As CHO approaches its 10th birthday in 2012, we can see
very clearly how God has used quite a number of quite remarkable men
and women (none of whom would call themselves special and who are in
fact extremely modest), each playing their own part, to build an
exceptionally vibrant and visionary proactive organisation, which is
making a serious impact for good in one of the poorest parts of one
of the most needy countries of the world.
This morning our team began working in earnest on the piece of the
jigsaw puzzle of this intentional activity which we have each come to
help CHO put in place. To have participated in the cultural and
program awareness sessions of last week (based on their own
recommendations) was absolutely vital in enabling us to communicate
with and work alongside them to do this effectively; we could not
conceive of coming alongside this dignified group of people in the
way we are now able to do had we not made a real effort to do
understand what they are trying to do and who they really are in our
first week. We have so much clearer an appreciation of the reality
of who they are and how they themselves view their past, present and
future. Most importantly, we understand how they view their own
priorities.
As many of you already know, my particular piece of the jigsaw is to try and make first steps to address the extremely poor oral health issues of the children in Safe Haven school. Cambodian children in general have an extremely high rate of dental decay and also other many mouth diseases, the most common of which is juvenile periodontal (gum) disease. The condition of their mouths also offers many clues regarding their general health, but we will leave that story for a future time and simply deal with tooth decay in this blog entry. In the UK, on average, a 5 year old child has just a single tooth (out of 20) affected by decay. Many of these teeth will have already been filled or extracted, so many less children than that actually have active decay in their mouths. Only very few have actual pain or infection present. In Cambodia, the average 5 year old child has 8-10 teeth affected by dental decay, and virtually none of these will have received any treatment at all. Most do not know what a dentist is, or what toothpaste and a toothbrush are. Many have chronic pain and infection, and no medication is available to help relieve this either. Today I started with Grade 1 students, dividing the class into two groups, one for the morning and one for the afternoon. With me I had an English speaking teacher and a most able “dental assistant” in the form of the ever capable Liu Liu, who can, it seems, turn his hand to almost any situation and who rose to this “hands on” challenge most gently yet proficiently.
I have brought with me a bilingual
Khmer/English educational tool containing culturally targeted
information diet and options for cleaning in order to make realistic
recommendations as to how to start to improve oral health. (This tool
was a gift from the dental colleague who compiled it herself – in
complete compliance with the Cambodians own national oral health
strategy- after she had returned from working in a different
location in Cambodia. The dental charity “Dentaid” introduced
us just at the time our team's intention to go to Cambodia was
confirmed. Having this information with me means the teachers can
work alongside me now, learning as we go, being sure of accurate
translation of key facts and I can leave copies with them to continue
with oral hygiene on the curriculum here long after I have left. My
main aims this week are the identification of any children who
require urgent surgical intervention and “damage limitation” for
the others by introducing simple changes to their diet and teaching
them why, and how to clean their teeth, and practising this with
them, while also supplying the tools which they need to do this. For
many of the children aged 5-8 I worked with today, we gave them their
first ever toothbrush (and will be ensuring that Safe Haven has
access to suitable replacement brushes for the future.) Of the 19
children we saw today, just one 5 year old had no dental decay, and
nearly all the others had 8 or more seriously decayed teeth;
including decaying adult teeth for those few children old enough to
have such teeth who are still in this grade. About half the children
reported having painful teeth (or earache related to decayed teeth)
either now or at some recent time in the past. They are pushing
their national average of poor dental health up (and by some!)
The staff at Safe Haven are really keen that all their children
should benefit from this work (and this should result in the future
of many more being able to eat and sleep more comfortably and
concentrate on school work better.) The staff are fully supportive of
the key changes I have suggested which will make a world of
difference given a relatively short amount of time. The
woodwork/carving department are now all lined up to make hygienic
toothbrush storage units for individually named toothbrushes for each
classroom and staff are happy to supervise tooth brushing after
school lunch before the school afternoon begins. They appreciate the
scientific evidence that if teeth are brushed well last thing at
night and also for a second time sometime during the day, and this
combined with simple diet changes of keeping sugary food and drinks
to mealtimes only and drinking & snacking on non sugary things
between, should result in the rate of new decay to plummet. The
developing adult teeth of the youngest children will then have a
greatly increased chance to stay healthy and that is a great gift to
a child.
All the children were very keen to learn about how to brush their
teeth and none of these, even the youngest ones, wanted to miss out
on having disclosing dye placed on their teeth to stain their dental
plaque to show them where and how much they needed to use their
brushes. Liu and I were kept very busy indeed!
As the week progresses I will conduct a similar program
(appropriately adapted to age and ability) with each group of
students in the school. Then on Friday I am due to talk to the
teachers and also the CHO staff about the basic science of the common
dental diseases and the strategic management of how to continue
developing the prevention program for the future.
Pray that I may have the grace to let you be my servant too
Although we are a very diverse team we are well bonded. “Team
time” including prayer every day is ensuring a wonderful team
spirit with mutual understanding and care.
Finally, I cannot covey in a blog like this just how warmly we have
been welcomed and how careful our hosts are to cater for our every
need and comfort. Their vision is so enormous, their faith is so
strong and their dedication to their individual part of the task so
sincere. Their faces radiate joyfulness even when they are so tired
they can barely stand up! It is humbling to now be counted among
their friends. To receive so much from these people who live so
modestly yet live so graciously with all the difficulties and
discomforts that are part of everyday life here is a challenge to us
every day.
Please continue to pray for the workers and the work of CHO and for
the people they hope to serve in the future as well as those whom
they currently serve. Please also pray for us that we will complete
the work we have come to do well and that we will be able to leave
behind a lasting legacy upon which they can build towards their
vision in a faster and stronger way than before.
Sue (24th October)
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