Igalukiro health centre lies in Magu district, around 45 minutes on a dusty, rough road from the nearest town. Along the way are scattered mud-brick houses, surrounded by dry farmland growing rice and cassava, stems brittle in the scorching air. A man of around 70 enters the clinic of Redempta, the Clinical Officer. His pain is evident in the way he holds his body, proud but stiff, and he explains it has been with him for a long time. He can’t remember exactly how long. Visiting the District Dental Officer for him is not an option. He simply does not have the eight days income it would cost to get to the hospital and pay for treatment.
Redempta calmly removes the offending tooth and the man gratefully hands over around Tsh4000 (£1.50). He steps out of the clinic door, into the sunshine, and she notices his renewed happiness, his sense of relief. The next day, the old man comes back to see her. He hands her some corn from his farm: he has come to say thank you.
Igalukiro health centre was where Clinical Officer of four years, Redempta, worked 10 years ago when she was selected alongside Clinical Officers Paul, Alloyce and Jacob* to be trained in emergency dental care on the first ever Bridge2Aid training programme.
Alloyce has equally vivid memories of treating his first patient after he had been trained. With a smile, he says: “I was really excited to be treating without a supervisor or the district dental officer looking over my shoulder. I extracted the patient’s tooth and they were so happy that they went back and spread the news that I was now trained, after that I started seeing many patients”.
Bridge2Aid-trained Clinical Officers are treating patients in pain every single day. In one year they can treat 200 patients who otherwise face the raw option of either enduring the pain, or risk visiting unskilled practitioners.
The face of a young girl who came to visit Paul in Nyaruhandi health centre has stuck in his mind. “She had been told by a friend that I was trained in how to do extractions and came with her mother. She had so many decayed teeth. I extracted two of her teeth. After a week, the same little girl returned with her father and had another extraction. I was very happy to have been able to help her”.
Paul, Alloyce and Redempta said that their training had not only given access to thousands of people in rural areas but had also had a big impact on their working relationships with their colleagues in the district hospital; the District Dental Officer and the District Medical Officer.
Ten years on, and no doubt partly due to the good working relationships with colleagues, Redempta is working in the District hospital in the dental department and Paul is an Assistant Medical Officer based at Magu district hospital. He often finds himself covering for the District Dental Officer when he is away. Alloyce is currently undergoing further training and hopes that when he graduates he will still be able to use his dental skills learnt on the Bridge2Aid training programme. These three Clinical Officers have moved on to more senior positions and are still using their dental skills to serve the communities of Magu district. Other Clinical Officers have taken their places in the rural clinics. To date, 74 Clinical Officers have been trained in Magu district of whom 92% are still in post, working as Clinical Officers.
“I was so excited when Dr. Ian showed me the certificate that meant I was able to start practicing. I feel very lucky being among the first Clinical Officers to be trained, it was a real success which is why B2A have been training for 10 years now.” – Clinical Officer Alloyce.
Prescribing antibiotics and painkillers is one of the few choices that an untrained Clinical Officer has at his or her disposal when faced with a patient suffering from dental pain. It is either this, or referring them to the District Dental Officer, a journey which is not an option for most. Bridge2Aid Clinical Officers can expect to carry out extractions on 84% of patient cases, give a prescription of antibiotics/analgesics (only) to 14% of patients and have to refer just 2% of patients.
A training programme which started in October 2004 with 4 Bridge2Aid staff, 3 volunteers (2 dentists, 2 nurses) the Regional Dental Officer and the District Dental Officer trained 4 Clinical Officers in emergency dental care. To date, Bridge2Aid has delivered 63 training programmes which has successfully trained 326 Health Workers in emergency dental care who, in turn have provided 3,260,000 people in rural areas of Tanzania with access to emergency dental care. In addition, 28,000 patients have been treated for free during the training programmes and more than 600 dental professionals have been provided with ethical volunteering opportunities.
Like Redempta and the old man returning with his corn in gratitude, each of these people has their story. These are difficult, searingly real human stories, of how they have been helped out of pain thanks to Bridge2Aid training.
The numbers we are able to speak proudly of today are many, but there is still a long way to go. Our vision is for all 30 million people living in rural Tanzania to benefit from improved access to emergency dental care. The story is still being told.
*Clinical Officer Jacob sadly passed away
