Malawi trip blog

By trip leader Nick O’Donovan 

In 2015 and 2017 I visited Malawi to provide emergency dental treatment with friends and staff from my practice, Dewsbury Dental Centre.  When I left Bulala in 2017 we had to turn scores of people away so this time Dentaid, who I have worked with in the UK, recruited 4 dental nurses and two dentists to accompany myself, Joe Bell (our foundation dentist at DDC) and three Malawian colleagues. Dentaid also arranged all the drugs/needles/ gloves/ toothpaste / toothbrushes etc to be sent out to Malawi on a shipping crate and we borrowed three portable dental chairs from Smileawi and arranged to do two clinics at their mission hospital in Embangweni in return. We had a team meeting in January, none of them had been to Africa before and only Joe had worked overseas. 

After we reached Bulala we talked about how we would run things.  99.9% of all patients would require extractions of one or more teeth. We had 3 dental chairs each one would be manned by one of the Malawians, one UK dentist and a nurse.
The 4th nurse would be in charge of loading local aneasthetic syringes, instrument cleaning and disinfection. I also had several meetings with village heads and chiefs – local politics!
The plan was to use tickets and post-it notes. We had 60 tickets made up and saw patients in order.  We arrived at the clinic in the local school on the first day to find nearly 100 people waiting. All 60 tickets had been handed out.

On the first day we saw 125 patients including several nasty cases of swollen faces and one with an abscess draining out of her cheek.
We saw a lot of children some with decayed teeth and some with crowded wonky teeth. In the UK these kids would receive orthodontic treatment here they will not. On several occasions we pulled out perfectly healthy teeth to relieve crowding. In Malawi it is more socially acceptable to have a gap rather than wonky teeth. So sad.

Over the first 3 days we saw over 500 patients.  We had picked up the pace and got into a great rhythm.  On Thursday we got our second wind and saw nearly 250 people in a day. As I pulled the car in there were already 40-50 patients waiting. My eye was drawn to a lady clutching her face.  She was clearly in a lot of pain. I went over to her and asked her to show me. She had 2 rotten teeth on her lower right side I numbed her and extracted both teeth. She had a 5 mile walk home. Handing out tickets had become a real mess, the patients would initially line up neatly but it would always end up a proper scrum.

We saw lots of patients with supernumerary teeth and one lady had a lump of tartar the size of a grape between her teeth.  On Friday Brino, Chelsey and Sam went to the primary school at Malinyete to apply fluoride vanish and give toothbrushes and paste to the 150 children.  Meanwhile in Bulala the others were going berserk seeing nearly 150 patients in a day.  
We then headed to the mission hospital at Embangweni. The guest house there was basic but luxury compared to Bulala. Who’d have thought what a pleasure it is to sit on a toilet seat! The toilet did flush but you had to fill the cistern from a bucket. 
We had our own cook, the showers were cold but better than using a bucket and the girls were relieved as the bug count was not as high!

We turned up on the Monday morning to find 2 people waiting.  I wasn’t having this! I made a sign up in the local language saying “UK DENTIST free dental treatment at youth wing at the mission hospital” strapped a pole to it and Zak and Sam volunteered to carry it round the town. White people get stared at and if they are carrying a sign then it’s going to be read. 
It worked by the end of the day we had seen 72 patients. 
The following day word had spread we saw a further 130 on the Tuesday.
We treated 1100- 1200 patients in Bulala and Malinyete and a further 200 or so in Embangweni.  
So much else went on that week – dinner with the football team, watching Man United v Barcelona in a shack with wooden benches in an atmosphere that cannot be described, the market, the children playing and interacting with the team, getting stuck in 3ft of sinking sand in a car, the stars at night, the camp fires.
  
We ended with a trip to Lake Malawi and some tearful farewells.