18-19th Dec, 2012 Acknowledgement The East Africa Dental Project

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3. EADAP Management: Roles and Responsibilities of Project Partners and national project coordinators, Desiree Narvaez, UNEP Chemicals.

The organizational structure of the project is horizontal as opposed to vertical. All players will be working together.

Roles and Responsibilities:

3.1 iLima

This is the expert group on the project.

Roles and responsibilities:

  • Desk study to gather information on current practices on dental waste management in the three countries.

  • Gather and compile information on dental materials trade flows.

  • Gather information on supply and distribution of alternative materials.

  • Estimate environmental costs of the use of dental amalgam.

3.2 National Project coordinators

Roles and responsibilities:

  • Validate results of country dental materials trade data and waste management practices.

  • Gather information about current set up in dental clinics and local recyclers

  • Community preparation, identify stakeholders, invitations to meetings/workshops.

  • Coordinate training of dental personnel on BMP of amalgam waste.

  • Coordinate demonstration activities.

  • Contact local waste management company.

  • Supervision of day-to-day work at national levels.

  • Prepare project implementation report.

  • Disseminate awareness raising materials to the health sector.

  • Organize project inception (Kenya) and results workshop (Tanzania).

3.3 IDM and FDI

Roles and responsibilities:

  • IDM will provide amalgam separators to 3 countries.

  • Develop protocols through illustrative diagrams on BMP of dental amalgam waste which will include guidance from WHO on ESM of healthcare waste and the Basel technical guidelines on the ESM of mercury waste.

  • FDI will conduct training of health personnel on the BMP of amalgam waste.


Roles and responsibilities:

  • Assist in social preparation.

  • Assist in dissemination of awareness raising materials on preventive care and use of alternative materials.

3.5 WHO

Roles and responsibilities

  • Coordinate the development of awareness raising materials.

  • Assist in development of training materials in ESM of amalgam waste.

  • Provide information on WHO and its country offices.

3.6 UNEP and WHO

These are the overall project coordinators.

Roles and responsibilities:

  • Synchronize with project steering committee and national project coordinators.

  • Keep all stakeholders informed.

  • Ensure quality reports from national project coordinators and project partners.

  • Ensure timely and quality project implementation.

  • Write the final project report.

The proposed work plan with the schedule of activities for 15 months was discussed.

  • The project is currently in month 5.

  • Selection of dental clinics and installation of separators will be conducted in January 2013.

  • Training of dental personnel will be conducted at the same time as dissemination of information materials for raising awareness.

  • Results workshop will be held in August 2013 in Arusha. Tanzania suggested that September would be the preferred month for the workshop. Kenya and Uganda also prefer September.

  • UNEP would like to see more participants from Uganda and Tanzania at the workshop.

  • Final report will be written in month 15.

3.7 Question and Answer Session:

  1. Request for a soft copy of the brochure was made. This would aid in revision of the brochure.

  2. Request to know the timelines for submission of comments on the brochure. It was agreed that the soft copy would be sent by WHO by 4th January 2013. Suggested deadline for feedback is 14th January 2013.

  3. The budget was discussed. Budgetary constraints were cited as reason for countries not having more participants at this workshop.

  4. There was a question as to when monies would be availed to avoid delays in implementation. Countries already have 75% of the total budget .The remaining 25% would be availed after the final report.

4. Action planning by country. Kenya, Tanzania, Uganda.

The general objective will be stated. Then the following would be stated:

  • Specific Objective

  • Expected Output

  • Activity

  • Time Frame

  • Resource Requirement

  • Responsible

4.1 Kenyan Action Plan











To gather information on dental materials trade and waste management

Representative situation of dental restorative materials trade and waste management

Reformatting questionnaire
Validation of survey
Data collection analysis

Report writing



Dr Kisumbi


To Sensitize Stakeholders of 3 countries on phase down of dental amalgam

stakeholders sensitized

Inception workshop

Editing report/ printing and circulating to all

1 week




To Gather information about current setup in dental clinic s and local waste management systems

