One of the things that has struck me most strongly since I became involved with the MalDent Project is the large number of organisations and individuals undertaking support and development work in low and middle income countries. This was exemplified by the presentations at the recent Scotland Malawi Partnership AGM and NHS Scotland Global Citizenship Conference, both of which were described in earlier posts.
Historically, oral and dental health have been viewed as relatively low priorities in many low income countries, when compared with such overwhelming health challenges as HIV, malaria and tuberculosis. Nevertheless, groups such as Rotary International and the UK charities Dentaid and Bridge2Aid have been operating in this sphere for many years. More recently, the Scottish charity Smileawi was established by Glasgow BDS graduates Nigel and Vicky Milne, as discussed in a previous post.
A number of friends and colleagues have voiced to me the potential value of “joining up some of the dots”, by linking together organisations and activities where there are synergies and benefits from working together, both from a skill-mix and capacity perspective. With that in mind, Glasgow Dental School hosted a meeting recently which brought together a group representing the charities Bridge2Aid and Smileawi for discussions with University of Glasgow staff involved with the dental school projects at the Universities of Rwanda and Malawi and two leading academics from the Childsmile programme.
The first part of the meeting was devoted to a presentation and discussion of Scotland’s Childsmile programme (www.child-smile.org.uk).
Lorna Macpherson gave an excellent overview of the programme, from its inception to the present day. Points that came through very strongly were:
- The Childsmile programme is a theory-based initiative founded on established sociological and public health principles.
- It has benefitted from the combined power of academic, health service and political buy-in, under-pinned by continual evaluation of the programme and its outcomes, with ongoing modifications as necessary.
- The proven, significant health economic benefits of the Childsmile programme provide a persuasive argument for policy-makers:
This approach has significant implications for those attempting to improve oral health in low and middle-income countries, where prevention of dental disease, as opposed to treatment of established disease, is a number one priority.
After a break for coffee, Nigel and Vicky Milne described the work of their charity Smileawi, since its inception in 2012.
The scope of their activities in Northern Malawi has been growing annually, including delivery of dental care through teams of volunteers, provision of oral health education, re-equipping of dental clinics and sponsorship of Malawian students training as dental therapists. They had approached Glasgow Dental School in 2017 to enquire about the possibility of taking some student volunteers to the villages in which they work to begin collecting some baseline epidemiological data. This will come to fruition in June 2019 when five BDS4 students will join a volunteer team for that purpose. Lorna Macpherson and David Conway have agreed to guide development of the data collection forms. These pilot data, once collected, will feed into the activities of the MalDent Project, one stream of which is the establishment of a version of Childsmile suitable for use in rural African environments.
Lunch in Café AntiPasti, just across the road from the Dental School, was followed by an update on the progress of the MalDent Project. Next, Niall Rogerson spoke about his experiences over the past four years collaborating with the University of Rwanda, which has seen its first cohort of students from the new Dental School graduating this year.
This is a tremendous achievement and provides strong encouragement for the ongoing work in Malawi.
Finally, Shaenna Loughnane, CEO of Bridge2Aid, and Andrew Paterson, who is a clinical lead and trustee of the charity, spoke about its work up-skilling clinical officers to perform emergency dentistry in Tanzania.
I had observed their work first hand in September this year when I was privileged to visit one of their volunteer teams in action in Chato (see earlier blog post). The model of working was very impressive and over the past 14 years a large number of clinical officers have been trained, providing access to emergency dental care for many residents in rural parts of Tanzania
The afternoon closed with a wide-ranging discussion that identified multiple ways in which joint working would be feasible. Already, Niall’s experiences at the Dental School in Rwanda are providing valuable indicators for the Malawi Dental School Project. The Childsmile model lends itself to a wide variety of modifications suitable for different environments and will be developed as part of the prevention package for the MalDent Project, but would be equally applicable in Tanzania and Rwanda. Similarly, the Bridge2Aid model has clear potential in Malawi and it was agreed that further exploration of this possibility would be undertaken.
Discussions centred on collaboration continued into the evening over dinner. A number of plans were hatched – follow the blog for updates!