A Summer in Malawi by Paula Houston

Paula Houston is a dental student at the University of Glasgow. She undertook her elective project in Malawi between the fourth and fifth years of the BDS course. This is her reflection on that elective experience.

In June 2019 I was fortunate enough to travel to Malawi with fellow BDS students, dentists and volunteers with the charity ‘Smileawi’. We were conducting a survey of the prevalence of dental caries in children aged 5-12 years in rural primary schools across the country. We visited six schools in total and surveyed more than 2600 children’s teeth. I believe it will be the largest study of its type among children conducted in Sub-Saharan Africa and it was an invaluable experience.


As a group we discussed and strategized over the daunting task of charting 3000 children’s dentition within the narrow timeframe that we had. (It would require seeing a patient every 2 minutes on average).

We used basic fold down dental chairs (manufactured by the charity Dentaid), a plastic mirror, some cotton wool and a head torch. We took it in turns to assess the patient and to scribe the results and swapped roughly every 20-minutes when inevitable fatigue set in – in order to minimise human error.

Myself and Nigel Milne conducting an exam 

In addition to gaining significant data, we were able to give the children of Malawi a positive impression of dental treatment. Unlike children in the UK, most (if not all) of the children that we looked at had no previous experience of dentistry and this survey stood as an opportunity to acclimatise them to dental treatment. It was so encouraging to see how cooperative the children were and how excited they were about our visit!

We had some local Malawian volunteers who helped the children complete the questionnaires and also taught us some useful local phrases.

‘Yasa Mula’ – Open your mouth

‘Yasa Mula Chomeni’ – Open your mouth very much

‘Tawonga chomeni’ – Thank you very much.

These basic words got us by, although admittedly on occasions we mixed up ‘thank you’ with ‘open your mouth’ and had children climbing off of the table post-exam, then jumping back on with wide open mouths in perfect obedience!

An oral health lesson in Ekwaiweni Primary School

For each school that we visited we also spent some time teaching the children some basic oral hygiene and delivering tooth brushing instruction. With the help of our translators, we conjured up a song which reminded the children to brush their teeth twice a day. It wasn’t a chart topper, but it was certainly trending in Malawi! One of the moments that really stands out to me on this trip was hearing an assembly of children singing our song back to us in both Tumbuka and English.


It was an educational trip and checked a box in completion of our required university project, but in the end, it was so much more than that to all of us. Not only have I fallen in love with the beautifully kind people of Malawi, but I am left in awe of the incredible work that Smileawi conduct annually. This small charity, founded by Nigel and Vicky Milne, has made such a noticeable difference to the rural villages of Northern Malawi. They provide emergency dental treatment, in addition to funding dental therapy students to complete their education and provide materials to DCP’s working throughout the country. Furthermore, Smileawi has funded the construction of a kitchen at one of the schools we visited, in order for the children to be fed at school and encourage attendance.

I left Malawi with some great memories, great friends and a great desire to return and help as a dentist in the future.

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