When the U.S.-based Rwanda Human Resources for Health (HRH), was tasked with rebuilding Rwanda’s only dentistry school, leaders faced a dilemma. Dental therapists had practiced in Rwanda for several years, but their education wasn’t viewed as quite up-to-standard. HRH wanted to improve the education of dental therapy students to provide higher quality care in a clinical setting. But they didn’t have any experience with dental therapy.
“I’m taking the lessons we learned developing the dental therapy program at the University of Minnesota, and applying them here at the University of Rwanda,” Self told HealthTalk over Skype while working in Kigali, Rwanda.
HRH, founded in 2012, is addressing the shortage of health care workers in Rwanda and is revamping its health education system. Self joined the program in January to provide strategic planning for the dental therapy program.
“Rwanda is really an up-and-coming country here in Africa,” Self said. “It’s critical for public health to improve in order for society to progress as well, because you need healthy people to participate in the development of civil society.”
Twenty years after the genocide, Rwanda is still rebuilding. In the aftermath of the 1994 atrocities, life expectancy at birth was just 28 years, according to Worldbank. Today, that figure has more than doubled.
Still, oral diseases caused 15 percent of morbidity cases at Rwandan district hospitals in 2011, so improving oral health is a priority.
“We know that most oral diseases are easily preventable. The high number of people visiting hospitals with oral problems suggests there is an access to care issue,” Self said.
There are currently about 330 dental health providers (including about 30 dentists and 300 dental therapists) in the country, Self said. For a population of 11 million, that means 33,000 patients for one dental provider.
The ratio for dentists is even more alarming, with 300,000 patients for every one dentist. By comparison, in the United States there are about 2,000 patients per dentist on average, Self said.
By implementing change in the education system, Self and others with HRH are hopeful they can not only increase the number of dental providers in Rwanda, but improve the quality of dental care.
“We want to train the new dentists alongside dental therapists to create a more collaborative work setting,” Self said. “It helps these future providers understand their role and how they can seek or provide support from others on the care team. And because oral health impacts the whole body, improvements will have a cascading effect on other aspects of health and wellbeing.”
Self will continue his work in Rwanda through the end of March.
“Gaining a comprehensive understanding of Rwanda’s oral health care system is more complex and nuanced than the 3-4 sentences that usually are said about it,” Self said. “But this project will have lasting impacts on the people of Rwanda and we hope this can be a model for other countries in Africa.”