The end

The sun is setting over Kampala as I write this, I am sitting in the hotel garden enjoying a cold beer, and mulling over my visit.

Uganda is a country of contrasts, hot, noisy and dusty. In  Kamapala the streets are a swarming with people, cars and motorbikes. The roads are lined with people living in the most basic accommodation, selling anything and everything to survive. Large houses are visible everywhere, mingling cheek by jowl with these shacks. Poverty along side wealth, modern civilisation along side something more akin to the medieval times. And then there's the depravation we saw in camparingisi and the Alcholi people, a whole different level of poverty and need.

Today I spent time at the Dental school where they teach the three year diploma students (similar to our dental therapists). The staff were charming and proud of their clinics and achievements, but with only 11 students qualifying a year the demand far outstretches the supply.

We need to appreciate what we have, and not to take our medical and dental services for granted.

Barlison Dental Clinic, Maya

26th & 27th February

This morning John, from Link, came to collect me to take me to his project, the Mary Ann clinic and Barlison Dental Clinic in Maya. The clinic is located in a rural location 15 minutes down a dirt track of the main Kampala to Rwanda highway. John's vision is to provide medical and dental care for the local community, as well as establish a centre of excellence as plans for new housing in the area come to completion. He is hoping that eventually the clinic will provide paid services to a more middle class population, allowing him to be able offer subsidised care to the rural communities. Uganda is a country of contrasts with large affluent houses mingling side by side with what can best be described as the shacks which provide accommodation for the less well off, who survive on subsistence farming.

Part of John's projects is to help provide sustainable energy sources for these communities, and the clinic is powered by solar panels for electricity, bio gas to produce methane from the clinics two cows and water harvested from the roof. It works well, to a point, unfortunately dental equipment requires more electricity than he is currently able to provide form his inverter, and so this either needs to be uprated, or supplemented with a small generator to allow for more than extractions.

The bricks for the clinic, and the new maternity block he is currently building, have all been made by volunteers from the soil dug for the foundations and water tanks. The soil is compressed into bricks  in a hand press and then dried in the sun. They are not fired in a kiln, a common practice seen along the roadsides of all Ugandan roads. John's bricks also interlock, so there is no need for cement.

Currently all he has is a dental clinic, fitted with a Dentaid chair. He has a self contained portable dental unit supplying suction, scaler and drill, as well as an amalgam mixer and light curing unit. Unfortunately without more power he is mainly limited to extractions and simple fillings. John is not a dentist, so he employs a dentist from the teaching hospital on Tuesdays, Thursdays and Saturdays. We saw three patients on each of the two days I was the, so I fear he has a long way to go to reach his dream, especially with the typical African lack of urgency. If it happens it will be a great resource, I wish him luck.

Sterilisation Uganda style

X

The Barlison Dental clinic in Maya is a purpose built building which is slowly being developed by the Link Charity to provide medical and maternity care to the local rural community. Thanks to Dentaid it has a dental surgery, and thanks to Dentaid the means to sterilise instruments!

So where, I hear you ask, does the gas come from to heat the pressure cooker?

Well...........

Q

Biogas.

The cows eat grass and that produces poo.

The poo goes down the chute into the bio digester, and that produces gas....

And that gets piped to the clinic, the waste from the bio digester then gets used to fertilize the land, to grow the grass, to feed the cows, to produce the..........well you get the picture!

Oh and by the way the cows produce milk which is sold, and the money pays the man who looks after the cows........'simples'

The Acholi clinics

24th & 25th February

Yesterday we moved from the Mildmay hospital to the Sky Hotel in the Ntinda district of north Kamapala, and this morning (Monday) set off the the Alcholi community. The Alcholi people come from north Uganda on the border with Sudan, but due the the violence in that area have moved to the outskirts of Kampala. Many of them work in a nearby quarry, breaking up rocks into smaller piece for use as hardcore. 

We set up our clinic in a hall which served as a community centre. Five dental chairs, five Dentaid dentists, and four Ugandan colleagues. On each day we saw around 80 patients between us for pain relief, mainly extractions, but the occasional small filling as well. We also provided some oral health education to the many children who seem to accumulate wherever we show up.

The spirit in the clinics is amazing, the banter and camaraderie has to be experienced, one colleague said it felt like being in a scene fro M.A.S.H and in a way it was. No egos, everyone just out to help. I feel privileged to have been apart of it. Sadly the rest of my team have moved on as they are staying in Uganda longer than me, and are moving out into rural areas further north west. I will be spending my final three days at the Miya clinic. I will miss them and wish them luck, they are a great bunch of people.

 

Sterilisation?

......and our sterilisation suite, eat your heart out CQC!

Waiting room

And here's the waiting room!

Blue Dentaid chairs

So you want to know what we do with the chairs?

Kampingisi

22nd February

The night club down the road kept us all awake last night until 3.00 with loud music. But we were all up for breakfast at 7.30 and on the road to the prison by 9.00. Kampiringisa Youth Rehabilitation Centre is on the other side of Kampala, so it meant an interesting journey into the outskirts of the city, and then out again to the west. Traffic, noise, dust and road works were the order of the day, the streets were teeming with people and motor vehicles of all sorts. The main road out of Kampala was being rebuilt, and at times was no better than a dirt track.

