Following return to Glasgow, Jeremy Bagg worked with Mwapatsa Mipando in October 2017 to prepare a bid for a small amount of pump-priming money from the Scottish Government. If successful, this would fund the inward visit of a delegation from Malawi to the Dental School in Glasgow, and also allow acquisition of some replacement pre-clinical dental skills equipment for the training facility in Lilongwe, currently used by trainee Dental Therapists and which, in future, would also be used by BDS students.
Making the case for support included the provision of some headline figures relating to oral health in Malawi and perhaps this is a good time to air them with you, our readers. In a National Oral Health Survey of 5400 subjects in mainly rural areas, conducted by the Health Ministry in 2013 utilising multi-stage sampling and WHO diagnostic criteria, 37% had dental caries, 35% had missing teeth, only 6.5% had dental restorations, and poor oral hygiene with accompanying periodontal disease were very common. Those interested in further detail may wish to read the following paper: Msyamboza et al, BMC Oral Health, 2016, 16:29 DOI: 10.1186/s12903-016-0190-3. Furthermore, there is a high incidence of head and neck cancer, and oral manifestations of HIV disease remain important markers of those who are defaulting on antiretroviral medication.
At the time of writing the application, Malawi had 27 dentists for its population of 18 million citizens. Of those 27 dentists, only seven were employed by the government and the remainder were in private practice. The majority of treatment is delivered by dental therapists, who complete a three year course within Malawi, and of which there are 2-3 in each of the 29 districts. Most patients only seek treatment when they are in pain or have serious odontogenic infections and the service is completely dominated by treatment, with little attention paid to prevention in the rural areas.
We were delighted and very grateful when our bid to Scottish Government was successful, setting us off on the next phase of our journey towards the development of an enhanced oral healthcare system for Malawi, and the ultimate establishment of Malawi’s first Dental School.