"A Hectic Day at Fantsuam"

The Fantsuam Foundation team could have been forgiven had they spent the whole hour of last Wednesday's UK-Nigeria online meeting talking about the success of their UN Sickle Cell Awareness day which had taken place just a few days earlier.

However, they knew the UK team had already been fully updated about this superb event via Cicely's blog, John's report about the radio panel and, of course, by viewing the great photos taken by those on site. So instead we moved on swiftly to the next pressing issues.

John started the meeting by explaining that it had been a "hectic" morning as they had been visited by a project review team from Save The Children. He told us: "We have just completed the Child Carers project which they funded. They have come to talk to the children and grandmothers whom we worked with during the project."

This is part of the social care that Fantsuam provides for the community. The grandmothers, known locally as Kakas, have offered their help to care for a number of their orphaned grandchildren. John went on to explain that there is now a role reversal and in some instances it is now the children who are caring for their grandmothers and siblings.

The second half of the meeting took the form of a discussion looking at some of the practicalities and applications of mobile phone use in rural Nigeria.

John went on to inform us that staff had found phone access in the most remote locations during Fantsuam Foundation's ESSPIN visits which took them to remote areas in Kaduna State.

Cicely, a VSO at Fantsuam, said that a big problem for her is the lack of phone networks in those rural areas, plus their erratic nature and the cost of making calls. She reported that a 10 minute phone call cost her nearly N300.

John explained that: "The providers are concentrating on urban centres where they can make the most profit. Government is yet to meet the challenge of providing the incentive for providers to explore rural locations. The providers say they have to cover cost of diesel for their generators: that's where the high price comes in."

This led to a lively discussion about how mobile phones could be used in rural communities to save lives and to share important information about events or health education. John concluded: "That should be the challenge, what do you do in spite of these constraints to save life through easier, affordable phone access?"

The team had many good ideas so it was agreed that "mobile phones in Rural Africa" should be the topic for next Thursday's First Thursday meeting. Please do join us in the continuation of this debate.

Other subjects mentioned included:

The development of the Fantsuam Foundation website
Ladi, who recently joined the Nigerian team as Knowledge Resource Officer, is now into her second week and John confirmed that she will be an important administrative link between the two teams.
MIS advisor due to arrive at Fantsuam on the Wednesday.



