Humde, Manang District, Nepal

nepalclinic2.jpgPerched at 3000m, in the shadow of the Annapurna mountain range, the Humde Dental Clinic provides much needed dental care to the entire Manang District of Nepal, from Chame to Kangsar.  Originally funded by Rotary and the Snow Leopard Foundation, the clinic is hosted by the local Tibetan school and managed by the Manang Youth Society. Prior to the clinic's opening, residents had to walk six days to the nearest road before boarding a crowded bus to the dentist another three hours away.



The region experiences two types of dental problems that are generally stratified by age. Periodontitis (gum disease) is the greatest problem for the adults in the area. Their diet is primarily rice and grains, so they do not develop many cavities. However, without regular cleaning by a dentist, they accumulate heavy tartar build-up and consequently suffer from gum disease. It is common to see young adults in their 20s or 30s with no cavities, but several mobile teeth with associated gum infections. Children, however, suffer from decay due to the introduction of sugar from the advent of tourism in the area. Unfortunately, the majority of cases involving all patients in the area are due to pain. Traditionally, preventative dentistry has not been a part of their way of life. So long as there is no pain, residents typically do not seek treatment.  Unfortunately, premature tooth loss often results when pain, rather than prevention, finally motivates a patient's visit to the dental clinic. 


karma%20face.jpgDental care is improving with the introduction of the resident Oral Health Worker, Karma Buti.  A local graduate of the high school in Manang, Karma has been working at the Humde Dental Clinic since it opened in 2004. In addition to the instruction and guidance Karma has received from various visiting dentists, she has further enhanced her skills with training in Kathmandu during the winter. She is adept at performing simple dental extractions, thereby providing immense relief to numerous patients.  She also has basic knowledge and skill at providing deep cleaning (scaling), and placing simple fillings.


humde%20kids%20sized.jpgWisdomtooth's ongoing work at the Humde Dental Clinic remains focused on two substantial goals: to expand the present proactive prevention program, and to improve Karma's clinical skills.  The clinic's proximity to a Tibetan school has facilitated excellent oral hygiene, instruction, and care in the local student population.  We would like to expand this level of prevention to all area schools. In addition, Karma would like more mentoring in providing fillings. While she has training in Atraumatic Restorative Treatment (ART), Karma still feels hesitant placing fillings confidently. Additionally, the clinic has a dental unit (drills, generator, and compressor) to prepare teeth for definitive (amalgam and composite) fillings. With the addition of a 220V amalgamator or curing light, she could be trained to place more definitive restorations. In short, additional hands-on instruction from visiting dental professionals would support the clinic and Karma in providing essential services to the local people.


As you see, there has been great progress, investment, and hard work to improve the oral health of the people in the region. However, there is still significant opportunity to develop new programs and clinical skills. We invite you to come share your expertise with the hearty people of this high Himalayan region.  Your effort and skill are essential to building an on-going sustainable program to improve the dental health throughout the Manang region.

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Posted on Thursday, April 17, 2008 at 06:41PM by Registered Commenterwisdomtooth | Comments Off

Leh, Ladakh, India

leh%20sized.bmpIsolated in the Indus River Valley, high on the Tibetan plateau, Leh serves as the capital of Ladakh, India. Originally from Mongolia, Ladakhis settled the valley over a thousand years ago, farming barley in the marginally fertile soil.  Here lies the Lamdon School. Founded in 1973 by the locally created and administered Lamdon Social Welfare Society, the school has grown from its original seven students and one teacher to a local enrollment of 1200 with an additional 800 students in 10 remote sites. The school consistently produces highly educated students, many of which are full time boarders, coming from poor families on full scholarships, and places a strong emphasis on maintaining local Ladakhi and Buddhist culture.


dr%20keall%20sized.bmpAs with many traditional cultures, these students are not immune from modern influences. This is evident to a great degree in diet. While still relying primarily on barley as their staple, the allure of refined sugar has gained a strong foothold, with devastating consequences. An evaluation of the school children in 2006 revealed that every single student (100% prevalence), and many of the staff suffered from tooth decay. Many suffered in the true sense of the word, with multiple, painful, infected teeth.

This evaluation, and the realization that something could be done to halt the problem spurred the school’s administration to take several steps to improve the students' oral health. The principal, Mr. Eshey Tundup, has banned sweet tea and candy at the school. In addition, Bill Kite, and American resident of New Zealand and long time humanitarian in the Himalayan region is facilitating the efforts of foreign volunteers. In 2007, under the guidance of Dr. Kelvin Chye, a group of 85 students from Singapore (UWSEA and Tanglin Trust School) provided each student and staff with a toothbrush, paste, and floss, as well as instruction in their use.


clinic%20plan%20sized.bmpThanks to the hard work and generosity of many donors, a plan to construct a dental/medical facility on Lamdon's campus is now underway.  Matthew Frantz, an architecture student at the University of New Mexico, rendered the plans (at left) for the structure due to be completed in summer 2009.  Furthermore, the Singapore Dental Society has committed to send a dental team, led by Dr. Myra Elliott, for five days in July of 2008 to provide direct care. Several other dentists have expressed strong interest in coming to provide direct care. These efforts are all critical to addressing patients' immediate suffering.  Both Wisdomtooth and all those who receive treatment greatly appreciate these services.


cavity%20kid%20sized.bmpWhile direct care produces immediate benefits, tooth decay results from a chronic infection. To address the long-term needs at the school in a sustainable fashion, Wisdomtooth has committed to training the school nurse in basic dental care. A long-time presence at the school, Yangchen has earned the students’ trust and respect, and has proven her commitment to the children's health. In June of 2008, a dentist will be going to Lamdon to provide initial training. The program will focus on teaching her proper diagnosis, simple fillings and extractions, in addition to reinforcing the foundation of prevention that has already been laid.

Wisdomtooth is currently seeking more dental professionals to continue training Yangchen at Lamdon School.  Ideally this could be as early as July of 2008 or anytime thereafter. This is a great opportunity to be on the cutting edge of international dental aid while empowering the Ladakhis themselves to meet their dental treatment needs. Please join us in one of the most breathtaking Himalayan settings as an honored guest in this Tibetan community. Room and board will be provided, as will the potential for treks in the area.

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Posted on Thursday, April 17, 2008 at 06:39PM by Registered Commenterwisdomtooth | Comments Off