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  1. Locuming at Hope – The same but different

    May 21, 2015

    hope 3

    Phil Loughnane has recently returned home to Gloucestershire from a short stint as a locum dentist at Hope Dental Centre in Mwanza, Tanzania. He shares with us some of his experiences

    hope 2

    I have been involved with the charity Bridge2Aid for over ten years, volunteering on the Training Programme, raising money with my teams at Chipping Manor Dental Practice in the UK, and even taking a group of team members and patients out to Tanzania to help refurbish a community health facility.

    This trip was different, though. I wasn’t going to Tanzania as trainer, fundraiser or even flag waver. I was going as a locum dentist, to join the team at the new Hope Dental Centre. Hope is run by Bridge2Aid as a social enterprise. It is a fee-paying dental practice, and all its profits are transferred to Bridge2Aid to extend its invaluable work in East Africa. Hope offers access to quality dentistry in Mwanza. More importantly, though, the more patients it sees, the greater the support for Bridge2Aid – and that’s where we visiting locums can help.

    I was excited to see the new facility. I had visited the old Hope clinic, which was no longer fit for purpose, and I’d heard a lot about the new one. I wasn’t entirely sure what to expect; I knew that the equipment was all new, as it had been donated from the UK during the building project, but seeing how well the surgeries were equipped and stocked was great – and having an air con unit in my surgery was amazing!

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    A friend, Julie Williams, had visited the clinic a month earlier, and she warned me to expect a warm welcome. That’s exactly what I did receive – a very welcoming team who coped patiently with me learning the ropes and consequently running into lunchtime (just like at home!).

     

    And it wasn’t just that that felt like home; the standards of cross infection control employed at the clinic were really reassuring, the computer system uses the latest version of Exact, and most of the kit and materials were very familiar.

    phil hope 1There are of course some adjustments to make. It wouldn’t be worth travelling 4,000 miles if there weren’t. There are some challenges we don’t face often at home, such as frequent power outages, and the resident team adjust easily to these. Though the Hope project manager summed up my contribution by saying that I was wonderfully ordinary – when the power went down I was the only one working because it was still possible to extract teeth without the compressor.

    Although there were some ex-pats, the majority of patients are Tanzanian. I did anticipate I may have a problem communicating, but it was no issue at all. I saw wonderfully well-informed, appreciative patients who nearly all spoke English. When they didn’t, my nurse was always on hand to translate so this was much less of a problem than anticipated.

    Beware; depending on the season, it’s not always baking hot – one afternoon there was torrential rain which sounded so loud on the tin roof. It would have been hard to hear yourself speak. I just looked at my nurse and smiled because it was so unique.

    The resident clinicians do not have much contact with other dental professionals, so an important role for the visiting locum is just to share how others go about things. I’m a little disappointed in how little time I ended up spending with Drs Yusuf and Mo. We had hoped to do some training but in fact the appointment book filled so quickly this was barely possible. I hope instead I was able to provide a role model of hard work, efficiency and professionalism; being organised and productive. They are working in a busy practice, so any tips on how to be more efficient were seized upon eagerly.

    In some ways, I felt more like a learner than a tutor. I felt like a Foundation Dentist working in their surgery on the first day, so it was a great way to empathise with that experience of feeling so new.  I even struggled with a surgical extraction and had to get help! The experience of starting a difficult procedure without really knowing the experience or training of your team was an education. I had checked the instruments thoroughly  but I hadn’t discussed the nurse’s role beforehand.

    And it wasn’t all work, either; one unexpected event was a ‘boys night out’ with the two resident dentists, Yusuf and Mo, which was a great team event.

    Doing a stint as locum at Hope is hard work, but extraordinarily satisfying. Everyone there is eager to learn, but also quick to jump to assist. The team and patients are all so appreciative, and although the area outside the clinic is unmistakably ‘Africa’, inside it is familiar to anyone who has worked in a general practice in the UK. The same, but very different!

