Firstly thank you Vital for publishing our article in the autumn issue ('I feel truly humbled'; Vital pages 20-22); furthermore thanks for doing such a wonderful job of it! For those of you who missed it I, along with the rest of our eight-strong team, have recently returned from our latest African adventure with dental charity Bridge2Aid, this time in Kirambi, Rwanda. This was the charity's first trip to this country, which meant we were unsure exactly what to expect in terms of the need and desire for our work there. We were met with a very warm welcome and great demand for our service. Hopefully this will be the first of many trips to such a fantastic country, filled with the most wonderful and inspiring people who were genuinely grateful for the treatment they received.

The Kirambi community are amazing people who welcomed us with open arms

Rwanda is the most densely populated country in Africa with a population of roughly 11,690,000, meaning that there is approximately one dentist for every 1 million people (and people complain about our NHS waiting lists here in the UK!). The average life expectancy in Rwanda is sadly only 58-years-old and the average monthly wage is the equivalent of just £30.

The Kirambi community are amazing people who welcomed us with open arms; they are so proud and self-sufficient, very keen to learn and also to help us. The population of Kirambi is around 31,870. Their main income is from subsistence farming and the leading occupation is agriculture, which in itself shows just how hard working they are. It is a very structured nation, focussing on improving itself for the future.

Sarah wins Beverly Hills Formula products worth £100.

Sister Sekunda, who ran the health centre where we were based for the duration of the trip, spread the word prior to our arrival through local churches and health workers, who informed the local communities that we would be arriving and setting up a 'tooth camp' where we would be training local health workers as well as having the facility to get people out of dental pain; this ensured a steady flow of patients as the nearest health workers with any dental skills were many miles away in Nyanza.

The main aims of the Dental Volunteer Programme were to teach the four nurses - who were all male and aged between 26 and 29 - extended skills in dental extractions, cross infection prevention, sterilisation and oral health education. It was very important that the training was standardised with practical and theory integrated; the nurses' progress had to be carefully monitored and recorded to ensure this. Most importantly the focus, as always, was on training the nurses and not on patient numbers. It is an incredible bonus that we can treat so many people who are suffering with dental pain, some of whom have been in agony for a number of years, although by focusing on the training, we ensure that we leave the knowledge and skills behind thus empowering the local people and allowing them to continue treatment long after we have left. This is one of the main reasons I continue to be involved in Bridge2Aid as the training aspect is something which other dental charities don't provide. As previously mentioned it is not just the education around the skills to diagnose and extract the teeth that is shown but also the knowledge of limitations, when to refer to a hospital for surgical procedures etc; as you can imagine these are very difficult skills to learn, which means an element of experience is also needed. This is something that the nurses are keen to get!

The caries rate in Rwanda is mainly related to sugar cane consumption with soda being the secondary cause, as is the case in Tanzania; sugar cane grows freely which means that locals, particularly the children, snack on it. It is also mixed with water to produce a syrupy solution and given to small babies and young children as a high calorie meal. Hopefully with the help of our education and the community's desire to improve and progress this will change in the near future.

After passing the training and the examinations the nurses are presented with a 'dental kit' for use in their health centres by Bridge2Aid which includes instruments needed for extractions and a pressure cooker and equipment to sterilise the instrumentation after use.

Thanks again Bridge2Aid and the people of Kirambi for yet another wonderful, life changing experience that I will always remember with fondness.

If anyone would like more information they can contact me through Vital's Editor, Kate Quinlan (k.quinlan@nature.com).