Restoring Smiles, Changing Lives – The day we went to Geita #livefrommwanza #GGCBlogNo6
November 1st, 2012
Kimberley, David and I spoke over breakfast of the mix of nerves and butterflies about the day ahead. I know my nerves were also tinged with guilt because it wasn’t actually us doing the hard work out there! All we were doing was reporting it and providing the looking glass perspective for those at home. It was, from my perspective, only the dental volunteers that had the right to feel anything.
I was also worried about keeping my emotions at bay while on site. You have to be a pretty tough individual to not be moved by seeing people in pain, particularly children and I was conscious of keeping my own feelings to one side for the sake of the volunteers and the patients. However, you cannot possibly preempt how this could make you feel. Hence the nerves, guilt and anticipation during the journey!!
The journey in itself was an experience. We travelled through a number of villages, noting the increase in poverty the further we travelled from the city of Mwanza. Children looking on wide-eyed as we passed and groups pointing at our truck carrying the five white people.
The heavy clouds that had produced enough rain to put the UK to shame was holding back for now, which we were all thankful for. Mark and Jo made us aware of the challenges the weather can bring, with patients pushing aside any oral pain in favour of managing their fields if the rain were to come. Therefore we all prayed that the weather would hold off as long as possible during DVP.
Nizza and John Simba, Bridge2Aid employees had travelled to site in the days leading up to DVP to market the programme to those in the surrounding villages. This involved travelling around in a truck with a PA system to announce the arrival of white dentists, providing free pain relief. However until the first day, you cannot anticipate the numbers that may show up.
Most of the journey involves an African massage (the name they give to a journey on a bumpy road) but the latter part is navigated practically through trees, as Leonard, our Tanzanian driver finds the site for us.
And as the sun continues to bear down we arrive on site just after 11.30am.
The shelter that has been chosen for this DVP is currently used as a healthcare centre. Among the trees and literally in the middle of nowhere the local clinical officers are currently offering some healthcare to the local villages and after this DVP training, should they pass the programme, dental pain relief will be added to the list of services available.
We climb out of the truck to be greeted by Dr Graham Stokes, the Clinical Lead at Geita. Smiling he said the team had already had a good morning. The clinical officers seemed to be responding well to the training and there were long queues of patients. Each of us looking a little nervous and anxious to not get in the way, Graham kindly guided us to the back room to show us the nurses station that had been set up by the teams.
The nurses were hard at work ensuring cleanliness and hygiene is always of the highest standard and supporting the dentists as far as they possibly can. Later they will be undertaking some oral health education to the clinical officers, so that they can work on prevention with the patients in the future.
Then we leave the room and look on at the dentists training the clinical officers. A little boy in a blue top catches all our eyes and I had to hold my breath as I saw the side of his face swollen to twice its normal size. Accompanied by his father, UK dentist Jill asked the clinical officer to translate the little boy’s complaint so she can understand exactly what pain he has been experiencing. The clinical officer explains that two days ago the little boy, who must have been around 11 years old had woken with severe tooth ache which had very quickly led to the swelling in his face.
I commented to Graham that Jill had arrived ‘just in time’, to have him explain that there is never a right time. Of course there isn’t, a queue of over 200 patients are gathered around, all of them in pain and some of them for years we must all remember that it is the training that is the most important factor. That by leaving trained clinical officers, these people need not suffer for months and days again and will continue to have access to emergency treatment whenever they need it.
The clinical officer tells the little boy that the tooth must be removed and that an injection will be given to him, which will make his face numb. He does not seem too concerned by this and waits quietly while Jill prepares the anaesthetic. The clinical officer explains that he may experience some pain but he doesn’t make a sound, before being guided to a step to wait for fifteen minutes while the anesthetic takes hold.
It’s at this point that I move over to speak to Nizza on the ‘welcome desk’. Nizza works for Bridge2Aid in Mwanza and is embarking on the first of the Monitoring and Evaluation programmess on site. This involves the collecting of important information from a cross section of patients from each site visit in order to report on the current problem and improve future services. I sit with Nizza to discuss his findings so far and start to read through some of the completed forms. The forms collect basic information such as name, sex, marital status, address and so on as well as whether the patient is HIV positive and the condition they have come with. I ask Nizza whether he has experienced any difficulty in collecting the data and he mentioned that some were reluctant to discuss how many children or wives they have, for fear of judgment. The form in front of me describes a 42-year-old man with 3 wives, 18 children and 32 grandchildren. Nizza explained to me that he had to coax this information from the man by reassuring him that the data was being used to improve their services and that there was no judgment from the team with regards to the information provided.