    Contact visits@bridge2aid.org if you’d like to find out more about locuming at Hope


  2. The multiplier

    May 5, 2015

    As the countdown for my return to the UK continues, it’s been a time for a lot of reflection. I guess it’s inevitable that once the end of your time gets closer that you begin to not only reminisce but also reflect on how much of an impact you’ve really been able to have.

    For those that don’t know, I am not leaving Bridge2Aid, but after almost 10 years here in Tanzania and having worked hard to establish the programmes and the team, Jo and I will relocate to the UK, but continue in our current roles. With a great Tanzania Management Team in place, we’ll be able to focus on developing the next steps for Bridge2Aid and in particular, raising the funds we need to expand what we’re doing here in East Africa, and extending the work to other parts of the region where treatment and training is desperately needed.

    Overwhelmingly we’re leaving with a great sense of achievement. It has been so rewarding to see so many people relieved of pain they might have suffered for many months, and without our help, would have continued to do so. The last DVP team saw over 1,000 patients – a fantastic achievement. It has also been immensely satisfying to work with so many teams (over 60 now) who have given so freely and had life changing experiences themselves.

    As good as these things are, I keep reminding myself that behind the founding of Bridge2Aid was a dissatisfaction and ultimately a recognition that most dental volunteering and charitable intervention was not enough. Ian’s passion, which every one of the team still carries today, is that training at a basic level has to be the key. After more than 10 years in the 90s volunteering all over Africa as a dentist, Ian had seen plenty. And that’s the difference with a Bridge2Aid volunteer programme. Each one not only treats patients, but more importantly trains local health workers to educate the community and provide simple pain relieving dental services long after the volunteers have left. And the results are clear. Our friends at ApexHub helped create this graphic which shows the difference:

    VolMultiplier

    As you can see, training multiplies the impact of a volunteer placement many times over.

    Over the past few months I have been discussing the next stage of the programme strategy in Tanzania with senior officials and ministers in the government. It’s been a fascinating insight into how governments view programmes and external assistance like ours. It has made me realise that even our 10 years of work is short term. Projects come and go, and what is ultimately needed is the building of human capacity within the government that is sustainable. As valued and appreciated as our work is, we have a duty to pass skills and knowledge to government and/or indigenous groups as fast as possible, so that the dissemination of that knowledge is not reliant on external intervention.

    This is of course what the issue is with so many dental volunteer and charity interventions. It’s good work, but it’s not great work. As Dickson and Dickson say:

    ‘The assumption that we are the solution to another’s problem becomes a proposition of self-interest, whereby we feel we are able to tell people what their problems are, and then deal with them on our own terms.’

    It’s not difficult to see why governments and communities are tired of projects that don’t involve training and perpetuate the need for external intervention. These projects leave a vacuum, there’s no long term change. The very change which communities are crying out for.

    Our strategy will adapt and evolve to embed what we do even further into District and Regional government plans. Because when it comes to oral health, we have to start with the most basic services for the masses. Anything else is unaffordable and given a limited ‘pot’ for healthcare (especially in developing countries), ignores their plight.

    With our departure date fast approaching, I’m increasingly seeing that despite what Bridge2Aid, the volunteers and our supporters have achieved being significant, there is still a long way to go. We can be very proud of the 30,000+ people we treated, and the 350+ Health Workers we’ve trained, but that work must continue. What we’ve seen after 10 years on the ground, year round with a team working hand in glove with the existing structures to strengthen them is that our work has an impact. But it takes all those things and long term, big thinking to achieve it. Short term projects that don’t include training or focus at the right level will of course do good, but ultimately will be quickly forgotten, leaving the communities they visited in the same position as they found them.

