Newcastle University 2011

Dentistry, Sri Lanka Kandy

As a fourth year dentist at Newcastle University we are given the opportunity to do an elective placement in our summer break before entering final year. Work the World have always had a good reputation at Newcastle and I’d heard fantastic stories from the year above.
 

I wanted to do my elective on my own so I could experience some independence but I also wanted some help with the organisation for security purposes and Work the World was the perfect solution. I have always wanted to visit this region and when I heard about the opportunity to spend a week doing Ayurvedic medicine in the jungle, I signed up straight away.

I was met off the plane by Nili, one of the Sri Lankan Work the World team and we spent the night in Negombo before travelling to Kandy in the morning. The first day was spent getting settled into the house, meeting the other people doing placements and having a tour of the town centre. It was really great having someone to take me round and show me where all the good internet cafes and places to eat were, we all would have been lost without their help!

The hospital placement started the next day and all the students who arrived the same weekend as me were taken to the hospital together and shown to their respective departments. In the dentistry corridor, there are three separate clinics – orthodontics, oral surgery and out-patients. I spent one week on out-patients, one week on the Ayurveda course in the jungle and my last week on oral surgery.

There are several qualified dentists working in the out-patient clinic at one time. The aim in the morning is to see as many patients as they can on a first come, first see basis. Most patients are presenting with dental pain of some description. I was allowed to start seeing patients on my first day and by the end of the week was seeing around 20 patients during the full morning slot. The clinic is completely different to what we are used to at home and some concepts took some time to get used to. However, the whole experience was incredibly rewarding and was a real eye-opener. Many of the dentists were very interested in comparing my knowledge and techniques with theirs and learning about all the new technologies that we have now such as light-cure composite! 

In the afternoons, there are appointments for more complex treatments such as endodontics and some crown and bridge work although this is very rare. The dentists often would not recommend staying in clinic during this time because it would not be hands-on; this gave me plenty of time to explore Kandy and the surrounding areas with the other students at the house. We saw most of the main attractions including the Temple of the Tooth, the elephant orphanage, spice garden, Kandayan dancing and town centre.

During my second week I travelled north with two other girls and Nili to do the Ayurveda course in the jungle and even though the treatments concentrate on orthopaedic conditions, the experience was incredible. This was my favourite week by far for many reasons. The accommodation in an eco-lodge was unbeatable and the food was the best I have ever had! We spent the mornings with the doctor learning about the ancient, alternative medicine that he practises and we spent the afternoons doing the local attractions, this included climbing Sigiriya, walking through Ritigala, learning how to cook Sri Lankan curry and having a traditional Ayurvedic massage.

For my last week, I shadowed the oral and maxillofacial surgeons. Madame Aberante is head of the department and she is very good at putting you on the spot! I learnt a huge amount during my week here and saw some conditions and treatments you would rarely see in the UK. The main difference between the Sri Lankan dental conditions and the UK ones was down to chewing betel. Betel is a leaf mixed with tobacco and other products and is chewed like gum for most of the day. It gives the patients very characteristic tooth staining, can lead to caries and most dangerously oral cancer. The oral cancer rates in Sri Lanka are very high and most clinicians believe that betel is the main reason for this. Since cancer awareness is low, patients often present very late and their disease will be advanced which is very different to what you would usually see in the UK. We also spent time on the OMF theatre ward where I saw some huge cancer resections and cleft lip and palate repair on a 3 month old baby.

I had two free weekends in Sri Lanka and I spent both of them travelling around the country. We visited Nuwara Eliya on the first weekend to see ‘World’s End’ and also had a tour around a traditional Sri Lankan tea plantation. On the second, we went to Yala National Park and went on safari for the day – an amazing experience!

Overall, my time in Sri Lanka could not have been any better, I met some wonderful people, saw some amazing sites and learnt a lot about dentistry and myself.
 

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