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AUDIO - HSP #215 - Anoziem Ohiaeri
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VIDEO - HSP #215 - Anoziem Ohiaeri
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Learn the value that Anoziem Ohiaeri, RDTH brings to dentistry in Nigeria.
I am a registered Dental Therapist who has practiced in Nigeria for about 9years working for private practices and currently working for the government at one of its Federal Medical Centres. I studied at Federal School of Dental Technology and Therapy Enugu Between 2002 and 2006, graduated with a Higher National Diploma. I also hold a Postgraduate Professional Diploma in Development Administration specializing in Health and Social Service Development.
Email: aohiaeri@gmail.com
Twitter: @zatoothfairy
Howard: It is a huge, huge honor to be interviewing my first guest from Nigeria.
Anoziem: Yes, the honor is mine sir.
Howard: Anoziem Ohiaeri.
Anoziem: Yes, yes you are right, sir.
Howard: You are from Nigeria where my first idol and role model in dentistry is from, the capital. Nigeria is the largest country in Africa. They got 173 million people, it's half the size of United States. What a huge country.
Anoziem: It's a huge country.
Howard: The biggest city is Lagos where my teacher is from, and the capital is Abuja, and where from in? Are you ...?
Anoziem: Personally I'm from Imo state. Imo state is in the south east of the country. Currently I'm in Abuja that is the capital city. I work at Federal Medical Center as Nasarawa state, that is a few kilometers from the capital city. I was able to come over here and have the Skype interview with you.
Howard: Now remember 84% of my audience is from America and 60% is from 206 countries. Americans, they don't know what a kilometer is. They only know what a gram is if they used to do drugs in college, but if they didn't do drugs, they don't even know what a gram is. Basically I got to tell you I was so excited to have you because my favourite teacher in dental school was [Mbabi Dero Ogantabi 00:01:32] and he was from Lagos Nigeria. His wife [Kami 00:01:36] and they had 3 kids Deji boy, [Puloka 00:01:39] and Koko. He was the greatest and [inaudible 00:01:43] in the world because he back in the day, remember this is before the internet.
When I go to school there was no internet, no computer, not that stuff, but being from Nigeria he studied [inaudible 00:01:55] from thinking from Japan, and Korea, and Germany, and the whole world whereas most people learn everything their gurus taught them inside their own country. Most old dental journals are only within a country, there is almost no dental journals read anywhere around the world. Everybody is in their own country drinking their [inaudible 00:02:16] and I'm sure the 86% of Americans are just tickled to get to hear someone working in dentistry in Nigeria, Africa.
Anoziem: In Nigeria, in Africa, yeah.
Howard: Tell us about yourself, your story, how you got into dentistry, and what it's like working in dentistry in Africa?
Anoziem: Like you introduced me, my names are Anoziem Ohiaeri. I'm 30 years old. I'm from Imo state, Nigeria. I practice as dental therapist which is like a dental hygienist plus some extra duties. I work at the Federal Medical Center, Keffi, Nasarawa state. It's approximately 40 miles from the capital city, Abuja.
Howard: You are so sweet converting that to miles for us. We are [inaudible 00:03:11] Americans.
Anoziem: I had to do that. How did I get into dentistry? I was 14 year old, I had a neighbor who happen to be a dental technologist. One day I saw him boiling out wax from a flask. He was trying to pack the acrylic in. I was like, "Excuse sir, what are you doing?" He says, "I'm making artificial teeth." I asked him [inaudible 00:03:41], it looked so interesting, how do I get to learn how to do this. He told there was a school, it's my alma mater in Enugu Nigeria, south east of Nigeria. Federal school of Dental Technology and Therapy.
After my o levels, I took the entrance exam and I got in, originally to study dental technology, but I eventually changed my mind and I decided to study dental therapy which was more clinically inclined as against working in the laboratory though I still liked the idea of being a dental technologist but the dental therapist seemed ...The dental therapy job seemed more appealing to me. That's why I chose that. I got into Federal School of Dental technology in 2002. Approximately 2002. I studied for 4 years, graduating with a higher national diploma in dental therapy. I went to ... After that I did my internship. From there I started practicing in a couple private practices, then did my national service. After about 10 years, sorry, 7 years I found myself in federal medical center, Nasarawa state. That's where I am till date.
Howard: Since most of our viewers have never been to Nigeria. Tell us about what dental decay is like. Would you say Nigerians have a high-sugar diet with lots of cavities or ... Does the average 6 year old child have a cavity, or 5, or not really have a cavity? Is sugar a big part of the diet? What is the diet like in Nigeria? Would you say it's a healthy diet, mostly fruits and vegetables, or is it just a lot of packaged food and carbohydrates and sugar like it is in the america?
