By the time you will be reading this piece I will have finished with the dental outreach setup, but this piece will introduce you to my journey in the development of the 2010 project.
The first question…..who can we work with?
The Ashanti region suffers from some of the worst dental care in Ghana
Every year we work with a partner to deliver the dental project – it is important as we must have experienced professionals to supervise and teach the students. We can also rely on their extensive knowledge of dentistry in Ghana and the problems that rural villagers face. This year, after a long discussion with dental health professionals here and also the team in the UK, we decided to approach Komfo Anokye Teaching Hospital(KATH), the regional hospital that serves the whole of Ashanti region. I began the project research with a trip to Kumasi to meet our key contact, Dr. Karikari (the immediate former Chief Executive of the Hospital). I have to say that journeying through the countryside for four hours from Takoradi to Kumasi went very quickly – it was more of brainstorming moment than a scenic drive as there was SO much to think about!
When I reached Kumasi I met with Dr. Karikari and Dr. Amoateng, who is head of the dental department and regional coordinator for Ashanti region. After a simple presentation on the outreach proposal, they jumped on board without many questions. Apparently they had already conducted research about the oral health condition in the region, and were alarmed by the prevalence of oral disease. To give you an example of how bad things are, their survey showed that the 27 districts in the region were top of the chart across the whole of Ghana for this problem! As is often the case in Ghana, a major reason for this is the lack of dental health care to deal with the problem, so our proposal for a 2010 dental outreach programme was a timely opportunity for them to act on the findings of their research. They are also keen to work with our students to help them gain hands on experience of the dental problems in Ghana.
Deciding on a destination…
Finding a project base can be difficult
I couldn’t have expected any better reception from KATH, and immediately we started to discuss the location of the project. Using their research, we began with a few key districts they had highlighted as suffering from a lack of dental care, namely Bosotwe or Amansie Central district. For us at Work the World, the location also has to provide some other main areas. Because the project is only for a short period, we need to have an adequate number of local schools that want to participate, a project base and somewhere for our students to stay for the duration of the project. It is my job to make sure that the location fits all these criteria, and it can be very difficult. Not wanting to fall victim of an arm chair research, I employed the services of a taxi to tour these villages and spent time lookingh around the. Before sunset that day I was confident that Jacobu was the best place for us.
Looking out for a local health facility in Jacobu was actually not as much of a headache as I had expected. In the past we have had to bring mobile clinics etc because there is nothing at the village, but in Jacobu there is a well resourced catholic hospital that we can use as our clinical base. It serves all the 200 villages in the district – treating the major medical conditions such as malaria, anaemia, pneumonia, diarrhoea, and complications of pregnancies. The hospital has an out patients clinic, two consulting rooms, injection room, pharmacy and 80 beds. Amazingly it has a newly set up dental unit, but this has never been used by the public since the establishment of the hospital in 1968. This is because there is no dentist in the hospital – whether this is because the dental staffs are not willing to stay in the village or simply a case of Ghana not having enough dentists to move to such villages where the people can not even afford the luxury of such services, we do not know. I feel it is the latter because the leadership of the health centre was very welcoming and thinks that running an outreach from his facility will provide a good opportunity to launch it properly. It was a great feeling to think that even before the commencement of 2010 dental outreach, it is already imparting positively on the people and authorities in the locality.
Barbecue night will come with us to Jacobu!
Accommodation for the team is one factor worth stressing on. Jacobu does not have many guest houses, but I did find one that stood out from the rest. It is in a safe environment, five minutes from the clinical base and has self contained rooms with their own toilets and baths. It was also nice and cool, with tiled floors and fans – it will be a good place for students to relax after the project. There is also a bar there so the students can get themselves a beer! Lewis tells me that the students often like to go to the local bars though, which I know is true at the Work the World house, so I was pleased to find a bar a few doors away where they can meet local people. I am sure the students will have lots of fun there!
And for those who love quality food, an arrangement has been made to engage the services of a professional caterer to prepare finger licking local dishes. Aunt Dorcas, who usually cooks in the Work the world house when Ophelia is not available, will prepare quality local dish for breakfast, lunch and dinner. Just as is done in the WTW house every Wednesday, students will enjoy a BBQ and enjoy a night of local Ghanaian music and dancing.
A bit more about Jacobu…
I shall tell you a little bit more about Jacobu now, to give you the picture of the village. It is forty five minutes drive west of Kumasi, Ghana’s second largest city, and four and half hours drive from Accra, the national capital. It is the district capital of Amansie Central which has a population of about 81,000 with 23, 000 pupil and covers an area about 274.1sq m. It has low level lands but not without the red soil hills creating valleys within. It is very beautiful and if you climb up one of the hills you can look out on the whole village surrounded with green vegetation. Most of the villagers work around the area in farming or small trading and by nature they are very friendly and welcoming. Twi is the language widely spoken in this part of the globe, which is different to Fante – the dialect spoken in Takoradi. According to the survey conducted by the Komfo Anokye dental department, this area has the highest prevalence rate of oral disease in the region with periodontal forming about 40% percent of all cases. Common apart from this are carries, fractured teeth, retained teeth, hypoptasia and satisfactory. This health condition means students will have a lot to do!
Navigating the red tape…
The villages we will be working in
Now that I had decided on Jacobu, the next crucial stage was to dispatch letters and organise subsequent meetings with appropriate authorities to regularise the outreach proposal. With the help of Lewis, all letters were duly organised and personally submitted to the Directors of Health, Education and the Chief Executive of KATH for discussion. I felt confident as everyone so far has been very happy with our proposal, involving themselves at local level too. The SHEP co-ordinator (School health education programme) and the Disease Control officer are already looking at dissemination of information and awareness creation in the villages surrounding our base.
It did not take long for word to spread around the villages about our summer programme and so it was very important that we live up to the high expectations of the villagers and KATH. We cannot compromise on the quality of the clinical practice, so I met with with the chief dentist in Accra to discuss how we would regulate the two groups of students as they screen and treat patients. We must have two professionally qualified dentists to supervise the entire team, and with the assistance and support of Dr. Amoateng and Dr. Karikari, the chief supervisor agreed that she was happy for us to proceed.
So, with almost everyone on board it was just down to the Chief dentist in Ghana, Dr. Constance. We were all thrilled when she said that she liked the project and it was even more exciting when she said she will visit the project on the first day to have some interaction with students and to teach them how to achieve maximum result with the limited resources available here in Ghana. With her position, inspiring personality and the keen interest to always teach, her visit will obviously be an asset to the team.
And so finally I can go home….
After a busy few weeks in Jakobu and Kumasi it now all looks pretty much sorted. Everyone we need is on side, we have the assurance of logistical support and dental equipment from the Ministry of Health, the backing of KATH and St Peters hospital, lots of work being done to ensure that the schools are fully involved, the expectancy of the villagers themselves generating a buzz about the project, a place for students to call home…….everything is done! I can now have a nap in the bus on my way back to Takoradi safe in the knowledge that no stone has been left unturned!
