My time in Kenya was truly unforgettable. I met incredible people, made new friends, and learned more than I could have ever imagined. To be able to say I traveled to Kenya is awesome, but to be able to add that I interned in a public hospital and got to observe patient care up close is really the cherry on top. The dentists that I observed were some of the nicest people I have ever met. The IMA team/mentors were always ready to answer questions, and they taught me so much about Kenya. The food was delicious! I usually went back for seconds, and it was such a treat to be looked after by the housekeeping team. Snorkeling in the Indian Ocean and experiencing Malindi/Watamu was definitely a highlight, but I also loved the day-to-day routine of going on the bus, driving to the hospital and people watching out the window, saying hello to and fist-bumping the guards, and walking all around the dental unit. Going out to local spots with my fellow interns was also so much fun. I really do hope I have a chance to return to Kenya one day. As a child, I was terrified at the thought of sitting in a dental chair. Sitting in the chair itself was a whole other obstacle. There I was sitting in a bizarre-looking chair with a direct view to a tray of dental tools that had 6-year-old me thinking would bring me nothing but pain and discomfort. Needles and drills moving towards my face with no explanation of what was about to happen. It was a complete nightmare…until I met the person that would end up being my pediatric dentist. Her office was warm and inviting. The chairs had TV screens attached to them so that patients could be entertained and distracted from all of the drilling and prodding. Her assistants always let me hold their hands while they administered the anesthesia, because even though squeezing their hands did not actually help much with the pain, it was nice to know that they simply cared to ease my pain. My dentist talked me through every little thing she did, and she got me cavity-free. Being her patient–a scared child desperately wanting someone to validate her fear–inspired me to want to become a pediatric dentist. I wanted the chance to help other children be calm and maybe even excited to sit in the dental chair. When I tell people I want to be a dentist, I usually get asked, “why teeth?” I do not think it has much to do with teeth as it does with patient interaction. I am fascinated by teeth and take dental hygiene quite seriously, but I am most excited about the thought of telling a young patient that I will leave the numbing gel on just a tad longer before administering the anesthesia if it means easing their anxiety. Or demonstrating proper dental care on stuffed animals just like we did during the hygiene clinics at the primary schools. The little things. In preparation for dental school, I have spent hours shadowing at local dental offices, but in 2022, I became interested in observing dental work on an international level. After some research, I stumbled upon International Medical Aid. I took a leap of faith and applied, and I landed in Mombasa, Kenya in the Summer of 2023. Being able to say I have traveled to Kenya has given me a lot of pride, but also being able to say I interned at Coast General Teaching and Referral Hospital just does not seem real... During my time with IMA, interning at CGTRH in the dental unit, I learned more than I could have ever imagined. I felt incredibly privileged being in a position to observe dental care in a country that has significant healthcare differences to the United States. Much of the healthcare challenges in Kenya are poverty related; for example HIV/AIDs is so prevalent that all patients are assumed to have it until proven otherwise (Current State of Healthcare in Kenya, 2022) . I observed that sanitation was at its best after procedures that resulted in some blood loss. HIV prevalence in Mombasa is actually 1.2 times higher than the national level at 7.5% (Disease Burden In Kenya, 2022). Additionally, I observed low health literacy–many patients did not fully understand their conditions or treatment plans, but they followed all of the doctors’ orders, trusting that the doctors knew best and accepting that they themselves did not know better ( Health Literacy, 2022). Notably, Dr. Khadijah did an excellent job helping patients try to understand the need for tests, treatments, and medications. She was compassionate and patient, and always encouraged her patients, particularly during painful procedures. I also noticed that many patients were coming in for issues caused by self-neglecting behavior. Most did not have the luxury of coming in for annual cleanings or routine treatment. If they noticed a cavity or a slight ache, this would go untreated for months or maybe years until the pain became so unbearable they had no choice but to come in. The dentists extracted many teeth that had complete decay of the crown. There were multiple instances in which they extracted teeth from abscessed sites, but due to the infection, the anesthesia was not fully effective, resulting in pain and discomfort. After root canals, most patients did not return for the crown. I was informed that they actually just keep the temporary filling in until that starts to cause issues. There was one particular patient who had cavitation on a tooth on her lower jaw, and it went untreated for so long that the infection spread to her roots and then to her neck, which resulted in necrotizing fasciitis. During my time in the unit, I saw her return for a check-up after prior treatment, and the infected site was healing well. The degree of infection was disheartening to consistently see, because it seems so normal to have these issues addressed promptly in the United States, and most of the time, the issue will be caught during regular cleanings before it can even progress to infection. Early detection and treatment seem like such little things. In Mombasa, they were not so little things, since early detection and treatment were not affordable for many. In the United States, there is a routine to most treatment plans. The patient sits in the chair, a bib is placed around their neck, the dentist applies numbing gel to the treatment site in preparation for the lidocaine, and then lidocaine is administered. I was incredibly shocked to see that numbing gel was not being used in the dental unit. There was