Beatriz Avila CurielMexico • Fellow since 1989
Beatriz is a professionally trained dentist who has worked for the past 10 years in rural organizations in different states of Mexico (Durango, Sonora and Veracruz). She now plans to combine her professional background and her rural experience and set up a preventive health care and training for "barefoot dentists."
The Person
Beatriz was born in Mexico City and trained to be a dentist there. After several years of professional practice she began to work in rural areas as a part-time volunteer eventually leaving the city to devote herself full-time to administrative, credit and productivity activities in various peasant organizations. She has however, kept up her professional interest in dentistry over the years and now seeks to bring together the skills and experience of the past ten years by taking dentistry to remote areas.
The New Idea
Although the idea of the barefoot doctor has become common in rural areas of the developing world, barefoot dentistry in countries such as Mexico is only just beginning to take hold as a viable proposition for providing isolated rural communities with preventive and primary level dental health programs. With a long back record of working in rural areas mainly concerned with developing women's programs and organizing credit schemes, Beatriz Avila is proposing to create a model low cost dental scheme involving women and their families in a training and treatment program in the state of Veracruz. Beatriz will be concentrating principally in the coffee growing region of the state of Veracruz. According to her, these are the poorest and most marginal rural communities. Located high in the Sierra, they are often the most inaccessible in terms of transport and services. Drawing on both traditional medicines and modern technology Beatriz is creating a fusion of ideas that will serve in the first instance as a pilot project to be extended later to other coffee growing communities of the country.
The Problem
Dental decay is a feature of virtually 100% of the general population yet only 5% of the population has access to dental health care. 40% has limited access and 45% have no possibility of dental care whatsoever. In Mexico, dental care has been primarily curative rather than preventive, with most care in the hands of private dentists charging inaccessible prices to the economically disadvantaged. If the rural mountainous areas of Mexico receive virtually no health care in terms of general medicine, dentistry, long a profession of money-makers and elites, is even more remote. Government dental services are non-existent and peasants have to travel long distances, walking or on horseback, to the nearest town in the case of a dental emergency. In addition there is no "culture" of preventive dental care, for either adults or children. Mothers are unaware of how to recognize or deal with dental problems in their children. Through her dental program, Beatriz proposes to resolve this problem, training mothers in preventive health care, and dental promoters in increasingly complex dental procedures.
The Strategy
Beatriz's strategy is focused on two main objectives: firstly, to diminish dental disease and secondly to form a brigade of dental health workers composed of members of the communities. She hopes to achieve these two objectives by giving general talks in the community, to mothers in particular, on aspects of nutrition and dental hygiene. The training courses for the dental health promoters will be focused initially on techniques of prevention: teaching them about bacterial infection and decay, oral hygiene and how to apply fluoride in gel form. Beatriz also proposes to carry out, in coordination with the health brigades, epidemiological studies of schools and families in the community. As the health promoters progress, they will gradually deal with more complex dental problems. Finally, she also proposes that in the training sessions the promoters create their own working instruments, experiment and use alternative curative materials.