Taking dental care to new heights
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“Being part of something that is adventurous, worthwhile and quite different to everyday life. Being involved adds a huge dimension to my life. For me it is not so much a case of ‘why help?’ it is ‘why not help?’” explains Dr Julian Haszard about his inspiration for working with SmileHigh, an organisation committed to reduce the level of dental caries in Nepalese children. As SmileHigh director, Dental Learning Hub spoke to Dr Haszard about the achievements and future goals for the initiative.
It seems that SmileHigh came about through a number of circumstances, mountain climbing being a prominent aspect. Did the opportunity came to you or did you create it?
Julian Haszard: I saw an opportunity to do something that I had dreamed of and at the same time combine some large aspects of my life. It was an opportunity to combine my dental skills and knowledge, my passion for climbing and what I had learned in the New Zealand army about leadership, management and organisational structures. In 2003 I actually believed that I might have the knowledge, skills and ability to start a project that would have a good chance of reducing dental caries in the Nepal.
Briefly talk about your work with Dr Mingma Sherpa and how this formed the basis of SmileHigh.
Julian Haszard: I met Mingma in Kathmandu just after I arrived for the first time, about to attempt to climb Cho Oyo (8201m) the sixth highest mountain in the world. I was quite daunted by this prospect. Mingma had just completed his dental training in Fiji and was working in a dental hospital in Kathmandu. I was very keen from this initial meeting to do all I could to support Mingma. He had a very friendly personality and I could tell he was going to be a great person to work with. After climbing Cho Oyo I met up with Mingma again and we travelled up into the Khumbu valley.
It was here that we started talking about how we might reduce dental caries in the children of this region. The friendship has grown over time at the same time that SmileHigh has developed. I have been aware of the challenges that Mingma has faced as a dentist in Nepal.
How do you recruit volunteers to join you on these missions in the mountains?
Julian Haszard: We do not actively recruit people to help with SmileHigh. Our approach is to let people know about what we do and leave it open to them to decide if they are interested in becoming involved in some way. Generally speaking, people want to contribute in different ways. We feel it is important that those that do become involved are able to decide for themselves the extent of their involvement.
SmileHigh is about helping people in Nepal, many of whom are our friends. To achieve this we do our best to remain sensitive to their needs by asking the people to actively participate in problem-solving. It is important that the outside people who become involved with SmileHigh understand this approach.
Explain SmileHigh’s approach to train local Nepalese people as dental therapists in order to continually carry out your work.
Julian Haszard: We believe very strongly in the principles of empowerment and sustainability. This is why we are helping with the training of people who in turn will educate and train others in their communities about dental health care. We do not want SmileHigh to be reliant on clinicians from outside of Nepal. Otherwise we would be in a position where once the flow of clinicians from outside stops (which is inevitable) that the original problems will resurface. It is far better to promote the concept of communities taking real responsibility for solving their own problems. SmileHigh is just in the background trying to initiate and facilitate this education and problem-solving process.
Your approach to dental care is firstly preventive, with extraction as a last resort. Are there any challenges to educate the population about adopting personal oral hygiene habits?
Julian Haszard: It is very difficult to change the habits of anyone. The only way to achieve a change in diet and oral hygiene habits is by delivering a simple and consistent message that must be repeated and consolidated over time. This is what we are doing. We have a long-term approach to the problem of high caries in certain communities of Nepal. Communication is very important. Above all we are prepared to examine all the children once a year and determine where we are seeing changes and where we are not.
In this way we can identify children at risk and look more closely at the situation that is leading to the problem on an individual or family level. For example, where we have discovered patterns of high caries within a family we have SmileHigh staff go into the home and educate the parents about dental health. We have also made a very big effort to distribute tooth brushes and fluoride toothpaste. Having fluoride available through toothpaste is critical to a reduction in caries as this is the only source for these populations.
What’s next in store for SmileHigh?
Julian Haszard: We are trying to consolidate the achievements of the last 5 years and refine SmileHigh so that information is easily accessed, easy to understand and resonates with potential supporters. We have achieved a big part of it recently with the launch of our new website. We have also launched the SmileHigh Club, which is a support group for our organisation and we would like to expand the membership as much as we can.
On the ground in Nepal we are focussed on training more therapists and getting into the field as much as possible to provide care and constantly reiterate our diet and oral hygiene message. We have also made plans to expand into a new region, the Langtang region. Now that we have 5-year track record of success we want to plan ahead as much as possible with a vision of achieving much more.
Hear first-hand about volunteering for SmileHigh from Antonia Moa here
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