We need to volunteer, but we need to do it right

There's no room for knee-jerk reactions, writes NGO boss Mark Topley.

Yesterday was International Volunteers Day. The news got kind of lost in all the comment on the Autumn budget, but in these times of austerity perhaps we should reflect on the importance of volunteering. An organisation like mine, for example, simply could not exist without its voluntary help.

We operate in rural Tanzania (and are piloting projects in Rwanda) where we train up local health workers in basic dentistry skills; skills which can make a huge difference to the quality of life of rural communities. Three-quarters of the world’s population has no access to a dentist. Where dentists do exist they tend to be based in cities, often far away from most of the population. Therefore millions of people are suffering (often in agony) on a daily basis from pain that could be simply treated. Often they wait years for a tooth extraction or turn to traditional medicine – sometimes with horrifying or even lethal results. 

As well as everyone giving up their time to support us back home in the UK, we’ve had dentists, nurses, hygienists and therapists queuing up to deliver this training for free, often in the most basic of circumstances. Most of these volunteers have entered dentistry to help others. Of course, occasionally such altruism can be wasted.

During the first few years I was here, we heard of a visiting group of North American dental practitioners. This group had plenty of enthusiasm but very little understanding or respect for the local culture, government structures or issues that existed on the ground. They simply brought all of their complex dental equipment, set up a mobile clinic in the middle of a field and began doing all manner of treatments under generator power. They did not register with the local authorities or seek their involvement. Undoubtedly there was a benefit for some members of the community. Unfortunately, though, when they left there was a huge vacuum which the local dental and medical practitioners could not fill. They in turn became demoralised and many had to move away, as patients would no longer visit them.

So whilst volunteering is important, we must avoid knee-jerk reactions. In our case, we created the Bridge2Aid dental volunteer programme, or DVP. It’s a training programme which uses voluntary trainers in short bursts to train local health workers in simple, emergency dentistry and with full government support. By training local health workers in the way that we have done – thanks to our volunteers – not only are we removing often-crippling dental pain, but hopefully creating a lasting legacy long after the volunteers have left. Everyone wins.


So this week we celebrate volunteers and volunteering across the world. But for us this is not just a celebration of 'free help' as a token contribution: it is to celebrate those who give up their time as true partners, fellow family members working together to bring lasting change to people who are in pain.

Mark Topley is chief executive of Bridge2Aid, a British-run dental health charity operating in east Africa.


A nurse prepares an injection in a Mauritanian hospital. Photograph: Getty Images

Mark Topley is chief executive of Bridge2Aid, a British-run dental health charity operating in east Africa.

Getty Images.
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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.