Evolution of a Humanitarian Dental Mission to Madagascar

Excerpted and modified from an article by Laurence Wynn, DDS, David Krause, PhD, et al. published March 2010 Journal of Dental Education

To date, we have undertaken seven dental missions to Madagascar. The status of oral health care on the island of Madagascar is desperate, with only two dentists (the vast majority of whom are located in major cities) for every 100,000 people. Many of the villages in the rural areas are too isolated for the government to build schools, so most of the people can never get an education that will help them break free of crippling poverty. In addition, the lack of access to health care, including dental care, and little, or no access to suitable clinical facilities adds significantly to the burden. The aims of our dental missions to Madagascar are to provide dental care to communities in remote villages, to educate villagers regarding basic health and hygiene, and to gather data on oral hygiene. Through the efforts of our skilled team leaders, we are able to run temporary dental clinics despite the fact that where we work there is no access to electricity, running water, or any semblance of modern dental facilities.

Organization of the Missions

The first dental mission to Madagascar, in 1999, was minimal in that only a few oral surgical instruments and supplies were available. During the most recent mission in 2010, several large crates of supplies were shipped with the dental team. Among the supplies sent were approximately 8,000 pairs of gloves, 1,500 masks, 1,000 gut sutures, 5,000 anesthesia needles, and all of the surgical instruments and local anesthesia needed for surgical procedures. In our temporary clinics we use three Aseptico (TM) portable dental units, allowing for restorative as well as surgical procedures. Electricity for the dental units, as well as for the radiographic equipment, is supplied by two 220V generators. In the absence of room lighting, battery-operated camping headlamps were used in the first five dental missions. In 2008, however, Designs for Vision, Inc. headlamps were used, and these vastly improved visibility for all dental procedures. The dental chairs that we use are canvas camping chairs, and the empty packing crates are used as bracket tables. In the absence of running water and cuspidors, bottled water is used by the patients for rinsing, and the bottom halves of plastic bottles are placed in the cup holders of the camping chairs to allow patients to expel blood, saliva, etc. Sterilization of instruments is achieved by thorough boiling on a propane gas heater.

All radiographic images, beginning in 2006, were obtained using a Nomad (TM) portable hand-held x-ray machine and beginning in 2007 with Schick (TM) digital sensors. The primary uses of the radiographic system were for endodontic and oral surgery procedures. All resultant images were stored for viewing both during and after the mission. Communication with patients was facilitated by translators who spoke both Malagasy and English. Our teams use four-wheel drive vehicles, vans, drivers, and mechanics - supplied by the Malagasy Institute for the Conservation of Tropical Environments.

In addition to our missions to remote villages, the Madagascar Ankizy Fund has provided much needed curricular materials, training, equipment, and supplies to the Institut d’Odontologie-Stomatologie Tropicale de Madagascar (IOSTM), the only dental school on the island, located in the city of Mahajanga. The IOSTM was established in 1977 and trains forty students per year. Students from the IOSTM have rotated through our remote clinics beginning with the 2005 mission.

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Alternatively, you may send a donation directly to: The Madagascar Ankizy Fund/284300, c/o Department of Anatomical Sciences, Stony Brook University, Stony Brook, New York 11794-8081, U.S.A.