PAOH President’s Message: Eradicating Infant Oral Mutilation

By Steven Perlman, DDS, MScD, DHL (hon)

"Mutilation is confirmation to the evils of the world." -- Stevie Wonder 

There is something special about a person on a mission that is so committed they never give up, no matter what obstacles come their way. Especially a mission that involves eliminating the pain, suffering, and death of children by the tens of thousands each year and involving many countries in Africa.

Where is the Army from the World Health Organization (WHO), The United Nations Children’s Fund (UNICEF), public health leaders, and the countless number of public health physicians and dentists who are not behind the effort to eradicate the practice of “infant oral mutilation” (IOM)?

What is Infant Oral Mutilation? Infant oral mutilation (IOM) is a primitive traditional practice involving the 'gouging out' of an infant's healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/ AIDS, septicemia, and death. Other complications include eradication and/or malformation of the child's permanent dentition. IOM is usually performed by village healers in low income countries as an accepted remedy for common childhood illness. Why haven’t these colleagues stormed the castle to help end this barbaric and heinous practice?

In 2019, Professor Arthur Kemoli of Kenya contacted me to collaborate with him and the Chief Dental Officer of Kenya on his mission to eradicate IOM in their country and many others in East and Central Africa. At that time, the Global Medical Advisory Committee of Special Olympics International was meeting in Nairobi, Kenya and Professor Kemoli and the Chief Dental Officer of Kenya came to plead their case to help them create awareness, develop a task force, and an action plan to address this issue.

On June 20, 2019, Global Child Dental Fund called for the Global Dental Community to support the Chief Dental Officers of East and Central Africa to end the practice of IOM within 10 years. This declaration was signed by seven Chief Dental Officers of the countries in which IOM is practiced.

In September 2019, The American Academy of Developmental Medicine and Dentistry (AADMD) issued this policy statement: “The American Academy of Developmental Medicine and Dentistry (AADMD) condemns the practice of Infant Oral Mutilation and calls for its eradication across the globe. The AADMD understands that this is a form of child abuse and that education is needed to explain the irrationality of the practice to tribal leaders, healers and parents, and has offered its support and assistance to dental and public health officials in Kenya as an initial start in the campaign to eradicate the practice.”

IOM is still common and practiced in Burkina Faso, Chad, D.R., Congo, Ethiopia, Kenya, Rwanda, Burundi, Somalia, Sudan, Tanzania, and Uganda. It has also been recognized in African immigrants living in France, Israel, USA, Australia, Norway, New Zealand, and the UK.

“Champion for the Eradication of Infant Oral Mutilation”: Prof (dr). Arthur M. Kemoli, BDS (UoN), MSc (UvA), PhD (UvA), DGDP RCS (Eng), FICD, FDS RCPS (Glasg).

Dr. Kemoli recently visited a school in Machakos, Kenya where he dropped by a first grade class with 60 students where 60 percent of the children had gone through IOM. Upon visiting the nearest hospital in the same month, seven children had been admitted due to IOM and two more had already died. Another Children’s Hospital in Kenya reported at least five children were admitted a week.

A problem that exists is that there is a scarcity of absolute data to show quantitatively how prevalent the practice is.

Arthur is emotionally and physically drained from helping families and looking into the eyes of children, especially of those with disabilities who were so sick or nearly dead.

Normality must be restored to millions of children suffering from a practice that has no health benefits. People have often told me that the practice of IOM is so difficult to stop because it financially supports the tribal healers and others who practice it.

When I asked Arthur how much the procedure usually costs, he said it is commonly under a dollar or possibly receiving a chicken in return for the service. Surely, the life of a child is worth much more than a dollar or a chicken.

Shame on the previously mentioned WHO, and the profession of the public health dentists who have sat on the sidelines and remained silent on this health crisis. Recognize that the way the practice is conducted, it is both a public health issue and a child abuse/safeguard issue. Surely, we can all or individually do something to protect these children from harm! Yes, we can.

About the Author

Steven Perlman, DDS, MScD, DHL (hon)