by Joe Jamieson

Dentistry, Nepal Pokhara, Clinical Features, Destination Features, Where Are They Now?

Indy is a qualified dentist with her own successful practice based in Essex. She travelled to Pokhara in Nepal back in 2014 and had what she describes as a life-changing experience.

We caught up with Indy to see what she was up to now and how her elective in Nepal helped get her where she is today.

Bhattu, Inderpreet

So what got you into dentistry?

I wanted to always do something within the sciences. There are no medics or dentists within my family, so it was a bit out of the blue.

I really enjoyed both art and science, so I wanted something that amalgamated the two together. I found that dentistry, through doing work experience and shadowing other dentists, was a career I wanted to pursue.

Dentists worked with their hands and it was surprisingly creative. I saw it as an art form mixed with biology.

But the main draw for me was making a positive impact in someone’s life. That ‘wow’ factor patients have when they see their improved smile for the first time. I remember as a teenager my teeth were quite crooked. I was quite self-conscious, and I never smiled in photos.

Bhattu, InderpreetAfter I had braces, I felt a big boost of confidence. I wanted to give this feeling to other people, to make them smile too.

I think when you’ve experienced something yourself, you can relate to others more who are in the same situation.

And what was it that prompted you to choose Leeds as a university?

To give you a bit of background, I’m from quite a rough area in East London. I went to a state school where not many people were thinking about dentistry or anything like that.

During my final year of A-levels, I applied for dentistry and had an interview. Unfortunately, I was not successful, and my lack of interview skills showed. I got the grades, but I did not get into dental school the first-time round. 

I decided to take a gap year so I could reapply for dentistry whilst I worked in a pharmacy. The following year, I got into the University of Leeds for dentistry and I was really grateful.

Bhattu, Inderpreet

- Take a boat out through the mists on Lake Phewa -

I’m a real homely person and I never thought I’d leave London, but I couldn’t pass up the opportunity. I ended up loving the Leeds campus — I think it’s one of the biggest campuses in England as it’s all on one site.

The simulation technology in the skills suite were new and the clinics themselves were well equipped, so I knew I was going to get a lot of experience.

It was a great journey.

So how did your elective fit into all that?

It was between my fourth and fifth year, so 2014.

It wasn’t compulsory for dental undergraduates at Leeds to do an elective. However, my best mate and I knew we wanted to do something. I think someone at the uni advised us about Work the World because other Leeds undergrads had travelled with you in previous years.

N PO VE PataleWhen we did our own research, we saw you were well established.

That was important to us because it was just us two girls and we wanted to feel safe in what we were doing — we wanted that reassurance.

Leeds actually let us do an extra module where we wrote a reflective report on our experiences overseas with you.

So, then you got in touch with us and spoke to our team. How did you decide that you wanted to go to Nepal?

We just loved the sound of it! We chose Pokhara because it was less busy than the big capital city of Kathmandu where your other programme is.

Did you take that amazing Yeti Airlines propeller plane ride from Kathmandu to Pokhara?

We did. It was a tiny little plane where we could hear the propellers going. It was the longest 30 minutes of my life! But you could see the mountains from the window, and it was all part of the fun.

Nepal, Kathmandu

So, then you landed in Pokhara. What was that first impression like, and then the first 24 hours in this new place?

It was amazing. I remember getting there and then heading to the house with the person from Work the World who picked us up from the airport.

When we got there, we met our housemates. They were from all over the world. Medics from America, nurses, physiotherapists and we made really good friends with an undergraduate pharmacist from Ireland.

Bhattu, Inderpreet

- Hike up a nearby mountain to for incredible views of the city below -

We all gelled really quickly because we all knew what we’d gone there for and we were all ready to have a good time.

I loved the house we stayed in and the food was amazing all the time — the catering team were really good. We felt really secure too.

What was it like living with all those other people from different disciplines over the course of the trip?

