Background
I am a newly retired dental surgeon who has been working on Gotland during approximately 35 years.

For a while I worked at the clinic of Oral and Maxillofacial surgery at Visby Hospital. There I worked a few years with Samuel Assaf and Hans Forsslund, both specialists in Oral and Maxillofacial surgery. After some discussions, reflections and conversations we came to decide to try to start a clinic in Samuel's home country, Ethiopia. The object for a clinic was obviously, as there is severe shortage of specialist care as including dental care in the country.

We could after talking to people in charge of the health organization get access to a lot of surplus equipment. Gotland Municipality was sympathetic to let us have it with no charge. Equipment and miscellaneous materials for medical and dental care could then collected and later transported by ourselves to Erikshjälpens depot in southern Sweden. Here everything that was useful (i.e. most) was loaded in a container that was shipped to Djibouti for transshipment to train and then truck for transmission to the final target Bahir Dar in Ethiopia. Samuel along with local talents has been able to organize a provisional clinic, using the advice of His Forsslund and others who visited the city where Samuel Assaf now lives. (The final clinic - "health center" - which is situated on the outskirts of Bahir Dar has not yet been an issue as the building is far from finished).

PICT1820s

Travel to Ethiopia
I traveled in February 2010 to Bahir Dar, together with Lasse Ahlner, service technician, how also live and works in Gotland. Our main task was to make the temporary clinic in Bahir Dar prepared for clinical dentistry activities on a smaller scale.

Getting the hardware
Some parts of the equipment was already in place and other parts and components we got after having inventoried the container, which now is positioned in an industrial area outside the city. Of course not all "conventional" solutions were at hand so there was much improvisation and imagination to help us beat on the road. An operating chair and unit with acceptable lighting (spliced together with fiber optics from an ear clinic, among others). Suction function with help of a an vacuum equipment for a laboratory and an extra "water bottles" screwed to the unit for cooling water to the high-speed function were some of the solutions that came about. Unfortunately, all the X-ray tubes were damaged during transport and non-functional. Samuel was probably like us mightily disappointed as the opportunity for having X-ray exams are very difficult in Bahir Dar. Another problem was to obtain a satisfactory sterilization process. One of the autoclaves would in the end start and we could prepare for the first patient.

Finding parts for plumbing, electrical connections and finding someone who understood our intentions were not an obvious task. We had good help from Samuels 'manager' Tadessa, his Bajaj-taxi driver Dzellalen and Chris, a Jamaican Born dental technician who now had to be instructed in the repair and servicing dental equipment by Lasse Ahlner. Due to daily power cuts, which were long we decided to install a diesel-powered generator outside the window. There we had already installed the compressor (purchased at the “Öveskottsbolaget” in Visby).

Now it seemed that most of it was operational. But the water was of course very rare in the tap so we planned a water tank to the already crowded balcony. This is only a "temporary" solution, we hope!

Patient treatment
After about 4-5 days of work, Samuel finally called the patients he promised dental care for some time. They got to act as volunteer guinea pigs in the now after cleaning really neat clinic with both waiting rooms, sterile and a treatment room. The waiting room is decorated with posters and paintings of Gotland Grounds.

Patient treatment - performed by myself without assistance and with Lasse Ahlner partially sterile assistant - was not quite up to the standards that I and we are used to in Sweden. However, it appeared that most of the patients we had during two days were satisfied with what was offered. Charging fees that occurred were extremely low and consistent with the person's ability to pay. Payment was managed by Samuel himself. Medical records and receipts were of course manually-written.

Planning for the new clinic
We also did an effort to look over the planning and construction of the new clinic building outside town.As the progress of building seems to have more or less stopped in lack of funding we thought it be appropriate to discuss some of the already fixed spaces for different functions.

What we noticed first was that areas for administration and hygiene concerning employed staff not were sufficient. We thus advised the engineer and Samuel Assafa to remake some of the spaces for post treatment into dressing, hygiene and administration for personnel

Important was also at this instant to plan for treatment rooms concerning supply of water, electricity, air and suction. This implies a new layer of concrete onto the floors in the treatment rooms. As concrete now in Ethiopia seems to much more expensive this is one reason for new funding plans.

We did some measuring concerning placement of dental units and operation installations in the surgery. We marked out where connections should be placed into the so called “box” on floors and also marked out wall connections in the surgery. We based our planning on condition that the equipment used still is the surplus materials from Gotland. We could verify that the concrete pavement tile now is completed with bricks and concrete walls but without the roof construction has being even started.

A sincere hope that funding soon can be established giving opportunity for completing the clinic within reasonable time.

A visit that makes you wanting more. It was obvious to us, and hopefully it will encourage more people to engage in this health care project.

Sincerely, Björn Franzén: This email address is being protected from spambots. You need JavaScript enabled to view it.