World Smiles Adventures in Uganda

When I was in dental hygiene school, one of my instructors asked our class, “Why did you choose dental hygiene as your profession?”

Jan 1st, 2007
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When I was in dental hygiene school,one of my instructors asked our class, “Why did you choose dental hygiene as your profession?” When I said “Because I want to travel the world and help people with my dental skills,” most of my classmates thought I was living in a dream world.

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Many dreams get set aside once we enter the workforce, obtain a mortgage, or begin a family. Travel is a priority in my life, and I have made a commitment to myself to fight dental disease at home and around the world. Volunteering my dental skills abroad has allowed me to fulfill both of these needs. Volunteering leaves me with more than a good feeling - I find friends and love wherever I go, and most importantly, I help save teeth and lives.

It’s hard for most people to imagine that children and adults all over the world die every day from dental disease. I recently volunteered my services in Uganda, a beautiful country on the equator in Eastern Africa. Of the 25 million people there, nearly 87 percent are rural. This makes access to medical and dental care almost impossible. The lack of access to professional dental care means people suffer from dental infections that, if left untreated, systematically sicken the entire body, especially children, the elderly, and those who are immune-compromised. In outlying regions, there may be only one dental professional for every 100,000 to 300,000 people. It takes days to reach a dentist, and then patients must have money to pay for treatment. Larger cities have dentists, but many people struggle every day just to put food on the table. Going to the dentist for an extraction can seem like a luxury. People just live with tooth pain every day of their lives.

My first volunteer dental trip was to Cochabamba, Bolivia, in 2000. There I met two good friends, Dr. Sherwin Shinn and his wife, Jerri, a nurse. They had just started a nonprofit organization called International Smile Power Foundation (smilepower.org). They and their organization have provided much-needed medical and dental services, education, and training to thousands of people in many impoverished countries around the world, including Nepal, Jamaica, Guatemala, and the Cook Islands. After that trip, I knew I wanted to follow them wherever they went. When I heard they were planning a trip to Uganda, I packed my bags.

Getting acquainted and seeing the source of the Nile

I spent my first week in the capital of Uganda, Kampala, working with a very modern local dentist, Dr. Tom Multayebe, and his staff. We spent most of the time working on customer service-related training as their clientele includes a lot of international businesspeople. I was happy to see that they used an ultrasonic scaler to clean teeth, and even had the only intraoral camera in town. During this time, I stayed with Dr. Tom and his family in their home. It was a nice opportunity to see how upper middle class Ugandans live. I was surprised that kids in private school have classes from 7:15 a.m. until 5 p.m., and many stay at school until 6 or 7 p.m.


Getting dental lessons at school
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At the end of the week as a thank-you to me for working with his office, Dr. Tom, his wife, and five children took me on an overnight trip to Jinja, a small town at the source of the Nile River. He grew up there, so we went to visit some of his family and spent much of the day swimming and floating down the Nile. I even got to bungee jump into it! They made sure I got a good taste of Africa by buying me things I had not tried before, such as jackfruit, ugali, which is a stiff maize porridge, and matoke, a cooked plantain dish served boiled or mushy that is a staple in many parts of Uganda. I had a great time.

Since volunteers come fully equipped with portable dental equipment that can be set up just about anywhere, I was able to do dental work on some of the staff at our hotel in Kampala. When I was heading to dinner one night after a long day’s work, I noticed the light was on in the room set aside as our clinic. I found Dr. Shinn and Jerri working on a young man who was about to spend the next six weeks in a lockdown refugee camp visiting his family in northern Uganda. The civil unrest there for the last 20 years has left 1.7 million people displaced and living in unsafe, disease-ridden tent cities. This man was one of the few who somehow made it out and was lucky enough to find a good job that allowed him time off to visit his family.


Far left...Carrying dinner home to her family
Top Right...Children taking home water for the day
Above...Brandi and her translating assistant for the afternoon from the Batwa Pygmy tribe
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I slept well that night after I skipped dinner to assist with that patient. Not only did we extract infected teeth, we also restored most of his decayed front teeth with composite fillings. Most of the people working at the hotel have customer service positions, and a nice smile is required. I had fun walking around the hotel after I had become friends with many people there, seeing their big smiles. I knew I’d helped make those smiles beautiful, and the people were so appreciative. Since I’m trained in anesthetic and restorative work in the state of Washington, I’m able to do more than clean teeth, but that is what most of them wanted. Even if they had many dental problems, having a nice, clean smile was important to them.

Smile Power team visits Bwindi medical clinic

The Smile Power dental team included four dentists, two hygienists, and seven others who assisted, sterilized instruments, and educated. We even had an artist on our team who set up an art project with the local kids. When the whole team had arrived in Kampala, we set off in a bus loaded with our supplies to another town. We headed to Queen Elizabeth National Park for a few days of animal watching. When we showed up at the park after dark, we were greeted by a family of hippos enjoying their midnight snack. The next morning we woke to an amazing sunrise over Lake George and Lake Edward. We went on a cruise on the lake, a safari drive, and saw almost every animal and bird in the park. Elephants, lions, hippos, cape buffalo, and warthogs were all around, even on the way to our rooms. But we had dental work to do, so we set off again.


