The “RotaryDentaidBox” Presenting.... The “RotaryDentaidBox” Opportunity to introduce yourself as presenter and your connection with this initiative.

The “Rotary DentaidBOX” Agenda About Dentaid The Global oral health need Dentaid and Rotary The “DentaidBox” Taking things forward How can your club get involved Here is what I intend to cover in my talk – I’m going to start by telling you a bit about Dentaid, the oral health charity who have developed the equipment and the concept of the Dental Box. It’s important to have an idea of the need that this initiative will provide some answers to, so I will devote a little time to outlining the global oral health situation and then move on to explaining how the relationship between Rotary and Dentaid came into being. From this came the idea of a Dental Box, a simple concept which I will explain. I will conclude by explaining how this initiative is moving forward and how I would like to see your club get involved.

to improve the oral health of disadvantaged communities around the world It has done this by..... Mission: Sending dental equipment abroad - 260 projects in 60 countries and now also focused on, training, oral health education and prevention Action: So, to introduce the charity Dentaid to you. It has been in existence for 16 years and it’s mission is a simple but extensive one (read mission statement). Dentaid is based in Landford in the New Forest and from these premises they have built up an effective operation to achieve their mission. Traditionally the charity has received donated equipment from dentists upgrading their surgery and have fully refurbished this and sent it all round the world to hospitals and clinics looking to provide dental care. In recent years an emphasis has also been given to oral health programmes focussed on oral health education and prevention, looking to move upstream to deal with the causes of dental decay rather than purely implementing a curative approach.

The charity now has a worldwide reach and network and is one of the world’s leading oral health charities. It is a neglected but very needy area of work as you will gather from the next few slides. 260 projects in 60 countries

The Oral Health Need...... WHO estimate 5.6 billion of 7 billion people on earth suffer from dental decay Dental decay is the most common chronic non communicable disease affecting the world today. That’s a lot of pain The World Health Organisation estimates that 5.6 of the world’s 7 billion population suffers from dental decay. Here in Britain where, despite our complaints about the NHS, we have easy access to dental care and might not realise that dental decay is the most common chronic non communicable disease affecting the world today. Decay doesn’t come without the attendant problem of pain – if you’ve suffered a really bad toothache you will acknowledge that it is one of the most severe types of pain the human body experiences. For many people that is a daily reality as they do not have access to any form of dental care.

UK = 60 million It has 28,000 dentists Ratio = 1: 2,150 Ethiopia = 77 million It has 93 dentists (WHO figures) Ratio = 1: 828,000 (not the worst case!) And here’s why. In the UK our dentist to person ratio is quite reasonable, 1:2,150. Compare this to Ethiopia with a roughly similar population, where there are only 93 dentists according to WHO figures. Then ask yourself where those dentists are going to be located. Yes – almost all are in the capital Addis Ababa, many providing their services to the expatriate and wealthy Ethiopian communities. That makes the ratio quoted even worse. And Ethiopia is by no means the worst case around the world.

When there are no dentists... You seek help from a “street dentist” When you are suffering from excruciating pain and there are no dentists what do you do. Street dentistry is the experience of many. This one is in Uganda and you can see the sophistication of his dental instrument – it’s the iron chisel lying next to the patient (or should I say victim). He conducts the treatment without any anesthetic or sterilisation.

Dentaid supported Oral health outreach clinics like this in A much better way Dentaid supported Oral health outreach clinics like this in Kampong Cham Cambodia Cambodian nurses

Dentaid Portable Chair Production of the chair was supported with grants for tools by Rotary Club of Romsey Test To support such oral health outreach work, Dentaid designed some simple, cheap and effective resources. A much needed item is a portable dental chair. A Rotarian working as a volunteer at Dentaid recognised the value of the portable chair and encouraged his Club – Romsey Test, to support this development with a grant for tools to enable production of the chair to proceed. From this a valuable relationship has grown. Here you see some of the first portable chairs being manufactured in the Dentaid workshop.

