Dental
Outreach Work In Zimbabwe
How to
proceed step by step
Quentin
Voellinger, 1998
Secours
Dentaire International
INDEX
Introduction
First Step:
First inquiring
Second Step:
Establishment of a provisional ORW program
Third Step:
Contact with the local authorities
Forth Step:
Contact with the Rural Health Centres and Schools
Fifth Step:
Definitive program
Sixth Step:
Materials
Seventh
Step: Organization
Eighth Step:
Going out into the bush
Ninth Step:
Coming back to the base
Tenth Step:
Adapt your system in function of the local needs
Eleventh
Step: Importance of the maintenance of the materials
Twelfth
Step: Evaluation of the costs of your outreach work program
Zimbabwe is
a landlocked in south-central Africa shaped roughly like a water droplet
falling from the Caprivi Strip of Namibia. It is situated entirely within the
tropics -between 15 degrees south and 22 degrees south latitude - but most
Zimbabwe consists of a highveld plateau lying between 900 and 1700 metres over
sea level. The country enjoys a remarkably temperate climate. The rainy season
is between November and February. Zimbabwe is bound on the north-west by
Zambia, on the east and north-east by Mozambique, on the south - west by
Botswana, and on the south by the Republic of South Africa. Four countries
(Zambia, Zimbabwe, Botswana and Namibia) meet at a single point at the
countrys westernmost extreme. Zimbabwes maximum width is 725 km, while north
to south it stretches 835 km. The total area is 390580 sq km, roughly about
9,5 times Switzerlands size.
The capital
of Zimbabwe is Harare and the whole country is divided into 8 provinces.
English is the official language, Shona the first national language and Ndebele
the second national language. Besides these 2 indigenous languages, about 15
dialects are spoken in Zimbabwe, depending on which tribe is concerned. The
population grows at a rate of 3.5% and in 1991 (last official census), Zimbabwe
had approximately around 11million inhabitants. The currency used is the
Zimbabwe dollar (Z$) and the exchange rate in 1996 was CHF 1.- to Z$ 7.7.-.
Zimbabwes
infrastructure is already on level which permits easy travelling, construction,
introduction of institutions, industrial and health establishments. Despite of
this, Zimbabwes economy is very low, but most of the inhabitants have access
to school and health care facilities. Progress has been made in supplying arid
regions with water in the development of irrigation projects for farming and
agriculture.
In all
African countries, it has been established that in the domain of dentistry, the
situation has deteriorated dramatically over the past thirty years. According
to the World Health Organization, we are witnessing a devastating increase in
the number of cavities and gum disease in this area of the world. Various
factors such as the unfortunate modification of eating habits which include
excessive sugar intake, the lack of knowledge of the mouth and dental diseases
and of their prevention, the shortage of health services available including
qualified staff and management and lack of equipment, the overall poor health
of the general population can often mask or worsen a dental problem. Not to
mention the harsh environment with its demographic problems both socio-economic
and geographic, can all be attributed to this decline in oral health.
Efforts have
been made to set up clinics and help Africans help themselves in treating
dental and mouth pathologies, but it has become quite evident, that it is
utopic to wait for impressive results in oral health on a long term.
"Dental-Aid International" has introduced dental health education in
schools and has invested time and money in such prophylaxis programs. A
coherent and credible prophylaxis program will be the only way to lastingly
improve the situation created by teeth and mouth diseases in Africa.
Chikombedzi Mission Hospital is located in the south-east region (Chiredzi South) of Zimbabwe and belongs to the province of Masvingo. It is 96 km east of Rutenga, it is 128 km south of Chiredzi and 244 km from Masvingo. The population area served by this hospital is 30000 for Chikombedzi, plus rural areas for a total of 100000.
Chikombedzi
Mission Hospital is owned and operated by the Free Methodist Church of
Zimbabwe. The responsible authority is the board of directors appointed by the
said church (Actual president Mr N. Zanamwe). The Medical Superintendant is the
person in charge of the whole hospital, he is a licensed medical doctor and
lives at the hospital complex (actual MSI is Dr Sibanda). The Dental Department
is an integral part of the 160 bed hospital and has been fully equipped by the
Swiss Foundation called Secours Dentaire International (SDI) since November
1993 (also called Dental-Aid International). The clinic includes a fixed dental
unit plus a mobile dental unit (MDU), which is used for the outreach work in
the Chiredzi South area. Most of the materials of the dental clinic have been
financed through the regional Swiss Rotary Clubs and the Swiss Association of
Albert Schweitzer.
At the Dental Department, the working staff is
composed of:
A dental therapist with Zimbabwean diploma: Mr
Manuel Chivavo (Upper-L)
An exodontist (aid-nurse trained by SDI): Mr
Naison Lukas Chauke (Lower-L)
An exodontist (aid-nurse trained by SDI): Mr
Clemens Sibanda (Lower-R)
An exodontist (aid-nurse trained by SDI): Mr
Nelson Gonese (Upper-R)
Chikombedzi
Mission Hospital is surrounded by 14 bush clinics (called RHC for rural health
centre) which have been constructed by the Zimbabwe Ministry of Health. These
clinics are located 25 to 100 km from the operation base which sits in
Chikombedzi.
Each of the
rural health centres (RHC's) are in the hands of a state certified nurse and at
least one aid-nurse. Materials at their disposal in the bush clinics are
essentially materials for emergency treatment (dressings, antibiotics ). The
major part of their work concerns the huge child welfare program and the local
births. Two of the 14 RHCs have a set of instruments for dental emergency
treatments such as extractions and treatment of abscesses. The set is used by
the state certified nurse in charge who has gone through an exodontist course
of 3 months duration in Masvingo to become certified for applying such
procedures.
After the
dental clinic of Chikombedzi, the nearest dental clinic is to be found at
Chiredzi Government Hospital (180 km) and the nearest maxillo-facial surgeon
works at Bulawayo Government Hospital.
FIRST
STEP: First inquiring
Before you start anything in any given country you must first inform yourself on the organization and local rules of the health system. In our case Zimbabwe, we did not inquire enough at the beginning and with passing time, we realized Zimbabwe had a very strict and complex health system. You should make a rough check of all such details to avoid future obstacles with government authorities.
The whole health system in Zimbabwe is supervised by the Ministry of Health which registers all health professionals and health activities. Once you are registered (and this is in itself a very long procedure), you must apply for a work permit. Without such a permit, all your activities will be considered as illegal.
The Acting
Director of the Dental Health Services in Harare is responsible for all dental
health activities and supervises the systems in the provinces. At the province
level sits a Provincial Medical Director (PMD) who supervises his districts. On
top of each district sits a District Medical Officer (DMO) who supervises all
Medical Superintendants of the hospitals of the district. This last Officer
(DMO) is also responsible for the local dental services. Further more, if you
intend to go into schools for dental health education, you will need approval
from the District Health Education Officer.
There are
other aspects to be considered before setting up such a programme including:
How many schools
are to be visited and how far are they ? Problem of transportation, costs ?
Is there already a
similar program running somewhere nearby the place youve chosen ? And if yes,
how does it work ? What is the attendance?
What is the
capacity of payment ? Treatments for free ? Do not forget costs of salaries, materials and maintenance
... must be covered
In what conditions
are the structures at disposal in the RHC's and are they O.K. to be used for
installation of mobile dental unit (MDU). Is accommodation possible ? How are
the roads and how is the accessibility during the rainy season?
Did you want to
introduce an outreach program or did the local population ask for such a
program ? Give preference to the
second case.
How can the
instructed population follow your education, accessibility of tooth brush and
paste, costs ...?
Once you
have thought over the above mentioned points, you must consider the question: Are the factors inquired in
your first evaluation more or less favourable to introduction of a dental
prophylaxis program ? If the answer is yes, you may now begin with the local
inquiries.
First you
will get in touch with the Medical Superintendant of the hospital where the
base of your activities sits. Together with the management of the hospital, you
will localize the different rural health centres surrounding the area. In the
case of Chikombedzi, the situation of the different rural health centres is as
follows:
Masvingo Province, Chiredzi District
Outreach Work catchment area
SECOND STEP: Establishment of a provisional ORW
program
Then, you
will need to establish an outreach work program for the next 12 month period.
Take into consideration the rainy season (roads passable) and the school
holidays. During one ORW week, we usually drive to our next destination on
Monday morning. Once arrived on the spot, the mobile dental unit (MDU) is
equipped in the dental room of the RHC and then the dental staff meets the
directors of the surrounding schools to organize the oral health instruction
lessons. On Monday afternoon, the local children can return home with dental
care information and inform their families of our stay at the RHC. Treatments
can be delivered from Tuesday to Friday midday and on Friday afternoon, the MDU
is packed and brought back to the base. For the year program, our first plan
looked as follows:
Dental Department
Chikombedzi Mission Hospital; Private Bag7075, Chiredzi, Zimbabwe
Outreach
Work Programme For The Year 1996/1997
22 April - 25
April 1996 ; Malipati Clinic
6 May - 10 May 1996;
Rutandare Clinic
20 May - 24 May 1996; Gezani Clinic
3 June - 7 June 1996; Samu Clinic
17 June - 21 June
1996; Dumisa Clinic
1 July - 5 July 1996; Davata Clinic
15 July - 19 July 1996; Muhlanguleni Clinic
29 July - 2 August 1996; Old Boli Clinic
16 September - 20
September 1996; Makambe Clinic
30 September - 4
October 1996; Chibwedziwa Clinic
14 October - 18
October 1996; Chilonga Clinic
28 October - 1
November 1996 ;
Chambutta Clinic
11 November - 15
November 1996; Gezani Clinic
25 November - 29
November 1996; Rutandare Clinic
20 January - 24
January 1997; Malipati Clinic
3 February - 7
February 1997; Samu Clinic
17 February - 21
February 1997; Dumisa Clinic
3 March - 7 March
1997 ;
Davata Clinic
17 March - 21
March1997; Muhlanguleni Clinic
31 March - 4 April
1997 ;
Old Boli Clinic
First term: 16
January - 3 April 1996; Holiday: 4 April - 6 May 1996
Second term: 7 May
- 8 August 1996; Holiday: 9 August - 9 September 1996
Third term: 10
Sept. - 5 December 1996; Holiday: 5 December - 7 January 1997
This program has
been established on 12th of April 1996 in arrangement with the actual dental staff and the hospital management.
