Internship report | Ghanaian 2017

Contact/Organization:

After travelling to Kenya with “Dentists for Africa” last year, I was once again bitten by the travel bug and the desire to work as a dentist abroad.

After some consideration, I contacted the organization “Dental Volunteers” in January and asked whether there was still a possibility of getting a clinical internship at short notice.
I also received an immediate response saying that I had the opportunity to travel either to a large refugee camp in Algeria or to Ghana. I decided on Ghana because I have come to appreciate Africa a lot over the last year. As a small state in East Africa with a diverse natural environment, a stable domestic political situation, no excessive infection rates for various infectious diseases and an interesting and friendly population, Ghana offered an attractive mix that I was keen to explore.

At that time, Ghana was essentially the pilot project for the “Dental Volunteers”. The organisation itself had only been there once before, to find out about the local options and the treatment needs of the population. Dentists from other organisations in Germany, with whom the “Dental Volunteers” is seeking cooperation, had also been there before.
Four other dental students and I were therefore the first interns on behalf of the organization, who were to visit various stations in Ghana and thereby provide the population with treatment options.

At the beginning of August, I and two other students from Marburg left Frankfurt for Ghana. We first flew to Casablanca and from Casablanca we flew on to Accra.
In Accra we were picked up from the airport in the morning by two other students from Kiel, who had flown to Accra a few days earlier, and Annette, Rose Sekhov's daughter. Rose Sekhov is very well known in the Accra area because she runs her own association from Kiel, which regularly sends interns and volunteers to Ghana. She owns a house near Accra where the volunteers can stay during their internship.

We were then taken to Rose's house so that we could recover from our long journey.
However, our recovery period was short because we drove back to Accra on the same day to buy various things such as cotton rolls and anesthesia for the upcoming treatments.

On the same day, we also screened more than 30 schoolchildren in a school in the immediate vicinity, as more interns will be coming to Ghana in September and would like to treat the schoolchildren. Most of the schoolchildren had never been to the dentist before, but were very open to the screening and possible dental treatment. Many children were already suffering from severe toothache and urgently needed a filling or possibly an extraction. We therefore created an index card for each schoolchild and noted on it what treatment the screened child needed so that the upcoming dental volunteers could start with the urgently needed treatment straight away.
After that, the first day in Ghana was over for us and we prepared for the long journey the next day. The first stop we were supposed to go to in Ghana was the West Gonja Hospital in Damongo. On the second day, we were picked up by a driver from the hospital and taken by car to Damongo, 15 hours away. Since we arrived there very late in the evening, we were only able to take care of the work that needed to be done the next day.

The next day we were first asked to speak to the hospital administrator, who greeted us formally in Damongo. He introduced us straight away to Mary Grace, who runs the dental unit when no dentists from Germany are visiting. During this time, Mary Grace carries out all dental treatments such as fillings and extractions completely on her own. So she was also very happy to have active support from Germany and gave us all a warm welcome. She first showed us around the entire hospital and introduced us to all the staff we met along the way. There was also a lot of advertising that a few students from Germany would be here for the next few days and would be taking over all dental treatments for the time being. There was even a flyer on the clinic's notice board announcing our visit.

Last but not least, Mary Grace showed us our workplace for the coming days. The dental unit consisted of a large room with a treatment bed for the patients and lots of accessories such as a micromotor for the contra-angle handpieces and extraction instruments. There were also plenty of opportunities to disinfect the instruments used.
The next room was the dental unit's office, but a treatment couch could also be added here if required. We began by sorting out the donations we had brought from Germany, which could stay in Damongo and which should be taken to another station. We were able to bring back a huge number of donations from Germany, including many tubes of toothpaste, toothbrushes, material for fillings and instruments for extractions. There were even various angle pieces and handpieces among the donations.

The first patients slowly started to arrive on our first day and so we carried out the first fillings and the first extractions. Our first extraction was a little more difficult because we had to perform a hemisection on a molar in order to remove it as best as possible. But we were able to master this more difficult and somewhat lengthy extraction well and the patient went home satisfied.

