by Megha Rana
What is the Issue at Hand?
Kenya faces a shortage of dental workers and dentists, leaving much of the population underserved for their dental needs. According to the Economic Survey, in 2020 Kenya had 1,090 registered dentists. However, following the pandemic around 2023, statistics from the Dentists Association of Kenya indicate that the number of dentists dropped significantly. Today, the estimated dentist to patient ratio is one to 70,000 people. Compare this to the WHO recommendation for a maximum dentist to patient ratio of one to 7,000. The lack of dentists and dental assistants in Kenya has created severe barriers to dental care for the lower and middle classes.
To compound this, the government does not view dental services as an essential part of healthcare, leading to high out-of-pocket costs which those financially struggling cannot afford. Yet, much of the Kenyan population suffers from dental diseases, which can further complicate into life-threatening conditions. An estimated 34% of the Kenyan adult population suffer from untreated dental disease (tooth-related), and 98% of the adult population suffer from periodontitis or gum-related disease. Periodontitis has been linked to respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome, and cancer.
NTS Attempts to Create a Dental Clinic
This year, NTS realized that none of our students have ever received dental care and decided to find a dental care partner, with the end goal of creating a clinic. As a long-term volunteer, I offered to take on this task in confidence that I would be able to find outside organizations. The hope was that these organizations would come to NTS to provide dental care or host a clinic at their site. Initially, I reached out to 20 organizations expecting that at least one would have a network through which I could wend my way. I also contacted dental schools, first in our Kisii region and then broadly. Not one dental school replied back.
Barriers, Barriers, Barriers
First, not one dental school responded despite multiple emails sent. The NGO’s I did contact, all had reasons for why they could not help. These ranged from losing funding during the pandemic and downsizing, to closing, to focusing their work on other areas of Kenya. Some lacked the resources to take on new patients, particularly a new school.
What Does this Mean for the Average Kenyan?
Like anyone, I hate to lose a battle. I am a scientist and have contacts to network within the medical world. So, what struck me most intensely was this: How does the low-income Kenyan, with no connections to the dental or medical world, limited phone access, and no internet for research, begin to find help? Who could they possibly reach out to? Even if they have some success, how will they afford treatment when there are few government subsidies? I also wonder about dental organizations and how they must struggle to survive, bombarded with patients and yet not making a dent in the thousands of people who need care. Are they well-supplied? Do they have access to trained clinicians, hygienists, or trained international volunteers? And what happens to communities when the organizations that keep the lives and health of thousands afloat, can no longer survive themselves?
References
Business Daily. “Kenya’s dentist shortage leaves rural poor underserved.” Business Daily. 22 Dec. 2020. https://www.businessdailyafrica.com/bd/economy/kenya-s-dentist-shortage-leaves-rural-poor-underserved-2111646#google_vignette
Gitonga, A. “Kenya faced with shortage of dentists.” Health. 1 Nov. 2023. https://www.standardmedia.co.ke/health/health-science/article/2001459677/kenya-faced-with-shortage-of-dentists
Ogada, Cyril, and Laetitia C. Rispel. ““Dentists are never seen”: Perspectives of key policy actors on multiple job holding among dentists in Nairobi, Kenya.” Jun. 2024, doi:10.21203/rs.3.rs-4518350/v1
Okumu, Brenda A et al. “Geospatial Analysis of Dental Access and Workforce Distribution in Kenya.” Annals of global health vol. 88,1 104. 21 Nov. 2022, doi:10.5334/aogh.3903
Winning, L., Linden, G. Periodontitis and systemic disease. BDJ Team 2, 15163 (2015). https://doi.org/10.1038/bdjteam.2015.163