This program has to be consulted and supported by the hospital management and
the hospital administration. The dental staff members will plan their holidays
during the periods of school holidays to provide the good running of outreach
work.
The running of the
program will be controlled and extended during the visits of SDI representatives.
Should the weather
be inclement and/or roads impassable, the schedule will be adjusted to make the
visit one week later. It maybe necessary to wait until road conditions improve
(insert your new schedule on the regular schedule) In all cases the visits must
be made up!
Signatures:___________ Date:___________
Before
starting out, the District Medical Officer must be informed of your activities
and must give you his approval for the program.
For the oral
health education in the schools, you will meet the District Health Education
Officer, who will need to give you his approval too and at the same time, he
will be so enthused with your program and you might have the opportunity to
receive all the addresses of the different schools in the district.
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Addresses
Of The Rural Health Centres & The Schools |
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Place |
Clinic
/ School |
Nurse
in charge / Headmaster |
Address |
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CHILONGA |
Chilonga
RHC |
Mr
J. Bvindi |
Chilonga
RHC, P.O. Box 142, Chiredzi |
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Chikovo
P |
Mr
Mepula |
Private
Bag 7104, Chiredzi |
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Chilonga
P |
Mr
Mutangirwa |
Private
Bag 7049, Chiredzi |
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Chilonga
S |
Mr
Museva |
Private
Bag 7097, Chiredzi |
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Gwaseche
P |
Mr
? |
Private
Bag 7069, Chiredzi |
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CHAMBUTTA |
Chambutta
RHC |
Mrs
R Chakauya |
Chambutta
RHC, P.O. Box 142, Chiredzi |
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Makhosiya
P |
Mr
? |
Private
Bag 7071, Chiredzi |
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Chambutta
P |
Mr
? |
Private
Bag 7064, Chiredzi |
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Chipinda
P |
Mr
? |
Private
Bag 7029, Chiredzi |
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Velemu
P |
Mr
Chauke |
Private
Bag ? , Chiredzi |
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CHIBWEDZIVA |
Chibwedziva
RHC |
Mrs
S. Muzenda |
Chibwedziva
RHC, P.O. Box 142, Chiredzi |
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Chibwedziva
P |
Mr
Makumi |
Private
Bag 7008, Chiredzi |
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Chibwedziva
S |
Mr
Ticharwa |
Private
Bag 7096, Chiredzi |
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Masivamele
P |
Mr
? |
Private
Bag 7007, Chiredzi |
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Chingele
P |
Mr
? |
Private
Bag 7072, Chiredzi |
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Chingele
S |
Mr
? |
Private
Bag 7095, Chiredzi |
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MAKAMBE |
Makambe
RHC |
Mrs
r. Mashayanya |
Makambe
RHC, P.O. Box 142, Chiredzi |
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Makambe
P |
Mr
Shuma |
Private
Bag 7047, Chiredzi |
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Makambe
S |
Mr
Rukuni |
Private
Bag 7108, Chiredzi |
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Tichidya
P |
Mr
Balloy |
Private
Bag 7079, Chiredzi |
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Chompani
P |
Mr
? |
Private
Bag 7053, Chiredzi |
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MUHLANGULENI |
Muhlanguleni
RHC |
Mr
H. Nyika |
Muhlanguleni
RHC, P.O. Box 142, Chiredzi |
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Muhlanguleni
P |
Mrs
Muguewe |
Private
Bag 7033, Chiredzi |
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Muhlanguleni
S |
Mr
Machaya |
Private
Bag 7038, Chiredzi |
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Machindu
P |
Mr
Gwachara |
Private
Bag 7028, Chiredzi |
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OLD
BOLI |
Old
Boli RHC |
Mrs
P. Dhewa |
Old
Boli RHC, P.O. Box 142, Chiredzi |
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Boli
P |
Mr
Moyo |
Private
Bag 7034, Chiredzi |
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Malisanga
P |
Mr
Mazuma |
Private
Bag 7052, Chiredzi |
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Majijimba
P |
Mr
Moyo |
Private
Bag 7031, Chiredzi |
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GEZANI |
Gezani
RHC |
Mr
C. Sithole |
Gezani
RHC, P.O. Box 142, Chiredzi |
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Gezani
P |
Mr
Maponde |
Private
Bag 7062, Chiredzi |
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Gezani
S |
Mr
Gumbo |
Private
Bag 7105, Chiredzi |
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Chilugwi
P |
Mr
Mubaiwa |
Private
Bag 7090, Chiredzi |
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Bondela
P |
Mr
Chauke |
Private
Bag 7087, Chiredzi |
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Pukupela
P |
Mr
Macheke |
Private
Bag 7066, Chiredzi |
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Makhanani
P |
Mr
Mavu |
Private
Bag 7050, Chiredzi |
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RUTANDARE |
Rutandare
RHC |
Mr
C. Mhango |
Rutandare
RHC, P.O. Box 142, Chiredzi |
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Rutandare
P |
Mr
Shumba |
Private
Bag 7039, Chiredzi |
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Maose
P |
Mr
Zindove |
Private
Bag 7055, Chiredzi |
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Chigalo
P |
Mr
Masetese |
Private
Bag 7068, Chiredzi |
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MALIPATI |
Malipati
RHC |
Mrs
G. Machicho |
Malipati
RHC, P.O. Box 142, Chiredzi |
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Malipati
P |
Mr
Baloyi |
Private
Bag 7059, Chiredzi |
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Malipati
S |
Mr
Ndevele |
Private
Bag 7086, Chiredzi |
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Ngwenyeni
P |
Mr
N'Dlovu |
Private
Bag 7077, Chiredzi |
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DAVATA |
Davata
RHC |
Mrs
S. Gweyi |
Davata
RHC, P.O. Box 142, Chiredzi |
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Pusani
P |
Mr
Murira |
Private
Bag 7056, Chiredzi |
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Davata
P |
Mr
Magumise |
Private
Bag 7048, Chiredzi |
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Gwaivhi
P |
Mr
Muthelisso |
Private
Bag 7076, Chiredzi |
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SAMU |
Samu
RHC |
Mrs
R.E. Mbiza |
Samu
RHC, P.O. Box 142, Chiredzi |
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Chishinya
P |
Mr
Chinondiwana |
Private
Bag 7083, Chiredzi |
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Samu
P |
Mr
Mhakeni |
Private
Bag 7080, Chiredzi |
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Mugivisa
P |
Mr
Mupa |
Private
Bag 7099, Chiredzi |
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DUMISA |
Dumisa
RHC |
Mrs
E. Mugova |
Dumisa
RHC, P.O. Box 142, Chiredzi |
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Dumisa
P |
Mr
Chauke |
Private
Bag 7081, Chiredzi |
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Addresses
Of The Chiefs & Headmen |
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Chief
Sengwe |
Pusani
School |
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Private
Bag 7056, Chiredzi |
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Headman
Ngwenieni |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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Headman
Samu |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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Headman
Gezani |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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Headmen
Mpapa |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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Headman
Chilonga |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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Headman
Masimavele |
Care
of the local administrator |
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P.O.Box
199, Chiredzi |
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FORTH
STEP: Contact with the RHCs and schools
At this
point, you know if an outreach program can be set up and is (or not) approved
by the local authorities. Further more, you will know exactly which of the
surrounding clinics could benefit from such a program. The next step will be to
make a visit to each of your listed RHCs and inquire about the necessity of
prophylaxis lessons at schools (inquiring has to be done by the directors of
the schools), about the necessity of dental treatments and at the same time,
you will find out if the motivation and the cooperation of those responsible
for the RHCs are sufficient support your program. For the first visit, the
following check-list has been established:
Questions
To Ask During Your First Visit Into An ORW Area
1.
Introduce yourself and your activities, introduce the hospital and the dental
department
2.
Ask for a meeting of about 30 minutes duration
3.
Introduce the Chikombedzi Mission Hospital Dental Department ORW program
4.
Explanation about your system of
-treatment
and referring
-prophylactic
lessons at schools and screenings
-information
for pregnant women
5.
Inform about your working hours: 8 am to 6 pm
6.Give
the program schedule of the week concerning the MDU and the school lessons
7.
Inform about the fee system and the importance of this financial support (trips
and materials)
8.
Following up after your departure, give document Indications for the
responsible of the RHC
9.
Give posters and ask for diffusion of the information, when are we coming
10.
What kind of medicines are available at the RHC?
11.
Ask practical questions:
-accommodation,
dental room, showers, toilets, ...?
-rooms
have to be locked, possibilities ?
-water:
Where is the borehole, river water, ...?
-electricity,
solar, ...?
QV,
SDI, 08.08.98
Chikombedzi Mission Hospital / Dental
Department
A. Capacities of the
dental team during outreach work with the mobile dental unit (MDU)
a)
Dental hygiene instruction to the patients e)
Extractions with local anesthesia
b)
Cleaning and scaling f)
Little surgery like abscess drainage or suture points
c)
Deep scaling with local anesthesia g)
Prophylactic lessons at schools (grade 1 to 7)
d)
Temporary and definitive fillings with local anesthesia h)
Screening of the children in all classes
B.
Capacities of the Dental Department at Chikombedzi
a)
All the treatments given by the MDU d)
Composites (esthetical fillings)
b)
Definitive root treatments for single root teeth e)
Oral surgery (jaw fracture, tooth luxation, abscesses)
c)
Dental X-Rays
C.