Anoziem: We are getting to the packaged foods and carbohydrates fast, we consume a lot of refined carbohydrates nowadays. But if you go to the rural areas, the diet is still is still very natural, so incidences of cavities still very low for kids but it's rising with the change in diet. We are adopting a lot of the western style; take-away, fast food, packaged meal and stuff. We are getting to that point where you see a lot of young kids, below 5, sometimes having cavities. Yes.
Howard: Do you ... Is it obvious to you, can you really see obvious in rural areas with the more plant-based natural diet less cavities than, and see more cavities in large cities with more packaged food? Can you really ... is that really obvious or?
Anoziem: It's not so obvious but it's significant if you've actually gone into the field. Like I did once, we went for an outreach program in a place called Nasarawa, in Nasarawa state. The kids we were dealing with were from the local community. What we saw just ... we only recorded about let's say 10%. Let me approximate here because I don't have the figures here, about 10% incidence of cavities. The rest were just accumulations of tartar, stains, very little periodontal disease of gingivitis. They generally had very healthy teeth, the kids. We saw kids within ... Between the ages of 4 to 13 years old. It was good, we didn't have so much problems.
The kids who have the most problems are the kids you find in the urban centers who ... High income, tend to eat a lot processed foods and that. The main problem here in Nigeria is not just the ... It's the problem of prevention and awareness, because a lot of Nigerians don't really know that they should see the dentist. Mostly they come to see us when they have pain. It's a symptom-based treatment seeking kind of behavior we experience here. If there is no problem, there is no need to see the dentist. That's the way it works here.
Howard: I did ... I went and worked in an orphanage in Tanzania. It was at the base of mount Kilimanjaro. Then after the orphanage we went and did climb mount Kilimanjaro. I swear to god that was the most beautiful I'd ever seen on earth.
Anoziem: Yeah, it's beautiful.
Howard: The Serengeti, oh my god, that is just ... that's better than watching a Star Wars movie. To just think that that still exist out there. I mean we just ... All we did for 3 days is like, "Oh my god, I can't believe it. I can't believe it, I can't believe." But the one thing-
Anoziem: We have beautiful places in Nigeria too. We have beautiful places. Beautiful-
Howard: I can not wait to lecture some day in Lagos. I would absolutely love to come lecture and spend time with that, it sounds like a blast. But the point that I left home with when I left Tanzania is how low the decay rate was compared to America. The other thing about America when we talk about water [inaudible 00:09:06] or fluoride in tooth paste [inaudible 00:09:08]. Tanzania has a very high amount of fluoride. It's all natural, it's all from the lake water. The lake water is very high-
Anoziem: [inaudible 00:09:17]
Howard: ... In Fluoride, and it's not like ... I didn't measure it so I can't say, but from going around affected countries, I would say it's probably about 4 part per million fluorosis. It's a good solid dose of fluorosis. [inaudible 00:09:33] those kids, okay they got a little, some little fluorosis on their teeth. They didn't need pulpotomies, [inaudible 00:09:40] steel crowns, they didn't need a bunch of [inaudible 00:09:42]. When people are telling me about fluorosis which can easily be wind out with bleaching. Sometimes you just a discounted tooth and smooth it out or whatever-
Anoziem: And smooth it out, yeah.
Howard: ... But fluorosis, there is not a kid in the world who would trade fluorosis for a pulpotomy and a [inaudible 00:09:59] steel crown. You literally got to be not right in the head to worried about fluorosis because the counties and their area ... By the way the ocean is 1.4 part per million, we just add fluoride to community water foundation for half that amount .7, but Northern Arizona is got a city of 44 part per million natural fluoride earth, 44 part per million. The teeth were all heavily fluorosis, and everybody doesn't have dental problems.
Anoziem: Everyone doesn't have dental problems.
Howard: I mean they are the-
Anoziem: We have a city in Nigeria called ... Actually it's in the North East where you have the Boko Haram problem going on now, Maiduguri. You should have heard of that, if you heard of that in the news, Maiduguri. Maiduguri has natural occurring flouride up to 1015 parts per million from the ground water sources. They have a lot of flourosis there. I worked there, I did my national service there for a few months, and I noticed that they had very low incidence of dental decay. The only problem they had, they had a lot of gum disease. Where there is no decay, they had a lot of gum disease. I had a lot of people with tooth mobility, and most of these people were, they were immuno comprised anyway. Most of them had HIV. Some of them had you know ... I think that could have a part to play in the tooth mobility and some other stuff I noticed there. All in all they had very good ... The dental ... They didn't have any ... they have very low incidence of dental decay.
Some of other parts of the country, it varies, Nigeria is a very big country. In some part they have-
Howard: It's huge.
