A practice in Africa

Graham and William Wadebho hard at work at a local school in Aru, in 2015

Graham and William Wadebho hard at work at a local school in Aru, in 2015

When many of their peers are contemplating retirement, Graham and Wendy Toulmin are ramping up their efforts to provide hope, health and healing to thousands of residents in the Democratic Republic of Congo, writes Tracey Porter

Blind faith is an incredible thing. At worst a destructive force that leads humans down a tumultuous path from which they may never fully return. At best an energy that empowers ordinary people to achieve extraordinary things they may once have believed impossible.

It was blind faith in its purest form that led the agnostic Graham Toulmin to become a resident band member in a church where he would meet a Christian called Wendy whom he would later call his wife. And it was a belief without true understanding that led Wendy to agree when her husband burst through the door of their comfortable Blue Mountains home and suggested they rent out their small rural practice and start again half a world away in the troubled Central African country formerly known as Zaire.

Now aged 68 and 63 respectively, neither Toulmin has regretted any of their decisions. The marriage, made official in 1973, went on to produce four boys and four beloved grandchildren.

The relocation has also borne proficiency in two new languages—French and Swahili—and inductions as Members of Order of Australia following nearly 25 years split between the duo’s African and Australian homes.

In strictly professional terms, the Toulmins’ story began in 1972 when Dr Toulmin graduated from Sydney University with a Bachelor of Dental Surgery. He spent the following years working with the university’s dental hospital before striking out on his own in 1974. In 1976 he and Wendy headed to London—he in private practice and she in the church—until their return two years later where they set up their own dental clinic in Springwood, New South Wales. In 1981, Wendy came on board as practice manager.

The pair’s strong faith (Graham became a Christian in 1970) and their shared musical talent—Graham on cornet and trumpet and Wendy on violin and guitar—meant they were regular attendees at the Church Missionary Society’s (CMS) annual summer school where they led the school’s music program. In 1985, a CMS rep showed a slide presentation about building a team to go to Zaire and the needs of that country, which at that time was still under the control of dictator Joseph Mobutu. Despite the instability of the area and the fact no mention was made of the requirement of dentists, somehow the talk resonated and the family’s fate was sealed.

Forced to undergo a two-year application and training process, they spent much of their downtime fundraising before flying to Kenya where they were enrolled in a 14-week intensive Swahili language course.

Equipped with about $40,000 worth of dental equipment, including a second-hand portable drill unit, generator and extract forceps, the Toulmins arrived in Butembo in Zaire in December 1987 eager to start a new clinic and embrace a new life.

It was not to prove an easy transition. “There was no house, no car, no water, no electricity and the clinic promised was mud bricks up to window level,” says Graham.

With their four kids in tow, the family lived in primitive temporary accommodation that had no kitchen, bathroom or toilet facilities. A red bucket with a lid doubled up as a toilet and a baby’s bath was used for washing. For 12 months before their home was built, Wendy did the cooking on a flattened 44-gallon drum she located in a market.

Professionally things weren’t much better. “I was an ordinary GP dentist from the suburbs but in Butembo, I was the only qualified dentist for about 300kms north and 600kms south. I was supposedly ‘the expert in all things’ [and as such] was expected to deal with fractures, huge facial infections and numerous other things that I had never seen before.”

But if the work itself wasn’t enough to test his resilience, the primitive conditions under which he was expected to operate even the most rudimentary of dental services, were.

The DRC government does very little for health and education. The country is rich in resources but deep-rooted corruption at all levels mean much of the profits are funneled out of the country and it falls to the churches to undertake the health work and education.

“The ongoing deterioration of the country under Mobutu’s kleptocratic dictatorship … made running a clinic very difficult. We evacuated by light plane and helicopter the first time with soldiers looting and gunfire on the hill opposite our home.”—Dr Graham Toulmin

Upon his arrival in Aru territory in the country’s north, Graham found the health centre he was expecting to have been built wasn’t, forcing early clinics to be held in the vestry of the Anglican Church with pews repurposed as benches. With no regular source of electricity, a generator provided limited relief while water was carried from a well two kilometers away. It was also difficult to keep the clinic sterile; an absense of glass in the windows brought dust in from outside.

