Patients with any dental problems would have endure a 1hr 30minute uncomfortable, bumpy, dusty bus ride to see the District Dental Officer at Geita district hospital, Clinical Officer Daniel Masesa told us -a familiar story told over and over again by Clinical Officers who are trained on the Bridge2Aid dental training programme.
Before receiving any training, the only options for a Clinical Officer when faced with a patient in dental pain are to prescribe patients antibiotics or painkillers or to refer them to the district hospital – a trip which the majority would struggle to afford and who instead suffer in pain.
Daniel was trained on the November 2012 training programme in Geita region.
At the time he was trained he had been working as a Clinical Officer from his rural dispensary in Nyamwilolelwa village and had previously had had no dental training.
Following the training, Daniel told us he felt confident in all areas in which he had been taught; patient communication skills, carrying out an oral examination, diagnosis, administer infiltration and inferior dental nerve block injections, he learnt how to confidently carry out dental extractions in adults and children safely, he understood causes of oral disease and basic principles of oral health and he had learnt about cross infection control.
He received a steriliser (pressure cooker) and basic instrument kit on completion of his training which allowed him to take his new skills back to Nyamwilolelwa dispensary and treat his own patients, taking them out of dental pain – no longer having to refer them to the district hospital.
At Bridge2Aid, supervision and monitoring forms a large part of what we do. Once a Clinical Officer is trained, the District Dental Officer takes on a supervisory role in terms of clinical skills. In addition to this, and to make sure clinical skills are maintained, Bridge2Aid monitor patient numbers.
We caught up with him three months following his training and again at six months following his training to find out how he was getting on with putting his new dental skills into practice;
During the first three months following training, Daniel has seen 28 dental patients, averaging around seven patients a month. By February 2013 he reported to have seen an increase in the number of dental patients attending his dispensary for treatment, the majority of whom he was able to treat with extractions. This success was echoed in his six month patient treatment records where he averaged a very respectable 17 dental patients a month. A year on after his training he was seeing an average of 27 patients per month and had been able to treat 86% of them with immediate pain relief through an extraction.
At 18 months post-training, the number of patients that Daniel was seeing had decreased slightly compared to that at 12 months, though still very commendable; averaging 14 patients per month and treating 95% of them with extractions.
Daniel continues to use the extraction technique that he learnt during training; he also said that all of his dental patients have received oral health information too. This has dramatically reduced the amount of referrals to the district which will help ease pressure on his district hospital based colleagues. The District Dental Officer who works in the district hospital in Geita town estimates that he has experienced a 44% decrease in the number of dental patients as a result of Clinical Officers, like Daniel now having been trained up in the rural areas in his district.
The success seen with Daniel is echoed generally in our monitoring data where up to a 82% decrease in the number of referrals to the urban district dental officers’ clinics can be expected and 64% fewer dental cases are being treated solely by painkillers/antibiotics as a result of patients immediately being taken out of pain by a safe extraction.