Kind of problems which can appear after a treatment at the MDU
EXTRACTING a tooth is like a small
operation. There will be bleeding and later on some pain and swelling. This is
normal and should
be
expected after an extraction. Inform the person about that fact. After
extraction(s), two main problems can appear:
One
day after the operation, the socket still bleeds. Explain to the patient that
he should not spit nor rinse his mouth. When he rests,
he
should keep his head up. He should not drink hot liquids like tea or coffee
because they encourage bleeding. The patient has then
first
to bite firmly on cotton gauze for an hour, and again later if blood still
comes out of the socket. Eventually, the nurse can do a
suture
point if that is possible. If the bleeding persists, refer the patient quickly
to Chikombedzi Mission Hospital Dental department
with
a compress on the socket. Notice that any bleeding can be stopped by direct
compression.
Rarely,
the development of a bone infection occurs (infected socket. The signs are pus,
pain and bad smell. Clean the socket
with
a Chlorhexidine syringe and give an antibiotic:
First
choice: amoxicilline
250mg caps adults 2cap
x 3/day during 7 days
children 25mg/kg
x 3/day during 5 days
Second
choice: co-trimoxazole
80+400mg adults 1cap
x 2/day during 7 days
children 8mg+40mg/kg/d.
during 5 days
or co-trimoxazole
20+100mg adults 4cap
x 2/day during 7 days
children 8+40mg/kg/day
during 5 days
Third
choice: erythromycine
250mg adults 2cap
x 3/day during 7 days
children 50mg/kg7day
during 5 days
It
is important to persist on the fact that an antibiotic has to be taken during
the prescribed duration, even if the pain and the
infection
have disappeared. If necessary, give also a painkiller.
It
is possible that a patient complains about sensitivity or pain after having
received a FILLING. Usually, the pain occurs
during
a few days only, the sensitivity can persist longer. Give some painkillers if
necessary, but if pain remains after 3 weeks,
refer
the patient to Chikombedzi Mission Hospital Dental Department.
After
a SCALING or a CLEANING, the patient may complain about sensitivities appearing
essentially during cold drinking
and
bleedings of the gums appearing during brushing of the teeth. Scaling or
cleaning of the teeth induces a microtraumatism
on
the gums. These lesions disappear after a few days if oral hygiene is correctly
maintained. Tell to the patient to go on with
tooth
cleaning 3 times a day, even if it hurts a little.
The
patients treated in outreach work by the MDU for a ROOT TREATMENT usually have received a
second and a third
appointment
for Chikombedzi Dental Clinic. Pain can occur during a few days after the first
intervention given by the MDU.
Give
a painkiller if necessary. Remind the patient that the next appointments are
100% necessary for a definitive treatment
and
for the conservation of the treated tooth.
QV, SDI, 22.07.98
FIFTH STEP: Definitive program
After your
first visit to possible sites, you will make a proposal to the hospital
management for a definitive program. This program takes into consideration the
collaboration of the responsible you have met at the bush clinics. In our case,
the provisional program became definitive.
SIXTH
STEP: Materials
Your project
is now beginning to take shape and you have the psychological support you need.
At this time you need to think about the materials you will use for the ORW. We
have made a list of all the materials needed. The mobile dental unit we have is
completely collapsible and can be loaded on a 4 wheel drive Toyota truck.
Check-list Of The ORW Equipment |
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SDI Code |
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SDI Code |
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Loading
Accessories |
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MDU File |
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1 |
Canvas Cover |
ZW |
1 |
|
17 |
Loading
Check-list |
|
1 |
2 |
Ropes |
ZW |
2 |
|
18 |
ORW Statistics |
|
1 |
3 |
Red & Blue
Rack (Wedge) |
QV |
2 |
|
19 |
Reduced Map
Of The Region |
|
1 |
4 |
White Board |
QV |
1 |
|
20 |
Check-list For
ORW File |
|
1 |
5 |
Little Water
Tank |
ZW |
1 |
|
21 |
Certified
Letter From Medical Superintendant |
|
1 |
|
|
|
|
|
22 |
ORW Program Of
The Year |
|
1 |
|
Repair
Materials |
|
|
|
23 |
Daily
Registration Patients MDU |
|
10 |
6 |
Spare Valve
Toyota |
ZW |
1 |
|
24 |
Agreement For
Administration Of Anesthetics |
|
15 |
7 |
Valve Key |
ZW |
1 |
|
25 |
Dental Clinic
Of Chikombedzi Receipts |
|
100 |
8 |
Bicycle Hand
Pump |
ZW |
1 |
|
26 |
Oral Health
Education Registration |
|
20 |
9 |
Spare Tube |
ZW |
1 |
|
27 |
Check-list
Forms & Medical-Aid Forms |
|
1/10 |
10 |
Tyre Levers |
ZW |
2 |
|
28 |
Services &
Rates |
|
2 |
11 |
Crick &
Handle Toyota |
ZW |
1 |
|
29 |
Memory-Aid For
Teachers |
|
20 |
12 |
Nut Spanner
Toyota |
ZW |
1 |
|
30 |
Indications For
Responsible Of The Clinics |
|
20 |
13 |
Spare Wheel
Toyota |
ZW |
1 |
|
31 |
Rate of ... |
|
2 |
14 |
Tube Patch |
ZW |
1 |
|
32 |
Use Of The
Dental Car |
|
2 |
15 |
Glue For Tubes
Repair |
ZW |
1 |
|
33 |
Costs Of ORW |
|
2 |
16 |
Craft Knife
(Cutter) |
ZW |
1 |
|
34 |
Monthly
Accounts |
|
2 |
|
|
|
|
|
35 |
Reports Of ORW
To The MSI |
|
|
|
|
|
|
|
36 |
Instruction For
Use Of Generator |
|
1 |
|
|
|
|
|
37 |
Evaluation Of
ORW |
|
2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Generator
Trunk Blue |
|
|
|
|
|
|
|
38 |
Robin Generator
RGD 3300 os (3000W, 24A) |
9700 |
1 |
|
|
|
|
|
39 |
Set Of Spare
Fuses |
9705 |
1* |
|
|
Compressor
Trunk Blue |
|
|
40 |
Set Of Various
Packing |
9708 |
1* |
|
45 |
DUERR
Compressor 5211 With Dryer |
9901 |
1 |
41 |
Air Filter
Robin |
9709 |
1* |
|
46 |
5 m Air Tube
With Connection |
9915 |
1 |
42 |
Oil Filter
Robin |
9710 |
1* |
|
47 |
DUERR
Compressor Filter |
6027 |
2* |
43 |
Gazoil Filter
Robin |
9711 |
1* |
|
48 |
DUERR
Desiccation Filter |
6027 a |
1* |
44 |
Starter With
Cable |
9706 a |
1* |
|
49 |
Pneumatic
Connection |
6029 |
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Little
Black Trunk |
|
|
|
|
|
|
|
50 |
Stuble Suction
Machine with Safety Bottle, Big Suction Bottle and End |
9906 |
1 |
|
|
|
|
|
51 |
Suction Tube |
9913 |
1 |
|
|
|
|
|
52 |
Plastic Glasses |
ZW |
5 |
|
|
|
|
|
53 |
Ink Bottle |
ZW |
1 |
|
|
|
|
|
54 |
Spare Philips
Lamp 35 Watts |
9904 a |
1 |
|
|
|
|
|
55 |
Philips Lamp
(chase) (see n 308 for Tripod) |
9904 |
1 |
|
|
|
|
|
56 |
ORW Money Box
With 20Z$ In Coins |
ZW |
1 |
|
|
|
|
|
57 |
Dental Study
Model "Nissin" |
9000 |
1 |
|
|
|
|
|
58 |
Enlarged
Toothbrush P3-TB |
9001 |
1 |
|
|
Middle
Black Trunk |
|
|
59 |
Mupani &
Mubhubhunu Green Branches |
Bush |
20 |
|
80 |
Gas Bottle |
ZW |
2 |
60 |
Tool Box With |
ZW |
1 |
|
81 |
Reserve Gas
Valve |
ZW |
1 |
61 |
* Starter Cable
Robin Generator |
9706 |
1 |
|
82 |
Domino Camping
Stove + Metal Cup |
9510 |
1 |
62 |
* Tap for
Supertank n 57027 |
9503 |
2 |
|
83 |
Sensitive Paper
Tape |
Hosp |
1 |
63 |
* Screw Spanner
10, 12-13, 14-17 |
9701/2 |
3 |
|
84 |
Steribags |
Hosp |
3 |
64 |
* Pliers |
4513 |
1 |
|
85 |
Paraffin Bottle |
Hosp |
1 |
65 |
* Sharp Pliers |
4512 |
1 |
|
86 |
Paraffin Lamp &
Funnel |
ZW |
1 |
66 |
* Big &
Little Screw Spanner |
4598/9 |
2 |
|
87 |
Pressure Pot,