We learned so much. And it wasn’t just the fact that they were from different disciplines, it was the different countries as well.

The American’s were brilliant. We chatted to them about all the different British cultural stereotypes!

In terms of different professions, it was interesting to hear how they practised in their home countries.

And I guess you heard lots about people’s actual hospital placements while they were in Nepal as well. You all get back together at the end of the day and talk through your experiences.

We used to take a bus from the hospital back to the house, so we caught up about our days then and when we all got together over dinner.

TRAVEL

- Pokhara's streets aren't like anything you'd recognise -

In the hospital itself, we were in the dental unit, but we used to go down to the pharmacy area and catch up with other students who were down there. We all had completely different experiences and it was interesting to hear about them from all the different perspectives in the house.

We might as well talk a bit more about the hospital seeing as we’re on the topic. You will have had your city orientation and then your hospital orientation before you started your placement. What was it like when you first walked into the hospital?

When we went to the hospital, one of the first things we noticed was that there weren’t many ambulances. People just drove there in their cars or arrived in taxis, even if it was an emergency.

Then, when we walked in it was so big and vast. There were so many floors and there was hustle and bustle everywhere. It was a bit chaotic, but totally expected. Before I travelled, Work the World gave me a good idea of what it would be like. And, coming from an Indian background, I thought it would be similar to how things are in India, which it was. So, it wasn’t too much of a shock to the system.

But even so, seeing it for the first time and realising it was where I was going to be for the next couple of weeks was a ‘wow’ moment.

Then I remember we went to the dental ward and met the MaxFax surgeon. We couldn’t believe we got to meet the consultant straight away.

That was a great start because he was the person who looked over the whole unit. Everyone was so friendly — all the dentists and all the supporting staff were really nice.

Pokhara

- Traffic means something completely different in Nepal -

Then how did it work day to day?

We saw a different branch of dentistry every day. One day we’d see restorative dentistry — fillings, root canals, that sort of stuff. Then another day we’d be with the orthodontist — braces, moulds and that kind of thing. We also spent time with the MaxFax surgeon where we’d see oral surgeries and more of the head and neck dentistry.

It was what I’d describe as textbook conditions. But I mean that in the sense that they were the kind of thing that you only saw in textbooks.

Don’t forget we did hospital placements while we were at uni, but never saw anything like that.

It was amazing as an undergraduate to see these things in real life as opposed to just reading about it in a book. You can’t put a price on an experience like that.

Other big differences were in the hygiene and sterilisation protocols and how the rooms themselves were set up. It was all so different.

The way local dentists approached their work was a whole other learning curve. One patient came in with a big facial abscess and the MaxFax surgeon was just so chilled throughout the whole procedure whilst draining it. He was carrying out life-saving treatment, but he was so confident in what he was doing.

It made me realise that I wanted to get to that level.

BPC - Natasha Carter

- Head into the mountains to see what village life is like -

I think there’s a lot of pride that goes into the work. I’m not clinically minded, but when I speak to students the sense, I get is that in countries like Nepal, patients are more appreciative of care because it’s that much harder to get.

Absolutely. There were a lot of striking differences in culture and society.

Another one of these was that local people saw having local anaesthetic as a weakness. So, a lot of patients had treatments without any numbing.

In the UK it’s a very different story. Most people here wouldn’t dream of undergoing a procedure without local anaesthetic.

And that’s the beauty of going somewhere like this — you get to see things you’d never see back home.

Exactly!

 

So, let’s chat about the Work the World staff in the house. What kind of involvement did they have in your day to day?

 

They were great because they weren’t overbearing. That’s what we really liked about them — they just went with the flow and did what they needed to do, when we needed them to do it.

 

And by the same token, they were never too laid back. It was just right for us. If we had any concerns, we knew who to turn to and we never felt like we couldn’t ask a question, no matter how small we thought it was.

I don’t know if that’s because you guys just go with the flow? 

Senaratne Dhaneesha

- