As a dentist, I have participated many times in poverty alleviation medical teams organized by international organizations. This time, I was privileged to join the “Africa Cries Out” Senegal Medical Team and brought my high school son with me. I wish to share some of my reflections on this trip.
Departure: Our African Journey
In the past, when I participated in free clinics, I didn’t have to worry about medical equipment and consumables. But this time, I heard that the dental facilities and treatment conditions at the “Africa Cries Out” base are still in their infancy. Therefore, before departure, another Filipino dentist and I began to plan a long time in advance the medical equipment, instruments and consumables we needed to carry, with the youth volunteers actively helping to pack and disinfect them.
On the day of the trip, my son and I carried six large suitcases, two of which were filled with dental medical equipment and consumables. I also brought a portable X-ray machine. The other two large suitcases were filled with sports shoes donated by Alliance of Youth Leaders in the United States (AYLUS) volunteers, as well as a box of food and a box of clothes. Considering the poverty and food shortage in Senegal, I brought a lot of portable food, which could not only replenish the energy of the volunteers traveling with me, but also be donated to the local children.
6 suitcases
First Touch: Dakar’s Heat Wave and Friendship
The journey was relatively smooth. After a full night of flight, we arrived in Dakar, the capital of Senegal. The accommodation conditions at the “Africa Cries Out” base are like those of university dormitories, with doctors and children assigned in different rooms. At first, we were a little reserved, but by the end of the trip, the children in the same dormitory had become good friends. Although the room did not have air conditioning, it was still cool at night when the windows were open. However, avoiding mosquito bites is a difficult task. In addition to vaccinations and taking anti-malaria drugs, we also brought our own mosquito nets, electronic mosquito repellents, mosquito coils and topical mosquito repellent. I was certainly a little too thorough in my preparation.
Interior of the dormitory at the “Africa Cries Out” base
Just after a few days, the youth volunteers have become good friends
After arriving at the base, the youth of the “Africa Cries Out” youth team immediately began to pack the medicines for distribution. I was also fortunate to witness the full preparations made by medical colleagues for the free clinic. The medicines brought in suitcases were piled up like a small mountain. The youth packed them according to the common dosage and attached instructions on how to take them. The medical team covers multiple specialties such as ophthalmology, gynecology, rehabilitation, cardiology, surgery, rheumatology, oncology and family doctors. Each doctor applied and shared their knowledge to the patients. The youth were also privileged to hear the professional knowledge shared by doctors of various specialties and have a deeper understanding of the different medical specialties.
The youth team packing and organizing medicines immediately after arriving at the camp base
Challenge: Walking with Patients
Before officially starting the consultation, we first set up the dental clinic of the “Africa Cries Out” base and debugged the dental equipment donated by people last year. The “Africa Cries Out” youth team assigned me three assistants. I gave them brief job training and safety knowledge, and they started working. I asked the assistants to take turns performing different duties and dental work such as receiving information input, chairside diagnosis, treatment support, and disinfection and cleaning. The assistants were all very smart. Basically, they can learn everything after teaching them just once. They can can also apply what they learned from me to other situations, which makes me feel satisfied as a teacher.
My assistants and I at the dental clinic of the “Africa Cries Out” base
Speaking of patients, the awareness of preventive dental care in Senegal is almost zero. Regardless of age, patients generally have the problem of multiple teeth being affected. I organized the assistants to apply fluoride to the patients for prevention and distribute toothbrushes to the patients. For teeth that were painful or cannot be saved, we performed extraction. At the end of the day, I felt very sore in my arms, shoulders and waist. I also felt deeply the lack of dental resources and the severe situation of lack of dental dental measures here. Although the “Africa Cries Out” base is located in a city with better conditions than the rest of Senegal, they only have dental chairs and disinfection machines. Although it was the first time to use these, at least the procedures could be done. Thinking of more difficult conditions in rural areas, I had the impulse to go to more remote villages to see the local dental situation. So I volunteered to travel a long distance with the doctors and went to the remote leprosy villages with a dental treatment box.
In-depth: Visits to Leprosy Village and Free Clinics in Remote Villages
Leprosy villages, as the name suggests, are historically set up for people with leprosy abandoned by society. The development of modern medicine has made us no longer afraid of leprosy, but my family was still a little worried before me and my son left. I was deeply moved by the testimony of an “Africa Cries Out” volunteer who has worked in the leprosy village for ten years, and this feeling surpassed the fear of “leprosy”. Although I have done enough psychological preparation, being actually there in the leprosy village, and seeing their poor economic conditions, infrastructure and medical conditions still shocked me. In leprosy villages where even essential necessities are difficult to obtain, dental health may be the last thing they consider.
Kitchen in a local family’s home
There is an endless stream of patients coming to see the doctors. The local hospitals are either unable to treat them or the patients cannot afford the medical expenses. The arrival of the “Africa Cries Out” medical team provides free medical services to people in the surrounding areas. The locals either speak the local language or French, and our doctors need to use translators to communicate with patients. I remember a patient who didn’t know which department he should see when he sat down. He pointed to his knees, waist and shoulders, which were obviously joint diseases. I quickly told him that these problems could be handled by other doctors, and we would first check if there was any discomfort in his mouth. As a senior dentist, I knew he had periodontal disease as soon as he opened his mouth. But when he heard that this was a dental clinic, he immediately stood up and wanted to leave. We quickly told him that even if there was no discomfort, he could receive fluoride, preventive treatment, and a toothbrush, and he reluctantly accepted our service. In fact, his periodontal disease was already very serious. When he spoke, his mouth would have the smell of plaque and tartar, and his teeth roots were also exposed, but in his cognition, only the painful parts of the body needed treatment, and there was no problem with his teeth.
