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FRANCESCO CAMMARANO

Target Population:
Venezuela,

Francesco Cammarano has created a student-to-student didactic model in dental health and hygiene in order to lower the high incidence of dental diseases, promote prevention and education over costly treatment, and form youth leaders to teach other students and their communities the techniques of sound dental health.

This profile below was prepared when Francesco Cammarano was elected to the Ashoka Fellowship in 1998.

INTRODUCTION

Francesco Cammarano has created a student-to-student didactic model in dental health and hygiene in order to lower the high incidence of dental diseases, promote prevention and education over costly treatment, and form youth leaders to teach other students and their communities the techniques of sound dental health.




THE NEW IDEA

Francesco is converting the fifth-grade students in his program into promoters of dental health and hygiene with increased capacity for leadership. During the year of study in Francesco's program, students receive training that enables them during subsequent years to disseminate a Program for Education and Prevention to their families, communities, and the rest of their classmates in lower grades through a student-to-student didactic methodology. In this way, Francesco is forming leaders in oral disease prevention, benefiting entire communities through education and groups of youth who receive constant preventive treatment.

The country's only other existing educational programs on dental care and hygiene are implemented through the formal educational system at the university level. These programs are much more costly in terms of both time and resources, focus on treatment over prevention, and are dedicated to theory instead of practice. Such methodologies have not resolved the country's severe dental problems. Francesco's innovation is in implementing an informal educational program for younger students, motivating them to become promoters of dental health to their families and communities and educate others on the importance of dental care to prevent disease. The idea for Francesco's model was sparked by his realization that the network of dental professionals currently in Venezuela would never reach the majority of the country's population in need of dental care.




THE PROBLEM

According to national statistics by Proyecto Venezuela and Fundacredesa, 90% of the Venezuelan population has dental problems and diseases, especially cavities and gum disease. Of this affected population, statistics presented by the most recent health census show an incidence of 96% cavities and 92% gum disease. Cancer of the mouth is the third most common type of cancer in Venezuela. All of these diseases are preventable. If these problems are not resolved, the percentage and severity of disease will only increase and could spread to other organs of the human body. State priority and dental policy has focused on curative attention, which is more costly, time-consuming, traumatic, and individually-focused, than prevention and education. Moreover, the improvement and maintenance of dental health and hygiene has never been a state priority. The population wants to resolve their dental deficiencies, but is not able to due to the high costs of curative attention and lack of information on the prevention of dental diseases.




THE STRATEGY

In 8 day-long courses throughout the school year, Francesco is training 100 fifth-grade students each year to become promoters of dental health in their communities and schools. These students then take the ideas to other students in lower grades through Preventive Education Programs, of 10 minutes every 15 days, in which they discuss how to prevent dental problems, the requirements of good dental hygiene, and the application of fluoride. Currently, Francesco is developing his idea through agreements with six primary and one high school in urban and marginal zones throughout Caracas, including continuous evaluation and follow-up with 10 student promoters in each school. During the next three years, he hopes to incorporate 10 additional schools each year. Francesco calculates that these student promoters will each disseminate the information to 15 additional persons; in five years he hopes to have reached 90,000 people, not only in Caracas but in other parts of the country as well.

Francesco is training students of private and state dentistry universities through courses on General Odontology and Integrated Dentistry Clinics. He hopes to instill in them his same concerns about social dentistry and prevention programs and motivate them to develop similar programs, with his assistance in the design and application, in their own regions. Through his teaching at the Central University of Venezuela, Francesco involves increasing numbers of dental students and future professionals in his model. He also has an agreement with the Santa Maria Odontology Faculty, the only other dentistry school in Caracas, to train 25 first-year students in his methodology.

Francesco develops all of his ideas through the Foundation for Integrated Oral Prevention, FIPO, which he founded two years ago. He relies on a team of 4 staff members, as well as volunteer odontology students serving their internships. The team develops materials and training courses for each grade level, gives educational talks, and will present studies on impact and feasibility of replication in other countries.

According to national policy, all school directors in a given district, representing approximately 40 public schools, convene once a month, along with a representative from the Ministry of Education. Francesco has been invited to these reunions to share his ideas, in the hopes of incorporating his didactic program within national educational and health policy. He has attended many international and national conferences on dentistry to disseminate his model as well, including the 5th World Congress on Preventive Dentistry. Most recently in August he attended the National Odontology Conference and contacted 60 others interested in replicating his model throughout the country. In 5 years, Francesco hopes to have implemented his model in five states across Venezuela through the country's Odontology Congress.




THE PERSON

Since his high school and university days, Francesco has combined interest in social work with his desire to become a dentist. As a university student he volunteered to provide dental attention to indigenous populations and developed an educational program in two urban Caracas schools. He influenced the creation of a university subject to link students with their communities. During his last year of odontology studies he was required to serve 3 internships, which he chose to realize in two rural areas and another in a marginal zone of Caracas.

Since his graduation, Francesco has felt the need to respond to the national problem of the lack of dental care and has dedicated part of his time to social preventive odontology. He has no desire to attend to patients in a private office, but instead develops programs to reach the masses in education and prevention. He is convinced that as a health professional he must do more than simply apply techniques to cure symptoms and should be an agent of social transformation in dental health.




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