From Riverside to Rarotonga

A Dundee dental student’s elective of discovery
Kathryn Graham with young patientthe Dundee dental team by their tuk-tukthe Dundee dental team, Sri Lankaoral hygiene lessons, rural Sri Lanka

Of all the highlights over a five year degree at the UK’s No.1 dental school, and there are many, most students would agree that their Year 4 elective is the greatest.

My name is Kathryn Graham – and this is my elective story.

Keen to make a real difference to local communities, improve my clinical skills and gain remarkable cultural experiences, I decided to travel from the banks of the River Tay in Scotland to Sri Lanka and the Cook Islands, accompanied by two fellow University of Dundee dental students Laura Feeney and Sophie Ferguson.

The social fabric of the Indian Ocean island state of Sri Lanka is scarred by decades of ethnic conflict and the longlasting impact of the 2004 Boxing Day tsunami. Despite a growing economy, poverty levels are high and increasing. As a result, dental care is somewhat primitive and oral care often neglected.

Based at Teaching Hospital Karapitya in southern Galle, under the direction of Dr. DK Dias, we received extraordinary insight into the examination and surgical management of orofacial trauma, cleft lip/palate defects, oral cancer and rare developmental cysts - conditions we had only ever encountered in library textbooks!

To complete our clinical work in Sri Lanka, we made the rickety tuk-tuk journey to the rural Baddegama and Kalegana Orphanages, armed with a formidable supply of toothbrushes and toothpaste. There, we gave oral hygiene instruction to classes of 15-20 children of various ages and set about brushing the toddlers' teeth.

This was a heartbreaking and humbling experience; though spending time with children so appreciative and eager to participate was also rewarding.

Of course, the Sri Lanka stage of our elective was not ‘all work and no play’. We enjoyed elephant rides, trips to Unawatuna beach and took in as many sights as possible, including the Temple of the Tooth where Buddha’s canine tooth remains. Well, we are dentists after all .

Staying with a host family, we shared meals, learnt some of the local language and immersed ourselves in their way of life. In fact, at no point did we rely on any typical commercial tourist excursions and this made our free time so unique and memorable.

From the Indian Ocean to the South Pacific – and the isle of Rarotonga, northeast of New Zealand with its total shoreline of just 20 miles and a population of 14,000.

Here, we worked at Te Marae Ora Dental Centre - the sole clinic to care for all the people of the Cook Islands. A typical day was spent mainly on extractions and restorations. This is where Dundee’s excellent teaching and experience proved invaluable.

Rarotonga, however, presents many more challenges than working on Tayside. Te Marae Ora relies on donations shipped in from all over the world, so we often lacked the best restorative material or tool for the job at hand. Cook Islanders also tend to be large in stature, with dense strong bones, so we often encountered stubborn teeth that did not wish to be pulled !

I thoroughly enjoyed the challenge of having to think on my feet and employ initiative. Then we would often reward a morning’s work with lunch on the beach to enjoy the paradise views and look for whales swimming at sea.

To conclude our clinical work, we visited the on-site surgery at Avarua Primary school. Tooth decay is widespread, despite compulsory lunchtime toothbrushing sessions, due to the sugary Maori diet. As a result, we were kept very busy placing fissure sealants, restoring, extracting primary teeth and giving advice on diet.

We stayed with a Maori lady called Tara. The Cook Islanders are very laid back and we enjoyed nothing more than relaxing with Tara and her friends in the evening. They would often cook for us as well as sing and dance as they for their upcoming island festival.

Rarotonga is the most idyllic, welcoming and culturally exciting place I have visited - a real ‘must’ for all keen travellers looking to explore somewhere off the beaten track.

To anyone contemplating an overseas elective, I would thoroughly recommend embarking on such an experience that is truly a credit to the excellent Dundee dental curriculum. It helped improve my diagnosing, treatment planning and communication abilities, as well as bolster my independence both in and out of the clinical environment.

The cases we encountered consolidated our existing knowledge and converted textbook teachings into clinically relevant real-life scenarios. Most of all however, it was great fun and we had the time of our lives !

With such an elective, you will build new friendships and see parts of the world you once could only dream of.  As a 2014 graduate, I am grateful for the lessons and skills gained that I will take with me on to the next stage of my career. I look forward to planning a similar trip (this time as a qualified dentist) in the not too distant future.