The pictures show
some of the many school assemblies that got the dental health lecture
dental chair ready for action outside a village school
Bottom; school which received their new uniforms from harden JMI and in theatre watching some of the 57 cleft repair operations by a brilliant USA surgeon.
Report of Mission to Pakistan. This is a very brief draft of first impressions and suggestions... more to follow!!!
The visit to the Punjab area of Pakistan was most interesting, stimulating and rewarding. People were very friendly and welcoming and I am immensely grateful to Mohammed Aslam who was so helpful in explanations, descriptions and translations throughout the whole time I was in Pakistan and was directly helpful in the dental project aimed at education amongst children and teachers to improve standards in tooth brushing and modification to the damaging high sugary diet.
I was also able to meet the eye surgeon who performs the free cataract operations while we in Oak Tree cover the cost of eye drops and blood tests ( cost about £30 a patient) I was also able to watch the cleft repair operations at the newly opened cleft hospital built by the Japanese embassy.
Travelling down to the flood affected areas in southern Punjab I was able to join in distributing food parcels and quilts to those many people who had lost their homes and who have not had any help from a very corrupt government.
Thanks also to the many schools I visited who made me most welcome and allowed me to address so many of their pupils on my messages on the importance of diet and tooth brushing on the health of the children’s’ teeth.
I am also most grateful to Dr Bashir from Gurjurat who provided wonderful hospitality during my visit and facilitated the timetable of visits to many schools often at short notice.
Myself managing to get round around 20 schools with overall over 10,000 young children as pupils along with a great many teachers, I was able to get over to them the simple messages on tooth brushing and reduction in frequency in sugar intake both in drinks and foods. Examining the mouths of around 30 on average pupils in each school, there was the evidence of a high level of caries in their primary teeth and many cases of poor oral hygiene with their tooth brushing. This was repeated in a wide range of schools, Government only run, private schools, part private schools and in very rural schools. I saw a lot of evidence to suggest that children were receiving a high sugar content diet on eruption of their primary teeth starting at age of around 1 year for the upper front teeth. The first and second primary molars often also show evidence of gross caries, again suggesting the diet on eruption of these teeth consists of too frequent sugar exposure. Encouragement and repeated reminders to these children to modify this diet pattern and to brush their teeth with a very small amount of tooth paste containing fluoride last thing at night, without rinsing their mouths out will reduce the caries rate by over 30%. To sustain this programme requires the school teachers to repeat this message at least every week, introduce supervised in school tooth cleaning especially in the very youngest children ( 5 to 6 year olds) . Reinforcement by School visits by a dentist... Dr Mustafa was offering... along with possibility of encouraging other dentists, hygienists, final year dental students or dental nurses... perhaps as part of their elective research , to return to these schools and repeat the message and using the dental chair I left, examine more children and identify those who have particularily badly decayed teeth. Even better is if these volunteers had ability to converse in Urdu and so could train others more easily to continue to promote the path to good dental health.
It was possible to get into action the dental chair and surgery at the cleft centre hospital.. There is a need to provide dental care and assessments to patients who may need cleft surgery, along with very thorough instructions for continued good dental health with tooth brushing and a suitable place to provide dental assessments , taking of impressions etc for those who would benefit from provision of obturators I managed to do some impressions for these and treated a number of patients who needed scaling of their teeth..
I managed to pack into a fortnight a lot of activity and also made some detailed investigation of the running , financing and administration of the hospital and the welfare centre with a number of recommendations on how the cleft centre could run on a more full time basis. I left the portable dental chair in the welfare centre in Gurjurat with the promise that a local dentist will continue to access schools using this for examinations of patients, and use the chair facility for other medical checks in outlying villages. Overall the trip was very worthwhile and has given me a very good understanding of Pakistan so that future missions to help the many very poor and displaced people can be targeted effectively.
Ian Robertson 30th October 2012
