DTAP0310

20 Trends & Applications DENTAL TRIBUNE Asia Pacific Edition The access and quality agenda— in the slums of India Dr Seema Sharma UK When I heard that 6,000 children die every day in India, my responses were WHAT! WHY? Isn’t India an emerging economy? Growing up in subSaharan Africa (Zambia) I had seen poverty, but I had never appreciated that India had 20 times the population of the UK and 100 times the population of Zambia: one billion in Africa—47 governments, 1.2 billion in India—one government, not easy. It is no surprise then that when I was approached in the Autumn of 2009 to participate in the UK Channel 4 series Secret Millionaire I felt compelled to say yes. I meet dentists and doctors from the Asian subcontinent every day, and we often wonder how many of us owe AD our success to our brave ancestors who migrated in search of a better life and to the opportunities that Britain offered us. I also meet many dentists and doctors who are not from the Asian subcontinent, who want to give time and love to those less fortunate in Africa and Asia, for example through Bridge2Aid. Some really bizarre thoughts went through my mind when I first arrived in Dharavi, the largest slum in South-east Asia. It houses 1.2 million people in 1 square mile; in fact 60 per cent of Mumbai’s residents live on 6 per cent of Mumbai’s land. I wanted to pick some of those helpless children up and cuddle them—but what were their local child protection policies? I wanted to pull them away from the flying glass in the recycling areas—where was their health and safety policy, Not so, little was I to know that I would fall in love with the sensibilities and sensitivities of the social entrepreneurs I met in Mumbai. Whilst I couldn’t tick the boxes on ‘quality’ as we know it, I saw incredible strength in the teamwork and resilience of charity workers determined to make a change in India, and I was overawed by the personalised care, respect and support people living and working in the slums showed for each other and for me, a total stranger. How could I have believed that India should have fed its poor before it developed its space programme? What can India do to help its poor unless it creates riches with which to help them? I did not teach my kids to write the ABC before numbers, and I certainly won’t be waiting for registration with the Care Quality Commission before I register with the Charities Commission. I have learnt not to judge what I see in India, but to accept it as it is, with its multiple social and commercial facets, and many cannons firing simultaneously. India is cited as one of the BRIC economies by Goldman Sachs, and Indians are deservedly proud and work hard for what they have. However, it requires foreign investment, an influx of wealth, and a speed- Dumping ground in a Mumbai slum. (DTI/Photo courtesy of Bosschimp, UK) let alone risk assessments and safety glasses? It got worse. The dumping ground was a cesspit, swarming with flies, sewage, animals and people. Not much infection control going on here; HTM 01-05 wouldn’t get a look in. Slips and trips policy? Well in a nutshell: try not to slip or trip when the bulldozers come to the dump to make space for more garbage, or you will get hurt. We in the UK are just waking up to the fact that one year is a challenging timetable for us to meet the standards of the Care Quality Commission. What would happen if the Care Quality Commission came to the slums? The experience changed my life. I sat in a comfortable space back home in London—I under- “I was overawed by the personalised care, respect and support people living and working in the slums showed for each other and for me” stood Delivering Better Oral Health and care pathways in dentistry; we risk assessed our patients in East London and targeted high-needs patients with preventive advice, fluoride and fissure sealants. Dental disease was preventable and I was used to droning on about sugar intake and cleaning habits, and spending hours on toolkits. National Health Service contracts and secondary school entrance exams were the only frustrations, but both were getting better. After all, the Department of Health’s cool A-team had come up with a contract that dropped the weighting of Units of Dental Activity to half their previous value, and one daughter had already made the transition to secondary school—just one to go. On the Honey and Mumford learning styles questionnaires, I come up strongly pragmatic, not an activist, not a theorist, not a reflector. I expected to go to India, get some sanitation and education projects going and come home feeling good. ier pace of development to help its people. Go India! You are home to 17 per cent of the world’s population; you need a measurable share of the world’s wealth to care for them. Otherwise, 6,000 children will die every day for some time to come. DT Contact Info Dr Seema Sharma currently works for Dentabyte.co.uk, a practice management and training consultany website in Southeast London. She can be contacted at info@dentabyte.co.uk.