Community rehabilitation workers: do they offer hope to disabled people in South Africa's rural areas?

This article outlines the thinking behind the Wits/Tintswalo community rehabilitation worker training programme which is located in South Africa's eastern Transvaal Lowveld. Drawing on a combination of qualitative and quantitative evidence collected during the first eighteen months in which the CRWs were working full-time (January 1993 - June 1994) it suggests that the two year training programme has been successful in providing therapeutic skills. Key issues raised are whether the coverage of disability is adequate in terms of numbers treated or in terms of categories of disability treated.

Effectivity of the Electronic Dental Anesthesia in controlling pain caused by local anesthetic injections.

This study was designed to determine if an electrical signal can effectively control the pain caused by injection of local anesthesia for mildly and moderately apprehensive patients. Five techniques were used in this study: the Mandibular Block injection, Long Buccal nerve injection, Maxillary Infiltration injection, Incisive Papilla injection, and the Great Palatine nerve injection. Two injections, using the Electronic Dental Anesthesia (EDA/EA) as the adjunct, and the other using a topical anesthetic ointment of Xylocaine 5%, were performed on 30 patients who passed the criteria we have set including the indications for use of the EDA. The volunteers were asked on the spot to report the level of pain they felt during the penetration of the needle in the mucosa, and during the deposition of the local anesthetic solution. A pool of 47 patients were gathered for this experiment. Of this number, 11 failed to pass for reasons of high-anxiety level and 2 were contraindicated for use of the EDA. Of the 34 who successfully passed the screening, only 30 patients were chosen. A total of 6 patients each, 3 males and 3 females, were used for the five techniques. The results of this study show that in all five injection techniques, the EDA is effective in blocking pain transmission. The EDA is proven to be an effective adjunct to local anesthetic injections.