Introduction:

On November 30, 2024, Mr. Mikal Devkota, the President of the Dental Science Hygienist Association of Nepal (DSHAN), accompanied by a team from the Karnali Province Committee, visited Raute Basti, a rural community located in the Karnali Province of Nepal. The primary purpose of this visit was to raise awareness about oral hygiene and to educate the villagers on the importance of dental care. During this visit, it became evident that many members of the community, especially in remote areas like Raute Basti, had limited access to dental care resources and were unfamiliar with basic oral hygiene practices, such as the use of toothbrushes and toothpaste.

About Raute People:

The Raute people of Nepal are a small, indigenous, and nomadic ethnic group who are among the last remaining hunter-gatherer communities in South Asia. Known for their unique cultural practices, they primarily inhabit the mid-hills and forested regions of western Nepal, including districts such as Dailekh, Salyan, and Surkhet. Their estimated population is less than a thousand, and they are recognized as a marginalized and endangered group.

The Raute traditionally live a nomadic lifestyle, relying on hunting monkeys and foraging for wild fruits, roots, and other forest resources for sustenance. They are also skilled woodcarvers, crafting wooden containers and utensils, which they trade with nearby villages for grains and other necessities. This exchange forms an essential part of their interactions with settled communities.

Language and oral traditions play a significant role in Raute culture. They speak the Raute language, which belongs to the Tibeto-Burman language family, and they preserve their knowledge and history through storytelling and songs. Their spiritual beliefs revolve around animism, with reverence for nature and forest deities being central to their practices.

The Raute are fiercely protective of their nomadic way of life and resist assimilation into mainstream society. They avoid permanent settlements, considering their mobility a vital aspect of their cultural identity. They keep changing their living places if anybody dies from their tribe.  However, modernization, deforestation, and external pressures pose significant challenges to their traditional lifestyle. Governmental and non-governmental efforts have been made to support their well-being while respecting their cultural values, but balancing development and cultural preservation remains a delicate task.

The Raute people symbolize a rich but fragile cultural heritage, offering a glimpse into the diverse and complex fabric of Nepal’s ethnic mosaic.

Key Activities and Interactions:

• Introduction to Oral Hygiene: Upon arrival, the President of DSHAN addressed the community, emphasizing the significance of oral hygiene for overall health. He explained that poor oral hygiene can lead to various health problems, including tooth decay, gum disease, and other infections that can affect one’s general well-being. It was highlighted that the mouth is an essential gateway to the rest of the body, making oral care a critical part of maintaining health.
• Demonstration on How to Brush Teeth: One of the most impactful moments of the visit was the live demonstration on proper tooth brushing techniques. The President, along with a few hygienists from the Karnali Province Committee, showed the villagers how to properly brush their teeth using a toothbrush. The villagers, many of whom had seen a toothbrush and toothpaste for the first time, were keen to learn. The demonstration focused on:
• How to hold the toothbrush correctly.
• The correct angle for brushing.
• Brushing for at least two minutes.
• Ensuring all parts of the mouth (front, back, and chewing surfaces of teeth) were cleaned.
• The importance of brushing twice a day.

The community members were encouraged to practice these techniques and were provided with free toothbrushes and toothpaste to start incorporating these practices into their daily routines.

• Importance of Regular Dental Checkups: The President also explained the importance of visiting a dentist regularly for professional cleaning and early detection of dental issues. He highlighted that oral health could affect other parts of the body, and regular dental visits were an important step in preventing serious health conditions. Information on local dental clinics and how to access affordable dental care was shared.

• Distribution of Oral Hygiene Kits: To ensure the villagers could put the knowledge into practice, the team distributed oral hygiene kits, including toothbrushes, toothpaste, and educational pamphlets in the local language. These kits were designed to provide the community with the tools needed to maintain good oral hygiene at home.

Challenges Faced:

• Lack of Resources: Many of the villagers in Raute Basti had never seen a toothbrush or toothpaste before. As a result, there was a general lack of awareness regarding the importance of oral care.
• Limited Access to Dental Products: Access to dental hygiene products is limited in rural areas, and the lack of affordability makes it difficult for families to maintain regular oral hygiene practices.
• Cultural Barriers: Some villagers initially expressed hesitance toward adopting the new practices, as they were unfamiliar with the concept of using a toothbrush. There were also concerns about the cost of maintaining oral hygiene in the long term.
• Geographical Accessibility: The remoteness of Raute Basti posed logistical challenges for the team.

Impact of the Visit:

The visit had a positive impact on the community in Raute Basti. By educating them about oral hygiene and demonstrating proper techniques, the villagers gained valuable knowledge that will help improve their oral health. The distribution of toothbrushes and toothpaste was particularly significant, as it enabled the community members to take immediate action to improve their dental care habits.
The villagers expressed gratitude for the visit, and many were eager to share the information they had learned with other members of the community. The local leadership also expressed interest in continuing the initiative and suggested that future visits could focus on providing follow-up care and more in-depth education.

Recommendations for Future Initiatives:

• Follow-Up Visits: Organize regular follow-up visits to check on the progress of oral hygiene habits and provide additional education on advanced dental care.
• Establish Local Dental Clinics: Work with local authorities to establish accessible and affordable dental clinics in rural areas to provide ongoing dental care.
• Awareness Campaigns: Conduct awareness campaigns in neighboring villages to expand the reach of oral hygiene education and reduce the prevalence of dental issues in the region.
• Engagement with Schools: Partner with local schools to introduce oral hygiene education at an early age, fostering good habits in children who can influence their families.

Conclusion:

The visit to Raute Basti by the President of the Dental Science Hygienist Association of Nepal, along with the Karnali Province Committee, was a highly successful initiative in raising awareness about oral hygiene in a rural and underserved community. Despite the challenges, the team made significant progress in educating the locals on the importance of maintaining proper oral health. This visit marks the beginning of an ongoing effort to improve the overall health and well-being of rural communities in Nepal. Further efforts are needed to ensure that these communities have access to necessary dental products and services to maintain their oral hygiene practices.