Kinga Africa: “We have to work for a world free of Infant Oral Mutilation”

By Milena Rampoldi and Denise Nanni, ProMosaik. In the following our interview with Francis Muthama of the organization Kinga Africa, engaged in Kenya against INFANT ORAL MUTILATION. 
Part II of the interview can be found here.
IOM is a traditional practice violating children’s health rights. Before the interview a definition of this practice from the article “Infant Oral Mutilaton – A Child Protection Issue? By Girgis S., Gollings J., Longhurst R., Cheng L., 2016. 



Infant oral mutilation (IOM) is a primitive traditional practice involving the ‘gouging out’ of an infant’s healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/ AIDS, septicaemia and death. Other complications include eradication and/ or malformation of the child’s permanent dentition. IOM is usually performed by village healers in low income countries as an accepted remedy for common childhood illness. The gingival swelling of the unerupted teeth is mistakenly thought to indicate the presence of ‘tooth worms’. Crude methods to remove these are employed using unsterile tools. IOM has been reported in many African countries. More recently, some immigrants living in high income countries, such as the UK, have shown signs of IOM. Our aim is to raise awareness among clinicians about the existence of IOM practice being carried out among respective African immigrant groups. We encourage clinicians, particularly those working with paediatric patients to inform parents and carers of children with a history of IOM about the risks and consequences. As part of child safeguarding policies, dental practitioners and health care professionals should intervene if they are aware of any perceived plan that IOM is to be carried out in the future.



We would like to thank Mathama so much for his answers, and the photos he sent us. Infant Oral Mutilation is not spread only in Kenya, but in many other African countries. It is related HIV/AIDS transmission. And it is a pratice which must be stopped by awareness campaigns, education, and real dentists, helping people in the poor villages. 


How was Kinga Africa founded?
Kinga Africa was founded in the year 2011 by Francis Muthama and registered as a charity in Kenya on the 5th of January 2012. It was inspired by an urge to curtail dental pains after Francis’ mother and wife suffered dental problems. Looking at the oral situation in Kenya, a great need for intervention was born. Kenya has less than 1000 registered dentists serving over 42 million people. Only half of these dentists work in public hospitals hence the great need for dental clinics. Oral health education is very minimal among the populace especially from parents to their children.



What are the main factors that lead to lack of access to health education in Kenya?
One of the contributing factors especially in lack of oral health education is that oral health is not considered to be a major part of the general human health. This is the same across the divide; the poor, rich, learned, illiterate, young, old, name them, to a bigger percentage of the population, the teeth do not mean a lot.
The inadequacy of dentists and hygienists in the country has also challenges the implementation of oral health education programs. 
Health financing is either by the individual or by a national health insurance scheme that does not cover dental treatment. This locks out the poor from accessing dental services
There are always competing priorities as far as government budgeting and expenditure is concerned. You realize dental pain does not necessarily cause death as malaria, diarrhea and other ailments.  This hinders health education. Building of roads and other developmental projects come before this very important area of life. I always fear that 20 years from now we may have all the roads tarmacked, no one dying of malaria, electricity and internet connectivity for all etc, but half of the population is toothless!!!
The fact that Kenya has only two universities that are training dentistry and they each admit around twenty students for the six year course, dictates the increase in people to offer the much needed services including education.




How do you identify and select the communities where you intervene?
Upon registration, the organization was given some communities to work with. A majority of rural communities all over Kenya have no access to dental health and so the project moves from school to school, community to community educating them on oral health. Because of the prevalence of Infant Oral Mutilation among some communities, the project targets such with aim to clear the myth around the deadly practice.




What are the topics of your education programs?
In the schools
·         The importance of the teeth
·         How to take care of the teeth
·         Teeth destroying foods
·         How to brush and floss the teeth
·         When to brush
·         General hygiene including hand washing
To the communities
·         All the above
·         Teething process
·         What causes diarrhea in infants (majorly poor hygiene)
·         What to do when diarrhea strikes
·         The dangers of Infant Oral Mutilation
To teachers and community health workers
·         All the above
·         Main dental diseases, their causes, development, prevention and treatment
·         Their role in oral health promotion



Do you cooperate with local authorities and institutions? If yes, how?
We work in partnership with the ministry of health (MOH) and that of education (MOE) at the county level of administration. MOH gives us nurses and clinicians during our free dental clinics. Our school health program runs in collaboration with the public health school program (which is not operational in many rural areas).  MOH also organizes Community Health Workers for trainings on health promotion by our project. (The ministry of education arranges our visits to the schools and mobilizes teachers when we organize trainings for teachers.
Our project is the only one in Kenya that is promoting oral health. We pride in what we have been able to achieve so far; educating over 500,000 children on oral health and providing them with free toothbrushes and paste. Training over 5000 teachers and community health workers on oral health and offering free dental treatment to over 9000 patients. We host volunteers who offer free treatment and other services to the needy communities. Just like any other charity, we have challenges including limited and sometimes absence of funding. Finding dental volunteers in Kenya is a problem so we majorly depend on international volunteers who are only available a few times a year.
The project is looking forwards to building a first dental referral centre in Kenya. We are sourcing for partners.