The Bridge2Aid dental training programme has, since 2005, created access to emergency dental care for 3,380,000 people living in the rural areas of Tanzania and has provided free treatment during training to over 29,000 people. The numbers are significant, the impact is considerable, but this is only half the story, the individual people we are treating tell the other half. So who are these people?
Erestina Ereneji visited the dental training programme in Karagwe district in September 2014 having walked for two hours in the searing heat.
Erestina 75 is older than the most patients we see (60% of patients are aged between 11 and 40 years old). She is a widow and responsible for her nine children; four boys and five girls. Her children help her out on the family farm where they grow bananas for a living and for the family to eat. The majority (68%) of patients attending dental training programmes have a primary school education only and are small-holder farmers like Erestina, for whom subsistence farming is their livelihood. This statistic is representative of Tanzania as a whole where 80% of the population depends on subsistence agriculture, the country’s largest employment sector .
When Erestina arrived at the Bridge2Aid programme she had what looked like a huge swelling in her throat. She told us she had been in pain for 3 years – 27% of patients visiting training programmes, like Erestina have been in pain for up to 4 years. Over half (58%) of patients attending dental training programmes have been in pain for longer than 6 months and our data shows that people (3%) are left in debilitating pain for longer than 8 years.
74% of the patients visiting dental training programmes are subsistence farmers. Dental pain has a potentially disastrous effect on their lives and on the lives of those who depend on them. When a farmer is unable to tend to his or her crop or feed their livestock, the result is simple but crippling; the farmer’s family, who are dependent on the crops or the livestock for food for the coming months, will go hungry.
Erestina told us that her pain was so bad it was stopping her from doing simple everyday tasks. Instead of working on the farm and caring for her grandchildren the only thing she felt she was able to do was lie down and sleep. The pain affected her income and her ability to care for her family and her farm. She said that previously she used to do all the cooking for her children and grandchildren, but the pain had got so bad she has had been forced to train some of the children to cook for her.
Like Erestina, 62% of patients attending dental training programmes are female. When asked, the majority of women refer to their occupation as ‘farming’ however women in Tanzania traditionally have additional huge responsibilities within the household . When these women are disabled by dental pain, the consequences not only impact upon food provision and therefore their families’ nutrition, but also affects their ability to care for their children, collect water and firewood, clean the house, prepare food, go to market – all of the other domestic chores that are traditionally done by the women of the household.
When the Clinical Officer and the training dentist examined Erestina, they found that they would have to extract more than one tooth. Incredibly Erestina made the same 2 hour journey the following day to have the second tooth removed just showing how badly she needed to be out of pain. The swelling that Erestina had was diagnosed as a ‘Goiter’; a swelling of the thyroid gland. No plans were made to remove the swelling as it was causing no harm, this is common practice for swellings of this nature. However, Erestina was relieved of the burden of pain she had been carrying, and enabled her to get back to her farm and her family.
Erestina is one of millions of people in the rural areas of Tanzania who has benefited from the Bridge2Aid dental training programme. Erestina, and millions like her suffer because safe dental care is not an option for them.
Erestina, her family and the 3.3 million people who have been provided with access to dental care as a result of the training of rural Clinical Officers, are the lucky ones. 30 Million people (89%) of the Tanzanian rural population, a population 5 times that of Scotland will suffer because safe emergency dental care is not yet an option for them. The numbers are huge, but Erestina’s story reminds us that they are all individuals.
