Rotarians teach dental hygiene in Uganda

Susan Schrack Wood
York East Rotary Club

Editor’s note: Susan Schrack Wood is an environmental sciences instructor at Elizabethtown College and a member of the York East Rotary Club. She and her family joined other local Rotarians this month for a medical mission to Uganda, where the team is treating locals and teaching good health and medical practices. Wood is documenting the trip for The York Dispatch.

The great room at Kisubi Mapeera Secondary School stands empty and quiet.

Suddenly, hundreds of students file into the room, laughing and talking, carrying chairs.  They are excited to have visitors today, visitors with presents.

Lisa Helfrich is a former dental assistant from central Pennsylvania helping on the vocational training team’s dental unit. She lugs along a crate of goodies, but not the kind of goodies that would excite most high school students. The crate does not contain the newest smartphones or fashions; instead, it is full of toothbrushes.

“How many of you brush your teeth?” Helfrich asks the sea of faces in front of her. Most say “yes,” but they don’t own toothbrushes.

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Helfrich chooses seven “leaders” from the crowd and demonstrates proper brushing techniques, starting on the right side and moving to the left. The students giggle at the sight of their peers having their teeth brushed, but they pay close attention.

The student leaders then branch out among the crowd to demonstrate the brushing up close, They hand out close to 100 toothbrushes, but there are not enough to go around.  A Rotarian rushes to a store to buy more.  As they wait, behind Helfrich’s back, one boy uses his toothbrush to scrub the rust off a table leg.

In the meantime, Helfrich gets out the dental floss. If the toothbrushes were interesting, the floss is absolutely fascinating. Helfrich shows them how to wrap the floss around their fingers,

Children at the Kisiri Mapeera School try brushing their teeth.

“No, no!  That’s way too much!” she cautions as one child empties most of the small roll. “You want to gently wrap it around your tooth and wiggle. Don’t be alarmed if you see some blood — that means you need to do this more often — every day.”

The children beg for their own rolls of floss, but there are only a few containers.

Dental health is almost nonexistent in Uganda. There are a few dentists, but in the public hospitals and clinics, they are paid a flat fee by the government, about $600 a month. To survive, dentists must hold other jobs.

The Lancaster and York East Rotary Clubs were awarded global grants from Rotary International to perform a medical mission in Uganda. The VTT dental team has screened hundreds of people in the Entebbe Hospital and the village clinics.  After being checked, patients are given toothbrushes and toothpaste to take home.

The team spends each morning of the mission teaching dentists and their students about root canals, advanced procedures and basic hygiene. Dr. David Zelley, a dentist from New Jersey’s White Horse Rotary, leads the team’s training.

“They have a new dental chair with a working cuspidor (a small sink), and still they tell their patients to sit up and spit on the floor,”  he said.

Training the doctors and students and then supervising their work each afternoon ensures the work done on this mission will be sustainable once the team leaves Uganda.

York’s Dentsply Sirona donated about $13,650 worth of equipment and supplies, along with training on some of the newer procedures.

Many of the patients have advanced tooth decay and the painful oral lesions associated with HIV/AIDS.

“They don’t use proper sterilization here, no high-speed suction that you’d normally see in a dentist office in the U.S.” Helfrich explained, “We are wearing masks and wiping down the equipment, but you can feel the blood and saliva being aerosoled into the air and onto us.”

Back at the high school, an extra 130 toothbrushes arrive and chaos erupts. Team volunteers are surrounded by seas of hands all grabbing for the brushes. Some try to stuff extras into their pockets. Many will take them home and the entire family will share one toothbrush.

Within minutes it is over, all the brushes gone. A small case of toothpaste is left with the school administrators. There is no way the team wants to choose who gets it and who does not.

Although the Ugandan diet does not involve much processed sugar and candy is almost nonexistent, there is plenty of fresh fruit, which has a high natural sugar content. Their drinking water also is high in bacteria, which builds up in the mouth, as well as germs from various diseases and illnesses.

Dr. Ayub Twaha, a Ugandan dentist, said, “I tell people they must brush their teeth every day, but it is not traditionally in our culture to do so.  So changing people’s habits is difficult.”

The team hopes that education at the professional level as well as educating the children will create a generation that values dental health.  Twaha checks his last patient of the day, a 14-year-old who has four cavities to be filled and four teeth to be removed. He hands him a toothbrush and toothpaste.

“Come back next week,” he says shaking his head, “and please, brush your teeth.”