    Our charity interventions have to be better. We need brave strategies that will go beyond doing what we as outsiders see as the right thing (or even ‘what we can do’) to addressing the bigger needs that are all too evident, and pass on skills, not just use them. We need humility, engagement and real commitment. We need a bigger vision – one that will harness the immense goodwill that exists in a way that (to quote Jim Collins), goes beyond good, to great. Otherwise we will continue to visit, do what seems right, but sadly leave things just the way they are. The people we seek to help, deserve better.


  3. Fundraising isn’t just about running!

    May 3, 2015

    Every year, hundreds of people do amazing things to raise money for Bridge2Aid.

    Running through mud and over obstacles is great for some, but doesn’t suit everyone.

    Hannah Sutlow in Gloucestershire has been making tooth fairy bags for us for just over a year now. She says…

    “As a dentist, Bridge2Aid is a charity which is naturally close to my heart. I first heard about the wonderful work they do when I was at dental school, and I was part of a group who took part in an It’s A Knockout fundraising event. When I graduated in 2013 and started foundation training my interest in Bridge2Aid grew thanks to the enthusiasm of my adviser and various speakers, who had been lucky enough to go out to East Africa and shared their experiences with us.

    The stark statistic that three quarters of the world’s population has no safe emergency dental care pushed me into action, and I started thinking of ways in which to fundraise. I enjoy various crafts in my spare time, so decided to put my skills to good use and made a few little tooth fairy bags, hoping to raise maybe £50 by selling them at work and to family and friends. Almost a year and over £700 later the tooth fairy bags are still popular and have enabled me to share Bridge2Aid’s work with my patients and colleagues.

    My next goal is to go on a Dental Volunteer Programme to help train a health worker in East Africa and see first hand the difference that my fundraising is making to people’s lives.”

    archwaytoothfairyhannah

    Thanks to Hannah and all our amazing fundraiser.

    If you’d like to join in and raise vital funds that will make a lasting difference to the lives of thousands, contact fundraising@bridge2aid.org


  4. New Region, New Partner

    April 29, 2015

    We are very excited about extending DVP to a no fewer than three new regions in the next 3 months.

    In June we will be in Mororgoro and Tanga, and in July will move to the very far south east of Tanzania to Lindi Region.

    The Lindi project has been made possible by an introduction to the area through Songas, who pipe natural gas from offshore to a major power station in Dar es Salaam. We are particularly pleased to be working with Songas due to their strong commitment to community relations over many years in the area.

    CEO Mark Topley with Malcolm and Nic of Songas after signing the MoU

    CEO Mark Topley with Malcolm and Nic of Songas after signing the MoU

    CEO Mark Topley recently met with Malcom Taylor and Nic Chipakapaka from Songas to finalise the Memorandum of Understanding (MoU) which covers the partnership.

    As well as technical assistance, Songas will donate $12,000 towards the cost of the programme.

    We are hopeful of a very positive outcome from the training, and relationships with the Kilwa District that we work in are already very good.


  5. Effective and Efficient

    April 28, 2015

    We work very hard at Bridge2Aid to make the very best use of the money we’re entrusted with. If you’ve ever visited us in Mwanza or the office in Wotton-Under-Edge, you’ll know that we certainly aren’t flash!

    I am constantly impressed by how much the teams in both countries manage to achieve with the money we have and it really does go a long way.

    It’s particularly nice for us when that is recognised independently, and so I wanted to share with you the most recent report from Charity Choice on how we spend our money.

    Charity Choice use a standard methodology to assess the spending of charities and then publish the results.

    Here’s a graphic which sums up the main results here, and you can download the full report at the bottom of this blog post.

    CC Report 2013

    You’ll see that 88.9% of our donations went on charitable activities. To give you benchmark, the Top 100 UK charities averaged around 78%.

    So a huge well done to the team, and I hope that for our supporters, this is further confirmation that we’re an efficiently run organisation.

    Efficiency is one thing, but a charity can be very efficient but not at all effective! If your approach or strategy is wrong, then time and money is wasted.

