, delighted in their achievement. The four Health Workers are responsible for more than 25,000 patients each, that’s a lot of people with access to emergency dental treatment and pain relief.
The volunteer programme is tough but definitely worth it, says Jeanette. “Awaking for mass at 5.30 am, sitting on hard benches, walking on hard dusty roads and sleeping on a cot with a foam mattress listening to flying termites buzzing in the room. Fighting with the mosquito net and taking it in turns to wash in buckets of water. Using the long drop loo when on clinic, breathing the unique odours, coping with kerosene fumes and steaming pressure cookers in intense heat. Riding the emotional rollercoaster that is DVP.
“I would have it no other way, I have relished every minute.”
The Bridge2Aid team based in Mwanza, Tanzania, is currently evaluating the pilot programme alongside the Rwandan Government. If successful, the team looks forward to revisiting Rwanda for a series of training programmes from 2014.
To learn more about Bridge2Aid, visit their website at www.bridge2aid.org