Afghanistan Dental Health - You Don't Want to Have a Tooth Problem in Afghanistan...

We are having a tough time at the moment. I have had a toothache for the last four days which is increasingly painful and northern Afghanistan, while a great place in many ways, is not replete with good dental care services.

I can’t just pop off to the dentist here - I could go to the local one, but options they offer are to do nothing, or pull it out.

There is even a proverb to that effect..."The tooth that hurts – pull it out!

Must happen often.

Certainly plenty of Afghans, on hearing I have a toothache, grimace sympathetically, then stretch open their jaws, showing a landscape of gums, holes, fillings, empty spaces and the occasional tooth.

I probably should go out to Peshawar and have the dentist there look at it, but this means flying out and staying in Pakistan for a week.

I am not easy to live with.

Then again, [my wife] has had her own problems since last Friday. She doesn’t want to take anything in case she may be pregnant.

The drug we need is Furamide, but no one has it in town yet, 'though we have ordered it. Everyone I ask brings out Metronidazole with a confident smile. I say "No, Furomide, Furomide, Furomide! It’s like Metronidazole!".

The shopkeeper points to the Metronidazole. I repeat, "No, Furomide!". Incomprehension. As though I’d asked for a ride on a rockinghorse.

On Tuesday the toothache was bad; on Wednesday it was worse.

Liisa, our self-appointed team dentist, took me home, clucking maternally that I should have told her yesterday, at our staff meeting. She could have brought her tools to look at it, "so why didn’t I?" she asks.

"I donno", I mumbled. Like all toothaches, you just hope it will go away.

At her home, she sat me back in the chair and poked around and said she couldn’t see anything, but thought that the filling had gone bad.

On Wednesday night I took even more painkillers. On Thursday, I took a mind-altering drug called Sozagon...Liisa’s recommendation.

An innocuous little orange pill, and within 15 minutes I couldn’t walk straight and in a round-about way sort of went to bed and had strange, exciting, arousing dreams that I had to keep to myself.

On Friday, I was untouchable. Jumping, moaning until the painkillers set in, then I’d be bearable for about 2 hours, then they’d wear off and I’d take some more and I was grumpy again till they kicked in. Codiene, Sozagon, then later another Sozagon, Panadol, Ammoxcillan, more Sozagon, then Iboprufen, Penicillin, then Panadol.

On and on. I carried a wad of tablets in my pocket, I was eating them like Smarties. On Friday afternoon, Liisa and I decided to try to find a dentist.

In our town in Afghanistan, the dentists hunt in packs, alongside Hospital street. The internationally recognized dentist sign in Mazar-i-Sharif is a pair of Mick Jagger lips and a set of teeth on a sign. With surprisingly little difficulty, we found one.

Only a short wait and it turns out Liisa knows the dentist from a few years ago. He goes by the inauspicious name of Mohammed Ali.

He enthusiastically sets me down in one of those old plastic school chairs, and without the least hesitation – for example, to wash his hands or something like that, has a good look.

Liisa advises him not to drill it, saying this filling is a very hard amalgam from the West. She should know better than to set forth a challenge like this to an Afghan...sort of like saying "Betcha can’t pummel that Russian over there".

Rubbing his hands, the dentist cranks up his foot-pedal powered drill. The first and last time I saw one of these was back in Perth, at an antique display.

His pace is cracking to begin with, and he seems to be making headway, but his is obviously out of shape, and slower and slower the drill turns, till I can count the revolutions and hear him panting.

Liisa peers on nervously, obviously feeling motherly and responsible. "AHaaaaaa!" he says, like he’s found gold.

He pulls the drill back and I rinse and spit into a bowl that is still bloody from the last occupant’s expectoration, coagulated tissues wadding the drain hole. Then follows a short and heated dialogue about the next thing to do.

He has got through to the pulp and wants to kill off any infection with arsenic. Liisa won’t hear of it. She inflates in her vehemence, dwarfing the venerable doctor.

She allows him instead to pack it with a temporary filling. "Or I could pull it out?" he slips in.

Mohammed Ali packs it. Actually, until he started the packing, I had been feeling pretty good. The pain had reduced, and for that alone, I would have kissed the dentist and Liisa and the dentist again with relief.

But the packing changes things.

Into what must be a small, he manages to wedge about eight cotton balls and a tablespoon of cement.

Immediately, the pressure begins to build and my eyeballs begin to bulge, but optimistically, I tell myself it is just readjusting.

I rise, rinse and spit again and pay. 200,000Afs...about $1.50.

An absolute bargain, I tell myself and we shake hands. Mohammed Ali holds my hand long, and looks me deep in the eyes. "I really can pull it out if it hurts" he says.

Downstairs, Liisa and I part. I don’t let on, as I’m sure she will want to turn around and go upstairs again, but my tooth, mouth and head all feel as though they will imminently explode and I don’t want to be around her when they do.

I hail the nearest cab, scratch the paint off the door in my haste to get in and in the best Farsi I can muster, tell him to hotfoot it home, to the Street of Grandfather Qambar.

He drives, I pound the dashboard. "Tooth hurting? he asks, astutely. "You know, we have a proverb for this…"

"Yes, yes, I know. Let’s drive quickly" I say.

He gets the hint, drives fast and we bound along the stony track like a tin can strung behind a wedding car. I barely notice. Reality has become a narrow corridor, a passage between here and getting rid of the pain in my tooth.

Reaching home, I move faster than I have for a long time, flinging the driver 50,000Afs and leaping from the still-moving vehicle.

No time for customary long good-byes, may-you-not-be tired, may-your-night be safe, may you be well and go well.

I’m out of the car, in through the front gate, the front door and study door bang almost simultaneously as I grab the forceps and a mirror with precision efficiency.

[My wife] has only just caught on that I’m home, before I’m out again, back out in the sunlight, to illuminate my mouth as I pull out Mohammed Ali’s temporary packing. The relief is paradisaical, supernatural.

[My wife] comes out to find me leaning back in the chair, a mound of bloody cotton beside me as I gradually regain my vision, normal blood pressure and pulse.

I look at her as the pain subsides and it seems she has never been more beautiful. She looks at me...a dishevelled, sweating, a panting wreck created by a filling gone bad.

"You are going to Peshawar" she says.

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