Patients come in an endless stream
Of course, most people will take the initiative to express toothache when they hear that a dentist is here. When asked where it hurts, they will point to more than one place. During the examination, we often find widespread caries and extensive caries on multiple teeth. There are no disinfection equipment and dental instruments in the leprosy village, so we can only selectively extract those teeth with serious abscesses. Our instruments can only be used once, then they must be packed and taken back to the base for disinfection. Fortunately, I brought two boxes of sterile instruments, and with the help of my assistants, we were able to help many patients relieve their pain. However, during the diagnosis and treatment process, I deeply felt that my capabilities to help was limited and could not compete with the occurrence and development speed of the disease. There is an urgent need for education on oral health prevention, and it is necessary to start dental prevention and treatment work from childhood. More professional and functional dental clinics are also needed. We really need more colleagues to join and participate in the team and work together.
After the free clinic in the leprosy village, I sat in the open truck in a bumpy ride for more than 40 minutes under the scorching sun and temperature of more than 40 degrees Celsius, and arrived at another remote village that is extremely hard to reach – the Jinjin Village.
Transportation to Jinjin Village
The villagers here are penniless, and the only treatment equipment options we have are the dental chairs from the base camp, the semi-lying beds in leprosy villages, and the dusty chair in the thatched houses here. I had to place the chair by the window and conduct dental treatment in a well-lit place.
Simple clinic
Villagers lined up to have their teeth checked and receive basic preventive treatment
There was a woman carrying a baby on her back, with a painful expression. She told me that her teeth hurt, but when she opened her mouth, I found that none of her teeth were intact. She was still very young, about 30 years old, and we could only selectively remove the most painful teeth. Her front teeth also hurt, and she asked me if she could get dentures after the extraction. I told her that this would require time, equipment and support from local laboratories, but she had no money and would not go to clinics elsewhere.
I was deeply saddened. How can people born here just leave it to fate? I have participated in free dental clinics in many countries. Thinking of the free clinic trips in the past where I was able to immediately implant missing teeth and give them dentures, the conditions here are the most difficult and the facilities are the most primitive. As a doctor, I am eager to remedy the patients’ pain, but the reality is that, medical resources are limited and we can only solve some pain problems, which makes me feel powerless. The dental volunteer work here still has a long way to go, and more people are urgently needed to participate, invest time, love, technology, funds and equipment to be able to help more people.
Reflection and Vision: Africa’s Call and Resonance
Returning to the dental clinic in the “Africa Cries Out” base camp in Dakar, it feels like returning to another world. Within a country, the living conditions in cities and remote mountainous areas are completely different. In Dakar, we can sterilize and disinfect and work on dental chairs, which is already a very happy thing. The diagnosis and treatment process in that village is a great test for our bodies. The worst situation in Senegal might be the high temperature in the room, the machines sometimes stop working due to overheating, and people are prone to dehydration (I keep reminding the assistants to drink water in time). But patients come in an endless stream from morning to night, that we can hardly attend to all of them.
I feel especially sorry for the local children in Senegal. They need to have their permanent teeth extracted at such a young age because of tooth decay. What will happen to their future? We can only stay here for more than ten days. What should we do when they are in pain after we leave? The painful expressions of those patients and the innocent smiles of the children are intertwined in my mind, making me unable to calm down for a long time.
Local children in Senegal
This makes me think deeply about how to better help the people of Senegal. Now I understand why Lu Xun gave up medicine and became a writer. Although I can’t do that and my writing skills can’t reach that level, I still hope thru this article to share the current situation of dentistry in Senegal with caring people in the dental field hoping to gather more manpower and material resources in order to help more people. My vision for Senegal’s future is to improve oral health education and basic prevention for children, popularize relevant knowledge in schools, and teach people how to fish rather than give them fish. Let these children become people who can influence the next generation and drive the progress of the whole society. A journey of a thousand miles begins with a single step. I am very happy that “Africa Cries Out” has started to organize schools in remote villages. I hope that the era of civilization and health in this land will come soon as knowledge grows!
Author Profile: Joyce Guojun Ma, DDM
New Jersey practicing general dentist.
Graduated from the Department of Stomatology of Beijing Medical University, and later received a Ph.D. in Neuroscience from Johns Hopkins and a Ph.D. in Dentistry from New York University.
Participated in various international dental free clinics many times and joined the multidisciplinary diagnosis and treatment team of “Africa Cries Out” for the first time.
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If you feel moved to support our ministry in Africa, please contact us:
Jun Xu’s WeChat: jun9174343767
Email: Africacriesout@gmail.com
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Website: https://africacriesout.net
Editors in charge: Cao Juanjuan, Zhang Kun
Translator： Wei Peng
English editor: Xi Wang
Editor: Doris Cruz
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