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After a field-study in India the summer 1998, I stayed in contact with my Professor,
Dr Sumant Goel. When he came to Sweden in 1999, I mentioned that I wanted to take a year off from my dental
studies to do something different. He suggested that I should go to South Africa, University of Pretoria.
Dr Goel had a contact at the University and gave me an email-address.
After contacting the Dean’s secretary, Mrs Odendaal, I received the applications to
the departments of oral surgery and conservative dentistry.
I was accepted and it was decided that I would go to Pretoria.
Mrs Odendaal made sure to arrange a chauffeur to pick me up at my arrival
and the accommodation in Pretoria.
I stayed in a room at a student hostel, which was only a walking distance from the
university. It was a singel-room with a bathroom and kitchen.
The cost was approximately 160$ a month and it was considered a quite
expensive place to live at, especially for the South African students.
On the ground floor of the hostel, there was a restaurant which served
lunch and dinner for 3$ a day.
On the day of my arrival, I also met with the president of the student union and
together we worked out a schedule for me. The
students had four clinical sessions a day between 7.30-18.00, but I only had to
attend two sessions a day. The
president introduced me to the professors and showed me around the university.
The first week at the university was difficult.
I had to learn new routines, how to write journals and to sterilise the
instruments. In the beginning I did
not have any of my own patients, I only assisted other students while learning
all the new routines. The language
was not a problem. When my English
was not sufficient enough, I received help from the other students.
During the second week I received my own patients.
The oral surgery rotation consisted of more or less extracting teeth.
In the clinical wards there were 7-8 students and 2 faculty members.
The nurses prepared one patient for each student.
Then the students took the patient’s history and chief complaint.
The faculty members examined the patient and then we had a discussion
concerning the treatment plan. Extraction
was the most common treatment, but we also did some surgery, dry socket
treatment and consultation. We
treated all age ranges and this was a new experience for me, since I had never
treated children before. The minor
treatments usually went well, but the more difficult treatments were generally
complicated. Most of the patients
in this ward were black, poor and with acute pain. Due to the cost, the only
option that was most often available to these patients was extractions. For a root canal treatment with a filling the price was 130$,
whereas for an extraction it was 2$. Since most patients had an average income
of 250$ a month, the extraction was the most frequent choice.
In
the conservative dentistry department I only worked with acute patients, who had
fractured teeth, severe pain or other types of problems.
I diagnosed the problem, gave a temporary treatment and then I set up a
new appointment with the patient when the permanent treatment would be
determined. The number of patients
I had depended on the weather. If
the weather was bad there were no patients and vice verse.
I had similar types of experiences when I was doing my field study in
India.
Just
as in India, the students at the University of Pretoria had community dentistry.
The University had two projects where the students participated.
One was called Hammenskraal, after the name of the town.
Here the students were in charge of a mobile unit that they drove to an
elementary school. Inside the unit
the dental student had a chair and outside there were two chairs that were used
by the dental hygienists. In this project the children from school were treated.
I did not learn much from this project, but it was fun to discover that
children are always children wherever you go. The other project was called
Phelophepa mobile health care train. I
was invited to go on the train for two weeks.
The train goes from station to station to provide subsidised health care
for individuals. On board the train
there were nurses, dispensers, opticians, dentists and psychology-students from
the whole country.
Initially
I was supposed to stay at a hotel since there were not enough beds on the train.
While we were trying to organise a lift to the hotel, Lillian Zingo who
was the manager of the train, offered me accommodation on the train because one
of the students hadn’t arrived.
After
a light snack we were introduced to the dentist in charge, Dr Denicker.
She told us how to work in the different clinics.
The train consisted of 15 wagons, with different clinics, a restaurant
and accommodation.
The
patients came to the main registration in the morning, where they were sent to
the different clinics. Then we made
a quick examination and decided if they needed cleaning, fillings or
extractions. They paid between 1-3$
depending on the treatment. Then the patient was called into the train and was
treated. The train had three chairs
for extractions, two for fillings and on for scaling/polishing.
One person was working in the sterile to make sure that there were
sterile instruments at all times. We
were supposed to execute all the procedures by ourselves and only ask the
dentist if we had any problems.
During
the first day of work, I was reminded that this was not Sweden.
We did everything ourselves -- we were running the clinic all by
ourselves. It was a hard thirteen-hour day with many different problems.
One of the problems was the language. In the rural areas there was not sufficient English.
During the week I managed to prick myself with a needle. This was a serious matter,
considering the high prevalence of HIV in South Africa.
We had to HIV-test the patient. The test was negative, but it was a
nerve-wracking experience. Every Thursday we had a barbecue feast, which the catering
students arranged. The catering students were probably the most hard-working team and they prepared superb food.
After two weeks on the train I went back to Pretoria for a couple of weeks and then I
left to travel around South Africa for a couple of months before I went back to Sweden.
My
trip to South Africa taught me a lot about different people and cultures, but especially about my self. I would
like to thank Dr Sumant Goel, Belgaum, for all his help.
Sanjay Haryana
Faculty of Dentistry
University of Malmo
Sweden
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