University of Toronto 2011

Dentistry, Sri Lanka Kandy

Great people, great food, cute elephants and amazing dentistry experience - what a glorious summer! In Canada, we're not required to undertake elective placements as part of our courses, but I wanted to push myself out of my comfort zone, and experience dentistry in a country I knew nothing about.
Our house was situated half way up a small mountain with spectacular views of the city from the roof top. It is short ride into town as well as a beautiful run up Hantane road winding through the tea plantations nestled into the slope. But the house was simply awesome for the people in it. The Program Manager was simply a hero; helping us out with Sinhalese vocabulary at the house and throwing some shapes on the dance floor! The housekeeper never lets the house get messy and has many stories to tell of all the places she's been in a very colourful life. One night, the gardener and a group of us staying in the house made our way through the bush, grasping at thin saplings for support, descending for what seemed like an eternity until we stumbled upon a little Buddhist temple tucked behind a grove of mango trees! Finally, the real man of the house — chef! Classically trained and winner of cooking numerous competitions in Dubai, he made crepes for breakfast, curry for dinner and taught us important life skills like how to open a coconut!

The placement at the General hospital allowed me to spend lots of time in the outpatient clinic. It was eye-opening to see the speed and efficiency of the staff trying to provide care for what seemed like over a hundred patients per day.

Starting the very first day, I was observing restorations, which took place without local anaesthesia, Tofflemire matrices, or amalgam carriers. I saw many examples of local staff doing the best they could with whatever they had. In the orthodontic clinic they made up for their limited resources with amazing resourcefulness. Limited chair time results in limited use of fixed appliances, but they adapted with effective use of functional appliances and clever wire bending to reposition severely displaced canines and manage controlled space closure.

The most exciting dental experience during my four weeks were oral surgery theatre sessions. Once I'd proven my competence, the surgery consultant allowed me to observe and in some cases assist with a variety of procedures including extensive head and neck cancer resections and facial reconstructions. As the general hospital is one of the largest government funded facilities in Sri Lanka, they also receive infant cleft lip and palate cases from all around the central region of the country.

When I arrived, I naturally thought that my primary goal for the next four weeks would be to see how dentistry is practiced in Sri Lanka and how it differed from our training back home. However I quickly realised there is so much more to learn in a foreign country.  When we travel, we immerse ourselves in another culture through food, friends and experiences. Go out and eat every fruit you don't recognise and practice your Sinhalese with the vendors at the market, make new friends and try new things.

Before Sri Lanka, I had never smelled a wood apple, blind taste tested 5 different kinds of banana, nor climbed 7 kilometres up a mountain in the dark of night hoping to catch a glimpse of a beautiful sunrise. I had never slept without air conditioning at 28 degrees Celsius nor took shelter in an abandoned hut during a heavy rain storm, getting lost 3 hours after setting out for a short afternoon walk. These are the unforgettable moments that shape our lives.

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