Anoziem: It's huge, I mean it's huge. Abuja is ... Let me then put it in miles, Abuja is about 600 and something miles from Lagos. From Abuja to Maiduguri where I served about 700 and something miles. It's a big country and the distribution of fluoride is ... it varies from point to point. In some places you have really high, and some places you have normal, and in some places you have really low. We haven't really had a lot of studies that have been uncovered. We have some shortages in research. I can't say for sure whether research has been done in certain areas. I think there was a research that was done sampling the distribution of fluoride in the country. Something like that. So it's interesting.
Howard: You just mentioned HIV. What is the HIV status of Nigeria or Africa these days? Is it getting worse? Has it flattened out? Is it declining?
Anoziem: I think it's on a plateau now, because there is a lot of awareness. We have a lot of non-governmental organizations working on creating awareness, prevention, then managing clients or patients who have HIV. We have a large HIV clinic in my hospital where people come to take their drugs. There is a lot of awareness, so I think it's not progressing as one would say. But in areas with crisis, I would imagine that it be difficult to reach such places, like places in the North East where there is some crisis. I think there would be some increase maybe due to the lack of professionals around there to continue creating awareness and managing the existing patients there. That maybe the problem in such areas, but in the rest of the country, it's a peaceful and safe and people are going about their normal business, and taking their ... If they are ill they can access medical care without any problems.
Howard: Africa is so diverse. Africa has 1 billion people which is the same size population of North and South America combined. North and South America is a billion, Africa is a billion, and you could take the entire United States of America and set it in the Sahara desert and there would still be sand all around it.
Anoziem: All around it. Africa is large.
Howard: What percent of Nigeria is HIV positive, would you say?
Anoziem: I think it's very low, it should be ... I'm just guessing, I don't have figures with me, I would say less than 10%?
Howard: Less than 10%. You said 2 interesting things. You said that HIV was more prevalent where there wasn't a lot of people walking around in a public awareness campaign. So obviously the public awareness campaign is what has brought down HIV. Everybody has been talking about it. The countries that had a big problem talked about it even more, and that's what turned it around. But you also said said that a lot of people don't go to the dentist because there are not aware of it unless they are in pain. What I find funny around the world, in my country it was illegal for dentists to advertise until 1973. In the world today in many countries it's still illegal for a dentist to advertise-
Anoziem: It's still illegal, yeah it's illegal. In Nigeria it's illegal.
Howard: That's just completely crazy because if the dentist ... The more the dentist advertise, the more the people come and give them money, and what are they buying money for? They are not giving money for packaged food and [inaudible 00:15:35] they are getting money for health care, and the need of the day, at the end of the day I don't care how many luxury items you have, the ultimate luxury item is not dying, or in our profession-
Anoziem: It's not dying, it's good health.
Howard: Good health. Health is wealth. I'd rather be a peasant and live to be 100, than be a billionaire and die at 40. You know what I mean?
Anoziem: Yeah, I understand.
Howard: I hope our international listeners if you are a leader you got to write to your dental boards and societies and say, "Look, we brought down AIDS from public awareness, advertising, marketing, billboards, radio, TV, whatever you want to call it. I can't believe Hong Kong, you would think that's one of the most advanced civilizations on earth. If a dentist does advertising there he'll lose his licence.
Anoziem: You lose your licence.
Howard: It's just like ... I just don't get it. You are so young, you are only 30. I can't even remember when I was 30. I'm 53. I think I can only remember till last Thursday. I [inaudible 00:16:38] what I eat for dinner last night. You are so young, you think you'll eventually be a dentist, or are you very happy with being a dental therapist?
Anoziem: I would love to maybe do a masters degree in something related to dental hygiene or dental therapy because I had a passion for teaching. If I get a scholarship, I could study dentistry but I won't want to do that in Nigeria. I like to have a feel for it somewhere else. My main plan was to do a masters degree in something dental related, then maybe progress to a PhD, and eventually retire to my Alma mater to teach.
Howard: What would like to teach?
Anoziem: I would like to teach instrumentation. Maybe [perio 00:17:30]. I like instrumentation, I like perio, I like [pedo 00:17:34]. The 3 things I'd possibly teach.
Howard: What do you mean by instrumentation?
Anoziem: Instrumentation. As a dental therapist we use a lot of ... You call them curettes, scalers, curettes. I'm a very tall person. I'm 5 foot ... I'm 6 feet 5 ...
Howard: Are you serious?
Anoziem: Yeah, I'm 6 foot 5.
Howard: Wow.
