The day starts early for Bridge2Aid-trained health workers. But for the scores of people suffering debilitating toothache, the journey from their rural villages to one of the few health centres in Tanzania will have begun considerably earlier.
Before receiving Bridge2Aid’s practical training course in emergency dentistry, the only options open to government health workers faced with a patient in dental pain were to prescribe antibiotics or painkillers, or to refer them to the district hospital – a trip the majority would struggle to afford and so invariably do not end up making.
With training, the story is very different. In 2004, four health workers were trained in emergency dental care on the first ever Bridge2Aid volunteer programme. Eleven years on, some 50 health workers are trained every year by volunteers - and one such person is Daniel Masesa from a health centre in the heart of Geita district.
When asked about the key differences between Bridge2Aid’s work and other charitable help, Daniel said: “Bridge2Aid volunteers pass on the knowledge that stays long after they’ve gone home.
“This knowledge trains health workers in lifesaving dental skills. I am now confident in carrying out emergency dental care, extractions, effective oral examinations, diagnosis and infiltration and inferior dental nerve block injections. I understand the causes of oral disease; the results of cross infection, and sterilisation techniques, and can communicate oral health messages throughout my village.
“On completion of my training, I received a steriliser (pressure cooker) and basic instrument kit, allowing me to take my new skills back to my rural dispensary where I can treat my own patients - no longer having to refer them to the district hospital.
“In one year I can expect to free 200 people of dental pain, who otherwise faced the option of enduring the pain or risk visiting unskilled practitioners.”
Dental pain in rural Tanzania doesn’t just hurt – it’s destructive. It is a threat to lives and livelihoods. Experiencing pain, problems with communicating, eating and smiling due to dental decay leave people ostracised from their communities, unable to work or attend school.
Bridge2Aid-trained health workers can expect to carry out extractions on 84% of patients, immediately taking them out of pain, give a prescription of antibiotics/analgesics to 14% and to refer just 2%. This dramatically reduces the amount of referrals, which helps ease the pressure on district hospital-based colleagues.
Bridge2Aid training programmes provide a free emergency dental treatment clinic in remote rural dispensaries, providing much needed help to people who have been in pain for months and sometimes, years. So far, more than 30,000 people have been treated free of charge and over 350 health workers have been trained by more than 600 volunteering dental professionals. The charity now works with 21 districts in 7 regions of Tanzania, and one in Rwanda.
But is its legacy longstanding? Last year, Bridge2Aid carried out a survey of health workers who had been trained since 2004 in Tanzania. Ten years on, 89% of them were still in post. In fact, it found very few health workers moved on. Those who have done so have followed paths into administration, posts outside the government or have decided to undergo further training. Some who were trained on the very first training programme have indeed progressed through the Government health system, though they are still using their Bridge2Aid training to treat patients in dental pain.
With 289 trained health workers still in post, each able to see 200 dental patients per year, that’s 60,000 rural people a year whose livelihoods, education and ability to care for their families will not be compromised because they are fortunate enough to have access to safe emergency treatment.
That’s today - what about tomorrow? Three quarters of the world’s population has no access to the most simple dental pain relief, leaving billions to face a daily battle in the toughest of life circumstances.
Bridge2Aid believes the impact of untreated caries on people’s lives is huge – and demands attention. There is a simple, affordable and effective way to make access to pain relief possible - train rural health workers to safely extract infected teeth and relieve pain.
But instead of solely using UK volunteers to train health workers, Bridge2Aid wants to increase local ownership of the programme and exactly this has already been successfully piloted.
The new approach is that urban-based dental personnel are trained by one volunteer dentist and a Bridge2Aid clinician in how to train their own rural health workers. The goal is that in-country dental personnel are provided with skills necessary to train their rural-based health worker colleagues in how to provide emergency dental treatment to their communities.
The programme trains health workers, who then remain in the health care system and who are there for future generations. Workers like Daniel are heroes in their local community, and thanks to Bridge2Aid’d volunteers and supporters, they can now tackle one of the biggest global health issues – relieving and preventing pain.
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