Oral health in Mali's schools

12 World Health • 47th Year, No. l, Jonuory-february 1994 Oral health in Mali's schools Jacques Abellard A study in Mali in 1990 showed that, according to WHO's recommended criteria, 90% of children aged 12 have poor oral hygiene - allowing caries and other oral diseases to develop unchallenged. The scarcity of hospital structures and qualified personnel as well as the high cost of curative treatment means that they have almost no access to the care they need. In view of this situation, a programme was started by International Odontological Aid, a Paris-based agency, in collaboration with the Ministry of Health of Mali, in the region of Mopti, lying by the River Niger some 650 kilometres from the capital Bamako. The object of the programme was to teach daily hygiene to children while giving preference to traditional methods, such as using special sticks as toothbrushes (see photo on page 28). The programme' s thrust was aimed at raised awareness of the problems among schoolchildren, because they would spontaneously transmit the educational messages to those around them, whether younger children or adults. In each class, matching groups of a maximum of 20 children are trained by the health animator and by their own teacher. Two sessions are arranged a week apart. During the first, the children learn about oral diseases by inspecting each other's teeth and mouths and are helped to understand the causes of such infections and their consequences on health, how to prevent them, and what health care is available locally. During the second session, each child learns about good habits that can improve oral health. Whatever resources are needed for these classes are found in the locality concerned. Drawings displayed on a blackboard or felt-boards help all the Children readily become enthusiastic about dental care. children to discover for themselves what each session is about. The health animators act as helpers rather than instructors. They guide the children through each session by asking appropriate questions, making sure that every child takes part so as to become personally aware of the problems of oral health. The children . become actors, and together they make up a story with a moral which will drive home the messages of good hygiene. The teachers, whose role is to ensure that this knowledge is kept up to date, are issued with a manual on oral health. They are involved from the start of the course, reinforcing the lessons acquired. Evaluation of the results shows that in the course of the school year 1992-93 some 3000 schoolchildren aged between seven and twelve have benefited from this preventive action. In addition, about 5000 children who are not yet at school have learnt about oral hygiene from the older ones. An even more telling result is that 1100 children have gone for dental check- ups at the Mopti hospital as a consequence of these awareness sessions. Schoolchildren in one district of Mali hove reacted enthusiastically to special classes aimed at alerting them to the value of hygiene in preventing future oral health problems. The programme's impact is regularly evaluated by checking on the knowledge acquired, by periodic oral examination and by recording how often the children attend oral health consultations. Experience in the field has confmned the enthusiasm of both children and teachers for this initiative. As a result, with effect from 1994, a further 40 schoolteachers will be trained and this will enable the programme to reach another 7000 children in Mali. • Or Jacques Abe/lard is President of International Odontological Aid (AOI, Aide Odontologique lnternationale), based at I 15 rue Lamarck, 750 18 Paris, France .