Anoziem: Everything ... The equipment don't fit, gloves don't fit. The instruments are too small for my hand. I had to improvise, find more comfortable way of working without any detriment to my health because I suffer from a lot muscular skeletal injuries. This led me to develop my own technique of working. Like what we are taught in school to take intraoral rest, I concentrated on taking mostly extraoral rest because I have really big hands. These are the things I liked about instrumentation. I'm really good with my hands. I have always been very good with tools and that. I was pretty good at instrumentation while I was at school. Then coming to the aspect of pedo, I loved to do non-surgical periodontal therapy. I do a lot of curette touch. I do a lot of deep cleaning-
Howard: On children?
Anoziem: ... And I like ... No, no, not on children, on adults mostly.
Howard: Okay, adults.
Anoziem: Adults, yes, mostly adults. Children don't really have it that bad. Just cleaning around, just get rid of the tartar and pluck around visible. That's part of why I enjoy about those 2 things. I love kids. I find it a big challenge to get a kid to accept you, and allow you to treat him or her. That's one of the few things I like about [inaudible 00:19:36]-
Howard: If you love kids I'm going to give you all 4 of mine. I'm going on to put them in an airplane and give them all to you. Take them all.
Anoziem: No, problem, I'll take them.
Howard: I'm just kidding. The only good thing about having children is that one day they bring you home a granddaughter. That is your reward for having children. My little 3 old Taylor is my reward for not killing all 4 of my boys at the same time.
You talk about perio, what do you think you see a lot of perio in some of those regions that you were taking about earlier? What do you think it's behind that?
Anoziem: I think I'll just put it in 3 parts. In few parts I can say poor oral hygiene. Most Nigerians don't brush properly. You understand. Most of them don't have the basic skills of proper of proper oral hygiene. Tooth brushing, flossing, mouth rinse, and all that. This is due to lack of awareness. That's one part. In some cases you can attribute it to poor nutrition. I think I'll just use those 2 as [inaudible 00:20:50].
Howard: I guess I didn't ... I should ask my questions [inaudible 00:20:52]. When I go to China, not Hong Kong, but in main land china you see so much perio that the joke is in China that every restaurant has 2 sections. They have the smoking section, and the chain smoking section. There is not a no-smoking section. You have a cigarette after dinner.
Anoziem: Smoking is also a factor.
Howard: What is smoking like in Nigeria? Is it like it is in China? I have read that United States it's about 1 in 5 smoke, but at the 1950 it was half. In 1950 it was 1 in 2, now it's down to 1 in 5. Again, to all you dentists who live in countries where dentists can't really advertise. What changed that? Change that was government advertising, national campaigns, talking about mouth cancer, oral cancer. To see how that took United States from 1 in 2 smoking to 1 in 5, and then to have a country like Hong Kong say dentists can't advertise, it's just not right. What is smoking prevalence in Nigeria.
Anoziem: Smoking. Smoking is prevalent. I saw my last 2 clients on the tooth-fairy project. These are my private clients anyway, last 2 clients are smokers. I would say approximately 2 in 10 Nigerians smoke, 2 in 10, 2 out of 10 Nigerians smoke.
Howard: That's same as I said, it's 1 in 5.
Anoziem: 1 in 5? About that. It's mostly with the younger population, those under 30. A few older people smoke. It's relatively common, but it's not as prevalent like you find in China or Hong Kong like you said.
Howard: Why do you think smoking is more prevalent in China than Africa? When I was in Tanzania I didn't see anybody smoke.
Anoziem: You didn't see anybody smoke?
Howard: I didn't see it. You go to China, you can't see someone not smoking.
Anoziem: What happens is in Nigeria most smokers don't smoke in public. They smoke in gardens, in bars. It's not like you see somebody on the street smoking. Smoking in public is, I think is frowned upon. I don't think there is any law restricting. It's frowned upon. People don't really smoke in public, people smoke in private. You can't really see it like out in the open, but people do smoke a lot. If you hang out, if you go out to the bars and clubs, it's all filled with cigarette smoke. I may have to review that 2 in 10, I can bomb it up to 4 in 10. If I go to the club I see a lot of people smoking. The whole club is filled with smoking.
Howard: Now everybody figured out I'm boring because I obviously didn't go to any bars or clubs when I was in Africa. I'm too old for that.