    Thankfully that’s not the case for us – combining human capacity building training to make a long term investment in rural health systems at an appropriate level, we’re extending access to the most basic and vital emergency dentistry and oral health education to many communities. We are focussed on making services available to the many – the millions who haven’t even reached first base when it comes to simple pain relief. Using volunteers only as trainers, giving skills to local professionals uniquely suited to deliver services and education, combined with a highly professional team on the ground, and linking directly into government strategy, we’re achieving high levels of effectiveness.

    Download the full report here: Charity Choice – Charity Report


  6. DVP Developments

    April 22, 2015

    We are excited to be working at a Ministerial level on some developments with DVP.

    Dep Minster of Health Dr Stephen Kebwe with CEO Mark Topley

    CEO Mark Topley recently met with the Deputy Minister of Health for a strategic update

    Following the visit of the Deputy Minister for Health on behalf of the President in October to our practical training and treatment programme in Mara Region, we have been in discussions about how to make the programme more widely available.

    CEO Mark Topley and members of the dental team in Tanzania have been in meetings with the Ministry of Health Oral Health Section and the Deputy Minister as well as the Prime Minister’s Office over how we can extend the reach of emergency dental training to more regions.

    So far discussions are very positive, and Mark recently met with Dr Stephen Kebwe, the Deputy Minister of Health to update him on progress, which was very positively received.

    We’ll post progress updates here as things develop.


  7. Dentist Bashing

    April 14, 2015

    A post this week aimed mainly at non-dentist readers, but which I hope is an encouragement to dentists and the profession as well.

    IMG_0965There’s a great deal of ‘Dentist Bashing’ in the media at the moment it seems. Mainly coming from the Daily Mail from what I can see. Although a lot of this passes me by being based in East Africa, an article last week was shared on Facebook and made me so angry I felt I had to respond.

    I won’t share the ‘article’ because I don’t want to give it any more air time than it has gained already. In summary, it set out what an outrage it was that a group of dentists had made a large sum money from the NHS last year. Presumably these dentists had delivered services to patients in return for that money, and with my limited knowledge of the way the NHS works, they must have had multiple contracts across several practices in order to obtain those payments. They will have had many people working for them and invested a large amount of money in acquiring, equipping and running those practices to the required standard. Unfortunately the article took exception to people with a highly technical clinical skill who invest their own money and risk in running a clinical facility gaining the commensurate financial reward that results from a job well done. It also failed to point out that the vast majority of dental practices providing NHS dentistry are by no means making large sums of money.  It did the usual poor journalistic job of taking a stance, supporting it with limited one-sided quotes and demeaning the only response from the profession with a cursory mention at the end.

    We have no problem paying surgeons, specialists and other highly qualified clinicians appropriately, so why such a problem with dentists?

    Before I get too far into this (and these are my personal views), I want to steer away from the article and talk about my personal experience of the dental profession. I’ve worked alongside a fair number of dentists over the past 10 years. As with all sections of society, you will find a range of people. Are they all perfect – no. Do they deserve the bashing that they’re getting – absolutely not.

    The overwhelming majority of dentists I meet are highly professional, caring clinicians with a genuine desire to help people. Once you get past the dental phobia (let’s face it – a trip to the dentist is no-one’s idea of a good time), and consider what a dentist actually does inside the mouth, it’s incredible. The level of skill required to pull off what they do, day in, day out, is immense. That takes a level of focus and technical expertise to achieve that in my opinion, means they earn every penny they earn.

    The dentists that volunteer with Bridge2Aid do so because they care about people in pain. They help huge numbers directly, and make an investment on other clinicians by training them in emergency dentistry so that communities can be free of pain in the future. It costs around £2,000 to volunteer with Bridge2Aid, but dentists give up a huge amount more. Typically they are either business owners or self-employed, so 2 weeks away from practice can lose them tens of thousands of pounds in turnover.

    So to the dentists – I salute you. I am full of admiration for the job you do, and to those involved with Bridge2Aid – thank you for giving so much back.

