Surrounded by the Atlantic ocean, the city of Dakar is perched on the west most coast in Africa. As such, we experience both the heat and constant cool breeze as we drive through the relatively developed city. While Dakar is by all means a city in the developing world, it is more developed than many cities in Sub-S. Africa (I hate to generalize so forgive me). Developed shopping areas, organized beaches and even theme parks pass you by as you drive down the well paved roads of the main roads/high ways. But like many economically deprived communities, blatant contradictions exist. Neighborhoods with nice landscapes may lead to dirt roads with litter and even open sewage. Away from the city, villages are filled with trash and debris and so much dust that it’s impossible to pass a day without being drenched in it. But villages and cities are also filled with wonderful people, good food and amazing music (more to come on that later). In fact, all of Senegal is.
Ben and I are living GOOOOOD. Our host mother is very loving and sweet and has a house in the city. We have 1 host sister who is 12 and 3 host cousins visiting from France . The culture is very open, so the house can be filled with cousins, uncles, friends , coming and going in between and during meals. Meals are eaten on 1 huge platter, so that took getting used to, but it’s come along just fine. We have been taken in as family by everyone, so we are really just having a good time. The food is amazing and the only downside is I’ve officially gained 100 pounds..but who the heck is counting eh??? We have our own rooms and bathrooms, with AirConditioning (not present in the main rooms of the house), so we really lucked out. Unlike in the US, electricity here, even in the city is not always constant and A/C is a luxury (even though we hit over 100 degrees many times.) So they pay more than we even pay to have airconditioniner or a generator (used when the electricity in the neighborhood goes out..lasting sometimes for hours). Not everyone has AC or a generator either..infact the average person doesn’t have it.
Ben and I were fortunate enough to explore the city with our host family members. We’ve seen their “uptown”, called Centerville, which houses major banks, embassies and other government facilities. We’ve been to various beaches, all with their own personalities. While at the beach, we’ve played in the clean Atlantic water and watched the sunset, often times buying things from vendors. One of the beaches was located next to a former volcano erruption site, so it was naturally decorated with huge rocks and the accompanying beautiful sea life.
For the first week, I worked in the Fann public health dental clinic. The clinic is part of the Fann medical and Dental University, similar to UNC and it’s various schools and clinics. After the introduction, we were separated and put to work directly. I performed some extractions and also did a patient medical/dental history exam in French. I enjoyed this experience, since it was my first experience in Francophone Africa with patients. While
I was impressed with the 4 operatories and their ability to provide dental care to people who can’t afford it otherwise. I was also impressed with their administration and their organized way of tracking patients, treatments and payments. With this said, I have seen some things that needed improvement. Basic sterile practices were lacking, like covering the operatory chairs, or using different napkins for each patient. Serious sterile violations were taking place, such as the fact that we used the same exact round bur on every single patient that was treated. In between patients, the bur was wiped down with alcohol gauze, often by an ungloved assistant. If you gasped at this, you are not alone. But it’s not as simple as you think. The cost for supplies are very expensive and they already get low funding to begin with. I spoke with a clinic administrator and she told me they sadly have to rely on donations, which come and go. She actually showed me the stash of supplies and I they had only 8-10 new burs!!! And I think most of them were round burs. I am currently determined to help them get more sterilization supplies and tons of dental supplies, especially burs and anesthesia!!
Another major concern was their lack of anesthesia. Due to lack of affordability, anesthesia was only certainly used for extractions. Otherwise, most operative were performed sans anesthesia. Interestingly enough, many of the patients preferred treatment without anesthesia, expressing extreme fear of the needle. When I told the dentists that we couldn’t work on patients without anesthetizing them, they were puzzled and couldn’t imagine that we could use so much anesthesia. Because they have never had such an abundance of anesthesia to be able to do this.
The lack of sterile environment, spread of bacteria from patient to patient and minimal use of anesthesia were all things that reflected the lack of access to resources (information and products) in this public clinic in an economically deprived population. If they can gain access to more materials, more information, and more updated procedures/research, then I think they could improve their effectiveness and reduce risk. Overall, I think situations like this help give new meaning to “disparity” or “lack of”. In most of the US, we would never allow a bur to simply be wiped down with disinfectant and reused (not that I know of). But we can also afford to be that way. The folks here who can’t afford fancy private Senegalese offices don’t have a choice and the doctors who are willing to provided community health services don’t can’t always afford to purchase supplies on their personal tab. So I refrain from judging them at all, and instead try to find solutions to help ameliorate their current condition.
All in all, the experience is proving to be everything I dreamed it would be. Being back on this side of the world is just amazing. So much is new to me, but equally familiar to some degree. I am really starting to think…hmmm maybe I don’t need to buy a beach house in Wilmington…maybe I need to buy one in Dakar LOL. Dakar is safe, friendly, delicious, filled with disparities yes, but overflowing with culture and amazing people. C’est Bonne en Dakar. It’s ok in Dakar!! :0)
- Linda