Dr. Shinn triaging a patient outside a church
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The area of Bwindi sits in the southwest corner of Uganda near the Congo border. It is a beautiful tropical rainforest that includes a unique area known as the Bwindi Impenetrable Forest, home to unique animal and plant life, including the last of the mountain gorillas. The bus ride took us down endless, dusty, muddy, bumpy roads. It took us about 12 hours to get there - almost in one piece. As the bus went down the road, I was surprised to see many people come out of their houses to see who was in the big bus. They shouted, “Muzungu,” which means, “white person.” Children greeted us with their hands shaking uncontrollably, making sure we noticed them.

We were on our way to Bahoma Medical Center (pygmies.net) on the edge of the Bwindi Impenetrable National Park. When Dr. Scott Kellerman and his wife, Carol, came to Uganda for the first time five years ago, they fell in love with the people and the area, but they saw the effect of the lack of medical care. The Kellermans decided to move halfway across the world to open a medical facility, which is now big enough to accommodate a dental room and volunteers. Their hospitality made us feel right at home.


Dr. Christine and Brandi treating children at an orphanage near Kampala
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The first morning, 100 or more people happily met us on the front porch. When they saw us coming, they started playing their drums, singing, and dancing. Everywhere we went we were greeted in this warm way, a very energizing start to our mornings. Most of my days at the clinic were spent triaging and giving anesthetic to more than 60 patients a day. Almost everyone we saw had many dental infections and teeth that needed extracting, even the children. When there was an extra dental unit available, I did sealants or filled composite restorations. Somehow by the end of the day, most people had received treatment for at least one tooth.


A Ugandan woman showing Brandi which tooth is bothering her
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Going to the schools and working with the children is the highlight of my trips. Every child receives a toothbrush, often the first he or she has ever owned. After a nice dental story and lesson, children know they can keep their teeth their whole lives, and how to do that. Tooth loss is preventable, but most children have never seen adults with all their teeth. Education is the key to making our efforts last for more than a day. That’s why I was excited to spend a morning with the nurses at the local hospital. We held an informal class on personal oral care and disease prevention. The nurses see dental problems every day, but they have little education or training to treat them. They had lots of good questions and were very interested in learning about the mouth. Even Dr. Kellerman, an American physician, had questions about dental disease and prevention because it is not covered much in medical school.


Boys spending the afternoon reading RDH magazine
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Our portable equipment allowed us to travel to outlying tribes, including the Batwa Pygmies, a tribe of forest dwellers known for their unusually short stature. They were forced out of the forest 17 years ago when the land they lived on was turned into a national forest, which meant that no one was allowed to live or hunt on the land. Their traditional lifestyle was criminalized, and overnight they were forced into a world they knew nothing about. Life for them had never been easy, but taking them out of their familiar surroundings and forcing them to live in a new way was deadly for many of them.

Unfortunately more than half of the children born in that area will not live to age 5, and will die from malaria, parasites, TB, malnutrition, or dental infections. Before Dr. Kellerman arrived five years ago, the people in that region had only a witch doctor for their medical needs. Now they have access to more medicine for treatment and prevention. For most, this was their first visit to the dentist. We were very honored that the local people trusted us enough to let us work on them. Because Uganda was under British rule from 1900 to 1952, English is the official language, but is spoken as a second language by most educated Ugandans. More than 33 languages are spoken in different parts of the country. When we worked in the rural areas, we always found someone who spoke English to translate for us.

Throughout Uganda, we set up makeshift clinics in whatever building was arranged, generators and all. There is very little electricity throughout most of the country. Even in the cities, the power is shut off between 7 p.m. and 1 a.m. Businesses must run off generators. When we worked in rural areas we had to bring in all of our own water from Kampala for personal and dental use. Most people who live outside of the cities rely on streams and lakes for their water. Everywhere we went, we saw children carrying large containers of water on their heads to take home for the family cooking and drinking.

On our long trip back to Kampala, after who knows how many miles, along roads I wouldn’t drive my car down, the bus finally broke down. We spent four hours in the front yard of a family’s modest house, about 30 miles from the nearest town with a mechanic. Our driver hitchhiked into town and actually brought the mechanics back. How’s that for service! The family spoke very little English, but inquired about everything we had. As I spent the time reading copies of RDH magazine, I would find someone “reading” over my shoulder. Even though they could not read English and it was probably a subject they had little interest in, they thought it was more appealing than the People magazine others were reading. As we got on our bus after it was fixed, they asked for the RDH magazines. I happily parted with them, knowing that a family would learn to read English from them.

Volunteering can be as simple as spending a day at your local dental hygiene association sealant day, taking a box of toothbrushes on your next trip, or providing dental care in a Third World country. Supporting organizations like Smile Power through volunteering or financial contributions is a way to help others all over the world, and it supports something you already believe in - stopping dental disease. I have been fortunate enough to provide dental hygiene to people in six countries, and dental education to many more. I have made friends all over the world with a smile and a toothbrush, but most importantly I know I have saved lives.

Brandi Morang, RDH, is a dental hygienist and artist who lives most of the year in Seattle, Wash. She has been working in the dental field for more than 16 years, and has been volunteering overseas since 2000. You can find out more about her dental adventures at World-Smiles.com. In 2000, she went on her first volunteer vacation to Cochabamba, Bolivia. Since then, she has traveled to Central and South America, Europe, Asia, and Africa. She can be contacted at brandi@world-smiles.com.

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