The multiplier

Posted in: Blog, by Mark Topley, on 5th May 2015 | Comments Off on The multiplier

As the countdown for my return to the UK continues, it’s been a time for a lot of reflection. I guess it’s inevitable that once the end of your time gets closer that you begin to not only reminisce but also reflect on how much of an impact you’ve really been able to have.

For those that don’t know, I am not leaving Bridge2Aid, but after almost 10 years here in Tanzania and having worked hard to establish the programmes and the team, Jo and I will relocate to the UK, but continue in our current roles. With a great Tanzania Management Team in place, we’ll be able to focus on developing the next steps for Bridge2Aid and in particular, raising the funds we need to expand what we’re doing here in East Africa, and extending the work to other parts of the region where treatment and training is desperately needed.

Overwhelmingly we’re leaving with a great sense of achievement. It has been so rewarding to see so many people relieved of pain they might have suffered for many months, and without our help, would have continued to do so. The last DVP team saw over 1,000 patients – a fantastic achievement. It has also been immensely satisfying to work with so many teams (over 60 now) who have given so freely and had life changing experiences themselves.

As good as these things are, I keep reminding myself that behind the founding of Bridge2Aid was a dissatisfaction and ultimately a recognition that most dental volunteering and charitable intervention was not enough. Ian’s passion, which every one of the team still carries today, is that training at a basic level has to be the key. After more than 10 years in the 90s volunteering all over Africa as a dentist, Ian had seen plenty. And that’s the difference with a Bridge2Aid volunteer programme. Each one not only treats patients, but more importantly trains local health workers to educate the community and provide simple pain relieving dental services long after the volunteers have left. And the results are clear. Our friends at ApexHub helped create this graphic which shows the difference:


As you can see, training multiplies the impact of a volunteer placement many times over.

Over the past few months I have been discussing the next stage of the programme strategy in Tanzania with senior officials and ministers in the government. It’s been a fascinating insight into how governments view programmes and external assistance like ours. It has made me realise that even our 10 years of work is short term. Projects come and go, and what is ultimately needed is the building of human capacity within the government that is sustainable. As valued and appreciated as our work is, we have a duty to pass skills and knowledge to government and/or indigenous groups as fast as possible, so that the dissemination of that knowledge is not reliant on external intervention.

This is of course what the issue is with so many dental volunteer and charity interventions. It’s good work, but it’s not great work. As Dickson and Dickson say:

‘The assumption that we are the solution to another’s problem becomes a proposition of self-interest, whereby we feel we are able to tell people what their problems are, and then deal with them on our own terms.’

It’s not difficult to see why governments and communities are tired of projects that don’t involve training and perpetuate the need for external intervention. These projects leave a vacuum, there’s no long term change. The very change which communities are crying out for.

Our strategy will adapt and evolve to embed what we do even further into District and Regional government plans. Because when it comes to oral health, we have to start with the most basic services for the masses. Anything else is unaffordable and given a limited ‘pot’ for healthcare (especially in developing countries), ignores their plight.

With our departure date fast approaching, I’m increasingly seeing that despite what Bridge2Aid, the volunteers and our supporters have achieved being significant, there is still a long way to go. We can be very proud of the 30,000+ people we treated, and the 350+ Health Workers we’ve trained, but that work must continue. What we’ve seen after 10 years on the ground, year round with a team working hand in glove with the existing structures to strengthen them is that our work has an impact. But it takes all those things and long term, big thinking to achieve it. Short term projects that don’t include training or focus at the right level will of course do good, but ultimately will be quickly forgotten, leaving the communities they visited in the same position as they found them.

Our charity interventions have to be better. We need brave strategies that will go beyond doing what we as outsiders see as the right thing (or even ‘what we can do’) to addressing the bigger needs that are all too evident, and pass on skills, not just use them. We need humility, engagement and real commitment. We need a bigger vision – one that will harness the immense goodwill that exists in a way that (to quote Jim Collins), goes beyond good, to great. Otherwise we will continue to visit, do what seems right, but sadly leave things just the way they are. The people we seek to help, deserve better.

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