3rd July 2013

ORIENTATION DAY AND FLIGHT TO BUKOBA

0830: B2A staff collect luggage
0845: Meet with lady from safari company
0855: To conference room for orientation
0900: Orientation Part 1 starts
1030: Tea break
1100: Orientation Part 1 ends
1115: Depart Isamilo Lodge for Mwanza Airport
1300: Depart Mwanza for Bukoba
1345: Arrive Bukoba Airport
1415: Arrive and check into Walkgard Hotel
1430-1800: Free time
1800-1900: Orientation Part 2
19000: Dinner together

It’s calming to be woken by birds and crowing roosters and the cows mooing instead of the city traffic… unless of course it’s five in the morning and you don’t have to be awake for another two hours! The mornings are surprisingly cool and it doesn’t really start to warm up until midday and then the heat is deadly (or at least compared to Glasgow) and there’s no breeze, it’s just dry and dusty.

The view from Ismailo Lodge over Lake Victoria was breathtaking...

 

 

 

The first day consisted of orientation, giving us some insight how the rest of the week was to pan out. It allowed us to familiarise ourselves with the teaching, infection control and sterilisation protocols. Sterilisation consisted of pressure cookers – it wasn't HTM-0105 but yet to fall short for the work carried out in Africa. Our group consisted of six dentists and three nurses.. There was one fact to clarify before we started working. It wasn't about the number of patients we could treat as quickly as possible; it was about teaching the clinical officers meticulously and concisely. Teaching consisted of history taking, diagnosis, and positioning, charting and correct extraction techniques. We also had to make it clear to the clinical officer that they had to learn how to recognise their limitations and know when to refer.

 

The orientation was also useful to get a better insight into what my roles/responsibilities would be.
 
Part of my role as a dental nurse included the following responsibilities:

Cross infection control : you will be responsible for the sterilisation room and ensuring all the instruments are cleaned and cared for appropriately. This will be a very different process to what you are used to in the UK – but it is very effective.

 

Patient support : there are no fancy dental chairs so you will be around the clinic room looking at ways to support the patients, usually through standing behind the chairs and supporting their heads, or by holding their babies whilst they have their tooth out!
 

Teaching :

1. To ensure clinical officers are knowledgeable and effective in sharing oral health education (OHE) information with their patients.
2. To ensure the clinical officers are knowledgeable and can demonstrate safe techniques in sterilisation and instrument management so that they understand how to care for the equipment.

Dentist Support: you will not be allocated to one dentist but working with the whole team. One of you will be responsible for making sure they have the supplies / cotton products etc. that they need as well as the instrument supply.

Extra eyes and ears: the dentists are very focused with the training and delivery of treatment so we need you to keep an eye out for what is going on in the clinical area, how the Clinical Officers are communicating, ensuring that all is safe and effective. Often, the Nurses notice things such as whether the Clinical Officers are good with the patients and what improvements can be made. We also need you to keep an eye out for the dentist and help when needed.

 There were 3 nurses on the team and a rotation system was set up so that we had:

• 1 clean nurse
• dirty nurse
• 1 support / supply nurses

By rotating through the roles regularly, we would be able to experience the different areas and all aspects of the DVP.  

 

Facts from the orientation session are as follows:

• More work-days are lost in Tanzania because of toothache than because of malaria and hepatitis combined
• The ratio of dentists to people in Tanzania is now 100,000:1 and in Musoma (where they will be) the ratio is 400,000:1 (about 5 times the population of Stevenage for each dentist)
• The B2A Dental Volunteer Programmes have trained 212 Clinical Officers since 2006 and have treated approx 25,000 patients (but, of course, the main purpose is training)
• Aim is train 86 COs in 2013
• There is now a B2A office in Dodoma (the new capital)
• A pilot in Rwanda will take place in June and B2A hopes to expand into another East African country next year (I am currently writing a risk assessment for them)
• HIV rate is now at about 10-15%
• Urban population (where the dentists are) = 800,000 whilst rural population = 45 million.

Orientation day was split into two - first half in the morning followed by the second held later that day after checking into our hotel in Bukoba.   Later that morning we departed Isamilo Lodge for the airport to travel to Bukoba.  As we disembarked the plane and walked across the tarmac to the small Bukoba airport, breathing in the warm tropical air, it really hit us – we are in Africa, a place of dreams.  In my eyes, Africa holds a mysterious and exotic appeal and it was only at this point after what had seemed like days of travelling that it had finally sunk in that we were nearing our destination