The “RotaryDentaidBOX” The next step Our Vision To provide a self contained package, containing all the key dental requisites of equipment and consumables, to enable a dental professional to deliver, in any locality in the developing world, basic oral health care and emergency treatment to those in need. Dentaid has gone on to develop other complementary resources for the chair like portable lights and suction and has matched this with a portable instrument kit and steriliser. With the success of initiatives like Shelter box and aqua box it didn’t take too much deliberation to recognise that the placing of all these items in a suitable container would provide a very valuable resource to help improve oral health care provision around the world. The vision of the RDB was formed which is (can read the slide if necessary).

“RotaryDentaidBOX” Contents 1 x Portable Dental Chair 1 x Portable light with bracket to fit onto chair 1 x Portable suction unit with sterilisable tips 1 x Battery unit to power the portable equipment 1 x Inverter to allow use of car battery 5 x packs Fuji Glass Ionomer 1 x Small toolkit 1 x Solar recharging panel 1 x Non –Electric Steriliser module Full set of dental instrument modules Large quantity of dental consumables (donated?) + Shipping to desired global location for use The box in question is actually a wheelie bin and makes storage and moving of the equipment very straightforward. Here’s a list of what items are to be included in the box. It will mean that simple treatment can be given in remote rural locations where there is no electricity, running water or sanitation.

OUT ART AFT World Health Organisation Basic Package of Oral Care Oral Urgent Treatment (pain relief and extractions) OUT ART AFT Atraumatic Restorative Technique (simple fluoride releasing filling, with no drilling) As such the box is ideally suitable to help deliver the World Health Organisation’s recommended method of dental treatment for developing nations – the Basic Package of Oral Care. This slide shows the basic elements of the BPOC OUT – the relief of pain and simple tooth extractions ART – a simple technique using hand instruments and a glass ionomer filling material to fill and conserve teeth. AFT – programmes to help provide access to fluoride toothpaste which is essential in preventing tooth decay. Affordable Fluoride Toothpaste

The portable chair, instrument kit and steriliser Here you see the elements already extensively field tested by Dentaid which are part of the RDB.

Equipment. Feedback has been very positive The chair - Over 100 have been produced Welding of the aluminium - now done by a retired dentist in Bradford on Avon! Here is a batch of 25 of the portable chairs that were part of a shipment to Cambodia, for use in Community Health centres by specially trained Dental Nurses, along with other parts of the portable dental surgery.

Delivery of the basic package of oral care is improved enormously No dentist or nurse can work in basic rural conditions, with patients on benches or plastic chairs, for very long before suffering from serious musculo skeletal problems and you can see how in every aspect the resources available in the RDB would improve the delivery of oral health care in outreach centres like this one.

“RotaryDentaidBOX” Who will use it? Trained oral health workers providing oral health care in remote locations where no fixed surgery facilities or services are available Any oral health workers engaged in dental outreach programmes seeking to deliver the WHO’s basic package of oral care Dental professionals working in a disaster response situation seeking to provide emergency oral health care. Uganda 3091

The size of the potential market is significant – the vast bulk of oral treatment must be carried out by those with limited formal training who currently have access to inadequate or virtually no dental equipment with which to provide this treatment. The actual number of dentists in Africa and Asia, where there is the greatest need for the box, is 206,630 This is a trained dentist working in a government hospital in a remote part of Uganda. What you see is the sum total of his equipment. The resources in a RDB exceed this by a considerable distance. Equipping trained dentists like this with the box would have a tremendous impact alone.

The first Rotary Dentaid Box is given to Foodstep, Uganda by Rotary Club of Kyengera The first Rotary Dentaid Box was presented to Foodstep, a Ugandan charity working with street children and those in children’s prisons. Miss Uganda attended the event and has taken a personal interest in the oral health work. The first patient – Miss Uganda

“RotaryDentaidBOX” In Summary The Rotary Dentaid Box will make possible basic oral care in low resource settings, providing help to large numbers of individuals in a very cost- effective way. Benefits:- 4p per patient treated over a 10 year lifespan Each simple treatment costs less than 1p Let’s quantify the impact. Over the lifespan of the box and its contents, each simple treatment like those mentioned in the Basic Package of Oral Care can be provided at a cost of less than 1p. That is tremendous value for money when it comes to dealing with toothache and pain.