    To the non-dentists – don’t believe all you read in the papers – dentists and the profession are a great group of people when you get to know them.

     


  8. Dentistry Show special – thanks to Dentinal Tubules

    April 13, 2015

    Thanks to our friends at Dentinal Tubules, there is a great deal on offer for new premium subscribers at the Dentistry Show this week.

    Anyone who subscribes to Dentinal Tubules Premium during the show will receive a free copy of ‘The Smiling Dentist’ AND Dentinal Tubules will make a donation to Bridge2Aid!

    Alif moosajeeAlif Moosajee wrote ‘The Smiling Dentist’ because he was so surprised with the poor oral health knowledge of his new patients. It is described as a guide to ‘general dentistry for the general public’.

    Alif says;

    “The chapter headings are the questions that I am asked by patients and the content has been designed to be as clear and jargon-free as possible.”

    The great thing is he wrote this book to help others in 2 ways – the book helps and educates patients while all proceeds go to Bridge2Aid – helping us to do more of our vital and sustainable work in making access to emergency dentistry available to communities in East Africa.

    And so at Dentistry Show 2015 in Birmingham at the NEC this Friday and Saturday 17 & 18 April, Dentinal Tubules has decided to support Alif. They will give anyone who signs up for ANNUAL premium membership a copy of ‘The Smiling Dentist’ AND pay Alif the proceeds to pass on to Bridge2Aid.

    Visit Dentinal Tubules at Stand H23 to find out more about the benefits of a Premium Subscription and to sign up.


  9. Another milestone for the B2A team

    March 31, 2015

    I am so proud I could pop.

    A couple of weeks ago we ran our latest training and treatment programme in the Manyara region of Tanzania.

    Our practical training and treatment programmes create sustainable access to emergency dental treatment in rural areas. We treat the community for free, train local health workers how to extract teeth safely, and teach both health workers and the population how to prevent dental problems in the future. The training is delivered by a team of volunteer UK dental professionals, and the whole 7 month preparation and execution phase is managed by our team in Tanzania and the UK. We also follow up the trainees for 18 months after the programme. It’s a big job, involving multiple suppliers, government agencies and stakeholders.

    Manyara is an area we started work in a couple of years ago and the significance of this programme was that it was to be the first one where there would be no management team or expatriate involvement in the reception, orientation or day to day management of the programme.

    What this involved was our local team of a Site Administrator, Monitoring and Evaluation Administrator and driver travelling to the region a full week in advance of the team arriving to make sure that everything was arranged. They met the volunteers off the plane at Kilimanjaro Airport, made sure they were transported safely to their hotel and then carried out the orientation programme with them the following day. We had a fantastic Site Clinical Lead in the shape of Mark Inman, a multiple volunteer who has been a stalwart by our clinical lead team for many years. His input along with his assistant Kathy Davidson and the B2A team was supplemented by videos we have recently recorded, in anticipation of us moving to the next stage of our succession plan in Tanzania – to have the local team run the programmes day to day.

    I am so proud because at every stage of the programme and during the preparation, delivery and follow up, everything has been absolutely first class.

    11046382_10153112173690446_4456567486910015049_n-2This would have been a great success in itself, but is even more of an achievement due to the huge numbers of patients which this programme saw. Typically we would expect a team like this to see between 400 and 600 patients during the days that they run the training programme. At the last count on the last day this team had seen just over 1,000 patients, an enormous achievement and a testament to their hard work and dedication. Although this isn’t great because it points to a huge need in Manyara, (which we will continue to address over the coming months and years), to process that number of patients through a system safely and train 6 clinical officers (local government health workers) at the same time was a massive achievement. I am pleased to say that 5 out of 6 the clinical officers successfully passed the training and this is in line with our usual 92% success rate.

    So all in all, a very successful programme.