Perforated Bottom, Save Valve, Lid |
9908 |
1 |
67 |
* Dish
Screwdriver Set |
4504 |
1 |
|
88 |
Candles &
Matches |
Hosp |
1 |
68 |
* Plastic Dams |
4507 |
2 |
|
89 |
Hatchet White
& Red |
ZW |
1 |
69 |
* Electrical
Screwdriver |
4515 |
1 |
|
90 |
Paraffin Cooker |
ZW |
1 |
70 |
* Teflon Tape |
4517 |
1 |
|
91 |
Migros Working
Gloves (Pair) |
CH/ZW |
1 |
71 |
* Flat Nose
Pliers |
4514 |
1 |
|
|
|
|
|
72 |
* Hose Clips |
4516 |
2 |
|
|
|
|
|
73 |
* Insulating
Tape + Scotch Tape |
Hosp |
2 |
|
|
|
|
|
74 |
*String (in
meters) |
Hosp |
15 |
|
|
|
|
|
75 |
Mirror Box With |
ZW |
1 |
|
|
Mecadent
Dentaport Suitcase M 101 |
9900 |
1 |
76 |
* Demo Looking
Glasses |
9004 |
8 |
|
92 |
Flexiflon Tube
& Pedal (6 x 4) |
9902 |
1 |
77 |
* Chalk Box for
Blackboard |
9006 |
1 |
|
93 |
Air Tube with
Midwest Connection (to n 46) |
9915 |
1 |
78 |
* Displak
Coloration Bottle |
9005 |
1 |
|
94 |
Air-Water
Pistol Faro With Tube |
9911 |
1 |
79 |
* Cotton Balls
For Displak Application |
3007 b |
10 |
|
95 |
Support for
Pistol And Contra-angles & Screw |
9911 a |
1 |
|
|
SDI Code |
n |
|
|
|
SDI Code |
n |
|
Big Black
Trunk n One |
|
|
|
|
Big Black
Trunk N Two |
|
|
96 |
Inox Steel
Kitchen Utensil |
9514 |
1 |
|
118 |
Silamat-Silver
Mix 90 Amalgamator |
9903 |
1 |
97 |
"Campina"
Service (knife, fork, b & s spoon) |
9513 |
2 |
|
119 |
Plate Drier
Small/Big Or Kitchen Linen |
9518 |
9 |
98 |
"Marco"
Plate Aluminium 18 cm |
9512 |
2 |
|
120 |
Red Basin For
Sekusept |
9515 |
1 |
99 |
Blue Basin With
Lid (Sadza) |
ZW |
1 |
|
121 |
Green Basin For
Vimbath |
9516 |
1 |
100 |
Orange Basin
With Lid (Vegetables, Soup, Meat) |
ZW |
1 |
|
123 |
"Marco"
Glass In Aluminium |
9511 |
2 |
101 |
Little Blue
Lunchbox (sugar, rice, spices) |
ZW |
3 |
|
124 |
Sekusept
Granulated Little |
3127 |
1 |
102 |
Bottle Of Oil
(Olivine) |
Hosp |
1 |
|
125 |
Orotol
Granulated (Tin) |
3005 |
1 |
103 |
Dish Soap
Bottle (Sunlight) |
Hosp |
1 |
|
126 |
Hypochlorite
Disinfection-Solution-Spray |
1016 |
1 |
104 |
Shower Soap (FA
Light) |
Hosp |
1 |
|
127 |
Styrolog 1
Drawer |
1014 g |
1 |
105 |
Toilet Paper
Rolls |
Hosp |
2 |
|
128 |
Svedia Tray
Cover 4030-00 |
2067 a |
7 |
106 |
Pillow |
Hosp |
2 |
|
129 |
Duett Ana 2000
Amalgam Caps Set |
3056 |
1 |
107 |
Big Cooking Pot |
ZW |
1 |
|
130 |
Decontamination
Bath Brown With Cover |
CH |
1 |
108 |
Little Cooking
Pot with Lid (=>pan) |
ZW |
1 |
|
131 |
Suction Tip
Brushes Small 5mm |
3132 |
10 |
109 |
Teapot With Lid |
ZW |
1 |
|
132 |
Suction Tip
Brushes Wide 10mm |
3131 |
10 |
110 |
Tea Plastic
Cups |
ZW |
2 |
|
133 |
Metal Brush For
Burrs |
3100 |
1 |
111 |
M'Goti
(Porridge Stick) |
ZW-Art |
1 |
|
134 |
Kitchen Brush
(see n 115) |
CH |
2 |
112 |
Swiss Knife |
CH |
1 |
|
135 |
Tray Brush |
3132 a |
1 |
113 |
Low Basin
Green-White |
ZW |
1 |
|
136 |
Basin For
Suction Tubes Disinfection (Orotol) |
3005 a |
1 |
114 |
Strainer
(Sieve) |
CH |
1 |
|
137 |
Scissors |
CH |
1 |
115 |
Kitchen Brush |
CH |
1 |
|
138 |
Vim (Cleaning
Powder) |
Hosp |
1 |
116 |
Kitchen Scourer |
ZW |
3 |
|
139 |
Soap (FA Light) |
Hosp |
2 |
|
|
|
|
|
140 |
Cream For Hands |
Hosp |
1 |
117 |
food-salt, tea
leaves, coffee, |
|
|
|
141 |
Roller Gauze |
Hosp |
1 |
|
tomatoes,
matemba (fishes from Kariba), |
|
|
|
142 |
Toilet Paper
Rolls |
Hosp |
2 |
|
powder milk,
bread, margarine, |
|
|
|
143 |
Washing Powder
(Surf) |
Hosp |
1 |
|
soups,
tunafish, sadza, |
|
|
|
144 |
Cleaning Cloth
Piece Green |
Hosp |
1 |
|
Pilchards
tomato sauce, rape, |
|
|
|
145 |
Pet Bottle 1.5
liters |
CH |
1 |
|
other
vegetables, rice, |
|
|
|
146 |
Amalgame Rests
Bottle (Recycling) |
Hosp |
1 |
|
sweet
potatoes... |
|
|
|
147 |
Bottle with
Talk Powder For Gloves Sterilization |
Hosp |
1 |
|
|
|
|
|
148 |
Sieve For Burrs
(same as n 114) |
CH |
1 |
|
|
|
|
|
149 |
Migros Torch |
CH |
2 |
|
|
|
|
|
150 |
Spare Bulb For
Migros Torch |
CH |
2 |
|
|
|
|
|
|
|
|
|
|
"Zarges"
Case for Instruments in Aluminium Number One |
9500 |
1 |
|
|
|
|
|
151 |
Styrolog 3
Drawers: |
1014 e |
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. Pharmacy
& Cotton Rolls |
|
|
|
|
3.Anesthesia |
|
|
152 |
Long Plastic
Subdivision |
1014 a |
4 |
|
185 |
Big Red Plastic
Subdivision |
1014 b |
1 |
153 |
Amoxicilline
(1gr caps) |
8003 |
40 |
|
186 |
Long Red
Plastic Subdivision |
1014 a |
1 |
154 |
Co-trimoxazole
(Bactrim 80mg + 400mg caps) |
Hosp |
40 |
|
187 |
Aspirating
Syringe Socorex PD 1.8ml |
2005 |
16 |
155 |
Panadol (500mg
caps) |
Hosp |
40 |
|
188 |
Needles
Septodont 27G |
3002 |
50 |
156 |
Micropur 20
liters (20x) |
9803 |
40 |
|
189 |
Anesthetic
Carpule Lidocaton 2% |
3001 |
50 |
157 |
Vaseline |
8005 |
1 |
|
|
|
|
|
158 |
Aureomycine
(Paste, 30gr Tube) |
8007 |
1 |
|
|
|
|
|
159 |
Dontisolon
(1.8ml Carpule) |
3106 |
4 |
|
|
|
|
|
160 |
Plastic Syringe |
2026 |
2 |
|
|
|
|
|
161 |
Canal Luer Bent
Tip for Syringe |
2075 |
3 |
|
|
|
|
|
162 |
Spray for
Vitality Test |
3007 a |
1 |
|
|
Styrolog 3
Drawers: |
1014 e |
1 |
163 |
Cotton Rolls n
2 |
3013 a |
100 |
|
|
|
|
|
164 |
Cotten Rolls n
3 |
3013 b |
50 |
|
|
4.Gloves |
|
|
|
|
|
|
|
190 |
Latex Gloves
Sterilizable (Pairs) |
3006 |
50 |
|
2. Burrs, Periodontics,
Prophylaxis |
|
|
|
191 |
Preservatives /
Kondoms |
Hosp |
100 |
165 |
Burlew Cups
PN-210320 with Mandrels Long |
7020/22 b |
6 |
|
|
|
|
|
166 |
Polishing Cups
Young WST |
7023 |
20 |
|
|
5. Masks
& Emergency Pharmacy |
|
|
167 |
Inverse Cone
Shaped Diamond Burr Intensiv FG 223/014 |
7001 |
8 |
|
192 |
Face Mask
Technol |
3008 |
30 |
168 |
Cone Shaped
Diamond Burr Intensiv FG D 16 |
7002 |
4 |
|
193 |
Micropur 20
liters (20x) same as n 156 |
9803 |
20 |
169 |
Round Diamond
Burr Intensiv FG 201 S |
7003 |
3 |
|
194 |
Aspirine (500mg
caps) |
8002 |
200 |
170 |
Flame Shaped
Diamond Burr Intensiv FG 205 L |
7004 |
2 |
|
195 |
Adrenaline 1ml
(dosis ampulla) |
Ch |
3 |
171 |
Round Diamond
Burr Intensiv FG 400 |
7005 |
3 |
|
196 |
Valium 2 ml
(dosis ampulla) |
CH |
3 |
172 |
Cone Shaped
Diamond Burr Intensiv FG D 6C |
7006 |
6 |
|
197 |
NaCl 0.9%
(dosis ampulla) |
CH |
6 |
173 |
Round Burr WST
REF 23/025 |
7010 |
11 |
|
198 |
Syringe 10ml
& Needle |
CH |
1/1 |
174 |
Round Burr WST
REF 23/018 |
7011 |
10 |
|
|
|
|
|
175 |
Round Burr WST
REF 23/029 |
7012 |
10 |
|
|
6.Forceps |
|
|
176 |
Round Burr WST
REF 23/023 |
7013 |
11 |
|
199 |
Big Plastic
Subdivision |
1014 b |
1 |
177 |
Zekrya FG REF
151 Short |
7030 |
5 |
|
200 |
Long Red
Plastic Subdivision |
1014 a |
2 |
178 |
Zekrya FG REF
151 28mm |
7031 |
5 |
|
201 |
Forceps For
Upper Incisors |
2031 |
1 |
179 |
Paired or
Modified Scaler RZI 11L |
2061 |
5 |
|
202 |
Forceps For
Upper Left Molar n M18 |
2032 |
3 |
180 |
Straight Sickle
Scaler ZI 11 |
2062 |
5 |
|
203 |
Forceps For
Upper Right Molar n M17 |
2033 |
3 |
181 |
Universal Paro
Currette ZI 15 |
2066 |
5 |
|
204 |
Forceps For
Upper Premolars |
2034 |
2 |
182 |
Long Red
Plastic Subdivision |
1014 a |
1 |
|
205 |
Forceps For
Lower Molars |
2038 |
6 |
183 |
Cutter Socle
U-72 FG |
2071 a |
1 |
|
206 |
Forceps For
Lower Premolars |
2039 |
2 |
184 |
Cutter Socle
U-72 WST |
2071 b |
1 |
|
207 |
Forceps For
Lower Incisors |
2040 |
1 |
|
|
SDI Code |
n |
|
|
|
SDI Code |
n |
|
"Zarges"
Case for Instruments in Aluminium Number Two |
9500 |
1 |
|
|
|
|
|
208 |
Styrolog 3
Drawers: |
1014 e |
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
7.