Using the University of Toronto's Webmail service I have communicated with both Dr. Michael Gurstein at the University of Toronto and Pamela McLean. I have agreed to provide some open source information consisting of health topics on preventive dentistry, nutrition and hygiene. I hope this will be of some benefit for the Dadamac Community. Sincerely, Laurie Kagetsu University of Toronto, Masters of Information student INF2167 Final Project Laurie Kagetsu BIBLIOGRAPHY and SUMMARIES-Preventive Dentistry, Nutrition and Hygiene 712051618 Open Source Articles 1) Pediatric Articles – Ages birth to 25 years. A) American Association of Pediatrics (2008). Preventive Oral Health Intervention for Pediatricians. Journal of the American Academy of Pediatrics,122(6), 1387-1394. Retrieved June 28, 2010 from http://pediatrics.org/cgi/content/full/122/6/1387 SUMMARY: Dental caries is a common oral disease that occurs in children. Acids are formed when the cariogenic organisms feed on the dietary sugars that are contained in the dental plaque that adheres to the tooth surface. This acid demineralizes the enamel and can penetrate very deeply is left unchecked. It is therefore very important to practice good oral hygiene and eat a healthy diet. Parents and caregivers should be counseled on the importance of reducing exposure to sugars in foods and drinks. Starch causes decay at a slower rate than sugar. It is also important to practice good oral hygiene for infants who have teeth since they are at the same risk for developing dental caries as children are. The flowing are guidelines recommended by the American Academy of Pediatricians: a) It is beneficial to breastfeed infants beyond the first year of life if possible b) Be sure to cleanse the gums and teeth after feedings and before bedtime after nursing immediately after removing the breast from a sleeping infant’s mouth. c) If a bottle must be taken to bed it should contain only WATER. Try to discourage the child from sleeping with a bottle. d) Limit sugary foods and drinks to mealtimes. e) Avoid carbonated beverages and juice drinks since these have high sugar content. f) Encourage children to drink water and milk between meals g) Encourage children to eat fruits and vegetables, h) Limit the intake of 100% juice to 4 times a day since it is very acidic. Try to encourage the child to have the juice with a meal or rinse with water immediately afterwards to try to dilute the acidic effect. B) Iida, H., Auinger, P., Billings, R. J., & Weitzman, M. (2007). Association between infant breastfeeding and early childhood caries in the United States. Pediatrics, 120(4), e944-e952. Retrieved June 28, 2010 from http://pediatrics.org/cgi/content/full/120/4/e944 SUMMARY: This study shows that there is no connection between the development of early childhood caries (EEC) and breastfeeding. Unfortunately, socioeconomic factors such as poverty and ethnicity influence dietary and oral health related behaviours and thus an increased risk to ECC occurs. This could be related to access to dental care as well as duration of breastfeeding. More research is necessary to identify the contributing factors that link poverty and Mexican ethnicity to an increase in early childhood caries. Studies do show a positive relationship between EEC and children who are exposed to either prenatal or postnatal cigarette smoke. This stresses the need for timely caries risk assessment and regular dental visits for all children, especially those children whose mothers smoke &/or smoked during pregnancy. C) Marshall, T.A., Levy, S.M., Broffitt,B., B., Warren, J.J., Burns, T.L., & Stumbo, P.J. (2003). Dental caries and beverage consumption in young children. Pediatrics, 112(3), e184-e191. Retrieved June 28, 2010 from http://pediatrics.org/cgi/content/full/112/3/e184 .SUMMARY: Recently, milk consumption has reduced and has been substituted by high sugar content pop and 100% juice. This results in a decrease of calcium intake and an increase of dental caries and childhood obesity. Pain from untreated decay can affect eating, speaking and subsequently growth and development as well as decrease in performance and school attendance. Both excessive energy and poor nutrition are associated with diminished immune function. High sugar beverages are typically low in nutrients. Poor diet and low immunity plus a lack of calcium uptake leads to an increase in childhood illness. Fluoride is associated with a reduced extent of caries control and therefore shows a protective effect. It is important that pediatricians, pediatric nurse practitioners and dieticians support pediatric dentists in providing preventive guidance to parents of young children. 2) Adult Articles A) Fiscella, K., & Frank, P., (2009). Vitamin D, race, and cardiovascular mortality: Findings from a national US sample. Annals of Family Medicine, 8(1), 11-18. Retrieved June 29, 2010 from http://www.annfammed.org/cgi/reprint/8/1/11 SUMMARY: There is a strong association between low serum Vitamin D levels and an increased cardiovascular mortality (especially myocardial infarction) that is preceded by the development of cardiovascular-related diseases such as diabetes, chronic renal disease and hypertension. The research reveals that there are racial predispositions to the relationship of low serum vitamin D levels and cardiovascular mortality. Lower levels among blacks reflect decreased sum absorption due to a higher concentration of dermal melanin and subsequent lower Vitamin D absorption. Although limited data from randomized controlled trials (RCT) is available supplements higher than those currently recommended would be required to substantially increase levels among those in the lowest quartile. More RCTs of vitamin D supplementation for the population with low Vitamin D serum levels improve the outcome of cardiovascular mortality, particularly among blacks. B) Kawakami,N., Tsutsumi, A., Haratani, T., Kobayashi, F., et al (2006). Job strain, work support, and nutrient intake