As I noticed some of the children pointing at me – a white faced women – I saw how unusual I must have looked to these children and that this was the first time for many of them to see a white person and a woman with blonde hair! A little baby boy, around 2 years old screamed ‘mazungo’ (meaning white person) over and over to his mother while pointing at me. I smiled and waved directly at him in what was my kindest and most unimposing way I could, only to reduce the little boy to inconsolable hysterical tears, poor little thing! I walked away at this point to calm down the little one and went to see how the rest of the training was going.
Nizza followed me and I commented on the reaction of the little tot and asked if he thought I would be able to do his job on site. He shook his head aggressively, and explained that people felt comfortable sharing information with him because he was Tanzanian and spoke Swahili and that they felt he could relate to them. I was struck by the kindness of Nizza and the strength and power of his ability to communicate with the patients. This is such an important part of the progamme.
Nizza pointed out a little boy sitting and playing with two other boys a little way away from the welcome desk. The boy was 9 years old and had, Nizza explained, been suffering from toothache for over two years. When Nizza has spoken to him and filled out a form on this little one, he explained how he had walked for over 2 hours on his own to get to the site. Nizza had asked why he had not sought medical attention before now and why he had come on his own. The little boy explained that his mother had died and his father was busy working and had not been able to take him before or to come today. As he told me the story I looked over at this boy laughing and playing with his friends and am amazed at the responsibility he has taken for his own health.
At this point we return to see the little boy in the blue t-shirt being treated, his tooth now removed to reveal an abyss underneath. Jill is manipulating the area to drain the fluid from the socket and you can literally see the swelling reducing. The boy is quiet as his father looks on at the treatment and training Jill is doing.
At this point Jill stops for a moment and David moves around with his camera in his hands and sticks his thumb up and smiles at the boy. Going from pain to seeing this white man with a camera he gives his best beaming smile and thumbs up while David captures this moment with the camera. I have to look away at this point, at the pride I feel welling up in me watching this brave little boy, feeling so glad for the DVP team and thankful for the work of Bridge2Aid and the sustainability of what I see in front of me.
Stepping back I see the six dentists all treating different patients. To the left is a mother having her tooth removed while carrying her six-month-old baby. She was more concerned about feeding her child and comforting him than she was for her extraction.
To the right is a little girl so afraid by the white woman trying to treat her that the team asks her to come back tomorrow. Her shakes were so severe when the mirror was placed in her mouth, that the team make the decision to comfort her rather than continue. We all hope she returns tomorrow.
I look over and find David taking pictures of the boys queuing for their turn, including the 9 year old I mentioned earlier. They were all holding their thumbs up and gathering around to pose for the camera. Graham looked on and shouted at David to show them their picture on the camera. As he approached them to show them the picture their faces were of pure amazement – of course they had never seen a picture of themselves before. As they realized what they were looking at, the giggles broke and more children came over to look. Pure enjoyment at seeing a picture of themselves on a camera, and such a precious moment for us to capture.
As we return the little boy in the green shirt is called for his appointment. Nizza, who was clearly touched by his story stays by his side at all times, rubbing his shoulders. He explains the pain that he has and the clinical officer and the dentist investigate before telling him that in order to stop the pain the tooth must be removed. He nods, before being given an injection to numb the area.
The dentist reluctantly sends the boy to the step while the anaesthetic takes hold, commenting that she would rather look after him than send him off on his own. This is where Graham steps in and explains that he will be fine and that the focus must remain on the training of the clinical officers and another patient must be seen. She nods in agreement and while John Simba hands him a little bag of nuts as a prize for his bravery, we all appreciate how she is feeling as we look at the little boy sitting on the step on his own.
And then off we all head, leaving the teams to continue with their training and ensuring we get back to Mwanza before it gets dark. The journey back we are mostly quiet, taking in the day and reflecting on what we have seen. We are all full of emotion and a far greater understanding of the work undertaken by Bridge2Aid and the DVP teams, while quietly comforted by the lasting difference being made.
Sustainability is most definitely the reassuring word of the day!
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