Anoziem: They can go to open air ... Like here in Nigeria we have those popular thing we call them gardens. Green spaces where you sit out and drink beer, play board games, watch soccer, we call it football here, the English premier league and all that. Have a good time. In such places you find people smoking and-
Howard: I'm want to tell you what a Chinese dentist told me, and I want you to tell me if you believe it or don't believe it. He told me that the Chinese had a such a massive prevalence with periodol disease, because he said Chinese, Asians in general have a more constricted cervical neck. The tooth comes down to a constriction more and it really mechanically precipitates the calculus [inaudible 00:24:36] build up. Whereas he said Europeans were more in the middle, but he said the Africans had a more bobous circular singular constriction. He said he has pitied on his friends told them that [inaudible 00:24:51] crown snap on the Chinese kid because he goes into that [inaudible 00:24:55]. He says the [inaudible 00:24:56] on an African child often times they come up because they don't have that tight singular constriction. That's why they don't have as much tartar buildup. Do you find that true in comparative anatomy. Do you think Asian tartar and more [inaudible 00:25:14]crown stain on because of the constriction singular and less so in the 1 billion Africans.
Anoziem: I won't know about the Chinese because I have not had any Chinese patients, but for tartar buildup I think it varies with individuals. Even in Africa you see some people with a lot of tartar buildup, you see some without it. It's not like a fixed thing to say Africans don't have tartar buildup. Some don't have at all while some have a lot. Your Chinese dentist could have a point, he could have a point. I think that's-
Howard: When you are doing ... You do fillings then. You remove, you do MODs, the [inaudible 00:25:56].
Anoziem: No, as a dental therapist, what I do basically here in Nigeria, is that I do teeth cleanings, I do the curette [inaudible 00:26:06], I do temporary fillings once in awhile but under supervision. I do glass ionomer fillings. I do pedo extractions, I extract ... Do [inaudible 00:26:22] extractions for kids all under supervision. We are not really allowed to do extensive procedures on patients here in Nigeria. Those rights are reserved for the dental surgeons.
Howard: In your clinic how many dental surgeons are there? How many dentists?
Anoziem: In my clinic we have ... How many dentists? We have one general dental consultant, we have one [inaudible 00:26:50] surgeon. We have a periodontologist. Then we have about 18 dentists.
Howard: These 18 dentists, what is their most common restorative material? Are they doing their fillings mostly with amalgam, composite, glass ionomer, what do you they mainly ... What is their go to filling material?
Anoziem: The go to filling material for posterior teeth here is amalgam, and for anterior teeth we prefer to use glass ionomer cement. Then sometimes we do composites. I think that's it. Amalgam, composites and GIC.
Howard: I always ... I think amalgams are better. I think they are less expensive. They are less technique sensitive, they can be placed in a ... they don't have to have [inaudible 00:27:39] complete isolation to last as long. But I have noticed that ... I have always felt, and I really feel I'm right on this that Americans use the least amount of glass ionomer, and Japan where it's made, GC General Chemical, Fuji[inaudible 00:27:57]. Why do you think ... You are in the middle. Would you say you are in the middle? I'm looking at the map [inaudible 00:28:03] now, you look about half way between United States and Japan. Do you think ... Why do you think Africans are using more glass ionomer from Japan, and Americans use more composite from [inaudible 00:28:19] and [inaudible 00:28:20]?
Anoziem: We as Nigerians we don't make any of these stuff. We use the stuff that ... We use ... Most of the materials we use based on what we find in the patient. It's not because it's from the Japan or the US. We are just right there in the middle. If you are presented with a patient who has a cavity on his molar, we choose amalgam for it's mechanical strength. It's ability to withstand stress. If you put glass ionomer it might fill after awhile, and you know our patients are notorious for not coming back. We try to put something that can at least stay for awhile, that's why we choose the amalgam. In cases where some clients may request for filling at white, I don't want that black stuff in mouth, you can either go for the GIC or the composite. I think we are in middle, we borrow from everybody. We use everything we can. Anything that is available, because some of these materials are really expensive. Amalgam is relatively cheap. I work in a government hospital, most of our clients are really poor, they can't afford expensive restorations. We work with what we have.
Howard: A half of America has a hard time affording the dentist too, so I totally understand that. You have 18 dentist, and how many dental therapist?
Anoziem: We have 6 dental therapists.
Howard: So not every dentist gets to work with a dental therapist. There are just 6 dental therapists but 18 dentists, so there is more dentistry going on than-
Anoziem: Yeah, there are more dentists. What happens is that the dentists are broken into sections. We have those in diagnosis, in oral diagnosis. We have dentists in oral medicine. We have dentists in periodontology. We have dentists in child oral health care. We have dentists in post [inaudible 00:30:34]. They do different jobs. If you break it down you just find about 2 or 3 dentists, or sometimes 4 in different sections. We are 6 dental therapist. What happens is if a client needs to have his teeth cleaned. If his oral hygiene is assessed and there is a need for [inaudible 00:30:57] and polishing. The client is referred to the dental therapist. The dental therapist does the [inaudible 00:31:02] and refers back to the dental surgeons, like they are called here in Nigeria. If the dental ... If the client needs any prosthesis or appliance, or anything, he gets an [inaudible 00:31:16] and sent to the lab. We have the small, small departments in the dental clinic here in Keffi.
