Dental Health International Nederland
Dear friends,
Greetings from Togo where we have just arrived on Friday! We hope you are doing well and are surviving the cold winter in Europe while we are enjoying the African sun.

I would like to send you the final dental report from our last outreach in Sierra Leone to keep you informed of our work and ministry.

We are due to come in Rotterdam from August 26th until September 9th, but unfortunately I will not be on board as I will be on my LOA for three months. Frieda Schmidt will be on board though so hopefully you will get to see her.

Again we want to thank you so much for all your support and generosity and may God bless you.

Dominique

Dominique Vonnez
Dental Coordinator
Mercy Ships, m/v Anastasis
(currently in Lome, Togo)
phone # 1 954 538 4258   fax # 1 954 337 2811




 SIERRA LEONE DENTAL OUTREACH-
 November 9, 2002-February 21, 2003
 FINAL REPORT

 The M/V Anastasis entered the Freetown harbour on the 9th of November.
The  actual dental clinic did not start until the 28th.  Last minute personnel changes, along with a clinic site that had to be made secure with glass in windows and locks on doors put our start up date back by one week.

Finally the clinic was ready for set-up.  Nov. 26 had all equipment and the whole team out on the dock awaiting the arrival of the truck coming from the Sierra Leone Police Force.  It just never arrived and no explanation was  ever available! Another day lost!  The next day the Army sent a truck, along with 6 men, and we were off to the Hastings Police Training School, 18  kilometres out of Freetown, where our clinic would be held.  We had four of the eight rooms in the Guard House of the Training School grounds.  By the  28th we were ready to begin treatment.

Due to the new equipment we received from generous donors during procurement phase this past summer our clinic ran very smoothly.  Two new gas powered Honda generators ensured adequate electrical power for the whole clinic.
This includes 2 large sterilizers, a Kavoclave, three compressors and all the small items such as amalgamators, light curing units, fans and chair side lights for 4 dental stations as well as a TV and VCR for the reception area.  The two new electric compressors made the clinic environment much more pleasant with the reduction in noise.  We even had a CD player with quiet music playing in the main clinic room, adding a nice touch.  We had also purchased two new Forest dental units using grant money given for
this purpose.  This enabled us to put aside the old black box units that had become very difficult to maintain hygienically, purely due to age.  The work involved in having Mr. Wim Neising design and assemble new air hose terminals for unit connections paid off a hundredfold.  No longer do we have the myriad of hoses and lines running all over the floors.  Almost all of our equipment is now 220V, which has cut down on the number of transformers, electrical cords and multipliers needed.  All in all, our clinics are
 looking much neater and running more efficiently.  We are so grateful to the generosity of the many individuals and organizations who do not mind giving openhandedly so that we can provide better service to the very needy populations we come in contact with.

Having the clinic located well outside of the city allowed many to get to the clinic that would not have been able to afford the trip otherwise.
Our location was also close to 3 IDP (internally displaced persons) camps and several polio communities.  It was very rewarding to be able to provide treatment for these already marginalized people.  As you will see from the Total Statistics there were so many more extractions done than restorations. This is always very discouraging and again reinforces the need for education along with affordable dental care.  Sierra Leone has only 8 working dentists for a population of 5.4 million people.  Three of those dentists  run
'state of the art' clinics that are catering only to the very rich.  In the government hospitals the cost of an extraction is about 5,000 L ($2.50 USD or Euro).  Many cannot even afford this.  Most of these dental clinics are so poorly equipped that all the dentist can even offer to do are basic extractions. There are no compressors or hand drills for restorations available or functioning.

While looking on the Internet or at WHO indexes tell us that dental health in West Africa is not severe, working for 3 months on real people, not just looking at surveys done on 12 year olds, shows us the desperate need for greater efforts needing to be made in dental care.  So many women only in their mid 20's or 30's have only 10 -15 sound teeth in their mouths.  On their back is one baby while several children cling to her skirt.  How has she managed to carry on when you know that she has lived the majority of
her adult life with tooth pain?  The 7 year old with ANUG and the 14 year old girl with advanced juvenile periodontitis..they have no where to go for help, much less even understanding the severity of what is happening to them.

With our basic, though up to date supplies, consumables and equipment we were able to offer much hope and relief.  We tried hard to provide oral education to those waiting.  Oral hygiene presentations given each morning by trained dental staff explained the basics of the cause of tooth decay, answered questions and explained away many misconceptions.  Our education team also spent the better part of each day visiting all the surrounding schools and giving dental presentations geared to each age group.
We were very honoured to have a Sierra Leonian dentist working with us the entire outreach.  Dr. Aiah Dabundeh left Sierra Leone for Germany about 12 years ago with a specific vision in mind.  Without scholarships it took him 12 years to work and make his way through dental school.  In the early part of 2002 he returned, having completed and receiving his degree in Dentistry.
 Freetown, or the whole of Sierra Leone for that matter, offered him little opportunity to practice his skills.  When I met him in early November he was a frustrated man, discouraged to be doing only extractions in the government hospital and in one other private hospital that had inadequate supplies.
He wanted to work with REAL supplies, doing REAL dentistry and we were short on dentists for much of the outreach.  An agreement was reached and Dr. Dabundeh worked with us 3 day a week for the same wage the translators received.  He was a happy man.  It was also good to let Sierra Leonians see that it was not only the "white dentists" who could treat them knowledgably and with great care and skill.  He built up an amazing clientele while with us.  He reported that his Tuesdays, Thursdays and Saturdays in the government hospital were very busy now.

We were blessed to have 5 very mature and committed translators work with us.  They loved their countrymen and it showed in the care they took to reassure them as they entered our clinic, a first time experience for most of them.  While one translator was trained to work as an assistant, 2 more became very adept at delivering clear dental hygiene teachings.  Along with all that, they patiently, willingly, and often laughingly, helped us to understand their culture and people.

When I look at the final statistics of treatments and number of people served I feel sorry that we could not have done more. Then I remind myself that these numbers represent only 48 clinic days!  
Not bad. Now I feel better. J

 Our final totalled statistics;
 3447 treatments on 1403 patients. This breaks down as follows;
 Adults; 1288
 Children; 115
 Amalgams; 459
 Composites; 479
 Extractions; 2102
 Surgical extractions; 175
 Root canals; 12
 Scaling/prophies; 145
 Oral Hygiene teaching; 3527 YEAH!
 Teachers trained; 3
 Dental Assistants trained; 1

Our outreach came to a wonderful end.  On February 14th a huge white United Nations truck was sent out, free of charge, to load and return our mound of supplies and equipment to the ship.  By the end of the day it was all in containers and on it's way into the hold.  At our farewell party for our translators and Dr. Dabundeh we were able to present one of our older, though working, dental units and several hand drills to Dr. Dabundeh to compliment the dental tools and supplies we had given him throughout the outreach.  Now he can provide more than extractions in his clinic!  He has a huge heart for the poor and we know he will continue to make his services affordable.

Sierra Leone still suffers greatly for lack of adequate dental care.
However, changes have been made and they are all for the better.  A dentist has equipment, a trained assistant can now find work, 2 trained dental educators will continue teaching and 3527 individuals now know more about their mouths than they did before.  You have helped to make a HUGE difference.  We thank you!