Clinician reports on ‘rewarding’ experience with Bridge2aid
Keith McClean reports on his trip to Tanzania as part of Bridge2aid’s work to provide the community with dental care.
As part of its partnership with Bridge2aid, Mydentist provides funds for two of its team to travel to Tanzania every year and train rural clinical officers in vital dentistry skills.
Keith McClean of Mydentist, Sunderland Road, is most recent clinician to travel with the charity. He visited the Mara Region.
He says: ‘It was with some trepidation that I embarked on my Bridge2aid trip in November 2019. However, from the very start, the team, led by our senior clinical officer Andrew Paterson and assistant clinical officer Liz Stringer, formed a close friendship which would last with us throughout the trip.
‘Our journey involved three flights and a six-hour coach journey north. This took us around the side of the Serengeti National Park and towards the Kenyan border. Our destination was Shirati, located in the Rorya District on the shores of Lake Victoria.
‘Arriving in rural Africa is an assault on the senses. It took a while to familiarise ourselves to the noise, the heat, the smell, the colours and general craziness of it all. However, we made it with all our luggage, and we were excited to get started with the training programme.’
Keith’s clinical base for the first week was the Shirati Hospital, which receives its funds from the Mennonite community. There he met the clinical officers, led by Dr Nila, one of the regional dental officers.
He adds: ‘We learned that in Tanzania it is customary to maintain a handshake during introductions as a sign of respect and engagement. It is rude to point and we should address each other using our first names preceded by “doctor”, which I really rather liked. Formal yet informal.
‘The clinical officers were an impressive and great group to work with. They were already providing many medical services in their local communities. Some of them would spend all day training with us before heading back to assume responsibility for the delivery of babies. This, they thought, was easier than learning how to extract teeth. It was a privilege being able to help provide training to this group, which works in challenging circumstances every day.
‘The clinic was basic, but had the space to allow us to work together in the same room. Our clinical stations circled a central sterilisation area.
‘The training consisted of theory-based learning, demonstration, supervision, tutorials and knowledge-based assessment. There were no radiology facilities and little scope to provide any treatment other than oral health education and extractions. This reflects the conditions the clinical officers will be working in after the programme.’
The Bridge2aid team treated a wide range of patients during the programme, many of whom suffered with pain for many years. Two of the patients had undiagnosed stage four oral cancer, and the team had the difficult task of informing them and arranging some basic palliative care.
Keith says: ‘Many of the patients presented with challenges that we would not normally see in general practice. The HIV rate in Tanzania as a whole is around 4% of the population, but in this area it is around 11%. Many patients take state-funded antiretroviral medications.
‘We also had to manage sickle cell anaemia and patients suffering from other non-diagnosed diseases. Unfortunately, it is often the case that patients are unable to afford the medications to manage the diagnosis.
‘Every day we managed around 100 patients. Many had travelled up to 20km on foot without having had anything to eat or drink.
‘The Rorya District was an area without any dental provision at all before our programme. Now there will be six officers who will manage patients’ dental pain. Hopefully, this will help identify advanced cancer earlier.’
Keith highlighted one patient, a 23-year-old woman with a draining extraoral sinus, which had been present for six months. She had suffered from toothache for three years previously to this from a carious lower wisdom tooth.
He says: ‘She subsequently underwent the removal of the offending tooth by myself and my clinical officer – and hopefully to a full recovery emotionally, physically and socially.’
Rewarding and challenging experience
Keith concludes: ‘All the clinical officers had to deliver oral health education to larger groups of waiting patients and their own individual patients. Most of the patients spoke Swahili exclusively, so the clinical officers were invaluable with their translation and high standard of English. We were very fortunate that one of the UK dentists could speak fluent Swahili – having grown up in Kenya – and was able to connect with the patients on a much more personable basis.
‘It was great to watch the clinical officers progress over the training programme. Their ability to learn difficult skills over such a short period was very impressive. It was rewarding to report that all the clinical officers graduated from the course and they should all be extremely proud of themselves.
‘On a personal level I have found this dental training programme to be a rewarding and challenging experience. It was a privilege to help the Tanzanian people and leave a sustainable, lasting legacy. The UK and Education and Health For All team members are an inspiring and dedicated group of people. They help to ensure Bridge2aid continues to go from strength to strength.’