Introduction
The South Pacific Medical Team, a voluntary group organised byJapanese dentists, has worked to improve oral health in Kingdom ofTonga since 1998. Our team have also supported for disabled people intwo institutions for the disabled or the special class at a primaryschool in Tongatapu Island since 2005. The program for the disabled
has been promoted by the Tongan dental team from dental office ofthe Ministry of Health. Japan Overseas Cooperation Volunteers(JOCV) have supported us since 2008.

Introduction
Where is Tonga?
The Kingdom of Tonga (Tonga) is part of Polynesia in the South
Pacific Ocean. It consists of 170 islands divided into five main islandgroups: the Tongatapu Islands, including the capital city; the Ha’apaiIslands; the Vava’u Islands; the Niua Islands; and the ‘Eua Islands.
These islands are distributed across an area of 600 km north tosouth and 200 km east to west. In 1998, the population of Tonga wasabout 100,000.

Subjects and facilitis
1. Tonga Red Cross Society：OTA CENTER, Home visiting【Intellectual disability，Down's syn., CP, etc.】
The Ofa Tui Amanaki Centre (OTA) was established in 1968, andcontinues to have 3 major programs such as education, home visitationand early intervention program.

2. PETESAITA DISABLED ALONGA CENTRE【Physical disorder, CP, MR, DEF, Aut, etc.】
The ALONGA for adult disabled people was established in 1977.

3. The special class at Negele’la primary school【Aut, MR, Down's syn,】
The class was established in 2004 for primary school kids with specialneeds.

4. Care unit in the paediatric ward at the Viola’s hospital【Premature baby, Baby with cleft lip and palate】
Vaiola Hospital is the main hospital in Tonga, situated on Taufa'ahau Road
on the outskirts of the capital city, Nuku'Alofa.
.

Activities＜2005～2007＞

Japanese staffs had decided almost the missions and the schedule ofvoluntary activities.

Oral check andoral education＜ 2008 ＞

Donations:
toothbrushes etc.

Work shop for staffs(Re) habilitations of eating

We changed our previous ideas. We spent day time in the institutions andhad much time to discuss with staffs of the institutions and the dental
team for finding out their real needs.

Language exchange
Dancing time
Good relationship built trust♪

Tongan staffs cameto support positively.

They didn't know that theyshould use toothbrush for each,so we donated toothbrush
written name.

＜ 2009～ ＞
1. Oral education
Tongan staffs offered oral education
for the participants, their parents
and staff of facilities, Japanese were advisers for them.
2. Donations
We held the oral festival in a flea market on weekend.
・free oral check and oral consultation
・free fluoride mouth rinsing
・Information about our activities
・Sale of handicrafts and clothes

We got fluoride toothpastes which wereenough to use for a year.
Visiting first timeat 2009

We made boxes for each toothbrush bymaterials bought in Tonga.

3. Work shop for participants and staffs of facilities, etc.
We made slides ofpresentation together,
Tongan staffs offereda presentation for them by
Tongan language.

＜2011～＞

1. Oral examination: All participants can accept!!

Monitoring SPO2

Oral examination

Measuring oral moistureChewing gum test

2. Prevention for oral disease and dysfunction① Oral education

Tooth brushing consultation Education using drawing：We bought notebooks by money from flea market.
② Fluoride application③ (Re) habilitations of eating

3. Personnel training

Tongan staffs could perform preparation for
donation and making education materials,questionnaires , and results etc. bythemselves.

4. Distributing questionnaire survey
How many times do you brush
your teeth a day?
no answer
nothing 5%
3%3times
once
15%
20%

Do you have own toothbrush?
Do you know how to
97% Yes!!
brush your teeth?
85% Yes!!
Do you like brush
your teeth?

twice
57%

100% Yes!!

Do you enjoy
our program?
100% Yes!!

n=60

n=60

＜2012～＞

Home visiting for dependent people at home have started.

How many times do you brush
your teeth a day?
once aweek
34%
twice
10%

nothing
22%

Do you know how to brush
your teeth?
56% Yes!!
Do you haveown toothbrush?

once34%n=9100% No!!

Have you ever bought
toothbrush or toothpaste?
100% Never!!
Do you enjoy
our program?
100% Yes!!

n=9＜2015～＞
1. Orientation of dental treatment for OTA’s member

OTA’s member had never come to dental hospital, so we have invited themand staff of OTA to see and experience dental office.

2. Medical Check up: height and weight,blood sugar and blood pressure

ALONGA’s member had never tested blood sugar etc., so we havedone medical checkup with public nurse at ALONGA.

Conclusion
Daily oral care

Family，teachers etc
View of life, Sense of value
for everybody

Trust

National character,
Religious value, Opinion
on death and life, ect.

SPMTJapanesenational character

Share time,communication

Tonagan staffs

Cooperation

View of life, Sense of value
for everybody～2007

2008～present

future

SPMT-introductionof managements

Cooperation withTongan and SPMT

Build self-relianceamong local people

We have the relationship of mutual trust and good
cooperation with them by long term activities. We hope this program isperformed by self-reliance among Tongan people.