Elevators, Surgery |
|
|
|
248 |
Amalgame Carver
Deppeler SM 17 |
2049 |
5 |
209 |
Long Red
Plastic Subdivision |
1014 a |
4 |
|
249 |
Ball-Pointed
Probe 126 BR 127 |
2056 |
5 |
210 |
Elevator Bein
559/1 n00 |
2009 |
7 |
|
250 |
Excavator
Deppeler 17 EX 16 |
2051 |
5 |
211 |
Elevator bein
559/2 n 15 |
2010 |
7 |
|
251 |
Amalgame
Carrier 941 Hawe |
2048 |
5 |
212 |
Alveolar
Currette Deppeler AL 5 |
2022 |
5 |
|
252 |
Amalgame Probe
OP 43 |
2050 |
5 |
213 |
Remanium Wire
0.3mm Ligature (7m) |
3077 |
1 |
|
253 |
Luniacheck
Deppeler Spatula For Medications |
2083 |
2 |
214 |
Remanium Wire
0.8 mm Fixation |
5012 |
1 |
|
254 |
Red Occlusion
Paper Bausch |
3075 |
2 |
215 |
Scalpel
871A/3PD |
2025 |
1 |
|
255 |
Matrix For
Matrix Holder (Mol & Premol) |
3112-5 |
20 |
216 |
Surgical Blades
#15 |
3023 |
20 |
|
|
|
|
|
217 |
Suturing
Materials with Needles |
3023 a+b |
10 |
|
|
|
|
|
218 |
Langenbeck-Holder |
2027 |
1 |
|
256 |
Styrolog 3
Drawers: |
1014 e |
1 |
219 |
Raspatorium
#1804 |
2021 |
1 |
|
|
|
|
|
220 |
Gum Scissors PD |
2023 |
2 |
|
|
10. Annex's
to Mecadent Unit |
|
|
221 |
Luer-Forceps
Martin #1831/3 |
2076 |
1 |
|
257 |
Aluminium Box
21/10/3 With Sterile Gauzes |
1049 |
1 |
222 |
Mathieu Needle
Holder #1160/17 |
2018 |
1 |
|
258 |
Handpiece MM 47
IS |
1026 |
1 |
223 |
Hemostat
#1894/12.5 |
2015 |
1 |
|
259 |
Cotton Balls In
Little Bottle (evt same as n 79) |
CH |
1 |
224 |
Pliers Pointed
#1301 |
2042 |
1 |
|
260 |
Green
Contraangle 10 ISN n 92 04 026 |
1027 |
1 |
|
|
|
|
|
261 |
Red Contraangle
ISO 150 IS n 92 01 020 |
1028 |
1 |
225 |
8.Cements,
Endodontics |
|
|
|
262 |
Star Titan-S
4-Line |
9910 |
1 |
226 |
Long Red
Plastic Subdivision |
1014 a |
2 |
|
263 |
Titan Key For
Tips, Plastic O-rings |
9910 b |
1/1 |
227 |
Small Red
Plastic Subdivision |
1014 d |
1 |
|
264 |
Universal Tip
For Titan-S |
9910 a |
3 |
228 |
Dropsine Liquid
and Powder 15ml / 45gr |
3067 a+b |
1/1 |
|
265 |
Micromotor Air
MM 38 A Midwest 4 |
1030 |
1 |
229 |
IRM Liquid And
Powder |
3096 |
1 |
|
266 |
Lubricating Oil
For handpiece MM 30 CC |
3098 |
1 |
230 |
Endomethazone
Liquid and Powder 10ml / 14 gr |
3033 |
1/1 |
|
267 |
Lubricating Oil
For Handpiece mm 1 liter |
3098 a |
1 |
231 |
Plac Out 50 ml
#454 |
8011 |
1 |
|
|
|
|
|
232 |
Cement Paper
Plate |
2052 a |
1 |
|
|
11. Suctions |
|
|
233 |
Cement Spatula
PD n 80 |
2055 |
5 |
|
268 |
Long Red
Plastic Subdivision |
1014 a |
1 |
234 |
Tray For
Root-Canal Intruments & Contenance |
2041 |
1 |
|
269 |
Middle Red
Plastic Subdivision |
1014 c |
1 |
235 |
Chlumsky
Solution (Chlor-Camphre-Phenol) |
3017 |
1 |
|
270 |
Small Red
Plastic Subdivision |
1014 d |
1 |
236 |
Rubber Elastic
Tube to Drain Abscess Small |
3020 |
1 |
|
271 |
Metallic
Suction Tip "A" PD |
2002 |
20 |
237 |
Rubber Elastic
Tube to Drain Abscess Wide |
3021 |
1 |
|
272 |
Metallic
Surgilac Suction Tip Duerr |
2003 |
20 |
238 |
Asphaline-A2
Paste Tube 7.5 gr |
3028 |
2 |
|
273 |
Prophypaste Cup
Hawe #985 |
3093 |
10 |
239 |
Ledermix Dental
Paste Tube 5 gr |
3027 |
1 |
|
274 |
Needles
Septodont 27G reserve |
3002 |
100 |
240 |
Paper Points
Assorted |
3031 d |
1 |
|
275 |
Anesthetic
Carpule Lidocaton 2% reserve |
3001 |
50 |
241 |
Amalgam Resimix
Little Pot |
2047 |
3 |
|
276 |
Prophypaste 50
gr |
3094 |
1 |
|
|
|
|
|
|
|
|
|
|
9.
Instruments & Amalgame |
|
|
|
|
12. Mirrors,
Probes, Tweezers |
|
|
242 |
Long Red
Plastic Subdivision |
1014 a |
4 |
|
277 |
Big Red Plastic
Subdivision |
1014 b |
1 |
243 |
Iodoform Gauze |
8010 |
1 |
|
278 |
Long Red
Plastic Subdivision |
1014 a |
2 |
244 |
Dentatus
Toffelmair Matrix Holder |
2053 |
1 |
|
279 |
Instrument
Holder Duerr |
3128 |
2 |
245 |
Steel Matrix
Holder PD #1 |
3111 |
1 |
|
280 |
Cotton Roll Pliers
VR 1410 (Tweezer) |
2060 |
20 |
246 |
Interdental
Wooden Wedges #829/20 |
3064 |
100 |
|
281 |
Handle Mirror
Adaco & Mirror Adaco |
2065/68 |
40 |
247 |
Filling Spatula
Deppeler ZI 62C |
2058 |
5 |
|
282 |
Explorer
Maillefer n 6 (Probe) |
2064 |
20 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Divers
Annex's |
|
|
|
|
|
|
|
283 |
AOI / Colgate
Poster |
9003 |
1 |
|
296 |
Gazoil Tank
With Diesel For Generator 20 liters |
9506 |
1 |
284 |
Poster Information
Dental Department |
ZW |
3 |
|
297 |
Funnel For
Gazoil Tank |
9506 a |
1 |
285 |
AIDS
Instruction Poster |
CH |
1 |
|
298 |
Water Tank
"Super" 20 liters n 57026 |
9502 |
2 |
286 |
Magic Table n
44020 |
9501 |
2 |
|
299 |
Aluminium Folding
Chair n 43016 |
9504 |
2 |
287 |
Plastic Bucket
Blue |
ZW |
1 |
|
300 |
Standard
Camping Couch |
9509 |
1 |
288 |
Container With
Paraffin |
ZW |
1 |
|
301 |
Hospital
Collapsible Beds |
Hosp |
2 |
289 |
Plastic Bucket
For Gloves Purple |
ZW |
1 |
|
302 |
Blankets,
Sheets, Pillowcases |
Hosp |
2 |
290 |
Plastic Bucket
For Used Water Green |
9917 |
1 |
|
303 |
Personal
Luggage |
ZW |
|
291 |
Multiple Jack
220V |
9914 |
1 |
|
304 |
Katadyn KFT
Filter (Pump) |
9802 |
1 |
292 |
Electrical
Extension Cable 10m / 220V |
9703 a |
2 |
|
305 |
Katadyn Filter
LP-K7 (spare) |
1047 a |
1* |
293 |
Bur'n'Bin For
Contaminated Sharps Yellow |
ZW |
1 |
|
306 |
Aseptico Dental
Chair (for Patient) |
9800 |
1 |
294 |
Oil Container For
Generator Yellow / Black |
ZW |
1 |
|
307 |
Aseptico Dental
Stool (for Operators) |
9801 |
2 |
295 |
Robin Oil Gauge |
9703 |
1 |
|
308 |
Philips Lamp
Tripod (see n 55) |
9904 |
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
* |
materials which
stay at the clinic (stock) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
QV, SDI, 22.07.98 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loading Check-list For
The Dental Car
Materials
on the rear axle:
1. Wooden
Rack Blue (Wedge)
2. Oil
Container
3. Water
Pump Katadyn
4. First
Big Black Trunk
5.
Little
Wooden Rack Red (Wedge)
6. Second
Big Black Trunk
7. Middle
Black Trunk (lock against n 6.)
8. Little
Black Trunk (lock against n 6.)