Imagine a 2nd world war army camp; concrete buildings and metal framed windows. Now imagine how it would look today if it hadn't been touched since 1940; peeling paint, cracked or missing window panes, doors and windows hanging open. Add an all pervading stench of unwashed bodies, urine etc. and you might begin to imagine what greeted us as we drove up the road towards the prison. That and a hoard of small children running along side our bus, waving and smiling and shouting hello to us. We were mobbed when we got of the bus, children cuddling us, shaking our hands, wanting to be picked up, wanting to just stand and hold our hands; basically wanting some love.

80% of the children have not been convicted of a crime, they are mostly street children rounded up from Kampala, and dumped there because there is no where else for them to go, or some have been left there by there new step-mothers; unwanted step children are an all to common problem.

When they enter the prison the children are kept in isolation for a few days, and then moved to the 'Black Wing' where they are stripped naked and left in a dormitory without light for several weeks, day and night. This is designed to break them. They are allowed out when there are visitors, and given a trousers, but no shirts. Ages range from around 18 months to 16 years old. The older ones go out to work in the mornings, but the little ones are free to wander, there were no guards or other adults visible to supervise them.

We set up our clinic on the veranda of the school block. By school block I mean four empty rooms, each with a couple of desks and a few posters on the walls. Three of thew rooms were used by us, one to store clean instruments and equipment, one for post op and sterilisation, and one as a waiting area once the kids had been triaged. Five dental chairs were set up on the veranda,overlooking the central area where the kids played in the dust, and a couple of cows wandered around. 

The system works like this: the kids who need treatment are assessed and a note made of the main treatment need, then as each dentist is free the child is seen and treatment carried out. If it is and extraction then they are sent to post op until bleeding stops and they are given pain killers and antibiotics if needed. Actually the treatment need wasn't too great. We extracted several carious teeth, and filled a couple of small cavities with glass ionomer. I suppose if you have a diet without refined carbohydrates you don't get too many rotten teeth, chewing sugar cane is the main exception to this.

Today was a party day. Once a month Natalie organises a party day, and they have meat with their meal. We joined them and sat on the floor to eat rice, sweet potato and meat which we ate with our fingers. Well we had a couple of mouthfuls to be polite, and gave the rest to the kids.....nothing goes to waste.

We joined the kids for their party, singing songs and dancing to the beat of drums, they even let me join in !! We gave them balloons a football and blew lots of bubbles.

We get a very biased view, as today was very different to their normal day. Though conditions are very poor, we questioned that surely it had to be better than being on the streets with at least one meal a day and a roof (of sorts) over their heads. However on the streets they earn money, and that counts for a lot, and at least they don't get beaten and abused by the guards.

Sadly we weren't allowed to take photographs.

A well deserved meal on the way home. Would you believe it ......pizza, and it was as good as many a real Italian pizza, washed down by a couple of beers. Back to our accommodation at Mildmay, a long soak in the shower and bed.

Uganda

20th February

After an early start Richard and I arrived at Heathrow, and found Barbara, our team leader, at the Cafe Nero, as promised. Gradually the rest of the team arrived from as far away as Scotland, and it was time to board our plane and start our adventure.

Nine hours on an aeroplane seems a very long time, but we arrived in Uganda on schedule at 11.00 pm local time. We bought our visas, which proved to be fairly straight forward, and went to collect all our baggage, which included two portable dental chairs. We got through customs with any problems, and were met by Stevie, our bus driver for the week. We arrived at the Mildmay Hospital about 1.00 am, and we're allocated our rooms, which were I fact small self contained chalets, basic but clean. Into bed, under a mosquito net, and asleep.

21st February

Woken at 7.30 by the alarm, it only seems five minutes since I put my head down. We all met for breakfast, sausage sand which and tea at 8.00. After breakfast we boarded the coach to visit the children's home run by Natalie of the charity Food Steps. She rescues very young and sick children from the Government run Young Persons Prison where we will be running a clinic tomorrow. She also stores all the Dentaid equipment, so we spent the morning unpacking all the supplies which we bought with us, and topping up the boxes ready for the clinic visits scheduled for the group over the next two weeks. This was then all packed into the bus, where we are all going to sit I'm not sure. They kindly provided us with lunch, a local maize dish (similar to polenta) and a bean stew. Basic, but that's what the kids eat on a day to day basis.

After lunch we stopped off at a local shopping mall to refresh ourselves with a coffee, and to visit the bank to get some Ugandan Shillings, just under 4000 to the pound! Mind you prices are pretty cheap for us, 3000 shillings for a coffee, and petrol is about 3200/ litre.

The main road from the airport at Entebbe to the capital Kampala is very busy; cars, trucks and minibuses of all sizes and conditions, and of courses motor bikes. The street is lined with small makeshift shacks, from each of which there seems to be a business run, shops selling everything from local produce to clothes and toys. When we were travelling from the airport last night at 1.00 in the morning I even saw someone having a hair cut. The noise, heat and dust has to be seen to be believed, it really does assault the senses. 