lidocaine spray, but it was only used occasionally on pediatric patients. It was certainly not part of routine treatments. Even when the lidocaine spray was used on pediatric patients, they reacted poorly to the subsequent lidocaine administration. Some began crying while the lidocaine spray was getting applied, and those who made it through that stage screamed and squirmed at the sight of the needle. There were times doctors would jump in to hold a patient’s arms and legs down, and others would steady the head and neck so that the lidocaine could be given, but the patient would fight even more. This young boy reluctantly made it past the lidocaine, but the moment the dentist began extraction, the boy had had enough. He flipped over in the dental chair and slid off, refusing to get back on. He screamed, “Jesus” over and over again, and he was completely inconsolable. I felt awful, because I know how terrifying the dentist can be, yet I have all these little things that help ease my fear, like numbing gel. Maybe these “little things” were actually not so little. I also witnessed adults experience intense anxiety in the dental chair. They would grimace at the sight of the needle and even reach for the dentist’s hand while the anesthesia was getting administered. Something as not so little as numbing gel could make patients’ and dentists’ lives easier. I actually was able to sit-in on a meeting during which the dentists discussed pediatric treatment and how to manage patient and parent behavior better. They noted the importance of using simple terms, for example, referring to lidocaine as “sleeping juice.” They also mentioned how the presence of parents can change a child’s behavior. The previously mentioned combative young patient originally came in with his mother, and he left without having completed his treatment. However, he returned a few days later with his father and was fully cooperative. One dentist suggested using colorful composite for fillings to incentivize children to fix their cavities, and it just makes it more fun for them. The fillings would be on their primary teeth, so as they lose their teeth, they will lose the colorful fillings, but it could be something for children to look forward to. She also suggested limiting the number of people in the room during pediatric treatments because having more dentists present may make the patient feel uneasy and concerned about the need for so many people. I believe these changes can truly improve children’s experience in the dental chair. I was someone who hated going to the dentist, and now, I look forward to every visit. I want to help people take pride in their teeth and smile. I hope one day I am given the chance to heal any traumatic experiences a person has ever had in the dental chair.
What makes Philotimo Med special? Stavros! He truly cares about each student, always making sure we are getting the most out of our experience. I shadowed doctors in cardiology, general surgery, and emergency medicine and even observed a laparoscopic gallbladder removal! Everything was in English, and the excursions were just as exciting as the clinical experience. 10/10 recommend!
From Fear to Passion: My Transformative Dental Internship in Kenya
My time in Kenya was truly unforgettable. I met incredible people, made new friends, and learned more than I could have ever imagined. To be able to say I traveled to Kenya is awesome, but to be able to add that I interned in a public hospital and got to observe patient care up close is really the cherry on top. The dentists that I observed were some of the nicest people I have ever met. The IMA team/mentors were always ready to answer questions, and they taught me so much about Kenya. The food was delicious! I usually went back for seconds, and it was such a treat to be looked after by the housekeeping team. Snorkeling in the Indian Ocean and experiencing Malindi/Watamu was definitely a highlight, but I also loved the day-to-day routine of going on the bus, driving to the hospital and people watching out the window, saying hello to and fist-bumping the guards, and walking all around the dental unit. Going out to local spots with my fellow interns was also so much fun. I really do hope I have a chance to return to Kenya one day. As a child, I was terrified at the thought of sitting in a dental chair. Sitting in the chair itself was a whole other obstacle. There I was sitting in a bizarre-looking chair with a direct view to a tray of dental tools that had 6-year-old me thinking would bring me nothing but pain and discomfort. Needles and drills moving towards my face with no explanation of what was about to happen. It was a complete nightmare…until I met the person that would end up being my pediatric dentist. Her office was warm and inviting. The chairs had TV screens attached to them so that patients could be entertained and distracted from all of the drilling and prodding. Her assistants always let me hold their hands while they administered the anesthesia, because even though squeezing their hands did not actually help much with the pain, it was nice to know that they simply cared to ease my pain. My dentist talked me through every little thing she did, and she got me cavity-free. Being her patient–a scared child desperately wanting someone to validate her fear–inspired me to want to become a pediatric dentist. I wanted the chance to help other children be calm and maybe even excited to sit in the dental chair. When I tell people I want to be a dentist, I usually get asked, “why teeth?” I do not think it has much to do with teeth as it does with patient interaction. I am fascinated by teeth and take dental hygiene quite seriously, but I am most excited about the thought of telling a young patient that I will leave the numbing gel on just a tad longer before administering the anesthesia if it means easing their anxiety. Or demonstrating proper dental care on stuffed animals just like we did during the hygiene clinics at the primary schools. The little things. In preparation for dental school, I have spent hours shadowing at local dental offices, but in 2022, I became interested in observing dental work on an international level. After some research, I stumbled upon International Medical Aid. I took a leap of faith and applied, and I landed in Mombasa, Kenya in the Summer of 2023. Being able to say I have traveled to Kenya