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My elective in Vanuata (South Pacific)

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My elective in Vanuata (South Pacific)

In May 2012 I travelled to Vanuatu, a South Pacific island situated between Australia and Fiji to volunteer dental treatment abroad.

I also had a friend with me that chose to volunteer as well so it was good to share the volunteering experience together.

Vanuatu is made up of 82 islands of which around 60 are inhabited. I had contacted a charity in the South Pacific and they in turn gave me the contact details for James Bongnaus Stephen, who ran a dental centre in Vanuatu. He was very laid back and happy for us to come and help out for a couple of weeks. We arranged the mammoth journey and set off on the 21st May, and arrived in Port Vila after three flights and two long airport stopovers.

The dental centre in Vanuatu was definitely very different to what we are used to in Glasgow. The centre was an old concrete building, with an unfinished extension which was built around ten years ago. When we walked in nervously on our first day there were around 30 people standing in the small waiting area and queuing out the door. They all looked at us as if we had landed from Mars but smiled and said hello. James was just as I had imagined - very laid back. When we told him we were nervous he just laughed but made us feel very welcome and introduced us to everyone.

dental-volunteer-australia-02On our first day we mostly observed but on the second day we started doing extractions and restorations. Working in the surgeries was definitely an eye-opener. The spittoons didn't work so they were filled with cotton wool at the start of the day, and patients would spit into them all morning, and then the blood and saliva soaked cotton wool was changed at lunchtime or the end of the day. The water in the high speed hand pieces didn't work so the smell of burnt enamel was always emanating from the room. One of the three surgeries had no hand pieces so this was used as an extraction room, or as Karen and I liked to call it 'the torture room'. The chair was fixed a metre up from the ground and right the way back so patients would have to climb up onto it and the covering of the chair had come off leaving the foam exposed, not exactly ideal for cleaning. There was no such thing as an LDU, with burs and many of the instruments bring reused on different patients. If the mirrors ran out they were quickly rinsed in a basin of murky liquid and dried with an old towel. However, there was a steriliser which was used regularly although it did frequently sound as if it was about to explode. The kalzinol was put on a glass slab on the bracket table in the morning and was left there all day to be used on different patients.

So far it sounds as if I am moaning about their facilities but although not ideal, I loved my time in Vanuata and learnt to just get on with it. The patients more than made up for the facilities - they really are the happiest people in the world. Jenny, one of the dentists, laughed constantly. Carina, the dental nurse, would just laugh at us for no reason (that we know of...). There was never any rush to get a patient out and all the patients were all intrigued as to where Karen and I were from and couldn't believe we had travelled from the UK to look at their teeth.

dental-volunteer-australia-03The treatment we carried out during our elective was mostly extractions and restorations. The extractions were definitely a challenge. Compared to working in Glasgow the teeth were a lot more difficult to extract as the roots on the teeth were always huge and very divergent. In Vanuatu they did not have the equipment to carry out surgical extractions so a mallet and chisel were used to break the buccal plate to make it easier for the tooth to be removed. I hated watching this being done as the patient was often quite distressed, and the receptionist or nurse would casually walk in to hit the chisel with the mallet. It was interesting to see this old method being used but I'm glad we have all the equipment for surgical extractions in Glasgow, especially if I was to be the patient.

For my first few extractions in Port Vila I was left with a very sore arm and a tooth that James had to finish extracting but it was reassuring to see that they often struggled too. By the end of the two weeks elective in Vanuata I was much more confident about the extractions and was able to extract the teeth myself without getting help. I am by no means an expert yet but my technique and confidence has definitely improved. Karen and I even managed to recruit two new patients, two Australians who we were staying with, who came in to get a few teeth taken out. As well as extractions, I also undertook quite a few composite restorations on anterior teeth. The Ni-Vatu people have a lot more caries on their anterior teeth compared to Glaswegians and it was great to get this experience. This is a part of dentistry that I really enjoy and I like seeing the finished result and the patients were always grateful. Thankfully many of the patients spoke English or at least had a basic understanding of it so we were able to explain what we were going to do and give post operative instructions. If we struggled to make our point Carina was able to translate for us. There was a mini laboratory where the dentists made the dentures. They rotated from being the dentist to the technician throughout the week. The room was a total mess and the smell of acrylic was unbearable at times but the patients all seemed to be happy with their dentures and it made me laugh comparing it to our Glasgow lab.

Outside of the clinic, we made the most of our time on the island. We went snorkelling, visited cascades, went to traditional villages, made friends with the locals, tried kava, and saw as much of Vanuatu as we could. The highlight was flying to Tanna, another island, where we stayed in a beach hut for two nights and stood on the edge of an active volcano (Karl Pilkington flew over it in An Idiot Abroad). It was definitely an unforgettable experience and was quite surreal when the ground was vibrating underneath you and massive bits of lava were flying up into the air.

The Ni-Vatu people were what really made my time in Vanuatu so memorable. Overall the dentistry was the same as here even if the materials and facilities were different. I have never laughed so much as when treating patients for those two weeks. The environment there made the patients more relaxed and that always makes a dentist's job easier. I would recommend anyone to go to Vanuatu, just for a holiday or even better as a dental volunteer. I gained valuable clinical experience and had two of the best weeks of my life volunteering abroad.

Jane Rutherford

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