After enduring three years in these trying conditions, Graham successfully applied for a $60,000 AusAID grant, which funded a new clinic building. In 1990 the family returned to Australia temporarily and used the time to prepare a container full of building supplies and dental equipment. No one could anticipate the civil war that was to greet the family upon their return to Africa.

“The ongoing deterioration of the country under Mobutu’s kleptocratic dictatorship led to ongoing tension and suffering among the populace and an unbelievable inflation rate, devaluing the local currency by 50 per cent overnight, which made running a clinic very difficult. We evacuated by light plane and helicopter the first time with soldiers looting and gunfire on the hill opposite our home.”

After being evacuated a second time they again returned to Australia, just in time for the container to arrive—in Africa. It was a sign of the times that the local customs initially requested US$21,000 to receive this ‘gift to the people of Zaire’ but later agreed to allow it through for just US$300. The Toulmins’ first clinic, appropriately named Mama Wendy Dental Clinic, was eventually completed by locals and opened in 1993.

The family settled back into life in the Blue Mountains and followed with keen interest the political maelstrom that led to the First Congo War when Laurent Kabila proclaimed himself president after overthrowing Mobutu with the aid of Rwanda and with little resistance from the Congolese Army.

A return DRC visit in 2004 introduced the Toulmins to Aru local William Wadebho. Only too aware of the poor oral health of many of the villagers, Wadebho— who would later become one of Graham’s first dental students—requested Graham and his team provide equipment to help. More than A$35,000 was raised when the Toulmins put their musical talents to work by producing a ‘Dental as Anything’ CD. The initiative raised the required funds with enough left over to establish a second Anglican dental clinic.

It was around this time Graham and Wendy realised they needed more resources to staff their clinics. In time they managed to train three Zairian students – Wadebho, Timon Grodya and Ringo Wanzirendi, an apprentice mechanic who they had hired to dig them out of bog holes on safari and who runs the foundation clinic today.

1989-gt-at-mabuku-clinic

Graham with some of his patients and three nurses, including William Wadebho, outside the Maluku Health Centre Clinic in 1989

The Toulmins ensured their time abroad was well spent, setting up the country’s first dental conference and initiating regular visits to 10 outlying health centres in the bush. This brought dentistry to entire communities who until then had been at the mercy of so-called ‘traditional practitioners’ who, according to Graham “…do terrible things to people … We [then] have to try and fix up the messes they have created with a sharp knife
or nail.”

In 2008, seven years after Laurent Kabila was assassinated and the presidency given to his son, Joseph Kabila (who in 2006 ‘won’ DRC’s first democratic elections), the then 60-yar-old Graham sold his Springwood dental practice. Around this time he was invited to become Sydney University’s clinical dental tutor, a role that would eventually lead him to heading the dental hospital’s international dental training program, leading teams of dental students on fact-finding trips to DRC before the university withdrew permission owing to the instability of the troubled nation.

Two years ago, the Toulmins marked their 15th visit to DRC by returning to Aru where Graham took up a post as the director of dental training at the Institut Supérieur des Techniques Médicale (ISTM). In what has become their modus operandi, the Toulmins first managed to raise the US$80,000 needed to build the training school. Their visit coincided with the arrival of a large container packed with donated dental equipment.

Expecting to remain in the DRC for at least the next three years, the pair is now working hard to train the Congolese to take over but say they still face significant challenges in bringing sound dentistry practice to the Africans—the least of which is the requirement to teach in both French and English.

The Toulmin’s clinic is still the only one operating in Aru, which, according to Dr Toulmin, has a population of about 135,000. The nearest competition is a former student who practices hundreds of kilometres away. The nearest supplier of anaesthetic in 20ml bottles—“We mix adrenaline in the solutions ourselves and use 5ml syringes”—is a 30-minute motorbike drive away, and the nearest dental suppliers are 500 kilometres away in Kampala, the Ugandan capital. While the territory has a small airport there is still no public electricity grid.

Yet despite the volatility of the DRC and the lack of infrastructure, Graham and Wendy say there is much to love about their adopted home.

“The country is amazing, as are the ordinary people; beautiful in so many ways. Ultimately it’s the people that keep you coming back.”

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