I’m in that wonderful place today of having just returned from 2 weeks off. I am fresh, rested (despite holiday with three children under 10!) and ready to get going on a very exciting few months ahead.
One of the challenges of building the work that Bridge2Aid does – raising awareness of a hidden problem, challenging the ways that it is traditionally addressed, and developing an effective and sustainable means of tackling it – is that it is a hard slog. Sometimes progress is imperceptible. There are setbacks, and more setbacks. But wins as well. And one win, or rather a sign of progress came a couple of months ago, with the publishing of the World Health Organisation’s manual – ‘Promoting Oral Health in Africa’ –
Four years ago we were invited to take part in the workshop that started the process towards writing this manual, and I had the privilege of attending and speaking at the event. I presented on what Bridge2Aid had done in Tanzania to tackle the problems of untreated dental disease, and the impact it has on communities when left with no treatment. The data I presented and model I explained to the delegates from across the African continent highlighted the results we had seen from training local medical workers in Emergency Dental Treatment. Working alongside our colleagues from the Tanzania Government, we had worked hard to create a credible, safe, sustainable means of using volunteers as trainers to pass on their skills and thereby provide access to emergency treatment.
So it was very encouraging to see the final manual (you can view it in full here), and its support for the methods and models we presented, and an honour that some of our photographs were used.
In summary, what the manual proposes for NGOs (charities) and volunteering follows the same principles of the Basic Package of Oral Care, and the subsequent paper in the International Dental Journal which criticised much of the dental charity and volunteering work that sadly continues.
Firstly, (and aligned with the FDI’s Vision 2020), that Oral Health should be incorporated within other Non-Communicable Disease strategies at a Primary Healthcare Level. Essentially that Oral Health cannot and should not stand alone. And in this process of incorporation, a more holistic view of Oral Health within Primary Healthcare is advocated, and, most relevant for Bridge2Aid, that there are an essential set of interventions that must be made available for Primary Health Workers – the medical staff already based in the facilities where most people access care. In the absence of the funds, resources or support for ‘full-service’ dentistry, the manual advocates teaching local health workers to:
Promote oral health and prevention of oral disease:
- conduct routine oral and dental examinations during health centre visits
- conduct routine oral and dental examinations during school visits
- encourage regular general and oral hygiene
- promote healthy nutrition and an active lifestyle
- carry out sessions about tooth brushing with a fluoride-containing toothpaste
- carry out sessions about the harmful effects of tobacco and alcohol
Manage common oral diseases:
- treat dental emergencies, including the treatment of pain and oral infections
- manage periodontal disease
- recognise and stabilize simple disorders (prescription or procedures) and refer specific cases
- control cross infection by effective implementation of recommended hygiene and disinfection measures
- know how to recognise cases that need to be referred to a higher level, and have the connections and facilities to do so
And so this is why B2A’s model focuses on the above – simple, sustainable, transformational intervention that works, and is vital.
And so as I return to work this makes me more determined than ever for Bridge2Aid to lead the way, and show how even a small charity, that started life as a ‘kitchen table’ organisation, can work in a way which contributes meaningfully and valuably to development. Whilst retaining its passion, values and ethos, it matures into a primary healthcare charity that is about development not aid, and resists the temptation to do work which has limited lasting value.
Thanks for taking the time to read this. Take care,
Mark
