Dental Practice - February 2017 | Page 44

obvious periodontal disease with over half of those being very severe and almost all malocclusions were Class I .
Crowding was rare but if present was restricted in adults to the lower labial segment . One child had upper canines excluded bucally . Teeth extracted : this was restricted to those with gross decay , abscessed or where there was severe pain . Most were molars and many were roots only . Occupations : many ( 70 %) reported that they did not have a job however this does not tell the whole story as even those with no skills would fish from a wooden boat at night to get food for the family . Those that did report jobs came mainly from the hospital or the lodges where they were barman or watchmen .
CONCLUSIONS - THE REAL STORY Overall the lessons learnt are that one cannot impose Western values of healthcare delivery on a rural area in a developing country . Access to healthcare is highly sought after and accepted as it is given . Waiting and time are not factors that are the first consideration when delivering a service in the UK .
Once examined , patients did not wish
to discuss their treatment with either the operator or the interpreter . They were very clear about their problem and accepted the treatment plan without discussion .
The results show that there is a great need for dental care on Likoma . As it was not possible to carry out a proper epidemiological study no accurate data can be reported , but it is clear from the numbers attending the clinic and the data received from them that there is severe dental disease amongst the adult population .
Can a short-term dental project be helpful ? From this experience , it is clear that a comprehensive dental health programme is much more important to isolated communities than short-term interventions . 3 Realistically for these to be successful requires outside help however and requires ( charitable ) investment both in setting up the programme and training locals to implement and see the project through as well as a regular input of suitably trained dental educators to train local health workers and reinforce the oral health message .
We would however argue that short projects are crucial in order to “ get the ball rolling ”. Although only a few have been advantaged by it and had their painful teeth removed , the important outcome of this type of trip is the fact that the lab technician has had a muchneeded refresher course on his extraction techniques and , with this small beginning , crucial information has been collected on the needs for dental care on the island which can be presented professionally to agencies that can then construct long-term properly funded and large scale projects . Without credible information , larger NGO ’ s will not be willing to even read project proposals .
In addition , we had a fantastic experience as a family , and we all learnt a great deal about “ the wider world ”. My feeling is very much “ mighty oaks from little acorns grow ”.
ACKNOWLEDGEMENTS We would like to thank Malawi Dream . and the staff of the Hospital of Likoma Island for their support of this project . We would also like to thank our family who all gave up their time to help run the clinics .
CONTACT Malawi Dream - http :// www . malawidream . com /
REFERENCES : 1� ��l���e� �� �e����� �� � De���l ��l���ee���� � � ���e f�� �e�e����� ��d � ���e f�� �h���e� Br Dent J . 2011 Jun 10 ; 210 ( 11 ): 513-6 . d�� : 10�1038�����d��2011�426� 2� �������� � ����h� ���e ��d ���e����e�� Br Dent J� 2011 210 : 499� d�� : 10�1038�����d��2011�431 3� �� �� ���� ��d S� �������� �De���l ������ �f �h�ld�e� �� � ������� ��d �e���d��� ��h��l �� ����l �������� International Dental Journal 41 ( 3 ) 142�148 1991� 4� �� �� ����� �����e�� Tee�h �el�ef : De���l ��d f�� ����l �������� British Dental Journal 169 ( 9 ) 300�303 1990�
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