Elvin from Hong Kong, Dentistry Student:
What type of internship did you do, when and for how long?
In Hong Kong, as part of the 6 years curriculum we are required to obtain 6 units of exchange program. Which is equivalent to 2 weeks of dentistry related internship in another country but on one occasion the maximum amount of credit given is 3 units. For our internship program in Arusha we stayed for 1 week in the hospital for both hands on dental treatments and observation under the guidance of the dental team there. Even though our elective within the hospital is officially just 1 week long we stayed for an extra week in Tanzania and Zanzibar to experience the culture there.
During which year of your studies did you complete your internship abroad?
I completed my dental elective during 4th year of my dental studies.
Please describe why you decided to do your internship abroad.
I have always wanted to experience dentistry from a different perspective and being able to go to Africa and perform dental work there has always been in my bucket list. Previously, there were also seniors that have been through the same program and their positive feedback about their experience has affirmed my decision to do a dental internship in Africa. A lot of seniors have described the trip as a once in a lifetime experience and it will be something they will not forget about. Furthermore, I believe I can gain a lot of dental insight from this trip. Through we were very troubled at first by the the vast mount of things we will have to organise for this trip but World Unite has taken a lot of the burden off our shoulder.
How did you come across World Unite?
During previous years my dental senior told me they went to Africa for their dental elective and when I asked about the organisation they got in touch with they introduced me to World Unite. We then asked other seniors about it and found out that a few year groups before us have been in contact with World Unite too and every year there were dental students from our hospital going on elective through World Unite again. A group of friends and I also thought it was a good idea to organise such internship through a well recognised and reputable organisation so we decided to go with World Unite as well.
Which departments of the hospital did you work in? Did you stay in one department or rotate through multiple departments and why?
In Mount Meru Hospital there was only one Dental apartment which handled all sorts of dental cases. These include paediatric, endodontic, prosthodontics, oral and maxillofacial surgery, operative, periodontic and oral medicine. Even though we had the chance to visit all the different apartments and medical wards, we mainly operated within the dental apartment. However, for more serious dental/facial reconstruction work related to dental surgery they had an operating theatre for those kind of treatments. Also there was a room where the dental technician will work in. In there is where he will take impressions of the patient’s mouth and fabricate dentures for them. In comparison to other departments within the hospital the dental department seems to be relatively small.
Describe a typical day at the hospital, including your work days, working hours and your tasks.
On a typical day we will have to wake at around 7:30am to have breakfast and be ready to leave and head to the hospital at 8am. After 15 minutes of walking time we will need to catch the local transport (dala dala) for around 20 minutes followed by another 10 minutes walk to arrive at the hospital. After reporting to the dental staffs there we will change into our clinical uniforms that we brought from Hong Kong and prepare ourselves for the day’s work. Before we perform dental treatments on patients the supervising doctor will usually share some of his dental experience or previous cases which he finds interesting to us until patients start to line up in front of the door at around 9am. For the first time there we didn’t start work immediately but instead we had a tour of the whole hospital and basically gone through all the drawers and equipment they had within the dental department to familiarise ourselves with our working environment. After the first day we proceeded to start our day as the patients come in. Depending on the difficulty of the dental procedure, the doctor will ask if anyone wants to do the treatment. For more difficult treatments the doctor will usually still ask if any of use had the confidence to take on the challenge. Most of the time my colleagues and I will take turns doing simple extractions and restorations until lunch time which is usually around 12pm. For the one hour lunch break we will go out to the local restaurants and eat, there are a lot restaurants nearby so it doesn’t take a lot of time for us to get there. Coming back from the lunch break at 1pm we will carry on with similar tasks in the afternoon. Occasionally we will be asked to observe some interesting cases and go visit the wards with the doctors. This usually the case for patients who had severe facial trauma and will require to rest in the hospital bed. When there are not much patients coming in for dental treatment we will go observe the dental technician and see how he manufacture dental prostheses. Throughout the day we are free to ask any questions we like and when we need help the doctors are always there to lend a hand. The working atmosphere is actually really friendly and free, we can request to see things or do anything as long as the doctor agrees. The day should end at around 4pm and then we will get changed and leave the hospital.
Describe a situation that surprised you or that seemed special to you during the internship.
The most surprising thing to me during my visit is how appreciative the locals are. During one of my first extraction procedures in Africa I was asked to extract a molar tooth. The patient had really long and strong tooth roots and the extraction didn’t go according to plan as I have fractured the crown of the tooth from the root. Which leaves the root still being embedded in the bone and took extra effort to pull out even with the help from the doctors there. However during the whole procedure the patient was extremely cooperative and afterwards he was gesturing to me that I did a great job and even asked to have a photo taken with me. That was one of the most heartfelt moment of my trip to Africa.
What did you learn during your internship abroad?
My experience in Africa has made me realised how lucky I am to be living in a developed city. Many of the essentials that we usually take for granted back in Hong Kong such as clean water for drinking, hot water for shower, and a sophisticated medical system are not always accessible to those in Arusha. Throughout the trip we were all extremely cautious to avoid any potential health hazards. The water we dared to drink from were always bottled, we continuously used hand sanitisers applied mosquito repellents. However at the same time the thought that all the local citizens here will not even have the luxury to be cautious made me truly realise that we do in fact come from two different worlds. Many do not have the financial resources to take the necessary precautions that we do, for instance during oral examinations the dentist at the hospitals did not use gloves as it was only saved for dental treatments such as extraction. Even though I may never be able to apprehend their way of life but my experience in Africa made me feel that I have breached some distance between our two worlds.
Which cultural differences did you observe between the medical systems / treatments / doctor-patient relation etc. in your host country and your home country?
During my time in Mount Meru Hospital I have noticed the difference in their dental equipments and procedures compared to Hong Kong. In Africa the importance of dental treatment is outweighed by more life threatening medical procedures hence not a lot of resources are allocated for dental procedures. The dental department in the Mount Meru hospital had a total of three dental chairs, two of which were out of order for more than half a year. Where in Hong Kong we have around 200 or so dental chairs. Periapical radiograph and Bitewings were available within the department but after processing there were always many artefacts on the films. The hospital only had one functioning suction machine so some patients had to spit out the water themselves. All of these equipments were taken for granted when we were back home. In Arusha usually an OPG are taken only in special cases and must be referred to venues outside the hospital to be taken but back in the education hospital in Hong Kong almost every single patient will have an OPG radiograph taken for screening purpose. Here in Arusha, a lot of the times extractions are performed without any radiographs which is unheard of back at home. Things like sensibility tests such as EPT and cold tests were never used in Mount Meru Hospital and endodontic procedures are to some extent simplified and they do not have access to an apex locators.
How did you spend your free time abroad? Did you get to know other interns at the hospital with whom you did activities? Did you go on trips? If yes, what did you do and where?
For our free time we went on a 3 days safari trip to see the wild life in the national parks there and also went on a trip to a local island called Zanzibar where the food is amazing, accompanied by their famous beaches and sunsets.
Elvin completed his dentistry internship with World Unite!, a specialist provider for electives, internships and volunteering in medicine, nursing, therapies and midwifery. Click here to read more about their hospital options in Arusha, Tanzania, and learn how to apply for your own elective abroad!