among employed Japanese men and women. Journal of Epidemiology, 16(2), 79-88. Retrieved June 29, 2010 from http://www.jstage.jst.go.jp/article/jea/16/2/79/_pdf SUMMARY: There is a weak relationship and inconsistently association between nutritional intakes with job strain and work support. There was a positive correlation involving employed men who experience a high degree of job strain and high poly-and mono-unsaturated protective fatty acids. No significant association was found between job strain and nutrient consumption amongst women. There was also a positive correlation with the daily intake of crude fibre, protein, and vitamins which is attributed to a greater intake of vegetables and fruit during social interaction. C) Marshall, T. (2009). Chairside diet assessment of caries risk. Journal of the American Dental Association, 140, 670-674. Retrieved June 29, 2010 from http://jada.org/cgi/content/full/140/6/670 SUMMARY: Patient education and motivation are important factors in achieving the desired outcome. Oral health care practitioners should include an assessment of diet-related caries risk factors in the patient’s initial health history. It is important to assess each patient’s dietary habits before providing each patient with a custom tailored preventive dietary recommendation. D)Marshall, T.A., Stumbo, P., Warren, J.J., & Xie, X. (2001). Inadequate nutrient intakes are common and are associated with low diet variety in rural community-dwelling elderly. Journal of Nutrition, 131, 2192-2196. Retrieved June 29, 2010 from http://jn.nutrition.org/cgi/content/full/131/8/2192 SUMMARY: Poor/marginal nutritional statu is linked to increased morbidity, chronic disease and mortality in community dwelling and hospitalized elderly. Inadequate energy intakes results in lower body mass and is associated with functional decline, cognition abilities and elder failure to thrive. This study shows that rural, community-dwelling elderly consume inadequate nutrients and multivitamin and calcium supplements as well as consumption of a variety of foods from all food groups is recommended. E) Ojimima, M., Hanioka, T., Tanaka, K., & Hitoshi, A. (2007). Cigarette smoking and tooth loss experience among young adults: a national record linkage study. BMC Public Health 7(313), 1-7. Retrieved June 29, 2010 from http://www.biomedcentral.com/1471-2458/7/313 SUMMARY: Tooth loss results in a decrease of masticatory function resulting in poor nutrition. This may contribute to an increased risk of systemic disease such as cardiovascular diseases and hypertension as well as quality of life. This study revealed that there was a positive correlation between cigarette smoking and the prevalence of decayed teeth and tooth loss among young adults after behaviour factors such as oral hygiene practices were accounted for. 3) Oral Disease and Conditions A) Abdellahft, H., & Burt, B.A. (1987). An epidemiological investigation into the relative importance of age and oral hygiene status as determinants of periodontitis. Journal of Dental Research, 66(1), Retrieved June 29, 2010 from http://jdr.sagepub.com/cgi/content/abstract/66 SUMMARY: This study indicates that periodontitis is mainly related to the oral hygiene status of the subject. Although the prevalence of periodontitis increases with age the increase in incidence is significantly less in the good oral hygiene group. In fact, studies show that the effect of age is negligible when good oral hygiene practices are maintained. B) Marik, P., & Kaplan, D. (2003). Aspiration pneumonia and dysphasia in the elderly. CHEST, 124, 328-336. Retrieved June 29, 2010 from http://chestjournal.chestpubs.org/content/124/1/328.full.pdf+html SUMMARY: An intact cough reflex and preserved swallow function are important respiratory defense mechanisms that prevent oropharyngeal aspiration which increases the risk of aspiration pneumonia. In the US, for elder patients community-acquired pneumonia (CAP) is a major cause of morbidity and mortality. Risk factors leading to CAP include heart disease, malignancy, malnutrition, congestive heart failure and diabetes mellitus. This study shows that dysphasia has a negative impact on the quality of life and is the major pathophysiological mechanism leading to aspiration pneumonia in the elderly. Since dysphagia in the elderly is often left under-recognized, poorly diagnosed and managed it is mandatory that the medical profession increase its awareness of the diagnostic procedures and available treatment options for dysphagia in the elderly. C) Petridou, E., Zaras, A., Lefatzis, D., et al. (2002). The role of diet and specific micronutrients in the etiology of oral carcinoma. American Cancer Society, (94(11), 2981-2988. Retrieved June 29, 2010 from http://www3.interscience.wiley.com/cgi-bin/fulltext/93521232/PDFSTART SUMMARY: The Greek population has a high consumption of fruits, olive oil (lipid) and perhaps cereals. This leads to a low incidence and/or mortality from oral carcinoma which appears to be comparable with the dietary affirmation in the international literature. This study also indicates that there is relatively strong evidence that riboflavin, dietary magnesium and iron protect against the development of oral carcinoma. Open Source Associations 1) American Dental Association– http://www.ada.org/ 2) Canadian Dental Association - http://www.cda-adc.ca/ 3) Ontario Dental Association - http://www.oda.on.ca/ Open Source Databases 1) PubMed - http://www.ncbi.nlm.nih.gov/pubmed 2) World Health Organization – Health - http://www.who.int/topics/en/ Publications - http://www.who.int/publications/en/ 3) Kitchener Public Library – HealthLink - http://kplhealthlink.blogspot.com/

Hi Laurie, Many thanks for this wonderful information I will pass it onto Fantsuam Foundation. As this was published as a comment I'm afraid that some of the formatting has been lost. If possible could you please resend it to me at nicola.fishman@dadamac.net Your time and interest is very much appreciated. Nikki