We have a couple of hours to rest this afternoon, before heading out for an early supper. early to bed for a good nights sleep before an early start and busy day tomorrow. We have been warned that there will be some fairly harrowing sights in the prison, and we are due to see around 100 patients between us. We expect to have us four English dentists, and three Ugandan dentists, and we'll work in pairs. There are two sorts of dentists in Uganda; those who study a 3 year course and are trained for extractions and simple fillings, and those with a five year BDS. 

Heathrow

Sat in Heathrow terminal 5 drinking coffee and waiting for the rest of team. Everyone is busy weighing their bags to make sure we're not to heavy with all the equipment!

£3000 and counting!!!!

When I first thought about going to Uganda back in the summer of last year it seemed such a long time away, but time flies and it's tomorrow that we leave. I am indebted to my friends at Verwood Rotary for sponsoring me on my trip, their support and encouragement has been really valuable.

I set myself the target of raising £1500 to purchase a Dentaid Portable Surgery to take with me to Uganda, and as you know I visited Dentaid and collected the equipment so that I can take it with me tomorrow.
I am delighted to be able to tell you that I have now also raised enough money to buy a second surgery, so I will be looking for a deserving home for it while I am in Uganda.

In no particular order (as they say on all the best TV shows) I would like to thank all the following for their kind donations:
The Rotary Clubs of:

• Bishops Waltham
• Ferndown
• Havant
• Basingstoke Deane
• Fordingbridge
• Poole
• Ringwood

as well as the following individuals:

• Martin Haines of Dental Financial Associates
• Krishan Joshi of Dental Focus Website Design
• Chris Barrow of 7connections
• Lloyd & White Ltd
• Andy & Paul from L S Dental Laboratory
• Roger Woodhouse from Royal Bank of Scotland
• Keith Hayes of RightPath4
• Dental Directory
• Premium Plus UK
• John R
• Helen & Andy
• Mary N
• Fina B
• John P
• Liz I
• Ann I
• Mark S
• Joy

and of course a big thank you to my wife, Sue, for all her love and support.

Nearly there!!

Thanks to Poole Rotary Club and Kieth H for their kind donations. Nearly there:-  £2650 so far, only £350 to reach my target of two portable surgeries!

Half way to a second surgery!!

I am now well on target to getting the second portable surgery, over half way there!!!
Many thanks to Andy and Paul at L S Dental Lab, and to Joy for their kind donations; and to my lovely wife,  thank you for the present you bought to help me record my trip for posterity, I couldn't have done this without your support
Only 11 more sleeps to go until I leave. It's starting to get exciting!

Dentaid visit to collect my surgery

On Friday I visited Rob and the team at Dentaid HQ to collect my Dentaid Box. I say box, but they have developed a 'rucksack' to allow easier portability of the unit, an enormous wheelie bin being a bit cumbersome. I don't think that I'd want to walk miles carrying it, but certainly easier to handle than a wheelie bin, I just hope they'll let it on the aeroplane! The engineers have also developed and improved some of the other equipment. The solar powered suction was proving to be a bit delicate, the electronics suffered with rough handling and where not easy to repair in the field. So we now have a hand powered suction, which can also be converted to blow dry air to dry a cavity, and a hand held irrigation device. Thanks to Rob, Tony, Jacqueline and Gerry for all they do.

Thanks also toAnne I, Liz I, Mark S and Roger from RBS for their kind donations.

My Dentaid Box is ready for collection

My brand new Dentaid box is ready for collection from Dentaid Head Office near Salisbury, complete with a secret new addition. So I will go and visit Dentaid on Friday afternoon, and post some pictures. can't wait.

Thank you Dental Directory

Many thanks to the Dental Directory for their kind donation of gloves,local anaesthetic and dental needles for me to take to Uganda. It is much appreciated. Thank you

The Dentaid Box

The Dentaid box is a wonderful invention. It is basically a large wheelie bin which contains a collapsible dental chair, which was specially designed for Dentaid. Because they are often used in rural locations without electricity the box contains a portable suction unit and operating light, both of which can be run by mains electricity, battery or solar power. Instruments need sterilising between patients, this is done in a normal pressure cooker, which can be heated on a gas ring, or even open fire! Included in the box are also normal consumables, such as gloves, masks and scrubs, as well as dental instruments.

For an exploded view of the contents follow this link: Dentaid Box

Funds for first dentaid box!

I would like to take this opportunity to wish everyone a Happy New Year.
I am delighted to be able to tell you that I have now raised enough money to purchase the first Dentaid Box Portable surgery to take with me to Uganda. Thank you to every one who has donated, including Fordingbridge and Ferndown Rotary clubs, Martin Haines at Dental Financial Services and Chris Barrow at 7Connections.
Also thanks to Premier Dental Supplies for a donation of consumables to take with
I still have promises of more money coming in, so my sights are firmly set on a second box as well. So if you haven't donated then please follow the link to my BT MyDonate page, every penny helps. Thank you
Anthony