9. Mecadent
Dentaport Suitcase
10. First
Aseptico Dental Stool
11. Rain
Water Tank (without the tap)
12. Normal
Water Tank (without the tap)
13. Magic
Tables 2x (surface against surface)
14. Generator
Box Blue
15. Compressor
Box Blue
16. Zarges
Cases (one on top of the other)
17. Second
Aseptico Dental Stool
18. Posters
& 2 Folding Chairs
19. Aseptico
Dental Chair
20. First
Hospital Collapsible Bed
21. Gazoil
Tank with Diesel
22. Funnel
for Diesel Tank
23. Robin
Oil Gauge
24. Philips
Lamp Tripod
25. Standard
Camping Couch
26. Second
Hospital Collapsible Bed
Materials on the front seat:
27. ORW
File
28. First
Bucket with 2 Extensions
Cables
and 1 Multiple Jack
29. Second
Bucket with 1 Bucket and
1
Burnbin
30. Personal
Luggage
31. 2
Blankets, 2 Sheets, 2 Pillowcases
32. Fresh
Food
33. Little
Drinking Water Tank
Accessible materials in case of a car breakdown:
34. All
tools necessary for a wheel change
35. All
tools necessary for a tube puncture
repair
or a valve defect
36. Water
for the radiator
37. Something
to read
38. Drivers
license and eventually your sunglasses
SEVENTH
STEP: Organization
It is a very
interesting experience to go out into the bush and do dental health work, but
do not forget that everything has to be well organized and so you will need to
have a special file containing all the important papers. Our ORW file in
Chikombedzi is structured the following way:
description
in
1. Outreach Work
Program For The Year 2nd & 5th step
2.
Important Addresses And School Addresses 3rd step
3.
Questions To Ask During Your First Visit Into An ORW Area 4th step
4.
Indications For The Responsible Of The RHCs 4th step
5.
Check-list For The ORW Equipment 6th step
6.
Loading Check-list 6th step
7.
Memory-Aid For Teachers 8th step
8.
Oral Health Education Registration 8th step
9.
Daily Registration Of Patients In ORW 8th step
10.
ORW Statistics (Prophylaxis And MDU) 8th step
11.
ORW Evaluations 8th step
12.
Receipts For Cash Income 8th step
13.
Check-list For MDU Equipment 9th step
14.
Checklist For The ORW File 9th step
15.
ORW Report To The Medical Superintendant 9th step
16.
Information Letter For The RHCs And For The Teachers 9th step
17.
Letter From The Medical Superintendant
Certifying The Dental Activities 10th step
18.
Medical-Aid Forms And Its Check-list 10th step
19.
Services And Rates 11th step
20.
Monthly Accounts 12th step
EIGHT
STEP: Going out into the bush
Once the
mobile dental unit has arrived on location, the car is unloaded and the mobile dental
unit is set up in the allocated room. A test should be made to see if
everything is in working order and posters can be hung on the walls of the RHC.
The next duty will be to contact the directors of the surrounding schools and
to make appointments for the oral health education courses. If possible, the
lessons will be given the same day in the afternoon, so then the children
return home and inform their parents of your stay. These lessons are structured
after those presented on document 7, the Memory-Aid For Teachers. This
memory-aid can be used for further lessons given by the teachers themselves
after your departure. Normally, during your first visit, a basic oral health
education instruction is done. In the first theoretical part, you focus onto
the importance of the mouth and its structures. A detailed description of the
teeth and its brushing follows. In a second more practical part, the meaning of
dental plaque is demonstrated with the disclosing solution. The children will
then have to make their own wooden toothbrush and clean their teeth the way it
has been instructed. At last, a little test can be done by the teachers. Six
months later, during your second stay, the children come to the lesson with
their own sticks. An oral health education review is done and finally, everyone
is checked on his manner (technique) to brush his teeth.
After the
lessons, we usually have the opportunity to screen all the classrooms which
have benefited from oral health education and the children presenting calculus
(tartar) or dental caries are requested to come for treatment at the (mobile
dental unit) MDU.
Should there
be extra time remaining, a short lesson on AIDS prevention may be added.
Dental Department
Chikombedzi Mission Hospital
Lesson One
(grades 1 to 7)
5. Introduction and information about the Dental
Department at Chikombedzi Mission Hospital and the outreach
work program with the mobile dental
unit (MDU). Next dates of our visits.
5. The face: Importance of the eyes,
the ears, the hair, the nose, the mouth and the teeth
5. The mouth: Importance of...
Teeth:
cutting (front teeth), chewing (back teeth), mixing (all teeth)
Tongue:
talking, tasting, whistling
Gums:
keep the teeth strong
Salivary
glands: production of saliva
Saliva:
swallowing, mixing, digesting products
How
to protect the teeth?
15. Harmful
food 15. Brushing of
the teeth
Be
aware of the danger of sugar Kind
of wood to use (lesson 3)
Make
a toothbrush (annex)
How
to brush (annex)
5 Consequences:
CARIES
induces pain
TARTAR
induces pain
5. Discussion with the teacher,
questions and answers
Total
time: 55 minutes
Lesson Two
(to add to Lesson One, only for grades 4 to 7)
kind
of teeth number anatomy roots
1.
Incisors 8 in
front 1
2.
Canines 4 in
front 1
3.
Premolars 8 at
the back 1(2)
4.
Molars
12 at
the back 2
+ 3
Notice
that:
.
the front teeth cut the food into pieces
.
the back teeth chew and grind the pieces of food
Milk
teeth are important because:
. the baby (or milk) teeth are
adapted for a little mouth
.
the baby teeth keep the place for the permanent teeth
20. Discovering of a tooth, its
tissues and diseases
ENAMEL No
tooth-brushing but sugar -> little
DENTINE CROWN caries
-> big caries -> nerve dies ->
GUM
abscess
->pus & pain -> removal
of the
tooth
PULP
(nerves
& vessels ) No
tooth-brushing -> bacteria's stay
ROOT against
the gums -> plaque -> tartar ->
CEMENT inflammation
of the gums -> pain ->
BONE scaling
of tartar or removal of tooth
Treatments
for caries: If little caries -> filling. If big caries -> removal of the
tooth, tooth lost.
Treatment
of tartar: Scaling / cleaning. If severe, the tooth has to be removed.
Notice: While youre teaching this chapter with
the help of a drawing on the black board, modify the
healthy situation into an ill situation.
10. Discussion with the class, questions
and answers
Total
time: 55 minutes
Lesson
Three (grades 4 to 7 or second lesson for grades 1 to 3)
This lesson is to learn how to
produce a wooden toothbrush. First youll have to teach the kind of trees from
which
the wood can be used. Mupani, Mubhubhunu, Muhlangula, Samani trees (names in Shona) or
other harmless trees
can be indicated for this purpose.
Teach the way of how to produce a toothbrush, youll find indications in the
annex part. The following day, each
pupil comes with his own toothbrush. One pupil is then selected, comes in
front of the class and does a
demonstration of tooth brushing. Then form groups of two pupils and they will
have
to control each other. The teacher
controls the brushing technique. The teacher can give some more explanations
and repeats the frequency of brushing
required: 3 TIMES A DAY!
Test (only
for grades 4 to 7)
1.
How many teeth do we have in a 25 years old person's mouth? 3
points
2.
What kind of teeth do we have in our mouths? 4
points
3.
Do a good drawing of a tooth and put the following name:
Enamel, Dentine, Bone, Pulp, Gum,
Root, Crown, Cement 8
points
4.
Which are the two great diseases of the teeth? 2
points
5.
Give two possibilities to prevent these diseases. 2
points
6.
Give two names of trees with advisable wood to produce a toothbrush. 2 points
7.
Give the name of two harmless and two harmful foods 4
points
Scale: 23 - 25 points A (92% )
19
- 22 points B (76% )
15
- 18 points C (60%) Total
25 points possible.
10
- 14 points D (40%)
5 - 9 points E (20 %)
0 - 4 points F (16%)
1.
KWESHA, BVISA, IMWA MVURA, CHUKUCHA, PFIRA
Repeat
movements and words together
2. Mativi
mana ose enyika (2
times)
Uyai
muone vemazino
Mazino
akanaka akachena outano (4 times)
Technique
of brushing the teeth
NORMAL WOODEN
TOOTH
BRUSH TOOTH
BRUSH
-Brush
upper and lower teeth separately, open your
mouth
as wide as possible.
-Areas
to brush: external, internal, occlusal (upper)
sides
of the teeth.
-Always
brush from the gums to the teeth, never the
horizontal
way ! Brush from the red part to the white part.
-For
the front teeth put your brush the vertical way, see
following
picture :
-For the occlusal side of the premolars
and molars,
brush
the horizontal way.
DO
NOT FORGET TO BRUSH YOUR TEETH
THREE TIMES A DAY. AFTER BREAKFAST;
AFTER
LUNCH AND AFTER DINNER.
Use a small approximately 20 cm long branch. Cut a piece that is still green and soft.
Chew one end or use a small knife to make it stringy like a brush. Sharpen the other end so it can
clean between the teeth like a toothpick.
All classes
which have benefited from your oral health education should be noted down.
Important are the number of the instructions which have been given, the number of
school children taught and the number of school children screened as positive
(detection of a problem: caries or calculus). See document 8 : Oral Health
Education Registration. The teachers will sign this document to testify the
lessons.
All patients
who come to the MDU during the whole outreach work week will be listed on the
document 9 , the Daily Registration Of Patients And Treatments.
These
documents are very important for administrative reasons. If later on you have
once to prove your activities, you will be happy to have recorded these
details. Often, these results are necessary for the feedback reports to your
sponsor.
Document 10,
the ORW Statistics (Prophylaxis & MDU) will resume all the activities
during a certain time period. Document 11, ORW Evaluations will give you a subjective synopsis of
the collaboration at the different visited places. Therefore, the dental staff
collaborators locally evaluate how they found the different aspects of their
stay concerning the clinic, the schools and the population. This form will be
of advantage when redesigning your program after excluding those sites where
cooperation was not optimal.
