Our aims and objective were as follows:

  • To set up and run an urgent dental care unit, based in Moyamba hospital.

  • The clinic would run for the duration of the mission, around 7-10 days.

  • Equipment and materials would be purchased to run the clinic for the required period. An inventory was sent in advance.

Upon arrival, it became clear that apart from two reclining medical chairs, none of the inventory requested had been obtained. Fortunately, I had a feeling that this would be the case and had brought some equipment with me.

The team that was allocated to me included:

  • A medical student, Aziz, who screened and clocked patients in and managed the day list.

  • A male nurse, Mohammed Jalloh, who assisted me and whom I also mentored. He carried out autoclave duties and general cross infection control together with two other nurses.

  • A GP, Dr Antario Mohammed, who was with us on the last two days. He assisted me and whom I also mentored.

  • An experienced Dentist, Dr Morgan. He joined us for one day and was generous in providing us with additional supplies.

  • Last but not least, Kubba, whom I personally requested to be on the team. His experience in extracting teeth allowed us to run a busy two chair clinic back in Kabala.

Key tasks for the first day involved finding our feet and establishing the following:

  • Taking an inventory of equipment available and allocation of roles.

  • Putting in place an efficient rota to establish an effective and safe workflow and centralised autoclave.

  • Avoiding complications arising as we only had access to minimal amounts of equipment available and only a few qualified/experience staff.

  • As management of potential complications would be very difficult, I carried out a mental risk assessment for any given situation and continuously observed and monitored all activities.

We received a steady flow of patients. Each patient I saw received the same standard of care that patients would expect in my own private practice in London.

Over the course of the six days:

0
Patients were treated, safely and all were uneventful.
0
Teeth were extracted successfully

The equipment that I have left behind has allowed the clinic to continue running.

Dr Mohammed Jalloh, lead dentist, was able to hold a clinic the next day and successfully treated 10 patients.

Reflection, analysis, and recommendations:

  • The project could have so easily been a complete failure, due to the lack of equipment provided. It is not so much that the equipment was not made readily available, but the fact that I was left in the dark with regards to whether the the Ministry intended to provide the equipment or NOT!

  • My recommendation for future projects is that the lead dentist is allocated a budget to source the equipment and materials for setting up and running the clinic.

My colleagues on the project were fast learners. It became apparent that with the right members of staff, within a couple of weeks, they could be trained and mentored to carry out straight forward extractions as well as patient management and of course, most importantly, PREVENTION!.

This got me thinking, due to the great success of the Moyumba project. Why not use it as a template and take it to other parts of the country.

With a budget of around $1,200 and with a similar arrangement to Moyumba hospital, we could set up a clinic and train and mentor a team to continue to run the clinic after the mission was over.

Since I left Sierra Leone, I have continued to educate, mentor, and motivate the Moyamba team via email and Watt App. This continuous monitoring and education caould potentially be employed in all clinics we set up.

During my time in Moyumba I noticed that everyone, however disadvantaged, seemed to own a smart phone. We also know that prevention is the most important part of personal healthcare. The main obstacles to this are education and awareness. So, why not take advantage of this readily available technology and create an app for the masses. Giving them simple instructions, in the form of videos or animations to get the message across.

On a similar subject, we know of a diploma offered by King’s Dental school that is ready to be implemented. I am aware that the University of Sierra Leone would prefer this in an online format. So why not make this diploma app friendly and allow it to become readily available to all.

Conclusion

The success of this project both clinically and as a research exercise, has given me a clearer vision of how we can begin to tackle the dental issues the country faces. By implementing a multi-pronged approach, briefly discussed above, we may only begin to scratch the surface…. But at least it’s a start.

Gaz Radi

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