Jevaia Oral Health Care

JOHC (formerly the Kaski Oral Health Care Project) establishes sustainable, community-based based dental care in rural areas of Nepal. We work in each village for 2.5 years, and a team of three residents implements the project with intensive guidance.  Our comprehensive model includes a local dental clinic staffed by a rural dental technician, school-based oral health education and prevention, and vendor outreach.

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JOHC programs currently empower over 50,000 people to access dental care and basic oral hygiene products.

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Why Dental Care?

Untreated oral carries is Nepal’s most prevalent childhood disease, exceeding even malnutrition.  69% of adults over fifty suffer from oral disease, making it one of the most widespread and least attended health crises in the country.

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Oral decay is linked to malnutrition, cardiac disease, diabetes, low birth weight, and depressed immune competency.  These are all all high level public health issues that absorb tremendous funding.  But oral health is addressed almost exclusively by way of transient camps and mobile clinics – if at all.

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Oral disease is not all that hard to treat.  JOHC has taken rural dentistry techniques developed for remote regions and packaged them in to a model that allows them to be delivered sustainably by rural communities.  The result?

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A rural dental clinic run by a local health care provider with two years of mentoring and supervision; brushing programs and oral health education taught in every primary school; dental hygiene products in rural shops; widespread community awareness.

Seminars

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Seminars are organized through schools by local JOHC teams (a technician, clinic assistant, and team leader) to teach prevention, describe dental medicine, and introduce residents to the local clinic. Teams collaborate with the Oral Health Coordinator and seminars are open to all members of the community. After two years, schools run their own oral health education.  In fact, everything that happens in a seminar is replicable and sustainable by the local community.

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Day 1: Education & Checkups

• For children, parents, teachers, and community members near the school.
• Taught by the JOHC team with help from School Teachers.
• Introduces the services, hours, and staff at the new local clinic.
• Explains different types of dental procedures and addresses myths about dental treatment.
• Describes the benefits of prevention in terms of pain and long-term financial cost.
• Incorporates cultural references to purity and renewal.
• Free screening, with referrals to the local clinic or a city partner hospital.

Day 2: Local Treatment

• With referral slips from Day 1, children, parents, teachers and community members come to the local clinic for treatment.
• Treatment is always at the clinic itself, not on school grounds, replicating a normal weekly clinic day.
• Children must bring a parent or family member to observe the treatment.
• An open clinic room allows observers to learn and ask questions.
• Adults referrals are filled at the end of the day.
• Although schools and JOHC Teams facilitate the seminars in their villages, residents have access to the services provided every week of the year.

Clinics

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Medical Technicians & Clinic Assistants

Each JOHC clinic begins with dental training for local health care practitioner from the village. To qualify, technicians must have a community medical assistant degree or higher. The three-week training is provided by Health Development Society Nepal.

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Although their certificate allows technicians to practice freely, each new technician receives medical supervision and mentoring on a declining schedule throughout the first six months of service. Thereafter, clinics are supervised quarterly and participate in an annual medical audit by a medical trainer.

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Clinic Assistants are trained internally, largely through team-building workshops with their medical technicians. Many CA’s are promising high school graduates who aspire to social work or careers in health care.

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Building the Technician-Assistant team is one of the most creative and enjoyable parts of the JOHC model. We aim to facilitate the creation of clinics that offer a friendly, collaborative, down-to-earth culture.

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Because the clinic is folded in to a larger community education initiative, JOHC technicians provide an exceptionally high number of treatments. Over the course of the two-year seed program, our technicians are provided with extensive supervision, mentoring and medical auditing as they become rural dental care specialists.

Services at Weekly Clinics

• Filling is provided using Atraumatic Restorative Treatment (ART),
  a method appropriate for simpler cavities that do not require root canals. The tooth is cleaned using hand instruments, requiring no electricity, and filled using Glass Ionomer Composite (GIC).
• Extraction, address severely decayed teeth.
  Technicians are trained to identify cases that should be referred to a city hospital. ART and extraction allow local clinics addressing pain and halt decay processes for almost any condition.
• Referral is made to a partner city hospital for root canal therapy (RCT), cosmetics or other complex treatment. Partner hospitals offer care at reduced rates for our referrals. RCT allows patients to save a severely decayed tooth, but is more expensive than having extraction done locally.
• Carries Arrest using sodium diamine fluoride is a pending technique that we are looking at adding to our clinics in 2016-17.

School Brushing Programs & Oral Health Coordinators

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What better place for education than in schools?  Teams spend two years helping to integrate oral health education in to the schools in their villages.  Each school appoints one teacher as its Oral Health Coordinator (OHC). OHCs participate in an orientation at the start of the school year, and a wrap-up at the year’s end. Their responsibilities are to:

• Run a daily brushing program at school
• Ensure each student gets at least one dental checkup per year
• Include oral health education in the school health curriculum
• Organize fun, creative activities to promote oral health care: competitions, fairs, dramas, art exhibits…anything goes!

Like all full and part time staff, OHCs are encouraged to be original and fun with the tools we give them.  After two years, when JOHC is handed over, OHCs continue to provide oral health education and daily brushing programs at their schools.

Staff

Aamod Shrestha – Program Director

Dilmaya Adhikari – Education Field Officer

Gaurab Tripathi – Medical Field Officer

Muna Sharma – Office Manager

Office Contact

Lakeside, Pokhara
061-466942
info@jevaia.org