News Archive

A team of volunteer healthcare workers from Australia ventured into one of the most dangerous zones of South Africa last September to treat and help the poor and homeless. They stayed in an AIDS hospice in Johannesburg and were not allowed outside the razor-wired compound without the protection of local staff.

When they did travel to outreach health centres, their patients were frisked for drugs and weapons before being allowed through for treatment. But what they achieved under those conditions, and with the most basic equipment, was staggering.

Clinical Associate Professor Albert Tan, a periodontist and part-time staff member in the School of Dentistry, and Dr Elizabeth Day, a general dentist in private practice, were among a team of two doctors, two dentists, two general nurses, two dental nurses, an art therapist, and a social worker who gave up two weeks last year to minister care to
hundreds of patients in the neighbourhood of Hillbrow in Johannesburg.

They went there under the auspices of Equal Health, a volunteer organisation based in WA but which recruits nationally. The bulk of its work has been carried out for the past 13 years in India, where about 60 volunteers visit every year. For the last five years a small group of 10 has also gone annually to South Africa. This year, because of the violent crime rate, a team will not be sent.

Dr Day was inspired to volunteer because she wanted to combine travel with the desire to provide pain-relief and palliative care to the poor, sick and homeless.

“Working in comfort in our private practices insulates us from the thousands of people who desperately need dental treatment and pain-relief but who either cannot afford it or are unable to access a clinic,” she said. “Helping those in need is such a personally rewarding way to give, albeit in a very small way, to a less fortunate society.”

Clinical Associate Professor Tan was moved to volunteer because he was inspired by the work of his friend Paul Clark, an optician in Karrinyup, who founded Equal Health over a decade ago. “After more than 30 years in the field of periodontics, it was time to give something back,” he said. This was reflected by the dental team treating more than 300 patients of all ages, sometimes working late into the night.

They had only hand instruments and local anaesthetics with which to treat patients. There was no dental chair, no X-ray facilities, and no dental light, drill or suction. The medical team members supplied a variety of medicinal drugs which they had brought with them from Perth. Education in oral hygiene was important and toothbrushes and
toothpaste were given to all who presented for treatment.

A significant proportion of patients treated were medically compromised with HIV or advanced AIDS and some had the added complication of tuberculosis. In these patients, pain-relief and providing comfort was the goal.

One of the more destructive forms of periodontal disease, acute necrotising ulcerative gingivitis/periodontitis (ANUG/P) was relatively common, especially as a complication of HIV-AIDS.

“In my general practice I would see one case of ANUG/P every three years, but there we saw eight obvious cases within days,” Dr Day said. “This would be mainly due to their compromised general health, lack of good nutrition, poor oral hygiene, heavy smoking and alcohol consumption, all combining to cause a breakdown in body resistance.”

Clinical Associate Professor Tan and Dr Day scored every patient according to a periodontal disease severity/treatment needs index, and found the majority across all age groups had significant periodontal disease. They were treated using periodontal hand instruments supplemented by antiseptics and/or antibiotics in some cases. Teeth with decay that were considered salvageable were filled, and those that were not, were extracted. About 100 teeth were extracted during the two weeks.

The team’s initial work was treating staff and patients in the AIDS hospice run by Metropolitan Evangelical Services (MES) in the Hillbrow neighbourhood of Johannesburg, where crime and violence are rampant.

“It was a pretty dangerous suburb,” Clinical Associate Professor Tan said with a degree of understatement. “It is the typical cycle of poverty, despair and crime.”

The team also went out to five different community venues, ranging from a ship’s container, which served as the “sick bay”, to a hall, a church and night shelters. Posters were placed around the area to promote the free dental and medical services available on those days. A van did the rounds, collecting people from the streets who needed to see a doctor or dentist.

“These people live in abject squalor,” Clinical Associate Professor Tan said, describing the rat-infested disused multi-storey car parks where people set up camp. Many shied away from government-run clinics, often because they were illegal immigrants. A big number were from Zimbabwe. However, they felt safe going to the free non-government sick bay.

“We kept looking out the window to see if the queue was getting shorter but it never did,” Clinical Associate Professor Tan said. “The hardest part was when we had to turn them away at the end of the day.”