Dentist gets on board charity trip to India

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Dentist gets on board charity trip to India

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Dentist gets on board charity trip to India


Dentist gets on board charity trip to India

Following a partnership between my practice (Barbican Dental Care) and the Impact India Foundation (a global initiative supported by UNDF, Unicef and WHO to assist in the prevention of disablement around the world), I was able to take part in this fulfilling and successful journey.

India is a vast and varied country, with a population of a billion, of which 70 million are disabled – more than the population of the UK. I was looking forward to returning to my homeland and to work alongside those on the Lifeline Express.

After flying into Delhi, I caught the red-eye flight to Jabalpur in the state of Madya Pradesh. Jabalpur is like many other small towns in India: low rise, an army presence and an air of tolerance from all those who go about their daily routine, especially when it comes to the traffic!

The Lifeline Express team
Most importantly, it has a railway station. Neelam Kshirsagar, the general manager of special projects for Impact India, met me and took me immediately to the Lifeline Express, a hospital train that provides operations and dental care to rural communities in the state. The train was parked in the sidings where a platform had been specially built, and consisted of seven brightly painted wagons. There were families milling around, waiting for their turn for treatment, not worried about the baking platform and 45-degree-Celsius, oven-like heat. A quick tour revealed the train had two operating theatres (three beds in each) with waiting and recovery areas, three large gleaming industrial autoclaves, a lecture room, stores, an office, changing facilities, a staff room and finally the dental room, all wonderfully air conditioned!

I was introduced to Zelma Lazarus, the charismatic CEO of Impact India. She explained that the Lifeline Express was here to provide free treatment for all but it could only be successful with the support and cooperation of the local community. Local hospitals are contacted well in advance of the train's arrival and teams of local orthopaedic, eye, cleft lip and ENT surgeons agree to ‘donate' their time. The local Hitkarni Dental College also supports the project.

However, as only certain types of operations could be performed on the train, all patients had to be screened prior to commencement. The orthopaedic team alone saw over 3,000 patients to find 200 suitable cases! Zelma explained that the only way to really ‘get things moving' was to go straight to the ‘district collector'. He is the area head of local government and holds a position of considerable power and influence. He agreed to mobilise his network of officials to ensure that all the town and outlying villages would be aware of the visit. The collector also wanted to meet ‘the dentist from London', and so at a duly appointed time arrived for the inaugural ceremony for the dental suite.

He assured me that he was committed to spreading the word and promised me many patients for the next day. To prove his point he brought along the local television station to do an interview with me, which was shown that night.

Raring to go

The following morning I was raring to go. I hadn't been this excited about going to work for years. So at 9am I arrived at the platform ready, willing and able, only to find the place virtually deserted. Colonel Vishwen, who runs the Lifeline Express, invited me into his office for a cup of tea. In the nicest possible way he explained that in India, when a doctor says he starts at 9am he never arrives before 10am.

As a result patients never turn up before 10.15am. The team from the dental college arrived at 9.30am. I had thought they would send a dental nurse to assist me but to my surprise two dentists, Dr Mangesh Ghate and the newly qualified Dr Pratiba Patel, a hygienist, Amos, and our nurse, Reena, welcomed me.

True to the Colonel's word, at 10.15am the first patients arrived and by 11am we had a queue of 20. We turned the lecture facility into a waiting and post-op room. Extractions and scaling were the order of the day. Many patients had never visited a dentist in their life and most had travelled
enormous distances to be treated. By lunchtime, I had removed more teeth than I had in the past 10 years.

Two happy customers

I was thankful for the pristine ultrasonic scaler, which enabled me to provide some first-time scaling. All those I treated were incredibly grateful and remained stoic despite the considerable pain they had been in (probably for some years).

Some of those I examined had difficulty in opening their mouths and, on further investigation, I noticed clinical changes on the buccal mucosae consistent with chewing tobacco and betel nut. Dr Ghate later confirmed that they see many cases of submucous fibrosis at the dental clinic. I remained for the next two days when it was time to hand over to Dr Ghate and his team, who would be continuing the service for a further three weeks.

‘I hope that one day the train becomes defunct'

By the end of my two days we had seen and treated 62 patients for dental problems, which rose to an impressive 334 at the end of the three-week clinic. The medical teams on the Lifeline Express also treated 405 patients with eye problems, over 100 for cleft lips, 83 patients with ear problems, and 211 sufferers of polio; in total a staggering 1134 patients were treated.

Impact India's ultimate aim is to raise awareness in communities and encourage them to demand treatment at local and regional health centres.

Most poor Indians are illiterate and unaware of their right to treatment. For instance, in Madya Pradesh, those below the poverty line are entitled to £300 of treatment a year, paid for by the state, but less than 10% of allocated finance reaches those in need.

On my final day I asked Zelma what ultimate aim for the Lifeline Express would be. ‘I hope that one day the train becomes defunct,' she replied. ‘If we can educate and inform people of their rights, treatment will be fully provided locally and our train will be surplus to requirements.' Here's hoping.

• Many thanks to Claudius Ash for donating 500 much needed toothbrushes, all gratefully

The Lifeline Express is the world's first hospital train. To date, more than 500,000 patients, living in the remote rural interiors of India where
medical facilities are scarce, have been treated through the use of the train. Last year Impact India introduced dental services as a trial measure on the Lifeline Express at Mandsaur, in the Madhya Pradesh State. Patients received free treatment for scaling, fillings, extractions and minor surgeries, and biopsies of a few patients were taken for diagnosis. This trial project showed there was an urgent need for dental healthcare and so Neil donated funds to cover the cost of items such as a hydraulic chair, an oil-free compressor, a scaler with handpiece and other essential equipment. 
Neil is planning another trip to India, and has a list of further equipment needed, including more syringes and cartridges, sprays for disinfection and tissues, and sharps bins. For further information on Impact India, visit

 Posted on : Wed 16th - Sep - 2009


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