Howard: I was wondering in Africa, is there any country that's considered the dental leader. You are in the largest country Nigeria. Then the second largest based on population be Ethiopia, then Egypt, Congo, South Africa, Tanzania, Kenya, Algeria, Sudan. Is dentistry pretty much the same throughout those 10 countries or do you guys consider one country ... Is one country more a leader that has more African [inaudible 00:31:52] that dentists from other countries go to that country? Who is the leading, thinking, educating country in Africa where most dental meetings held. For instance in Europe, the biggest meeting by far is Cologne Germany. Everybody goes to Cologne for the latest, greatest stuff. Where is the latest cologne Germany of Africa?
Anoziem: I think I'll break it in, you have Nigeria, you have Egypt, and you have South Africa. I'll just put those 3.
Howard: Nigeria, Egypt, and South Africa would be the 3 leaders.
Anoziem: Yeah. But I'll personally give it to Egypt because they have a lot of good dentist there. I have read a lot of material coming out from Egypt. I see a lot of their stuff online, research, and all that. I give it to Egypt then maybe South Africa and Nigeria I give them a tie.
Howard: Give them a tie. Yeah, I see-
Anoziem: We have a lot of conferences in-
Howard: I didn't know the one thing Egypt is very good at is marketing the courses as a destination. People want to go there on vacation, see the pyramids and take river boats up the river, and then take courses on the sides. They kind of got that tourism dentistry going with a lot of great information. Since 86% of [inaudible 00:33:11], what do you think Americans would find interesting or don't know about?
Anoziem: Okay Nigeria. You just have to put us a few years back, but it's pretty much the same. The only problems we have, like I said where the fact that we don't advertise. In that sense we have very little awareness. We are still working on creating awareness. Every time I'm at work, I always get first-time visitors to the dental clinic. We get that everyday. "I have never been to the dentist. I have never cleaned my teeth before." We have a lot of these people.
Howard: How old would they be?
Anoziem: How old? The oldest client I have had who hasn't visited the dentist was 78? Yeah.
Howard: Wow.
Anoziem: 78. She had remarkably good teeth. She just had a few ... She had a lot of gum recession, she had few ... She had tartar.
Howard: What kind of advertising were the AIDS awareness, HIV people? What were doing? Were they doing radio, TV, billboards, pamphlets, handouts? What were they doing? What do you think was the most effective with them?
Anoziem: They did everything with the HIV campaign. They did radio, they did TV, leaflets. They did shows, dramas, and all stuff. They did a lot with the HIV campaign, same for malaria too. All those get a lot of airtime and all that. But dentist, no, we don't do any advertising. We only organize maybe free clinics where we are going to the community and we create awareness by doing free examinations. We do school visits. Sometimes I get on the radio and talk, but not in the form of advertising. I just talk about, "Hey, this is the way you should brush your teeth. These are the kind of toothbrushes you should use. You should see your dentist every 6 months, at least a year." That kind of thing. Sometimes I get on the radio to talk. Sometimes I talk to friends, in my own little way creating the awareness.
Howard: I think it's amazing how every time I have ever seen a study, there is "Humans killing humans in war." For the last 100 years, humans kill about 200 thousand other humans pr year on 100 year average. But the mosquito with malaria kills a million a year. Mosquitoes kill 5 times as many people as humans killing other humans. Do you worry ... I'm sorry to be ignorant, but do you worry about mosquitoes and getting malaria?
Anoziem: I have had malaria so many times I can't count.
Howard: Oh my god.
Anoziem: You just ... You get malaria-
Howard: Tell us about malaria because it is not a disease here, we are going have to wait for some more global warming. We are going to have to wait about another 10, 20 years of global warming before the malaria belt on planet earth gets big enough to get to Phoenix.
Anoziem: Get big enough to get to you.
Howard: So you have had malaria. What is that like? What is the treatment for it?
Anoziem: I have had malaria of course multiple times. I think the last episode I had was about 4 months ago. It comes with insane headaches. You have pains around your joints. You feel lethargic, you feel nauseous. But as an older person now, the symptoms are less, it was worse when I was a kid. I just have mildest symptoms. I'm still able to go to work when I take the medication.
Howard: It's a virus not a bacteria. Is it a virus or bacteria?
Anoziem: It's a protozoa.
Howard: Protozoa? That is ... what is a protozoa definition? Is that a single cell bacteria?
Anoziem: A protozoa is ... Let me get, it just skipped my head, my god. It skipped my head. It's a protozoa. It's a-
Howard: Google protozoa.
Anoziem: Yeah, just Google it's-
Howard: Not a fungus?
