The Clinic

Just when you thought that no work was being done I thought that I had better show you that indeed a dental clinic did exist. The clinic is about 10 years old and was converted from a eye clinic and expanded into the better and bigger dental clinic. The clinic employers two technicians /nurses/lab technichians/dental therapists. The two young men Mousa and Ajouba(Moses and Job) have a little of all of thoses jobs with incomplete education in all of them.Both of them have been largely trained on the job with Ajouba having have two years of nurses training ,which is significantly less training than we would get out of a two year nursing programing Canada The job required of them is to extract teeth, do simple fillings, suture cuts and lacerations, wire broken mandibles ,do simple partial dentures and keep the clinic running. They also are responsible for cleaning and irrigating ears, doing auditory tests , injecting keloids(large poorly formed scars)and removing polyps. The lay out of the clinic is simple with basis dental equipment in a cement floored and masonary block building.

My job has largely been to encourage and assist with their dental training. A large part of their time has been learning how to make simple dentures, both the lab component and the patient component. It has taken longer than expected as teaching things in two languages that you are not functional in, is challenging and time consuming. The education process had to occur around the functioning dental clinic ,and so I often used the patients that came in for the lesson of the day. No prep work for me because I never knew what to prepare.

We have largely succeeded in this goal and now I am in the process of writing an operations manual for the clinic so that others will know what and how the clinic functions, and what supplies and equipment it has so other short term missionaries have an idea about the scope and the functioning of the clinic.

I can basically do most dental procedures at the clinic except for anything that requires lab other than what we have on site. Any crowns needed to be done would have to be sent to France or some other African country, probably Nigeria to be processed .At this time that would be a big problem as no one here knows any one in that capacity in those countries.

Great things about working in the clinic is that every morning the day is started with a brief prayer time and a short time of planning the day. Every day has a break around which is religiously held to as most of the hospital personnel don't eat in the morning as preparing food over an open fire in their homes is a bit tedious in the darkness of the morning. So usually they will buy some food which looks and tastes like a bland potate with a thin sauce and a bit of chicken or beef. I have not gotten in to it and would rather have a banana and some Nescafe. Their meal usually costs about 150CFA's which is about 30 cents and would fill and average cereal bowl. The work day continues until 1pm .Takes two hours off for a rest and them continues from 3-6pm. In the hot season which I think is almost all year round the rest is needed as no air conditioning is present , but water coolers are available which help to cool things a bit. The temperature already is about 40C but during this time of the year it still cools off to low 20's in the night. In the hot season it usually stays above 30 all the time. Temperature is a real problem in the clinic as alot of the materials are temperature sensitive and should not be stored above 24C. So the fridge is only so big so always some material are failing and not lasting like they should.

The other big problem is the maintenance of the equipment as no parts are available. Should something break, parts have to be ordered form the US or Europe. Getting those parts in is usually only luck, as alot seems to get lost along the way. Also all the power supplied is 220 and not 110 like in North America ,so all the equipment has to be convered or run on a plugged in transformer.Now none of these things are a big deal but remember the guys in the shop are repairing things that are from all over the world on a daily basis and with no manual or help, so they do a pretty good job just to keep the country running.(Duct Tape is also almost unavailable so that repair solution isn't there sorry you Red Green followers)

Dust is the other problem and at times it seems that we are practicing outside as the Harmattan winds seem to blow right through the walls and coat every thing with thick layers of grit and dust. So if you ever send anything to be used as a donation on the mission field always think of sending new, simple to repair equipment, that can often be repaired with parts self made. Fancy is never good and remember if it is useless at home it will likely be useless out here.

So enjoy what you have as and keep your scarves on.

ps the lady in the green is not an assistant but just pops in for break on a fairly regular basis.

Dr. Jerry