Copyright 2020 - Bem Vindo

Interview with Dr Heinz-Oliver Siebelist, August 2016

Annette: Your team of dentists treated 510 patients, putting in 295 fillings and pulling 990 teeth in the process. Are you happy with these statistics?
Oliver: Yes, it’s more than I’d expected … On average, each dentist extracted 15.7 teeth, and did 4.7 fillings, every day. The publicity campaign was a success, with many people coming, and the team put in long hours.

Annette: Looking beyond the bare figures, was your visit to Cape Verde satisfactory in other respects?
Oliver: Oh, very much so! I am very fond of the Cape Verdeans, and the islands offer a wealth of appealing activities. We worked hard but also played hard!

Annette: Who are the people you came here with?
Oliver: Our voluntários came from Spain and Portugal – from Galicia, Bilbao, Madrid, Barcelona, Seville and Majorca in Spain, and from Ericeira in Portugal. We were a group of six women and six men aged between 25 and 42 – three oral surgeons, two paediatric dentists, one orthodontist, three non-specialist dentists and three assistants.

Annette: You need a well-functioning infrastructure to be able to examine and treat so many patients. Did you take everything you needed with you?
Oliver: Yes. We took the equipment that we needed – drills, a UV lamp, etc. Also on our take-list was medication: anaesthetics, antibiotics, painkillers, and so on. Not forgetting sterilizing agents, disposables such as face masks and the like, toothbrushes to hand out, etc. – on a venture like this, it all adds up! We had already sent some things ahead by post and brought the rest with us. Each of the ‘volunteers’ also had work-related supplies in their luggage. And I bought a compressor in Mindelo.

Annette: Did everything go smoothly with regard to transporting the equipment?
Oliver: Not exactly. The package sent on ahead was stuck in customs until the last day, and two bags with work-related gear that came with us on the flight could not be found for a while – before we were able to get them back from the airport police. But in the end we managed to get everything through the checkpoints in time.

Annette: Was it your first working holiday of this kind?
Oliver: No. I’ve already been to Madagascar, Nepal, Cambodia and Nicaragua on ‘Dentists Without Borders’ teams. Then, in 2015, several colleagues and I formed our own organization, called SMILES. This meant that, on these trips, we could plan, do and decide things the way we wanted.

Annette: So it was the first trip with SMILES. Why did you pick Cape Verde of all places?
Oliver: I had always wanted to visit Cape Verde because of the great surfing there. Then, my first time here, I noticed the widespread deficiencies in dental care. And, for these working tours with voluntary helpers, it’s also important that the destinations have a stable political system and little in the way of diseases such as malaria and dengue fever.

Annette: What can you say about the dental condition of the people you have seen here?
Oliver: The ‘caries index’ is not as high as in Europe, as this includes fillings and these are quite rare here. And, since sugar consumption is lower, the state of the Cape Verdeans’ teeth is better overall. The problem is that those teeth which are decayed are not treated, so that their condition rapidly worsens. The situation in Monte Trigo is a special one, as the water has extremely high flouride levels. This leads to demineralisation and, in turn, to damaged teeth, as well as brown staining.

Annette: How would you characterize Cape Verdean patients?
Oliver: Well, they have a very low ‘suffering threshold’ in this respect; all that many of them want is a cure-all pill to take immediately. But it doesn’t work like this, as all tablets can do is combat the pain, which is only a symptom.

Annette: Some of your patients had four, or even five, teeth pulled. How can these people still chew after this treatment?
Oliver: Yes, a tough crust of bread would be a problem in these cases! Fortunately, the diet here consists mainly of vegetables, fish and stews, etc. Harder food might well cause problems. But there’s absolutely no question about whether these bad or broken teeth should be removed. You can’t chew or bite with rotten teeth either, and they are acute centres of inflammation that can affect the entire body. These teeth have to go – there’s no alternative.

Annette: When did you opt for fillings instead?
Oliver: Where the teeth could be saved and there were good prospects of preserving them. We gave fillings to both adults and children; especially with kids, it’s important that the teeth are preserved wherever possible. But I also saw many cases where the children’s teeth were in such a bad state that there was effectively nothing left to fill.

Annette: Why is this?
Oliver: One reason is inadequate dental hygiene – it’s quite clear that there are many people, including plenty of children, who brush their teeth either irregularly or not at all. Another reason is that sugar is far more harmful to the people than it is to us in Europe. Over the long period in which we have consumed sugar, our bodies – including our dentition – have got used to this substance. In places where this has not happened, excessive sugar intake has a disastrous impact on dental health.

Annette: Were you able to explain this to the people?
Oliver: We tried, but I don’t know whether the message really got through. For someone who has never heard anything about this connection, it’s hard to understand why sugar should be a bad thing all of a sudden. And, of course, the children especially have a sweet tooth: for biscuits, confectionery – and, above all, for sugary drinks, which are the worst culprits. For many people, drinking through straws has even given them an actual hole between their upper incisors.

Annette: What can you do about this?
Oliver: We can come back again (laughs)! This won’t be our final assignment on Santo Antão. I’d like to come quite often, even regularly.

Annette: So what is there still to be done?
Oliver: Oh, plenty! For one thing, we weren’t able to treat all of the residents of the six villages, because in most cases we spent only one day there. It may also be that not everyone heard we were going to come, or was able to be there. And these aren’t the only remote communities on the island! Also, I’d like to make dentures as well – ideally, I’d even like to set up a clinic!

Annette: That sounds as if you already have another trip to Santo Antão in mind ...
Oliver: Yes, definitely!


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