‘Herding kittens’ pays dividends

This is a guest post written by Nigel and Vicky Milne, founders of the charity Smileawi. Smileawi is one of the major charity partners in the MalDent Project and this post describes the success of one of our recent joint initiatives.

2019 has been an incredible year for Smileawi (www.smileawi.com). During this year we have created some excellent new links both in Malawi and here in the UK. As alumni of the University of Glasgow Nigel and Vicky Milne were delighted when discussions with Professor Jeremy Bagg, the Head of Glasgow Dental School, led to our involvement in June in an Oral Health Survey of 5-12 year old children in Malawi.

The survey was designed by Professors Lorna Macpherson and David Conway. To help us collect and collate the data for the full three weeks we had three University of Glasgow dental students Paula Houston, Kirsty Smith and Katie Read-Challen and Abigail Gliksten a dental student at the University of Dundee. For our final week we would be joined by University of Glasgow dental students Rosie Grimes and Martin Laird.

Making up the rest of the team were Nigel and Vicky, Heather Lancaster a retired Medical Practice Manager, Conor O’Brien an Oral Surgeon from Glasgow Dental Hospital and his son Daniel. We were also joined by Alan Stewart and Andy Lancaster who were with us as ‘Smileawi Spanners’, an offshoot of Smileawi which puts hospital transport vehicles and ambulances back on the road. As we were to cover quite a distance in our rented 4x4s it was reassuring to know that we had our own mechanics with us.

4 students
Paula, Kirsty, Katie and Abigail meeting some of the children who took part in our survey

Our first communication attempts with the students proved difficult and answers to straightforward questions were not always forthcoming. As a result Nigel, muttering under his breath, described working with them as being like herding kittens. However, as soon as the students had completed and passed their final examinations, we were met by a completely different attitude. Suddenly we realised that we had working alongside us a focused, intelligent group of young professionals who intended to take full ownership of this project.

The project involved a number of different aspects. First, we would examine the mouths of all consenting children in 6 different primary schools. In order to do this we were all first calibrated using a test which the Scottish NDIP (National Dental Inspection Programme) teams use – http://www.wordpress.com/post/themaldentproject.com/621. This proved more challenging for the older dentists in the team!

The training and calibration allowed us to examine the mouths of the children, measuring the number of decayed missing and filled teeth in their mouths, looking for active signs of infection and checking to see if there was any fluorosis present.

Collecting data in the church at Ekwaiweni

Secondly our wonderful team of local Malawian translators would collect useful social data from the children on a form designed by Lorna and David.

Collecting the social data and carefully writing the child’s name on her toothbrush which was then kept in her own class toothbrush hanger

Thirdly we gathered data on the fluoride content of the water in the well closest to the school. This was done because Malawi sits in the Rift Valley an area where high levels of fluoride in water can be detected at times. The testing equipment and training for this came courtesy of the University of Strathclyde.

Testing the water from the local well for the presence of fluoride.

Finally we gave every child who participated a toothbrush and a lesson on toothbrushing. The toothbrushes were donated by the Humble Co. https://thehumble.co/ a wonderful organisation with a great ethos who make oral hygiene products which are as eco-friendly as possible. We were very grateful for the donated toothbrushes.

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One of the children practising brushing with his new Humble toothbrush
A toothbrushing and diet lesson being given at the Embangweni School for the Deaf, a challenge that our students rose to.

The students decided that it was not enough to simply teach the children, they also wrote a song called ‘Suko Mino’ in Tambuka, then translated it into Chichewa when we were in a different region. Finally they learned to sign it for the School for the Deaf. A particular highlight happened in Mua – after teaching one class of children the oral health message they returned to their classroom, where thirty minutes later we overheard them singing Suko Mino.

The Oral Health Survey was a huge success, with the team examining more than 2600 mouths and uploading all the data into a spreadsheet. In our final week Rosie and Martin joined us and proved to be every bit as hard working as their colleagues.

The full team and translators but minus our mechanics at Mua

Mua proved to be very interesting as it was the only area where we found marked fluorosis. This was backed by the team finding fluoride present in the local well.

Meanwhile the Smileawi Spanners were working hard at Mua. The following photo shows them fixing one of the six vehicles that they put back on the road during this trip. Alan is displaying one of the many toolkits donated by Arnold Clark to be given out to the Malawian mechanics, who were very grateful as they often have to work with a limited number of tools:


So a project that at first felt like herding kittens was transformed into one which felt like a huge success. We would like to thank the following people. A huge thanks to Heather Lancaster for her organisational skills and for keeping the data safe at all times! Many thanks to Jeremy Bagg for his tireless work in bringing the team together and for his patience in getting ethical approval for the project. Conor and Daniel for their hard work and sense of fun. Lorna Macpherson and David Conway for the wonderful work they did putting together the survey, ensuring that we were all calibrated and that we all understood the forms, the data that we were collecting and the spreadsheet for collating the data.

Finally we would like to thank the six students who worked tirelessly to ensure the success of the project. They give us enormous hope for the future of dentistry and now, when Nigel talks about them, there is no muttering, only pride in his voice.

If you would like to support the work of Smileawi, please visit their web-site at http://www.smileawi.com

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