Introduction

India has 1/5th of the world’s population, 75% of whom live in rural areas. Most socio-economic and health parameters in rural areas still maintain their negative positions. The dental health scenario is grimmer, with the average population to qualified dentist ratio at about 1:1,500,000 in the rural community. Most graduating dentists are uninterested in rural practice and work in urban or semi-urban areas. The rural community hence relies on unqualified practitioners using unhygienic procedures, resulting in poor services and transfer of diseases. EHA desires to take community based dental services into the rural and semi-rural areas through 'ComDent' (Community Dental Services) by working in conjunction with existing community health projects.

ComDent will achieve this by training individuals as Community Dental Promoters (CDP's). The individuals will be selected from existing community health projects, partnering organisations and eligible members of the community. The CDPs will undergo a comprehensive community dental training conducted by the Rural Training Institute (RTI), Duncan Hospital, Raxaul, Bihar. Self-supporting initiatives will see the continuance of the services.

Objectives of ComDent

1. To train 50 committed Christian Community Dental Promoters (CDP) through a nine-month programme within five years
2. To provide basic community dental programmes to 5,00,000 in rural India by January 2010.
3. To reduce the incidence dental caries (decay), periodontal problems and harmful oral habits by 30% over a period of 7 years.
4. To bring about holistic transformation of the community through outreach programmes, within 12 months of the CDP’s placement.

Activities

• To conduct the CDP course on a regular basis so that CDP’s will be trained, certified and placed into the community.
• To select candidates from a pool of applicants. The applicants will be drawn from sponsored staff and converts of the major mission agencies.
• To train the selected candidates at the RTI for the scheduled eight weeks.
• To conduct clinical and theoretical examinations at the end of the eight weeks.
• To return the candidate their community for a six-month field work. In this time they will be required to submit a survey and programme proposal.
• To conduct a two week review course.
• Conduct final examinations (both practical and theoretical) for the certification of the candidates.
• Issue certificates at a graduation ceremony.

The ComDent project named Dr. Ella Stamper Rural Training Institute (RTI) was funded by the legacy of Dr. Ella Stamper. It was officially opened by the District Magistrate of the East Champaran district and was dedicated on February 10, 2003.

The ComDent project syllabus:
The syllabus was completed and published in October 2003 by the team of Dr. Mathew George, Director ComDent Project and Dr. Stephen Doyle, Faculty at the Centre for Remote and Rural Oral Health (CROOH), University of Western Australia.

Cost of Training one Community Dental Promoter (CDP):
The cost of training of one CDP is:

1. Training Fees: Rs: 10,000 / Aus $: 400
2. Food and Lodging Expenses Rs: 4,000 / Aus $: 160
3. Stationary Rs: 1,000 / Aus $: 40
4. Total: Rs: 15,000 / Aus $: 600

Equipment Need

1. A multi media projector Rs. 1,50,000 (£ 2,100)
2. Photocopier Rs. 1,50,000 (£ 2,100)
3. DVD player Rs. 5,000 (£ 70)
4. Library Books Rs. 50,000 (£ 700)
5. Charts and models Rs. 75,000 (£ 1000)

The Pilot phase: The pilot phase was held in November and December 2004. The pilot phase was restricted to seven candidates. An outcome of the pilot phase was that some changes were made in the contents, sessions and also location of the practical phase so as to help a larger pool of suitable patients who are unable to attend/afford to come to the dental unit.

Next Course: The next course will be held in September / October 2005. From 2006 we plan to hold the course twice annually.

Conclusion
The full implementation of the Community Dental project will see the position of the rural India improve, physically, through dentistry, and spiritually, through outreach. It is through the CDP’s taking up this challenge that will result in the transformation of rural India.

For Further Enquiries Contact:
Dr. Mathew George,
Co-ordinator of Dental Services EHA, India
mathew@eha-health.org

Dr. Steve Doyle D.D.S
Dental Surgeon, Donnybrooke
doyle-6239@bigpond.com