Dental students’ first taste of refurbished dental clinic at Queen Elizabeth Hospital, Blantyre

After a short break on the MalDent blog, we are delighted to be back with a guest post from Chifundo Banda, one of the pioneer cohort of Bachelor of Dental Surgery students at Kamuzu University of Health Sciences (KUHeS).

However, by way of preamble I would like to congratulate Drs James Mchenga and Peter Chimimba on the work they have been doing with colleagues to improve the clinical facilities available at the Dental Department of the Queen Elizabeth Hospital in Blantyre.

These improvements have included installation of some new dental chairs:

and the installation of a digital pan-oral radiography unit:

• 

• 

These enhancements to the infrastructure will be a great benefit to patients as well as to staff and future students and were part of the experience gained by Chifundo and his classmates when they visited recently.

I hope you enjoy Chifundo’s reflection!

My name is Chifundo Banda, a second year Dentistry student at the Kamuzu University of Health Sciences. I totally had no idea of what a Dental Department at a Central hospital looks like. On the 27^th of October 2021, I had the privilege to visit the Dental department at Queen Elizabeth Central Hospital in Blantyre, Malawi. I was very eager to see and experience how the setup is like and how it operates. Everyone was excited and we were smartly dressed in our white lab coats, we really looked like Dentists. We were warmly welcomed by our Academic lead, Dr. J. Mchenga. We made a mistake by not arriving on time, and this was our first lesson that as Dentists we should always keep time. We also learnt that we should not just sit anywhere else because we do not know who was previously sitting there to minimize the risk of infection spread.

Our first room to go in is where extractions are done. The room is spacious with about 4 extraction units and it is well ventilated. I realized that the instruments that are used for extractions are kept in silver trays that are fully covered and each is classified according to its use. When one wants to get an instrument, they had to use forceps to minimize contamination. There was also a waste disposal bin and another one for sharps. We were lucky to see a little girl having her tooth extracted by one of the dental therapists. From there, we went to a room where surgeries like oral and maxillofacial surgery are performed.  It is the best room that we ever visited; the paintings, equipment and ventilation made it look good. There were two Dental chairs fully equipped and each had a separate radiograph machine mounted on the wall that could easily be used to examine a patient while sited on the chair. It is a convenient room to work in with a patient. The drainage system itself was very perfect.  There was a mobile suction machine ready for use in case the one mounted on the chair gets out of use. We were lucky that we had our first hands on experience by sitting on the dental chair, and using some of the things that are on it. While we were still there, we saw a boy with a swelling, probably a tumour on the left mandible who was with his guardians. Our academic lead, welcomed them warmly and they were helped. Every one of us realized that there is more to Dentistry than just teeth.

• 

• 

• 

Our next station was the Dental laboratory for the hospital. I was wondering of what would we would find in the lab. To my surprise, I really confirmed that Dentistry is an art too. This is the lab where we make false teeth (crowns, bridges, veneers) and jaw impressions on our own. Materials like acrylics and plaster of Paris are used, I really liked the lab since I love art. We then entered another room that is under refurbishment. This is the one that will be used for paediatric dentistry when it is complete. Our academic lead told us that he wanted it be painted with beautiful drawings since children like them. We loved the idea.

Pertaining the issue of infection prevention, we were shown another room where all used dental instruments are sterilized using an autoclave and other cleaning machines. In order for a Dentist to make a good diagnosis, there is a need to use supporting equipment like radiographs. It is therefore a privilege that our department has a radiology room since if we depended on that for the whole hospital it would take long to get the results. We were amazed to learn that as part of our training we learn radiology so that we are able to interpret the results on our own. We also entered another room where all other Dental procedures like orthodontics, periodontics and prosthodontics are done. It was also fully equipped, I really felt that I was in a clinic.

Finally, at the entrance there is a plasma that is supposed to convey Dental related education to the people who come to the clinic but that was not the case. It is the therefore our responsibility as Dentists-in-training to come up with something to show up to the community. It was really a wonderful experience that I have ever had in my life and am looking forward to the completion of my degree so that I serve mankind.

As Chifundo and his colleagues look forward to the clinical dentistry components of their BDS course from next February onwards, it is not only the technical aspects of the profession they need to understand, but also the social and environmental context in which they will be serving their fellow Malawians. This latter aspect is a very strong component of all healthcare courses at KUHeS and for that reason students spend time living with a family in a rural area for several days to understand and see at first hand how the social determinants of health play a key role in disease prevention and access to care. This module is called ‘Learning by Living’ and will provide great benefit to dental students as part of their learning to be dentists who are not only ‘globally competent’ but also ‘locally relevant’.

Chifundo and his colleagues have recently completed the ‘Learning by Living’ module as part of their BDS 2 programme of study and we look forward in due course to their reflections on the experience.