In her experience as a dental therapist, 26-year-old Esperance Niyigena has observed how difficulties in communication and language barriers can impede individuals from accessing or delivering services. She encountered a specific instance where she struggled to effectively communicate with a patient who had a hearing impairment.
During her fourth academic year in February 2022, Niyigena encountered a deaf man at UR Polyclinic during a clinical placement. Despite having a dental issue, the man faced difficulty expressing himself to Niyigena.
"I remember looking at him, trying hard to use sign language to explain his dental problem, but unfortunately, I couldn't understand him or his condition. I empathized with his pain. I asked for assistance, but most dentists were not proficient in sign language. Fortunately, a student with basic sign language skills was able to help him access the necessary services, but it was clear that the communication was not satisfactory."
Niyigena emphasised that providing information is crucial for a proper diagnosis. She pointed out that without the patient's history of the condition, healthcare workers are unable to conduct a thorough examination of the deaf individual.
The scenario prompted the dental therapist to enroll in a three-month sign language course at the Rwanda National Union of the Deaf (RNUD) after graduation. Her goal was to improve her communication skills with the deaf community. She successfully completed the course and received a certificate in March.
In June this year, Niyigena started an initiative, Leave No One Behind', that aims to provide oral health education to individuals with hearing disabilities by utilising sign language and practical demonstrations of oral hygiene practices.
The idea was developed after realising that these individuals are not taken into consideration when designing educational health-promoting programmes.
As a recent graduate without a job, she lacked the funds to support her initiative, particularly when it came to purchasing the necessary equipment. Fortunately, she was able to secure a small alumni venture fund of $500 from an international NGO, MCW Global, which she used to buy the essentials for her project.
The NGO also provided her with the skills to design solutions for community issues. As part of her initiative, she reaches out to communities with cooperatives for the deaf.
"I usually approach the deaf in their cooperatives, explain my initiative in detail to them, and schedule a convenient day to meet. When we meet, we introduce ourselves to each other and after, I start with the basic education. I explain to them the essence of oral hygiene," she said.
Niyigena then proceeds to demonstrate how to brush their teeth and tongue gently, along with other important techniques. After the instructional sessions, she requests them to depict the lessons they have learned and supplies them with toothpaste and toothbrushes.
After a week of oral health education, she communicates with community leaders to follow up and determine if what was shared had an impact.
According to Niyigena, some deaf individuals have admitted that their lack of knowledge about proper oral hygiene and infrequent dental check-ups have led to tooth sensitivity and pain in their gums and teeth. However, with oral education, they have been able to begin taking care of their oral health like never before.
Future plans/challenges
Niyigena has conducted oral health training sessions for 60 deaf individuals, including members of the United Deaf Women Cooperative and Icyizere cy'Ejo Hazaza Deaf Women Cooperative.
Niyigena looks forward to helping two communities every month. This month, she anticipates visiting communities, such as Gatagara, as she awaits confirmation from leaders of other communities.
Her plan is to reach more people, especially in rural areas. She wants to expand her services to other people with physical disabilities who find it hard to access medical care.
"I anticipate using my platform and skills to curb the language barrier and poor oral health, however, I can't do it all on my own. I urge the Ministry of Health to provide trainings for dentists and doctors in sign language all over the country to enable effective communication," she said.
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Niyigena also calls upon the Ministry of Health to deploy more dentists in different hospitals to reach more patients, especially those with hearing impairment in rural areas.
She also noted that the common diagnosis for most people was dental sensitivity, even though they didn't know the cause. Additionally, many of them chose to avoid seeking dental assistance from hospitals because they were unable to receive the necessary help.
The dental therapist encourages Rwandans to visit the dentist at least twice a year and to avoid excessive smoking and alcohol consumption, as these habits increase the risk of oral cancer.
She believes that proper oral care is everyone's responsibility. If it is not practiced, one risks developing conditions such as heart disease, stroke, dementia, respiratory conditions, diabetes, cancer, and others.
Niyigena said the journey has just started but she is fulfilled by the fact that her dream of being a dental therapist has been achieved.
In her free time, she loves to spend time with her family, watching medical-related movies, or meditating. She loves sports too.
