Jago J D
School of Dental Science, University of Melbourne, Australia.
P N G Med J. 1991 Dec;34(4):250-4.
For the past 30 years the organization of government dental services in Papua New Guinea has been modelled on the School Dental Service in New Zealand. Although the two most important mouth diseases occur in adults, children have been given priority. The dental work has been done by a workforce of less than 200 dental officers and dental therapists. Dental services are invisible to the mass of Papua New Guineans. Such organization of dental services has been disastrous for the oral health of the rural population. The need is urgent to integrate dental services within the mainstream health services, doing as much as possible at the aid posts, and referring on to health centres only what cannot be done at the local level. Both the present cadre of 2250 orderlies in aid posts plus the planned new 4750 community health workers by the year 2000 need to be trained in basic dental skills. The 2400 aid posts need to be equipped with a kit of basic dental materials and instruments, costing about K250 each. Training in basic dental care can be done in six weeks, and should take place within the province, under conditions as close as possible to real life. The benefits of providing a basic dental service at aid posts are obvious--the population coverage will be much higher, the range of diseases that are preventable or controllable will increase, and many of the deaths that now occur from cancer of the mouth will be prevented or delayed.
在过去30年里，巴布亚新几内亚政府的牙科服务组织模式一直效仿新西兰的学校牙科服务模式。尽管两种最重要的口腔疾病发生在成年人中，但儿童却被给予了优先考虑。牙科工作由不到200名牙科官员和牙科治疗师组成的 workforce 完成。巴布亚新几内亚的广大民众对牙科服务并不了解。这种牙科服务组织模式对农村人口的口腔健康造成了灾难性后果。迫切需要将牙科服务纳入主流卫生服务体系，在援助站尽可能多地开展工作，仅将当地无法处理的病例转诊至健康中心。援助站现有的2250名护理员以及计划到2000年新增的4750名社区卫生工作者都需要接受基本牙科技能培训。2400个援助站需要配备一套基本牙科材料和器械，每套成本约为250基那。基本牙科护理培训可以在六周内完成，培训应在省内进行，条件要尽可能贴近实际生活。在援助站提供基本牙科服务的好处显而易见——人口覆盖率将大大提高，可预防或可控制的疾病范围将扩大，许多目前因口腔癌导致的死亡将得以预防或推迟。