Oral
Health Education Registration (doc 8) |
Dental Clinic Of Chikombedzi |
||||||||
|
|
|
|
|
|
|
|
|
|
RHC |
date |
distance from base (km) |
school |
classes |
number of children |
lesson |
screened tot |
screened positive |
Signature |
Muhlanguleni |
15.07.96 |
25 |
Muhlanguleni P |
12 |
600 |
6 |
567 |
265 |
|
Muhlanguleni |
15.07.96 |
25 |
Muhlanguleni S |
8 |
285 |
2 |
240 |
122 |
|
Muhlanguleni |
16.07.96 |
25 |
Machindu P |
3 |
110 |
3 |
109 |
39 |
|
Old Boli |
29.07.96 |
37 |
Boli P |
2 |
60 |
1 |
59 |
10 |
|
Old Boli |
29.07.96 |
37 |
Malisanga P |
4 |
124 |
2 |
122 |
24 |
|
Old Boli |
29.07.96 |
37 |
Majijimba P |
3 |
145 |
1 |
145 |
27 |
|
Makambe |
16.09.96 |
37 |
Makambe P |
... |
... |
... |
|
|
|
... |
... |
... |
... |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
|
32 |
1324 |
15 |
1242 |
487 |
|
Daily
Registration Of The Patients And Treatments (doc 9) |
|
Dental Clinic Of Chikombedzi |
||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Nr |
Day |
Name |
Surname |
Sex |
Age |
Prof |
Village |
km |
Tooth |
Anes |
Clea |
Extr |
Surg |
Endo |
Amg |
Comp |
Exa |
Medi |
Income |
Remarks |
1 |
18.07 |
Gumbo |
Nelson |
m |
25 |
driver |
Malipati |
0 |
36 |
1 |
1 |
1 |
|
|
|
|
|
|
5 |
|
2 |
18.07 |
Mbiza |
Helena |
f |
12 |
school |
Thilo |
10 |
|
|
1 |
|
|
|
|
|
1 |
|
2 |
|
3 |
18.07 |
Chauke |
Lukas |
m |
47 |
director |
Vhusani |
18 |
21 |
1 |
|
|
|
|
|
2 |
|
|
25 |
|
4 |
18.07 |
Mukungulushi |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
... |
|
5 |
... |
... |
... |
... |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
6 |
... |
... |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
... |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5 |
|
Total |
|
|
|
|
|
28 |
57 |
2 |
2 |
1 |
0 |
0 |
0 |
2 |
1 |
0 |
32 |
|
Outreach
Work Statistics Prophylaxis (doc 10) |
Dental Clinic Of Chikombedzi |
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|||
Place |
Dates |
distances in km |
number of children teached |
number of lessons |
number of screened children |
||||||||
|
|
|
|
|
|
||||||||
Malipati |
22.04 - 26.04.96 |
100 |
|
|
|
||||||||
Rutandare |
06.05 - 10.05.96 |
116 |
|
|
|
||||||||
Gezani |
20.05 - 24..05.96 |
152 |
|
|
|
||||||||
Samu |
03.06 - 07.06.96 |
154 |
|
|
|
||||||||
Dumisa |
17.06 - 21.06.96 |
140 |
|
|
|
||||||||
Davata |
01.07 - 05.07.96 |
163 |
... |
... |
... |
||||||||
Muhlanguleni |
15.07 - 19.07.96 |
50 |
995 |
11 |
916 |
||||||||
Old Boli |
29.07 - 02.08.96 |
74 |
329 |
4 |
326 |
||||||||
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|||
Total |
|
949 |
1324 |
15 |
1242 |
||||||||
Outreach
Work Statistics MDU (doc 10 bis) |
Dental Clinic Of Chikombedzi |
|||||||||
|
|
|
|
|
|
|
|
|
|
|
Place |
Dates |
Nb Pat |
Nb Chd |
Anes |
Clea |
Extr |
Surg |
Endo |
Amg |
Income |
|
|
|
|
|
|
|
|
|
|
|
Malipati |
22.04 - 26.04.96 |
54 |
7 |
27 |
49 |
31 |
2 |
1 |
2 |
148 |
Rutandare |
06.05 - 10.05.96 |
46 |
2 |
13 |
41 |
16 |
|
|
|
214 |
Gezani |
20.05 - 24..05.96 |
64 |
3 |
25 |
61 |
26 |
|
|
|
386 |
Samu |
03.06 - 07.06.96 |
21 |
0 |
15 |
17 |
9 |
|
3 |
|
202 |
Dumisa |
17.06 - 21.06.96 |
48 |
4 |
12 |
45 |
12 |
|
|
|
260 |
Davata |
01.07 - 05.07.96 |
42 |
2 |
13 |
38 |
14 |
3 |
|
2 |
202 |
Muhlanguleni |
15.07 - 19.07.96 |
35 |
6 |
26 |
31 |
26 |
|
|
1 |
101 |
Old Boli |
29.07 - 02.08.96 |
52 |
5 |
15 |
47 |
17 |
|
1 |
1 |
95 |
|
|
|
|
|
|
|
|
|
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|
Total |
|
362 |
29 |
146 |
329 |
151 |
5 |
5 |
6 |
1608 |
Evaluation
Of The ORW System (doc11) |
Dental Clinic Of Chikombedzi |
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Place |
Clinic (RHC) |
Schools |
Pop |
|
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|
rooms accommodation |
facilities, shower,
toilets |
cooperation staff |
diffusion information |
teacher cooperation |
childre's cooperation |
diffusion infermation |
attendance |
financial cooperation |
Schools attended |
Malipati |
3 |
3 |
2 |
3 |
3 |
3 |
3 |
2 |
4 |
Malipati
P & S |
Rutandare |
1 |
1 |
1 |
2 |
1 |
1 |
2 |
2 |
3 |
Maose,
Rutandare |
Gezani |
5 |
4 |
5 |
4 |
4 |
4 |
2 |
2 |
1 |
Gezani,
Bondela, Chilungwe, Makhanani |
Samu |
2 |
1 |
1 |
2 |
4 |
3 |
2 |
4 |
5 |
Samu,
Mugivisa, Chishinya |
Dumisa |
1 |
1 |
1 |
2 |
2 |
2 |
2 |
3 |
3 |
Dumisa,
Ngwenyeni |
Davata |
1 |
4 |
1 |
1 |
2 |
1 |
2 |
2 |
3 |
Davata,
Pusani, Gwaivhi |
Muhlanguleni |
1 |
5 |
5 |
5 |
1 |
1 |
3 |
5 |
5 |
Muhlanguleni
P & S |
Old Boli |
4 |
3 |
2 |
4 |
1 |
2 |
3 |
4 |
5 |
Old
Boli, Tichidya |
Makambe |
1 |
1 |
1 |
3 |
1 |
1 |
3 |
3 |
5 |
|
Chibwedziva |
2 |
4 |
1 |
3 |
1 |
1 |
2 |
3 |
3 |
|
Chilonga |
2 |
3 |
1 |
1 |
1 |
1 |
2 |
1 |
3 |
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1= |
very
good |
2= |
good |
3= |
average |
4= |
bad |
5= |
very
bad |
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SDI, QV, 09.99 |
NINTH
STEP: Coming back to the base
Once the MDU
is back at the base on Friday evening, the materials are unloaded and parked in
the dental clinic. The next week, the program will be as follows (doc 13):
Check-list
For MDU Equipment (doc13)
Monday: -Make
a new requisition for the dental car for the next ORW
-Prepare
a batch of wooden toothbrushes
-Blankets,
sheets, towels and steribags are brought to the laundry
-All
dental instruments are sterilized
-Gloves
are washed, dried, powdered and sterilized
-The
tanks for Diesel, Gas, Distilled water and Oil are refilled
-The
stock of medicines (painkillers and antibiotics) is completed by the pharmacy
-The
stock for chalks, candles and Chlorhexidine are checked and completed
-Go
through the ORW file check-list (document 14.)
Wednesday: -Blankets, sheets,
towels and steribags are collected at the laundry
-Check
the reserve of: -Hygienic
(toilet) paper
-Liquid
soap
-Hand
soap
-Matches
-Vim
-Hand
Crme
Friday: -Check
the reserve of: -Roller
gauze & Face masks
-Collects
the sterilized gloves
-Collect
one part of the food: Sadza, Matemba, Cooking oil, rice, salt, ea leaves,
soups, sugar
Monday: -Just
before departure, get a kg of meat at the kitchen
-Just
before departure get the ORW money from the senior clerk at the workshop
-Load
the MDU equipment on the dental car
-Passing
through the township, buy some bread and vegetables
QV,
SDI, 17.07.96
On Monday
after coming back, the head of the dental department will have to go through
the ORW file check-list as mentioned next (document 14):
Check-list
For The ORW File (doc 14)
1.Fill
out the Daily registration of patients and treatments correctly and note the
totals. Check
the
amount of the money which has come in. Report the totals on the daily
registration of the
clinic
as well as on the ORW Statistics form (document 10).
2.
Check the Oral Health Education Registration, make the totals and report the
numbers
on
the ORW Statistics form (document 10)
3.Check
the complete number of blank papers and forms:
-Daily
registration of patients and treatments
-Receipts
for patients with stamp at the back
-Medical-Aid
Forms
-Photocopies
of the Memory-Aid For The Teachers
-Photocopies
of the Indications For The Responsible Of The RHCs
-Photocopies
of the Programme Of The ORW Of The Year
4.
Bring the filled out and signed Medical-Aid Forms to the hospital
administration
5.
Control the rates of compressor/generator and evaluate the working hours so
that services
can
be done punctually. Check the filled out Services & Rates form, document
19.
6.
Control and fill out correctly the Use Of The Dental Car form with the number
of kilometres.
7.
Control and fill out the Costs Of ORW form.
8.
Write a report of the last ORW week and transmit it to the Medical
Superintendant of the
hospital.
Send a copy to the administration of the hospital management.
9.
Write the letters to the headmasters for informing about your coming the week after,
document 16.
10.
Check and fill out the ORW Evaluation, document 11.
11.
Proceed to the supervision of the Check-list For MDU Equipment
QV,
SDI, 12.06.96
To point 3:
For the treatments administrated at the MDU, youll have to make receipts to
all patients who pay for their treatment. This receipt can look like:
Dental
clinic of
Chikombedzi
Mission Hospital
Name:____________________
First
name:_________________ The
stamp of the dental department
Place:_____________________ is
affixed at the back.
