University of Queensland

Dentistry, Nepal Kathmandu

 

At the beginning of the year, I had set myself two goals: 1) travel somewhere new, and 2) gain some work experience through volunteering. I'd heard of Work the World through other students within my year, particularly regarding the program in Kathmandu, the capital of Nepal; a place I had always dreamt of visiting. Needless to say, it soon became the obvious choice.

After registering, I was contacted by the Work the World team months ahead of the set date. Admittedly, I was difficult to reach over the phone due to the time difference between the UK and Australia, however the team was very accommodating and were able to set a particular time via email. Both Colin and Leah, who were the contacts I spoke with, provided me with a comprehensive briefing of what to expect whilst always encouraging me to ask any questions, which I usually had not prepared. Fortunately, I had everything I needed available online.

The most memorable moment was going out onto the rooftop, which overlooked all the other houses of Kathmandu"

Arriving at Tribhuvan International Airport was quite daunting and confronting. You’re thrown straight into a completely different environment. Amongst the crowd of taxi drivers beckoning me to get in their cars, it was comforting to see Krishna waiting for me, wearing a matching Work the World blue t-shirt and coming to my rescue and ready to take me straight to the house. On our way there I was able to practice a bit of the Nepali I had learnt. My pronunciation was off at times, to the point that I was incomprehensible, and I may have received some weird looks from our driver, but at least I had some proper Nepali lessons to look forward to. Upon arrival at the house, I was shown my bedroom, kitchen, dining room and lounge, all looking very cosy indeed. The most memorable moment was going out onto the rooftop for the first time, which overlooked Kathmandu, with mountains surrounding the city in all 360 degrees. I would later find out on a clearer day that those mountains were actually hills, and the true giants of Nepal were hiding behind them.

My orientation started off with meeting Sean and Uma and a visit to ‘Durbar Marg‘(the heart of Kathmandu city) to sort out money and SIM cards. We then dropped by the beautiful Garden of Dreams, which I would never have imagined existed in the heart of Kathmandu, with its quiet and serene greenery, separated by tall walls from the dusty streets. Uma then led us into Thamel for lunch to a restaurant called the ‘Phat Kath’, where I had my first taste of ‘momos’ (dumplings), chilly chips and buffalo. I would end up eating there two more times during our placement; the food was that good. I was then shown around the bustling streets of the city on foot, with plenty of photo opportunities around Thamel and Durbar Square. After buying out several stores of all their scarves, we finally headed back to the house.

At the Teaching Hospital, I was introduced to Dr Preeti, Dr Krishna, Dr Suvit, Dr Smiti, and Dr Nitin. Each doctor had interests or specialised in different aspects of dentistry and allowed us to be involved with patients from our very first day at the clinic. The typical day consisted of mainly examinations, but there was usually a chance to work with the doctors on patients that who needed things like restorations and endodontics.

 

I also got a chance to see some interesting cases that would be extremely rare back in Australia. The majority were trauma cases due to the high incidence of motor vehicle accidents in Nepal, ranging from the fracturing of the central incisors through to displacement of the zygoma. There was also a case where I observed the removal of the pack following the enucleation of a large dentigerous cyst a week earlier by Dr Krishna. This involves removing what I estimated to be roughly two metres in length of gauze from an opening in the patient’s right buccal sulcus, which had occupied a space that had expanded across her entire right maxillary sinus up to the floor of her orbit.

Another patient I observed came from outside of the Kathmandu Valley area and had allegedly survived an attack by a bear! The extent of the skin graft to his face was all the evidence I needed to believe in his story.

I’m still not entirely sure how Dr Krishna was able to stand and work on the patient for the entire duration of the combined maxillofacial-ophthalmology surgical"

However, the highlight for me was observing a five-hour surgery involving the placement of seven mini plates in a motor vehicle accident patient who had suffered panfacial fracturing to his mid-face, and had lost his left eye as a consequence. I’m still not entirely sure how Dr Krishna was able to stand and work on the patient for the entire duration of the combined maxillofacial-ophthalmology surgery (as I had to take frequent breaks on a stool); he even claimed it to be a typical day, and 12 hour operations were not unheard of. The following day, we were able to check in on the same patient in the post-operative ward, where his bandages were finally removed and the vision of his right eye was tested. “407c” was what he said when he read out loud the words written on the wall across from his bed. He would not be going blind after his accident, and that for me was a moment I will never forget.

Outside of my placement, there was plenty of time to see the sights of the city and Kathmandu Valley. I trekked through Shivapuri National Park to have lunch with nuns at a monastery; visited Patan, Bhaktapur, Swayambhunath, Boudhanath Stupas; and even escaped the pollution of the city by flying to Pokhara for paragliding. Even by the end of this trip, I feel that I have only seen the tip of the iceberg of what Nepal has to offer. There’s no doubt that I’ll be returning.

 

Nepal itself is unique, and I’d be hard-pressed to name a single experience that encompasses this trip. Returning home, I’ve come to realise that it’s not the temples nor the Himalayan Mountains that I’ll remember, it’s the people I met during my travels, the Nepalese and other visitors like me. The hospitality I was shown, and the memories I shared with those during my two and a half weeks in Nepal are what I will cherish the most.

To future students, my advice to you is that it’s up to you on how much you gain from your placement. Make every effort to show staff members what you’re capable of and ask if there are any opportunities observe or assist with any interesting cases. For instance, I started one of my days believing it would be slow, only to return to the house late for dinner after observing a five-hour surgery. It was one of the most tiring days, but it was also the highlight of my placement experience. This would never have happened if I hadn’t spoken up.

Finally, please share your knowledge and experience with those who are new to the house. I was very fortunate to have two of the kindest dental students I’d ever met, Lynn and Ange, who had started their placement at the same hospital a week earlier. They taught me all their know-how, ranging from bargaining with vendors and riding “tuk tuks”, through to walking to the hospital and assisting me when I needed help. My “Nepal experience” would have been incomplete if they hadn’t have encouraged me to take the 'microbus' home for a change. I would say that those acts of kindness are important and need to be passed on with every group of students arriving at the house.

As an aside, there were several basic supplies that other dental students and I found to be lacking at the teaching hospital that would be of great benefit to both staff and future students:

  • Dental floss
  • Articulating paper
  • Matrix systems of any type (for Class II, III and IV restorations)
  • Slow speed suction tips
  • High speed cutting and polishing burs
  • Masks
  • Gloves
  • Dental composites and bonding systems
  • Glass ionomer cements

I absolutely loved my time in Nepal and I appreciate all the effort that has gone into my placement by the Work the World team.

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