Planning planning planning

The good thing is I managed to get the Hep A/Typhoid vaccination at my home Drs last week. The bad (and annoying) thing is that it's given me a stinking cold/flu, which just seems to be lingering and getting worse......

Anyway, today we managed to get a few things sorted for our elective - we contacted the airline and managed to get some extra luggage allowance for the supplies we're taking over for the hospital. GSK are very kindly donating some toothbrushes, toothpaste and mouthwash and in return want some photos of our elective. We've also contacted other companies such as Dentsply, 3M and Septodont to see if they can donate any equipment. AHC have a long wish list of supplies that they use on a high consumption basis, or which they find difficult to get hold of in Cambodia. As they are a non-governmental/charity organisation, they rely on the generosity of donations.
We also ordered our prescription of HIV PEP (post exposure prophylaxis) today. [Something which you need to take if you are exposed to HIV infected bodily fluids, for example through a needlestick injury]. Cambodia has the highest HIV infection rate in all of Asia (~2%). AHC is the only centre outside Phnom Penh which provides antiretroviral treatment for Cambodian children with HIV/AIDS. So AHC really is a valuable centre for all Cambodians.

We also started planning our travel itinery for after our elective. At the moment, we want to visit the islands off of Southern Thailand's Gulf Coast: Ko Tao and Ko Pha Ngan in particular. I'm also really keen to see The Perhentian islands off the coast of Malaysia. <See google images> The trouble we're having is planning how to get there, as the FCO (foreign and commonwealth office) website advise against all but essential travel through parts of the the Thai-Malaysia border, due to terrorism. Which means we can't get the train to the part of Malaysia that we were hoping to. So we need another plan, maybe take the longer route around and then catch a bus? It's starting to look like 12 days isn't long at all to get from Siem Reap to Singapore and see some islands on the way!!

Lots more planning still needs to be done.....only just over two weeks to go!!

Intro to dental clinic protocol

Looks like the typhoid vaccination is popular at the moment: the student health service have run out! Hopefully I'll be able to get it at my family doctors when I go home....

But now for an update...we recently had an email from a paediatric Dentist (Dr. S) who's worked at AHC in the past. He's the key liaison with the dental volunteers and was telling us about the protocol for the dental clinic, as we only have a few weeks there so will need to get to grips with the way things are run pretty quickly.

The dental clinic has two dentists and three dental nurses. The dental nurses perform all procedures: injections, extractions, fillings, everything the dentist does! And apparently they are very good at it. This is a great example of how the Cambodians are utilizing the skills of all staff at AHC to provide decent dental treatment in large quantities for all the children who visit the hospital. (Over 600 children are treated in the dental clinic every month).

The guidelines for the dental clinic aim to make the best use of the volunteers' time to help the children in the most effective way. Dr. S has advised the staff to carry out quadrant dentistry (this is where you fix all the teeth in one particular 'quadrant' of the mouth at the same visit, as well as the problem tooth). The children who visit AHC often come in pain and have travelled for long distances to get there, missing a day of school/work. They most likely don't have enough money to keep coming back to the hospital, so the more work that can be done at their appointment, the better. Obviously this also depends on the cooperation of the child and how much treatment they can manage in one go. 

Some of the guidelines include: 

• take care of the adjacent tooth to the problem tooth, as this will already be numb....and it's better to treat it sooner, as you don't know what it'll be like in the future.
• extract all root tips even if they're in a different quadrant, as retained roots can deflect the eruption of permanent teeth and lead to crowding and periodontal problems.
• try to save the teeth by placing fillings, crowns or carrying out pulpotomies, instead of extracting as this then gives the kids teeth to chew with.

I've read a few accounts of students' dental elective experiences, and remember someone saying how they thought they were going to make a massive difference and change everyones lives etc, but found themselves disappointed afterwards as it was such an unreasonable expectation. This has stuck with me and I don't expect to have a HUGE impact but I do hope and pray that I'd make a small positive difference and that the children and the hospital would benefit from me volunteering there. 

As Dr. S puts it: ".....know that you have really helped the children of Cambodia. One tooth at a time. One mouth at a time. One child at a time."