The OHFR assists in structuring the dental care. She concentrates on schools for the prevention and potentially curative care. Next to this, the OHFR is approached frequently concerning the inquiry if the OHFR can provide dental care or assistance with the organization of a dental clinic. All these requests are taken into consideration and rated. Depending on the financial room and available manpower, help will be provided. During the assessment of the projects, several aspects are taken into consideration, including:

• Working with a limited number of smaller projects.
• The projects have to be able to be conducted by the local contributors independently over time.
• Closing the Memorandum of Understanding (MoU) with the organizations involved concerning the time span and the method which the OHFR will support and assist the project.

Out of experience it has appeared that regularly returning projects concerning clinics that are supported by the OHFR in any way, work the best. A benefit is that the children can be examined yearly and treated directly where needed in the nearby clinic and receive the necessary after care. Generally the health centers and schools are in close proximity so direct dental care is present. If de clinic is supported by the OHFR, good contact with the present dental therapists is immediately established.

A project can consist of:

• Prevention; a Dental Preventive Program (DPP) in nearby schools.
• Providing workshops.
• Dental reseach at schools and in dental clinics.
• Treatment based on Atraumatic Restorative Treatment (ART)
• Treatment of patients in dental clinics if needed.
• Training of a dental therapist by dentist of the OHFR
• The (re)furnishing of a dental practice area.
• To reach the goals set by the OHFR, the following sources will be used:

By setting up an infrastructure that provides the opportunity for people to visit dental clinics with certain regularity, the dental care of the rural population will be improved directly. The existing infrastructure of the ‘centres de santé’ will be used to achieve this goal. Not only does the curative care need attention, but also the preventative care.

Education about dental hygiene will contribute to preventing dental and general health problems. An education on dentistry of the dental therapists who are working within the ‘centres de santé’ is a condition for structural improvements of the dental care of the Rwandan population. This education begins with schools. With educational programs children gain knowledge of oral care. The OHFR has made a song in the local language of Rwanda: Kinyarwanda, with which the necessity of brushing teeth is explained. The OHFR has recorded this song on a DVD and shows this DVD during the DPP to the children.

Dental Preventive Program (DPP)

The Dental Preventive Program is an educational program that has been developed even further by the OHFR for the Rwandan situation. A lot of children in Rwanda live with toothache every day and that must change. To brush your teeth at least two times a day is something that has to be taught. Simple basic principles that are very normal to Dutch children are often completely unknown to the Rwandan children. Teachers have to be actively involved in the educational programs. They are stimulated in a “train the trainers” program and trained to structurally continue and pay attention to the dental health prevention with their students. De local dental health assistance keeps contact with the schools where the programs have been conducted.

Atraumatic Restorative Treatment (ART)

Even though the daily brushing of teeth with fluoride toothpaste reduces the caries activity; caries will not disappear entirely. If caries stays untreated, it will unavoidably lead to pain, infection and ultimately loss of teeth. A temporary curative treatment of caries is a way of prevention. The western curative treatment of caries relies on electrical equipment. De complexity of the instruments, maintenance and costs reduce the possibility of spreading the use of these instruments in less fortunate countries. In those countries these kinds of equipment are only present in private clinics and hospitals. With ART there is no drill or saliva extractor needed. This means that ART can be executed without electricity, without running water and without an expensive compressor and dental unit. Only hand tools are needed. Educated assistants like dental therapists who work with the OHFR can execute ART. These assistants can offer ART outside of the existing clinics and therefore ensure a bigger part of the population receives access to preventative and curative care.

Masterclass

Together with colleagues of the directly involved dental therapists with the OHFR a yearly masterclass is organized to activate several dental therapists to give a preventative lesson and to improve their techniques in dental care. In this case, the oil slick principal takes place. The more dental therapists participate in the masterclasses, the bigger the national coverage becomes.

Memoranda of Understanding (MoU)

At the moment, the OHFR has three Memoranda of Understanding (MoU) in Rwanda, namely: the ministry of health (Minisanté), the Eglise Presbytérienne au Rwanda (EPR) and Sinapisis (an organization that is dedicated to help orphans and displaced persons. The MoU’s are a continuation of the intention to work together on the dental care projects. The EPR manages hospitals, health centers and pre- and middle schools spread across Rwanda. Sinapisi has health programs at schools that are managed by Sinapisi itself. The MoU together with Minisanté are important, because the OHFR receives recognition and also approval of the Rwandan authorities to expand her dental activities.

Yearly request to extension of registration

To be able to work in Rwanda as an INGO a yearly request to extension of registration has to be presented. Documents that have to be discussed, among others, are those where it is indicated what de realized project were of the past year and what the activities will be of the following year. For the extension of the approval documents of the districts in which the OHFR has the intention to work and a financial justification of the realized and future projects also have to be presented.