Anoziem: Plasmodium falciparum . That's the name of the protozoa.
Howard: I'm looking at it right now. That's a interesting looking. You are saying that you kind of develop ... it's a protozoa of diverse group of unicellular euchariotic organism defined as a single cell organism with animal like behavior such as motility and [inaudible 00:37:56]. You develop immunity to it. You are saying that after you've got it a dozen times, it's not as severe?
Anoziem: Yeah it's not severe.
Howard: Do you know ... Have you had friends and family die from malaria over your lifetime?
Anoziem: No, no friends, no family has died from malaria.
Howard: When it's killing a million people a year, would that just be rural, rural areas, not with access to ...?
Anoziem: It kills ... yeah, even in the rural areas, it's not as the deaths are usually from ... The most vulnerable people are usually pregnant women and new born babies. Those are the most vulnerable people.
Howard: Really, a pregnant woman is the most vulnerable?
Anoziem: They make up most of the statistics.
Howard: Pregnant women and babies. I wonder why a pregnant woman is [inaudible 00:38:49]. I would never have thought that. I assumed infants and elderly. I figured a one year old and a 80 year old would be the most vulnerable to any illness. But a pregnant woman is more vulnerable to death from malaria?
Anoziem: Pregnant woman, yeah.
Howard: Why is that?
Anoziem: More vulnerable. There is has been studies to show that there is been ... There are adverse ... That malaria adversely affects pregnancy. I'm not an expert in that field but during the period of pregnancy the woman is more susceptible to malaria. If she has malaria it affects the stages of pregnancy and all that. During ante natal visits. Women are treated for malaria and given insecticide treated nets to prevent them from having malaria and causing adverse effects during pregnancy. It's more of a preventive thing. But that's the focus, the focus is on young infants and pregnant women.
Howard: At your house do you sleep under mosquitoes nets?
Anoziem: Under mosquito nets, no. I have nets on all my windows. What I do is I fumigate my house once in 2 or 3 days. I make sure I kill all the mosquitoes and I don't have any problem. Then I keep my surroundings clean. I make sure there is no stagnant pools because if you have a stagnant pool of water, that's where the mosquitoes go to lay their eggs and ... Just make sure your surroundings are clean so you have less mosquitoes around you.
Howard: You know what interesting is I live in Phoenix Arizona-
Anoziem: Recommended that you use-
Howard: It's a desert.
Anoziem: Yeah, I bet you don't have mosquitoes there.
Howard: Exactly, interesting. When I moved here in '87, it was mostly desert, desert landscaping and there were no mosquitoes or flies. Then the 30 years I have been here, all they have done is build golf courses and man made lakes and all these stuff, and now I'm eaten alive by mosquitoes. Golf courses, lakes, and there were so many of the screaming back in the days saying, "If you want golf courses and lakes and all" I said, "Go back where you come from in the Midwest. Go back to Kansas and Iowa." But they made it look just like Kansas, and there is mosquitoes everywhere. Those things ever did get malaria it would be an issue.
Anoziem: But you don't get malaria, do you?
Howard: No, we don't get malaria but-
Anoziem: Do you get malaria there?
Howard: No. I don't know why.
Anoziem: That's good. It's nasty. You don't want to have that.
Howard: I don't know why the mosquitoes [inaudible 00:41:28].
Anoziem: I was going to put this up, we are somewhat disconnected from the rest of the world when it comes to dentistry. I have noticed that dentistry is compartmentalized. There is dentistry in this country, there is dentistry in the next country. I was thinking of partnerships. Great minds such as yourself. You know a lot of professors, doctors, and I'm sure they are itching to do something good in dentistry all around the world. They could partner with our schools, and educational systems to give us the right kind of training or extra training. Get us up to date with the latest happenings in dentistry. I was fortunate to be introduced to Dentaltown or Hygienetown by a friend who used to get subscriptions magazines back in the day. That's where I started getting new research, ideas about what's happening in dentistry. We need partnerships. Exchanges, people going to study, bringing back this knowledge and using it develop our own dental profession here in Nigeria.
Howard: You know what? First of all, Dentaltown has been out since 1998, and every single time any dental ever got on the message board and says, "Is there any chance any you American dentist could come over here to Albania, any of these countries and teach a course on root canals, or implants, or whatever." Every single time they get a volunteer who says, "I'll do it." American dentist love that stuff. If you go on DentalTown, there is 53 sections. There is fillings, crowns, [inaudible 00:43:14]. One of them is international sections. If you went to Nigeria and you post it. You said, "We would really love to have an [inaudible 00:43:23] come over here or pediatric, or whatever." Oh my god they love it. That's why I started digitizing all those courses on Dentaltown. We are going to have those available on your [inaudible 00:43:35]. How is the internet speed on Dentaltown compared to other websites in Nigeria.