8
7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
8
7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
....consultation=..............(price)
....treatments=................(price)
total=..................(price)
date:............signature:...............
To point 6.
and 7.: In the case of Chikombedzi, we have documents for the ORW car trips and
the control of the costs for ORW. We will not make detailed mention of these
two forms, as they directly concern the Chikombedzi ORW system. However, think
about this type of control for your program and set up such documents should
you see it necessary for your own system.
To point 8.
The report to the Medical Superintendant of the hospital and the administration
is important to keep optimal collaboration between the two parties. Here, you
will have to mention the dates of ORW, the number of children instructed, the
number of patients treated and of course the weekly income.
To point 9.
Very important for good cooperation upon your arrival at the site is the
reconfirmation of your upcoming visit by the staff at the RHC and the directors
of the various schools taking
part. It is important to send letters in advance, so the local people can
organize themselves in the time period you will stay at a certain place.
TENTH
STEP: Adapt your system in function of the local needs
In the case
of Chikombedzi, two points should be explained now. These points refer only to
Chikombedzi and the local Zimbabwe system.
Document 17:
Letter From The Medical Superintendant Certifying The Dental Activities. This
document should be written and annexed to the ORW file in case the Ministry of
Health of Zimbabwe should ask for certification of the ORW program. It mentions
that the Medical Superintendant of Chikombedzi Mission Hospital is aware of the
dental activities of the MDU and the staff located in the outreach sites. It
mentions also the support of the hospital management concerning these
activities.
Document
18.: Medical-Aid Forms And Its Check-list. All people of Zimbabwe who are
employed by the government (police, military, aso.) have access to a government
subvention for medical treatment. These patients usually carry with them a card
which permits them to be medically treated without paying anything. The
Medical-Aid forms are filled out after medical treatment and signed by the
patient. These forms are then sent to the government which pays their
treatment.
ELEVENTH
STEP: Importance of the maintenance of the materials
Document 19
: Services And Rates. This form must be filled out in exact details so as to
provide a breakdown of the most important objects of your ORW materials.
Services
And Rates (for generator & compressor) (doc19) |
Dental Clinic Of Chikombedzi |
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place |
date arrival |
number hours |
date departure |
number hours |
difference |
total |
services |
remarks |
Malipati |
22.04.96 |
15742 |
25.04.96 |
15770 |
28 |
29 |
|
|
Rutandare |
06.05.96 |
15770 |
10.05.96 |
15792 |
22 |
51 |
|
|
Gezani |
20.05.96 |
15792 |
24.05.96 |
15821 |
29 |
80 |
|
cleaning |
Samu |
03.06.96 |
15821 |
07.06.96 |
15842 |
21 |
101 |
|
|
Dumisa |
17.06.96 |
15842 |
21.06.96 |
15852 |
10 |
111 |
ch .oil filter |
|
Davata |
01.07.96 |
... |
... |
... |
... |
... |
... |
... |
Muhlangul. |
... |
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It
is important to notice if the service has been done on the compressor or the
generator |
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Services
for the generator have to be done as mentioned in the instructions |
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(->Change
of oil filter, change of the plugs, change of air filter, aso.) |
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TWELFTH
STEP: Evaluation of the costs of your outreach work program
The most
important point for you will finally be to evaluate the costs of your outreach program.
Different points will have to be considered. Lets start with the major
concern, the cost of the dental car:
Fuel: Diesel
consummation is about 1 litre/ 7km and the actual
price
(summer 96) is Z$ 3.03.-/ litre. Making a provision for the
next 6 month
period, lets fix the price at Z$ 3.5.-/ liter 0.5.-Z$/km
Service
costs: Every 5000 km, a little or a big service has to be
done. Costs
for a little service is almost Z$ 250.-, for the big service,
youll have to
think about paying Z$ 1500.-. If the car drives
18500
km/year at Z$ 4000.- service costs an year, the rate will be 0.22.-Z$/km
Reparation:
Well evaluate the total reparation costs at
almost
Z$10000.- / year, for 18500 km, the rate is 0.54.-Z$/km
The costs of
a new 4x4 wheel drive will be Z$ 360000.-.
It should
last for a period of 10 years, driving almost
20000 km /
year. The rate /km for car amortization is 1.8.-Z$/km
Total 3.06.-Z$/km
Calculating
all distances to be driven for the whole outreach work program, 19 visits are
expected, for a total of 2337 km an year. This makes almost 7200.-Z$
an year for transportation only (change in 1996 CHF 1=Z$ 7.7, so equivalent to
CHF 935.-).
For all
other costs, you will have to elaborate a Monthly Accounts form, document
20.
|
Monthly
Accounts (doc20) |
Dental Clinic Of Chikombedzi |
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local currency: Zimbadollar (Z$) |
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Year:
1996 / Month : March |
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Exchange
rate / SF: 7.7 / SF |
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Income |
|
Expenses |
|
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|
Cash |
|
80 |
80 |
|
SDI
materials |
15387 |
S |
|
|
Credit |
|
|
|
|
ZW
materials |
|
D |
|
|
|
private
patient |
0 |
|
|
other |
|
I |
|
|
|
CSP |
405 |
|
|
|
|
|
|
|
|
ZRP |
20 |
|
|
salaries |
2633 |
H |
|
|
|
other |
|
|
|
materials |
1031 |
O |
|
|
|
Total |
425 |
425 |
|
medicines |
45 |
S |
|
|
Allowances
hospital |
|
|
|
|
ORW |
160 |
P |
|
|
|
salaries |
2633 |
|
|
buildings |
420 |
I |
|
|
|
materials |
1031 |
|
|
administration |
170 |
T |
|
|
|
medicines |
45 |
|
|
taxes |
|
A |
|
|
|
ORW |
160 |
|
|
maintenance |
|
L |
|
|
|
buildings |
420 |
|
|
other |
|
|
|
|
|
administration |
170 |
|
|
|
|
|
|
|
|
taxes |
|
|
|
|
|
|
|
|
|
maintenance |
|
|
|
|
|
|
|
|
|
other |
|
|
|
|
|
|
|
|
|
Total |
4458 |
4458 |
|
|
|
|
|
|
Total
income |
|
|
4964 |
|
Total
expenses |
19846 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total income |
4964 |
|
|
|
|
|
|
|
|
Total expenses |
19846 |
|
|
|
|
|
|
|
|
Profit/Loss month |
-14882 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance previous month |
-9564 |
|
|
|
|
|
|
|
|
Profit/Loss for the month |
-14882 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net balance |
-24446 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
The starting
costs of your outreach work program for an year will cost you (example
Chikombedzi):
Income:
Honorarium none Outreach
Work for free
Bonuses
none none
for the first year
Government
bonuses none no
government support
Total none
Expenses:
Salaries none paid
by the government & the mission
Materials car CHF
45000.- paid
by SDI
MDU CHF
30000.- paid
by SDI
Buildings none calculated
for the dental clinic only
Administration CHF
4000.- paid
by SDI
Taxes none calculated
for the dental clinic only
Transportation CHF
940.- subventioned
by SDI
Trip
into the country CHF
4000.- 2
trips to ZW of SDI representative
Maintenance none for
the first year
Total CHF
83940.- (Swiss Francs)
This amount
will be a close estimate for the original investment for setting up an ORW
program like the one we have set up in Chikombedzi. Then, yourself will have to
start the program and calculate locally what an ORW program costs are for
keeping it running. On the following sheet you will see an evaluation of how
much it costs SDI to keep the Chikombedzi outreach work program running.
With the
help of the Monthly Accounts, you will be able to evaluate your ORW program
costs:
Income:
Honorarium 27.- Medical
Aid, ZRP
Bonuses
250.- paid
by the government & mission
Government
bonuses none no
government support
Total 277.-
Expenses:
Salaries 1650.-* paid
by the government & mission
Materials 2400.- replacement
paid by SDI
Buildings 327.-* paid
by the government & mission
Administration 32.-* paid
by the government & mission
Transportation 940.- paid
by the government & mission
Trip
into the country 2000.- 2
trips to ZW of SDI representative
Total 8049.-
Subtotal CHF
7772.- (Swiss
Francs)
*calculated
50% of the costs of the dental clinic for ORW
CHF 7772.-
are the effective costs for the running of the program, but in the case of
Chikombedzi, the costs for SDI are now situated at CHF 5000.-. Although,
transportation is a big problem of discussions at Chikombedzi and the hospital
asks us to support this amount, as well as a part of the salaries. For us, the
costs will actually be around CHF 7000.-/ year.
Last
words
In all the
activities of SDI in foreign countries, the maintenance of good quality dental
treatment and the very strict hygienic and sterilization conditions we teach
locally, are two points which are close to our hearts. We realize though, that
we need to invest more time in teaching management and administration than
teaching dentistry and manual know-how. This most probably is what makes
instruction in deprived countries interesting, for we must learn to work and
collaborate with different cultures and mentalities.
International
help to developing countries must also consider the future, in relation to the
natural environment. This begins with the materials brought into a developing
area. At Chikombedzi, for example, we use latex gloves which are thicker and
therefore can be washed, dried, powdered and sterilized for reusing.
Finally, I
would like to thank all SDI representatives and those who have helped SDI
financially to survive through their generous support. Also, I would like to
thank the whole African community which has given us positive feedback and
support concerning the outreach work in the developing countries.
I would also
like to thank Jean-Martin Welker (Bienne, CH), Marco Giammona (Zrich, CH) and
Etienne Malherbe (Lausanne, CH) who participated greatly in bringing about the
hard work for the Chikombedzi outreach program and have helped make it what
its today.
At last, I
would like to thank Doris Zger (Wil, CH) for the great help she gave me for
writing this document in English.
Now, it is
up to you to continue. We wish you all the very best for an interesting and
fulfilling experience. If there
are any questions, please contact one of the SDI representatives. You can find
us on www.secoursdentaire.ch.
Best regards
Quentin
Voellinger