    But then to the volunteers’  evaluation. We always evaluate our programmes with a 12 point questionnaire which is filled in by the volunteers after the programme and they grade their experience on every stage of the preparation and execution process of the training programme. Our target is to score between 90% and 95% of scores at good, very good and excellent. I was astounded when we received the feedback on Tuesday of last week that the volunteers on this programme had scored every single aspect at 100%!

    There are moments in time when you can see in black and white where all of the hard work over the past 10 years has gone, that it really has paid off, and Tuesday was one of those days.

    I a10429859_10153073676430446_8976260801748500928_nm so proud of the whole team – of Jo for directing the programme and training and preparing the team so well, of Joyce for managing them excellently, for the team in the UK who have worked so hard to make sure that the volunteers are well prepared, allocated to the right teams and packaged off to Tanzania at the right time, but mostly, I am hugely proud of Haji, Abel and Moses who did such a fantastic job on the ground in Manyara, as well as Joseph our Clinical Director who was part of the training team. Their hard work combined with the professionalism, commitment and sacrifice of our volunteer team (and my huge thanks to them) has made this programme a fabulous milestone.

    Huge congratulations to all.

    If you would like to take part in a Dental Volunteer Programme, you can find out all you need to know here.


  10. Different landscape, same pain…

    March 20, 2015

    MbuluTwelve hours’ drive south east from Mwanza and you’ve barely covered a quarter of the length of Tanzania, yet it feels like a foreign land. “Sleepy Mbulu District” way up in the Rift Valley highlands, surrounded for much of year by clouds, to the east overlooking Tarangire National Park and to the north, the vast Serengeti and the Ngorongoro crater. “Mbulu is cold” said Haji, our programme administrator, “it’s like the UK; people are wearing about three jumpers”…

    The Bridge2Aid team have just completed 8 days’ training. Mbulu district proved to be far from sleepy with an Mbulu patients 1average of 126 patients visiting the training team every day – an astonishing 1010 patients treated in total with yet more people having to be turned away because the team was working at full capacity. “Patient numbers are not everything, it’s the quality of the Health Worker training that matters”…we repeat at every volunteer orientation; however the sheer volume of patients on the recent programme shocked everyone.
    Josephat 2 mbulu

    One of the 1000 patients treated on the programme was Josephat (7). Josephat lives with his uncle, because his mother is divorced and cannot afford to care for Josephat and all four of his brothers and sisters. Josephat has been complaining of dental pain for about 4 years; he had developed a swelling on the right side of his face. His mother and uncle, not really having any other option, relied on the witch doctor and traditional medicine. It was not helping; the pain was getting gradually worse. Josephat was now reaching the stage where he had started to miss school.

     

    As the Bridge2Aid Dental Training Programme expands across into different areas of Tanzania, the training teams come into close contact with different people, languages, landscapes and cultures; a hugely diverse nation.
    “The people in Mbulu district were proud to share information” Dr. Joseph (Bridge2Aid’s Clinical Director) Mbulu patients 2explained… “They came, they received treatment, and then they returned to their villages and each person then told their family, friends and neighbours, that’s why we had such huge numbers of people”. He went on to explain “Mbulu people are so kind, welcoming and calm; they listen inventively to instructions, there’s no scrambling for patient numbers which we sometimes see in other districts”

     

    While the people, the languages, the weather, altitude, landscapes and the cultures change as Bridge2Aid travels, one thing that we can be sure of is wherever we go, we meet hoards of people whose lives; their education, their work, relationships and social networks; are being affected every day simply because there is no safe, affordable option for dental treatment available locally.

     

    josephat 3
    For Josephat and the kind, welcoming and calm people of Mbulu district way up in the mountains, there are now five Health Workers who have the skills, knowledge and experience of collectively treating in excess of 1000 patients to help provide this evidently much-needed service. The Health Workers will be able to continue safely treating the people whom the training team had to turn away and the hoards of people who day after day will hear about their services as news continues to travel around their communities.

     

    A huge thank you to the training team for helping another community out of pain and for joining Bridge2Aid on the journey…