Anoziem: The internet speed here is really bad. I had to leave my station to come to Abuja to use a friend's internet in his office where it's really fast. If I was in my station I wouldn't be able to talk to you as smoothly as we are talking right now. But in-
Howard: Is Dentaltown about the same performance when you are on the computer at the other sides?
Anoziem: Yes, it's the same performance.
Howard: Some consultants were telling me I need to move my data bank over to the eastern hemisphere to increase performance time. We are looking into that now. But you think the performance on Dental Town is good?
Anoziem: The performance for us here in Nigeria, we have really slow internet. Our internet is not as fast as you get in the US, or Europe or in Asia. For our own level of internet performance, Dentaltown opens just fine for me. It works just fine. I use Hygienetown most-
Howard: Have you told the 18 dentist that work in your facility about Dentaltown?
Anoziem: Yeah, I have told quite a few of them. A few of them are aware of-
Howard: You know what would really help for ACL. If you go to my podcast on iTunes or you go to it on YouTube and you write a review. It really helps just here. In fact all my listeners out there I would give anything if you write a review because if you wrote a review from Nigeria and an Nigerian was searching dentistry on iTunes or Google or whatever, they point them to where the reviews are. If you could write me a review from Nigeria that would help me get into a billion people on Africa, that would be great. If there anything that you want to do a partnership with Dentaltown. If there is any ideas or dreams or fantasies you have about a partnership or working together, just get on Dentaltown, start you own thread and say, "I'm Anoziem Ohiaeri, and I'm a dental therapist from Nigeria, and I wish this," and I swear to god, I remember ... People have asked for used equipment.
There was one, I was in Tanzania and I went into a dental office. I was talking to some woman dentist who was all dressed up in her [inaudible 00:46:10] and Sari and I could just see her eyes. I asked her, I said, "What is your biggest dream or fantasy in dentistry?" She said, "Someday I want an extract machine." She posted. I took a picture of us, post it on Dental Town, and in one hour a dentist from India and two different dentists from United States said, "I'm shipping you my extra in right now. I just put in a new, and I have had this other one sitting in the backroom for whatever." Then it was so funny because then she told me she goes, " I feel bad because I have 3." I say, "Well then sell the other 2 and keep the money." In life we don't get what we deserve, we get what we negotiate. If you have a dream, whatever, just post it on Dentaltown, or you can email it to me, howard@denataltown.com. If somebody wanted to reach out to you, how can they reach out to you?
Anoziem: My email address. I have an email address is aohiaeri@gmail.com.
Howard: Spell that Aohiaeri. Spell that Aohiaeri. A-
Anoziem: A-O-H-I-A-E-R-I@gmail.com.
Howard: That was a-o-h-i-a-e-r-i. Men that's a lot of vowels in one name. You only have 2 consonants out 9.
Anoziem: That's my email, then I'm on Twitter @zatoothfairy.
Howard: How did you get that name? I thought that was such an adorable on Twitter, za. What's za toothfairy? What's za stand for?
Anoziem: It's like-
Howard: Zatoothfairy-
Anoziem: Tha tooth fairy-
Howard: Tha?
Anoziem: Yeah, tha like the way a German or Eastern European would pronounce the za tooth fairy.
Howard: That's what I thought it was, that's what I thought, zatoothfairy. Why the toothfairy?
Anoziem: A friend of mine ... Because I was always going from house doing cleanings, that's the tooth fairy project. Since a lot of clients would not come to the dental clinic, I put together some money. I got a mobile dental chair, foldable chair. A foldable xerobox with suction and the slow speed [inaudible 00:48:30] and the fast spied, and all that. The syringes and all that. Then I have my [inaudible 00:48:35] ultrasonic scaler. I have all that. I can go from house to house and do cleanings. Once in a while I get called up for community visits to programs where we do free health checks, dental checks, then few lucky people get to have their teeth cleaned. That's the toothfairy project.
Howard: on Twitter he is @zatoothfairy.com, you got go, somebody is on you.
Anoziem: Yeah.
Howard: I tell you what? Americans have big hearts, they love to share stuff, they love to help. You start a thread on Dentaltown, you tell them what you need. People listen here, and I tell you what, you'll get what you want.
Thank you for being my first guest from Nigeria, Africa. I just think you are adorable, I think you are amazing. I love your energy, your [inaudible 00:49:25], your passion, your enthusiasm. It was an honor that you spent an hour with me.
Anoziem: Yes sir.
Howard: Have a great day.
Anoziem: The honor was mine, sir, thank you very much.
Howard: Okay bye bye.
Anoziem: You too sir