March 08, 2008

Dentistry on Nabugoye Hill

If anyone told me four months ago that I would be taking out teeth and caring about the future of dental health in Uganda, the land of Idi Amin and the Raid on Entebbe, I’d have told them they were crazy. I knew I was going to Kenya for Operation Smile, as a dentist on a team treating children with cleft palate, and sent in a deposit to go on a safari after that. But a string of events led me to Samson Wamani, Medical Director for the Abayudaya community in Uganda— and helped me realize there’s a huge difference between what is dental care here in the U.S., and what is available to fellow Jews of the Abayudaya. This was more important than seeing lions.

Learning about Uganda

There are books and websites about the Abayudaya, a group of near 800 Ugandans who trace their Jewish history to 1919, when a tribal leader, Semei Kakungulu, led his people to begin practicing Judaism. I sought to read as much as possible. One book by Richard Sobol at Michigan’s Grad Library has wonderful pictures and a CD of community members singing songs and prayers they sing during their Shabbat service, some in Hebrew, others in their native Lugandan. I loaded this CD on my iPod and listened to it constantly. There were also pictures of community members, young and old, living in a rural, rustic setting. Many of them live on Nabugoye Hill, outside the city of Mbale, Uganda’s third largest city with a population of 75,000 in the foothills of 12,000 foot Mount Elgon in the southeast corner of the country.

I emailed Samson back and forth for a couple of months, asking questions and finding out more. Samson grew up in the community and always wanted to be their first physician. He recently graduated from medical school in Kampala, and his tuition was partially supported by some individuals from Rochester, New York. Did the community need dental care? Did they need equipment or personnel? He told me there was no dentist in the community, and that there was only one in Mbale. Access to that dentist was difficult both because of the challenge of transport and the cost of care beyond reach of most community members many of whom are subsistence farmers. In the health clinic was a military field-style dental chair which several dentists from California brought a few years ago when visiting. They held a clinic for three days and each day a line of people waited to have a tooth extraction. This told me that it was likely that there were people with dental pain in this community.

Before leaving, I gathered supplies to treat patients in Uganda. I sent an email to dentists in the Detroit chapter of Alpha Omega Dental Fraternity, and people came forward and sent me anesthetic needles, extraction instruments, and offers of money. I purchased some supplies, including glutaraldehyde (cold sterilization solution) from a dental supply company. I “borrowed” anesthetic solution from the dental school.

Operation Smile in Kenya

I arrived in Kisumu, Kenya and spent ten days with Operation Smile. Kisumu is in western Kenya on the east side of Lake Victoria, and north and west of Kisumu is Uganda. The mission of Operation Smile is to provide repair of cleft lip and/or palates. Dentists check the teeth on everyone, remove any teeth that were problems and could affect the cleft repair, and make special prostheses called obturators to cover the cleft palate for those who could not have surgery. To be honest, except for the first couple days of screening, I wasn’t terribly busy. This is likely because the children’s teeth in general were in good shape, and only one child needed an obturator. But it was great to be a member of a team that was doing important work and changing lives. I worked with my fellow prosthodontist and new friend, Dr. Omondi. Omondi was from the area and of the Luo tribe, but had traveled to Nairobi and then London for his prosthodontic training. We enjoyed working together and have kept in touch, especially recently with the turmoil going on in Kenya post-election.

The Journey to Uganda

I had told Omondi of my need to get to the Ugandan border to meet Samson and he was truly helpful in finding a car and agreeing to drive me to Busia, the border town. I didn’t want to rush him, but I wanted to get to the Abayudaya community before dark to make it to Kabbalat Shabbat services. He got the car late, and we left late. We drove off, first through the busy Kisumu downtown, then out the main road, with potholes that made this Michigan resident feel very much at home!

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