Last April [2010], for the first time as an elective in fourth-year, DMD students travelled to Cambodia on rotation with general practice residents in the General Practice Residency Training Program.
Emery Bland, Robyn Isaacs, David Wong and Diana Younan, in the final six weeks of their last year, that is, after final exams, with graduation on the near horizon, undertook a valuable learning experience at the Angkor Hospital for Children, in Siem Reap, a provincial capital city in north-western Cambodia. This experience shall serve them for life as dental professionals wherever they practice, even here at home.
Download the full DMD student report. It includes more photographs and details of how the UBC Faculty of Dentistry Competencies for the New Practitioner, which establishes standards for DMD graduates, were addressed in Cambodia.
International rotations, like Cambodia, are designed to broaden the scope of learning to include an understanding of regional disease processes, treatment modalities and cultural competency. Until now, mostly general practice residents (GPRs)—licensed dentists who receive advanced postgraduate training in several dental specialties—have benefitted from this career preparation. This year the GPRs, Drs. Fahad Cadili, Bora Moon and Bahram Rashti, had a more enriched learning experience: they also, along with Dentistry faculty members, Drs Christopher Zed, associate dean, Strategic and External Affairs, and head, Postgraduate and Hospital Programs and Bill Brymer, clinical assistant professor, played a key role in mentoring four soon-to-be professional colleagues.
Cambodia, devastated by years of political and military strife, has an acute shortage of health-care professionals: Western medicine, including dentistry, was destroyed during its recent history of internal conflicts. Now that civil stability has returned, Siem Reap’s Ankor Hospital for Children (AHC)—an independently operated non-governmental pediatric teaching hospital financed by the non-profit New York-based organization Friends Without Borders—provides outpatient, inpatient, acute, emergency, surgical, low-acuity, dental and ophthalmologic care. With 50 percent of Cambodia’s population under 15, malnourished, and cripplingly illiterate, the need for health-care service and knowledge transfer is staggering. The children’s hospital is a busy place.
DMD students note that, along with poor nutrition, “significant consumption of low-cost high sugar foods and poor dental hygiene lead to significant rates of dental decay in Cambodian children and adults alike.” They cite extraction as being the most appropriate treatment for non-restorable teeth which, when poverty-stricken desperation prevails, is often performed at the numerous unhygienic roadside shacks seen in Cambodia. The modest, four-chair dental clinic at AHC certainly provides a safer setting for extracting teeth—to relieve pain, and performing other dental procedures like pulpectomies, a type of root canal therapy.
Then fourth-year DMD students at the time of their rotation, Drs. Bland, Isaacs, Wong and Younan write in their report that they along with the GPRs and faculty members were able to share knowledge not only about pulpectomy procedures with the attending Cambodian-trained dentist, Dr. Naren Bou, but also the use of calcium hydroxide as an inter-appointment dressing and that “there were often exchanges in knowledge in regards to dental materials, restoration and endodontic (root canal) techniques between the Canadian and Cambodian dental teams.” The report further states that the local dentist frequently asked for their advice when planning and conducting treatment. The transfer of knowledge into a local resource plan is a corner stone of Dentistry’s international programs—what Zed describes as “true aid, the sustainable piece”.
Community outreach clinics in rural areas were also part of the Cambodian rotation. Sites in rural areas typically had no running water, electricity, or suction available. Although at one treatment station, a portable generator and dental unit were available.
Over the five-day rotation to Cambodia, the UBC team treated over 350 patients—130 in rural areas. Above this tally, a research project about diet (the most important factor to predict caries risk in populations) was undertaken.
The team interviewed local residents including children to determine what foods were most often consumed. Research results are intended to help develop programs to educate children about the effect of foods on their teeth. Decayed, missing, and filled surfaces (DMFS) scores were also collected to understand children’s knowledge about food choices and its effect on their caries rate and overall health.
Fourth-year DMD students reported that this elective improved their problem solving and decision making skills and increased confidence in clinic skills. “Overall, we are positive that exposure to different cultures, practices, and pathological processes less frequently encountered in North America will lead to our development as compassionate health care providers.” An educational, and community, outcome Red Barnes, general manager of Henry Schein (BC zone)—an international dental distributor—would be proud of: the fourth-year DMD student elective to Cambodia was supported by the Henry Schein (BC) International Dental Outreach Fund.
Read more about the Henry Schein (BC) International Dental Outreach Fund.
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