Adventures in Bush Dentistry

The small village of Chintatinga in Ghana West Africa.

by John Robinson

My dad Fuller and I are both dentists and we have just arrived in Chintatinga, a small bush village in the far north of Ghana in West Africa to perform basic dental services for people who don’t otherwise have access to it. Dad has been returning to this sub-Saharan region for three decades; this is my first trip. I’ve traveled to similarly remote areas before, but -truly- this is about as “out there” as I’ve experienced.

Isaac is greeting the village elders, and quiet and purposeful Alosan is already unloading the truck in preparation for our work. We couldn’t do much without our trusty assistants; Alosan and Isaac have been working with Fuller on his visits for years. Employees of the clinic, over the years they have learned basic dental procedures, such as anesthetic injections, and cleaning and extracting teeth. Our driver, Deacon, rounds out our party by piloting the old Land Cruiser and navigating the faint trails to the remote villages. All three of our Ghanaian assistants help translate for us.

At the front of the truck we place a wooden bench on which we sit as we clean the children’s teeth. We utilize ultrasonic scalers which are connected to the truck battery through a voltage inverter. Meanwhile, the rear of the truck is dedicated to our surgical setup; the tailgate is neatly spread with anesthetic, extraction forceps, and other instruments. Dishes of sterilizing solution are positioned at one end. This system has evolved over the years to be streamlined, efficient and effective.

With the village chief, Fuller and I are completing the brief formalities of our visit. The proceedings include kneeling submissively and smiling and nodding, while softly repeating “nah…nah…nah…nah.” This is accompanied by gently clasping and unclasping of our hands.

Returning to the Land Cruiser strategically parked under the village’s lone Baobob tree, we join Isaac as he initiates the kid portion of the show.  There might be thirty or so kids in a typical small village, and big, grinning Isaac gets their attention as he gathers them in a large circle. He enthusiastically delivers his dental care talk, complete with oral hygiene instructions. He also introduces us Obrunis – white men – as we give toothbrushes out to the kids. They start brushing their teeth with great diligence, with no water nor toothpaste, as we walk the inside of the circle offering eye-to-eye encouragement.

    After a few minutes of this scrubbing, one of us walks the circle, spraying off the toothbrushes with water from a pump-up garden sprayer. Then a bit of toothpaste is dispensed upon each held-out toothbrush and the brushing commences once again. More encouragement is offered, followed by a rinse-off of their brushes and their mouths with the garden sprayer. They giggle and open wide as I walk down the line squirting water into their mouths.

We’ve lined up the kids now, and we’re finally getting a good look into the now-fairly-clean mouths. Those children with clean teeth go home; those with heavy tarter, which is quite common, are gathered for the cleaning at the front of the truck. Two of us sit on the bench with the cleaning instruments; the kids sit on the ground with their heads essentially in our laps. They clutch plastic spit bowls, and they teach each other exactly what to do as each child takes her turn. Our patients are no-nonsense and extremely cooperative. Serious when they need to be, these kids will drop their guard and howl with laughter at something silly that the obrini does. We have a good time.

     As this business of examining and cleaning the children’s teeth has been unfolding, adults with abscessed teeth are quietly making their way to the rear of the truck for our attention. One of us examines the patient, ascertains which tooth or teeth needs to be extracted and injects the anesthetic. The patient is then directed to a bench where they await the effect of the anesthetic and the subsequent removal of the offending tooth.

It’s late in the afternoon. We’ve long since finished with the kids and have been steadily extracting diseased teeth for the past few hours. The work is not easy, but our patients are stoic, cooperative, and grateful. The sunlight filtered through the red dust Harmattan sky is lower down now, the soft breeze feels good on my craned neck. I notice that the line of patients has petered out; it’s time to call it quits.

As we pack up the last of the equipment and instruments, one of the village elders approaches in his gentle, gracious way. He grasps by the feet two Guinea fowl. I accept the gift as graciously as I can, but lose hold of one of the birds in the exchange. Raucous laughter erupts as Isaac, Alosan, and Deacon give chase to the fleeing bird.

I keep nodding off on the drive back to the clinic, in spite of the non-stop joking and laughing by our crew, the incredibly bumpy track we’re on, and the flapping and flopping of the Guinea fowl in the back. The sound of the Mampruli language is getting more familiar to me, the feel of the place more comfortable, and the smiles of the people more endearing. Tomorrow we plan to visit a few remote villages to the east.

I’m looking forward to it.

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