Sri Lanka – Anne Powders

Our team of volunteer dental professionals conducted 6 clinics in addition to 4 screening/ fluoride and OH sessions in Sri Lanka.  The clinics were varied however at times became overwhelming with large numbers of patients seeking dental care.  
Our first clinic was at Farms Lanka where we set up in the classroom and had good space for 3 chairs, a sterilisation and clean instrument area.  There was an initial expectation that we could see and treat 400 patients!  It soon became evident that the maximum number was about 100.  Oral health education was given to all the children in a gazebo alongside the building and children were able to brush their teeth at an outside sink.  

Next, we went to Dennipitya and set up clinic in the local medical centre, which looked somewhat derelict.  Here there is a small dental clinic, but no resident dentist and the facility is poorly supplied. We set up clinic on the airy verandah.  Many patients, parents and children arrived from the rural local community who worked in cinnamon, rubber and tea production.  There was a hectic schedule with many patients in need of treatments.  The heat was oppressive but we were able to treat many of the patients and had help from the 2nd local dentist on our team who was able to do a number of extractions in a small adjoining surgery.
From there we travelled two hours into the tropical rainforests and set up clinic in the small church where the local pastors had curtained off areas for a clinic and waiting area.  They had given out 50+ tickets the previous day although many others joined us for treatment and oral health education. 

Following a long drive to Trincomalee, we attended the Pattalpuram school and screened all the children.  In the afternoon we set up clinic at the Methodist Church and screened the 3-4 year olds. There were 18 children in this nursery and 50% decay of their deciduous teeth. The children and adults in this area have been displaced due to war three times.  This community is extremely impoverished with no public transport and no dental facilities for 15 miles.  The inhabitants must walk this distance if they need dental care.  They gain their living from local subsistence farming or collecting honey. There were several thousand women widowed during the war and some of these women do craftwork or take on small jobs to earn a living. Many of the fathers live and work in Colombo at the cement factory.  In these communities it is common to use home remedies for pain relief – often herbs for bleeding gums or betel nut paan to take away pain.  

The following day we set up a toothbrushing scheme in the school and teachers were instructed on brushing technique, the benefit of fluoride, twice daily brushing and to spit not rinse.
We also visited Kanniya Tamil School, used as a military base for 20 years during the war.  Many families were displaced and 150 families were sent to India and have not yet returned. This is a very underserved and desperate population.  The community was most thankful for our visit.  
In the morning, children were screened and fluoride applied. All children received a brush and paste.
In the afternoon, we set up clinic in the church and on the outside verandah with screening taking place under the trees.  It was extremely hot with many patients arriving both from the local community and the school. In total 69 people were seen and treated. 

At a nearby school for hearing impaired pupils, the team saw children for oral health education, one to one toothbrushing sessions and all students were given toothbrushes and paste. We also saw children and mothers at Sunshine Day Centre for fluoride varnish and OHI.  By the end of the trip we had treated 488 people and screened and gave OHI to 433 more.
The Sri Lankan health system gives a universal cover and includes dentistry, however there are disadvantaged communities that appear to “fall through the gaps” and do not have access to dental care.  Plantation workers, fishermen and their families, and those in the northern/ eastern territories that suffered the effects of Tsunami, ethnic unrest and poverty are some examples of communities are still in desperate need of dental care.