RotaryDentaidBox Rotary Club In Country Rotary Club Identifying a Dental Practice Supporting Practice in Fundraising Linking up with a Rotary Club in Country In Country Rotary Club Focal point for in-country support Local Dental Practice Focal Point for Fundraising Carry out fundraising events Dentaid Identifying projects Co-ordinating with Dental Practitioners Auditing role FUNDRAISING PARTNERS RotaryDentaidBox Dental Charity using the Box So I hope that in response to what I have shared with you tonight, this club will consider getting involved and supporting this worthwhile initiative. Here’s how it works. Explain diagram…..

“RotaryDentaidBOX” Help take this forward Key components have been identified and costed. At present the cost of a unit is £1,500 I hope your club will consider getting behind the funding of one box. The cost for this is £1500 plus shipping. If not then smaller donations can be made towards components of the box which will be combined with similar smaller ones to make up a whole. If clubs are not able to fund this amount, we suggest that they combine with other clubs or give a smaller amount towards a component in the box, e.g the portable chair costs £450

Results 6 Rotary Clubs have sponsored their own Wheelie bin surgery These have been/are being/ linked into charities in country along with local Rotary clubs. Already 5 clubs have sent in donations to purchase a portable surgery and many more like yours are showing a great interest. Share any other news here e.g. The presentation at the 2013 Wessex District Conference.

Results – Chididi, Malawi Christchurch Rotary club is one of the clubs to have raised sufficient funds to provide a Rotary Dentaid Box. Here it is being unpacked and set out for the first time at the Chididi Health Centre in Malawi. It’s always a pleasure to give people gifts and nice surprises. Now what’s in here?

Results – Chididi, Malawi This one will deliver oral health care to a totally different standard than ever before experienced by this community. SUCTION !!

“RotaryDentaidBOX” In Summary The Rotary Dentaid Box, as a Rotary Wessex project, is now making possible basic oral care. Each simple treatment costs less than 1p Clubs owning Boxes are in the processes of linking with overseas Rotary Clubs to help deliver dental care and support. During this year we hope that, with your help, we will have increased this number significantly so that we can celebrate this District’s achievement at our Conference in Plymouth. The charity now has a worldwide reach and network and is one of the world’s leading oral health charities. It is a neglected but very needy area of work as you will gather from the next few slides.

A tooth extraction Nepali style In the era of “pain free” dentistry, let’s spare people this experience. A tooth extraction Nepali style So thank you for your time tonight and for being such an attentive audience. This picture should motivate you to get involved and I’m happy to answer any questions you may have

? Any questions Dentaid Giles Lane Landford Salisbury SP5 2BG 01794 324249 Info@dentaid.org www.dentaid.org Any questions Answer questions with this slide visible. The end

Oral Urgent Treatment Relief of pain – Extractions/drainage/medication First Aid for Oral infection and trauma cases Referral of . complicated cases

Atraumatic Restorative Technique No drills, plumbed water . supply or electricity Manual Cleaning Adhesive fluoride . releasing filling 1 year - 95-100% 2 year - 92-94% 3 year - 85-89% ART Sealants

“RotaryDentaidBOX” Orders/Applications Contacts via Rotary network Dentaid partners and website GCDF Dental taskforces FDI via Dental associations IFDEA (Dental schools) NGO networks Applications to be assessed by Dentaid

Distribution channels Corporate sponsorship? “RotaryDentaidBOX” Distribution channels Distribution via Rotary network Direct shipping Shelterbox? Corporate sponsorship? An average shipping cost per box will be calculated according to support/sponsorship received

Extraction module - forceps