has given me a lot of pride, but also being able to say I interned at Coast General Teaching and Referral Hospital just does not seem real... During my time with IMA, interning at CGTRH in the dental unit, I learned more than I could have ever imagined. I felt incredibly privileged being in a position to observe dental care in a country that has significant healthcare differences to the United States. Much of the healthcare challenges in Kenya are poverty related; for example HIV/AIDs is so prevalent that all patients are assumed to have it until proven otherwise (Current State of Healthcare in Kenya, 2022) . I observed that sanitation was at its best after procedures that resulted in some blood loss. HIV prevalence in Mombasa is actually 1.2 times higher than the national level at 7.5% (Disease Burden In Kenya, 2022). Additionally, I observed low health literacy–many patients did not fully understand their conditions or treatment plans, but they followed all of the doctors’ orders, trusting that the doctors knew best and accepting that they themselves did not know better ( Health Literacy, 2022). Notably, Dr. Khadijah did an excellent job helping patients try to understand the need for tests, treatments, and medications. She was compassionate and patient, and always encouraged her patients, particularly during painful procedures. I also noticed that many patients were coming in for issues caused by self-neglecting behavior. Most did not have the luxury of coming in for annual cleanings or routine treatment. If they noticed a cavity or a slight ache, this would go untreated for months or maybe years until the pain became so unbearable they had no choice but to come in. The dentists extracted many teeth that had complete decay of the crown. There were multiple instances in which they extracted teeth from abscessed sites, but due to the infection, the anesthesia was not fully effective, resulting in pain and discomfort. After root canals, most patients did not return for the crown. I was informed that they actually just keep the temporary filling in until that starts to cause issues. There was one particular patient who had cavitation on a tooth on her lower jaw, and it went untreated for so long that the infection spread to her roots and then to her neck, which resulted in necrotizing fasciitis. During my time in the unit, I saw her return for a check-up after prior treatment, and the infected site was healing well. The degree of infection was disheartening to consistently see, because it seems so normal to have these issues addressed promptly in the United States, and most of the time, the issue will be caught during regular cleanings before it can even progress to infection. Early detection and treatment seem like such little things. In Mombasa, they were not so little things, since early detection and treatment were not affordable for many. In the United States, there is a routine to most treatment plans. The patient sits in the chair, a bib is placed around their neck, the dentist applies numbing gel to the treatment site in preparation for the lidocaine, and then lidocaine is administered. I was incredibly shocked to see that numbing gel was not being used in the dental unit. There was lidocaine spray, but it was only used occasionally on pediatric patients. It was certainly not part of routine treatments. Even when the lidocaine spray was used on pediatric patients, they reacted poorly to the subsequent lidocaine administration. Some began crying while the lidocaine spray was getting applied, and those who made it through that stage screamed and squirmed at the sight of the needle. There were times doctors would jump in to hold a patient’s arms and legs down, and others would steady the head and neck so that the lidocaine could be given, but the patient would fight even more. This young boy reluctantly made it past the lidocaine, but the moment the dentist began extraction, the boy had had enough. He flipped over in the dental chair and slid off, refusing to get back on. He screamed, “Jesus” over and over again, and he was completely inconsolable. I felt awful, because I know how terrifying the dentist can be, yet I have all these little things that help ease my fear, like numbing gel. Maybe these “little things” were actually not so little. I also witnessed adults experience intense anxiety in the dental chair. They would grimace at the sight of the needle and even reach for the dentist’s hand while the anesthesia was getting administered. Something as not so little as numbing gel could make patients’ and dentists’ lives easier. I actually was able to sit-in on a meeting during which the dentists discussed pediatric treatment and how to manage patient and parent behavior better. They noted the importance of using simple terms, for example, referring to lidocaine as “sleeping juice.” They also mentioned how the presence of parents can change a child’s behavior. The previously mentioned combative young patient originally came in with his mother, and he left without having completed his treatment. However, he returned a few days later with his father and was fully cooperative. One dentist suggested using colorful composite for fillings to incentivize children to fix their cavities, and it just makes it more fun for them. The fillings would be on their primary teeth, so as they lose their teeth, they will lose the colorful fillings, but it could be something for children to look forward to. She also suggested limiting the number of people in the room during pediatric treatments because having more dentists present may make the patient feel uneasy and concerned about the need for so many people. I believe these changes can truly improve children’s experience in the dental chair. I was someone who hated going to the dentist, and now, I look forward to every visit. I want to help people take pride in their teeth and smile. I hope one day I am given the chance to heal any traumatic experiences a person has ever had in the dental chair.
What makes Philotimo Med special? Stavros! He truly cares about each student, always making sure we are getting the most out of our experience. I shadowed doctors in cardiology, general surgery, and emergency medicine and even observed a laparoscopic gallbladder removal! Everything was in English, and the excursions were just as exciting as the clinical experience. 10/10 recommend!