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Life in the Slow Lane
Namibian technicians face challenges at home, including obtaining CE credit and cases, which are often sent to South Africa.
Namibia is a small African country bordered by South Africa, Botswana, Angola, and the Atlantic Ocean with a population of 2.1 million people. The landscape of Namibia includes gravel planes, bushveld, mountainous areas, and the Kalahari as well as the Namib deserts. Namibia was colonized by the Germans in 1884, with South Africa claiming occupation in 1915 and Namibia gaining independence on March 21, 1990.
Upon finishing school, graduates may choose to continue their studies by traveling to South African universities or attending more local institutions such as the University of Namibia and the Polytech of Namibia. Others immediately join the workforce. However, the majority of graduates interested in health professions study at South African institutions. Unlike other countries around the globe, in Namibia, nurses are trained locally, even though a medical training institution was recently opened in Windhoek, Namibia’s capital. For those graduates interested in the dental profession, South African institutions are the only place to obtain a qualification. Many of those professors have trained in Germany and relocated to South Africa to teach.
The author completed her studies in dental technology at The Cape Peninsula University of Technology in 2000, obtaining a Baccalaureus Technologiae in Dental Technology degree. Dental technology is a 3-year diploma, 4-year degree course. According to South African law, a technician with only a diploma can only work in a laboratory; however, South African law is not enforced in Namibia. Namibian officials are attempting to pass legislation that would prevent recent graduates from opening their own laboratory before completing at least 3 years of experience in the field. The new legislation also states that any individual working in the health industry must be registered with the Health Professions Councils of Namibia (HPCNA). The HPCNA aims to enforce standards of practicing health professionals in Namibia as well as to enforce the amount of continuing education required to be qualified to work. Continuous professional development (CPD) has been introduced in Namibia recently, and each registered technician is required to obtain 30 CPD points over a 12-month period;2 five points must be for medical law, human rights, and/or ethics.
Continuous education is obtained in much the same manner as the rest of the world. Training courses and dental shows for dental technicians are few and far between in Namibia; sometimes they do not exist at all. There are currently 28 registered dental technicians1 with the HPCNA. Unlike dentists, technicians do not have their own association. As a result, most of the dental technicians rely on the Namibia Dental Association’s (NDA) congress once a year to obtain CPD points. A few go to the expense of attending the Cape Dental Show in Cape Town, South Africa, once a year. Unlike the NDA’s congress, the Cape Dental Show caters to the dental technicians as well as the dentists, dental hygienists, and dental assistants. A small number of technicians (including the author) turn to the internet and printed/digital publications not only to earn CE credits but also to expand their knowledge of the industry and their field of expertise.
Another drawback for technicians in Namibia is the amount of work leaving the country, despite an abundance of qualified technicians there. Some dentists in Namibia prefer to send their laboratory work to South Africa although there are more than enough technicians in Namibia with the experience and knowhow to perform complex cases. Even simple cases, like a single full porcelain unit, are sent to South Africa. There is unfortunately no law in Namibia that prevents them from doing so, and as yet we were unable to have such a law implemented. The author believes that one of the main reasons is the connection dentists make with laboratories in South Africa while studying there. Then, when they return to Namibia, they maintain that relationship. In addition, many dentists who return to Namibia after completing their studies develop the habit of sending work to South Africa from the dentists they work for. The author is of the opinion that some of the younger/new dentists do explore and support the local market and for that the dental laboratory industry is thankful.
The majority of laboratories (10) are located in Windhoek, with another two in Swakopmund (main town on the west coast) and one more in Oshakati (main town in the north). The majority of these laboratories are one-technician laboratories. Most of these laboratories only do crown-and-bridge work, with one doing prosthetics only and another two being full service. One of these full-service laboratories outsources some of its work to South Africa. Three of the laboratories have at least three technicians. These laboratories are all full-service laboratories with the exception of one that does not do crown and bridge work. As mentioned previously, there are 28 registered dental technicians in Namibia. Not all of them are actively practicing anymore and a small number work for dentists who have their own in-house laboratories. In cases like this, the law states that these dentists may not accept work from another dentist; the laboratory is for their exclusive use only.
They say that in Africa, time stands still. There is no time like African time, Even though we live life in the slow lane, it does not mean we are behind on technology. A couple of dental practices throughout the country are equipped with state-of-the-art Sirona equipment, from dental chairs to x-ray units. A local supply company not only sells Sirona equipment and consumables, they also do the installation and maintenance. Their technicians received the necessary training at Sirona in Bensheim, Germany. Namibia took on the CAD/CAM technology very quickly, and currently, there are 11 CEREC® users in Namibia, as well as one inLab® user, making Namibia one of the top CEREC users per capita (dentists) in the world.2 The author is in the fortunate position to be working for the inLab laboratory. Some of the CEREC users already converted to SW 4.0, with the laboratory ready to quickly convert to inLab® 4.0. At first, dentists (not using CEREC) were very reluctant to prescribe work that was to be manufactured with the CAD/CAM technology. The more exposure they get to the different products available, the more they are informed, not only by the laboratory but also by ‘outside’ speakers at dental shows, the more they become aware. The upside to converting clients to full ceramics is the turnaround time (even though it is slightly more expensive than PFM units). They do not have to wait that long before receiving the finished product back from the laboratory, especially with anterior units.
1. Health Professions Councils of Namibia. Available at www.hpcna.com. Updated 2011. Accessed August 8, 2012.
2. Sirodent. Available at www.sirodent.com. Updated 2012. Accessed August 8, 2012.
About the Author
Margot Louw is a dental technologist and manager at Windhoek Dental Laboratory in Windhoek, Namibia.