Information and data is gathered

Develop Checklist

Visit sample clinic

Gather information from waste companies

Report writing




Dr Irungu



To create awareness among stakeholders (communities, dentists, technician, trainers, policy makers )on phase down of dental amalgam

Awareness created on phase down of dental amalgam

Identify stakeholders

Hold meetings with stakeholders

Hold national stakeholder workshops non phase down of Feb, March,

4 months




To train oral health personnel at three sites on BMP on dental amalgam waste

Oral health and personnel trained

Receive training materials from UNEP/WHO

Identify officers to be trained

Approve/ratifying curriculum

Conduct training

4months(by march)


Prof Gathece/Coordinator


To train TOTs on prevention and waste management

10 TOTs trained on prevention and waste management

Receive FDI Training Assistance

(By March)

FDI to say



To train oral heath personnel on prevention, oral diseases at the pilot sites

Oral Health Personnel trained prevention and BMPC county by county

Identify officers to be trained

Conduct the training at the three clinics





To demonstrate ESM of dental restoration waste material

ESM demonstrated in Mathare Hospital, UON Dental School and a deserving private facility

Collection, waste management best practices activities

Technology transfer

NEMA Certificate

Installation and launch

Preparatory Meetings

Sessions held

May, 2013

IDM plus 2312



To develop initial guidelines and draft regulations for disposal of collected/stored dental amalgam waste

Guidelines and draft regulations developed

Drafting regulations and guidelines






To Monitor and evaluate

Monitoring and evaluation



10 Field Visits


Develop monitoring and evaluation checklist


Dec2012-Septermber 2013




To disseminate country report

Project outcome disseminated

Prepare project implementation report

Attend Results Workshop

Hold a stakeholders meeting

Write Final Report

July 2013

Sept 2013

Sept 2013



  • Add to number 4 comments on flier and brochure that were sent by Dr Petersen. to be done by mid January.

  • Number 6 TOTs are two and will train those in number 7.

  • Need to be precise on dates for separators i.e. time and cost. Separators will be sent to the WHO offices of each country to ease clearing bureaucracy. Action Pam Clark. Letters for waivers should be sent out early.

4.2 Uganda- Action Plan Dr Margaret Wandera

Specific objective

Expected output


Time frame

Resource requirement/ budget

Responsible persons

1.a. Investigate the current supply and trade of dental amalgam and make recommendations for future information systems

Report on supply and trade flow data of all the dental restorative materials and recommendations for future information

Assisting in the trade and waste survey; validation of results of country dental amalgam trade data and waste management practices

2 weeks


National Project Coordinators

2 research assistants)

b.assess the current waste management practices in Uganda

Report on dental waste management practices of all dental restorative materials in Uganda

c.Current information on dental amalgam management in dental clinics

Report on dental amalgam use in dental clinics

Gathering of information about current dental amalgam management in dental clinics and local waste management systems

2 weeks


National Project Coordinators

2research assistants)

2.Raised awareness of al stakeholders involved in the regulation, use and management of dental amalgam

Reports on issues raised by the stakeholders

Community preparation, identifying stakeholders, inviting to meetings/workshops, including facilitation of the meetings and preparation of the reports, arrange logistics

1day meeting

800 x3 meetings

National Project Coordinators(other people to invited 25)

d. to collect

Contacting local waste management companies

4 days


Project Coordinators

e. to train trainers

Training Report

Training of trainers

2 days


FDI, WHO, Project Coordinators

f. to coordinate and train clinic personnel on dental amalgam waste

Training Report

Coordination of training of dental clinic personnel on BMP of dental amalgam waste

2 days


Project Coordinators and ToTs

g.To coordinate demonstration waste management activities

Collected , taken amalgam capsules and treated sludge

Coordination of demonstration waste management activities: collection, take back of dental amalgam capsules, on site-storage, treatment of sludge.