We spent the following time in Damongo mainly doing extractions, fillings and teeth cleaning. We already knew some of the things from our university treatments and were able to implement many of them very well. We discussed more difficult cases among ourselves and advised each other on how to best care for the patient.
But every treatment was always something new and an interesting case. Be it patients with very severe chronic periodontitis or patients who urgently needed an extraction but refused it and preferred medication. It was sometimes very difficult to explain to patients that medication is only a temporary solution and that in the long term it will eventually lead to an extraction. Many patients were afraid of the extraction or did not want to lose the tooth for aesthetic reasons.

For me personally, the most interesting cases were the extractions, as they were very varied and always a new challenge for us. I particularly remember a patient who came in for a dental cleaning and did not want his front tooth to be pulled, even though it was already very wobbly. He asked me to help him somehow, as he did not want to lose this tooth for aesthetic reasons. In the end, we splinted the tooth to the neighboring teeth during one treatment to temporarily stabilize the tooth. However, we had to explain to the patient that he could still lose the tooth and that this might not be a permanent solution. He was very grateful to us, however, that we had at least found a temporary solution for him and that he could keep the tooth for the time being.

In addition to treating patients, we wanted to see the area around Damongo and make use of our free time at the weekend. Damongo is close to Mole National Park, which is the largest national park in Ghana. It is also known for the fact that the safari there is a bit cheaper and therefore also suitable for students' budgets. We spent time there at the weekend and were able to see various animal species such as elephants, monkeys, antelopes and many bird species on safari.

I also visited the children's ward of the hospital one day and I wanted to give out cuddly toys to the sick children. Unfortunately, the hospital did not have the financial means to build a playroom for the children where I could have put the toys. However, I had the chance to give each child a cuddly toy and at least give them a little joy during their stay.

The organisation suggested Langbensi as a further stop in Ghana. Unfortunately, the organisation itself had never visited this stop and we therefore had no idea what to expect. It was a bit too risky for me to go there and I returned to Germany early.

My general conclusion after my departure is that it is very important to carefully choose the organization with which you plan your internship and to find out exactly what is planned for the stay and where exactly you will be traveling.
It is also important that the organization plans and ensures that you are picked up from the airport, that reasonable accommodation is available, that there is a contact person on site and that you as an intern know how to get back to the airport safely at the end of your stay. Last year with "Dentists for Africa" ​​all of these requirements were met, but this year unfortunately the organization did not. In principle, you travel with a German organization to get this kind of support.
I also personally think it is important to take the time to get to know the other students you are doing your internship with before you leave. This can be through several phone calls or personal meetings if this is possible due to the distance.

Last year, before my internship in Kenya, I spoke a lot on the phone with the other student from Würzburg so that we could see whether we were on the same wavelength and whether we would be able to manage the three weeks together. In the end, we managed it well together because we could rely on each other in every situation.

Unfortunately, it is not enough to just communicate via messages, as this will not help you get to know each other and you may experience unpleasant surprises. I therefore recommend taking this point seriously. It is also often better to travel with people you already know.
It is also an advantage if you do not necessarily start an internship in a large group. In Ghana there were five of us and that was definitely at least two students too many in one treatment room. It is generally fine if the organization sends several students to one country, but it would be better and more educational for everyone involved if they were divided up into different wards. In the end, for example in Ghana, two or three people are in Accra and two people are treating in Damongo. During the stay, you can always discuss whether you want to swap wards or go somewhere else entirely.

Despite these experiences, it was still a special experience for me to travel to Africa. It is very interesting and educational to get to know other cultures and, above all, to gain new experiences in the field of dentistry. Treatments in Africa take place under very different circumstances to those in Germany. You have to make do with much less than you are used to for treatments in Germany, be it materials, electricity, time or even hygiene.

In Ghana itself, there was also an enormous need for treatment. Many patients had never been to the dentist or had not been for treatment for a long time. They came to the dental unit in great pain and hoped for quick relief from the pain, which was not always possible. Many patients were then afraid of the treatment and went home in the hope of escaping even greater pain. Even discussions about the fact that treatment was important and urgently needed in the current situation were not always successful.

Working in Ghana was not always easy, but it was certainly an unforgettable time for us. We collected wonderful and new impressions and experienced unforgettable moments.

I am sure that I will return to Africa after my exams and gain new experiences.