2 weeks days


Project Coordinators


Waste handlers

h. To Coordinate, Supervise day –to-day work of project activities


Supervision of day-to-day work at national level

11 months-project preiod


Project Coordinators

i. To prepare project implementation reports.

Projects implementation reports

Preparation of project implementation reports

1 week


Project Coordinators

j.To disseminate awareness materials to the health sector

Developed awareness materials distributed to the health

In coordination with Ministries of Health, dissemination of awareness raising materials to health sector (Chief Dental Officers)

2 weeks


Project Coordinators


-When we have waste management it should be to all materials not only amalgam. Should reflect in all presentations.

- suggested they should have specific persons responsible such as coordinators- there are two project coordinators the team will liaise with other parties but the two main coordinators will run activities.

- To include brochures for awareness raising.

-to realign budget for shipment of amalgam separators

4.3 Tanzania Action Plan- Prof Kahabuka


Specific objective

Expected output


Time frame

Resource requirement



Validation of trade and waste management practice study results with respect to the 3 participating countries and revision, where necessary, of their national mercury inventories

Data and information on newly filled questionnaires

Identify participants

Jan 2013

Project coordinator

Face to face interview

Feb 2013

Telephone interview

Feb 2013


Project group


Stakeholders’/interagency meeting to present the desk study and proposed demonstrations in the phase down approach

Information about the project, inception workshop and final activity plan between

TDA, MoH&SW, Dean, Environment, Govt Chemist, Project group

Meeting and documentation of activities among Dean, Environment, Govt Chemist, Project group

Jan, April and August 2013


Project group


Selection of 3 demonstration dental health clinics (one representing government hospital/facility, one private clinic, one University/teaching hospital) based on criteria set by the IDM

Three clinics selected

Identify one clinic representing government hospital/facility, one private clinic, one University/teaching hospital

Jan 2013

Project group

Clearing and transporting amalgam separators

March 2013


Coordination with local waste management provider/company

Reach agreement with local waste management provider/company

Telephone calls

Physical visit


March 2013


Project group


Training of trainers

Three participants from the selected sites

March 2013

Ugandan colleagues


Capacity building/training of the dental health sector in the environmentally sound management of dental amalgam waste using training materials developed by WHO, FDI and IDM

Knowledge on Preventive dentistry and BMP of dental amalgam waste

Trainers to train more participants from the three sites

April 2013


Project coordinator


Demonstration of best practices in the environmentally sound management of dental amalgam waste: source reduction, use of dental amalgam separators, collection of waste, take back of contaminated capsules by manufacturers/recyclers, on-site storage, and, where treatment facilities exist, the treatment of contaminated sludge

Environmental sound management of dental amalgam waste

Trainee under 5 above will apply the knowledge or demonstrate what they learnt

May 2013


Project coordinator


Awareness raising activities to promote preventive dental care and encourage a switch to alternative materials for dental restoration amongst patients and dentists. This activity could be conducted and/or supported by local NGOs

Communication with WHO about input on brochure and fliers

Give feedback to WHO on the brochure and fliers

February 2013


Project coordinator

Printing of brochure and fliers

Print the brochure and fliers

April 2013

Distribution of brochure and fliers

Distribute brochure

May 2013


Results workshop

Available data on the project

Workshop to discuss results of the project by the three demonstration countries

September 2013


Project coordinator

4.3.1Comments made on the Action Plans:

Concerns on budget differences for the three countries-same amounts were allocated to the three countries.

FDI- training time plan- Jean-Luc Eisele

  • Feb 2013- to finalize curriculum and educational material onBMP ,waste management, alternative materials and preventive dentistry with WHO,UNEP and IDM.

  • Early march-TOT workshop, 2days Uganda.FDI to invite 2national educators from each country and 3-4 international experts.

  • March 2013-national educators to organize the local training workshop for the dentists/staff in the 3sites.

  • 2013- Option to organize further national training using the material prepared/adapted for the pilot and create a wider awareness.

Comments-request to include a technician in the team to be trained-subject to availability of funds

Each country to send final work plans by 1st week of April to Desiree.

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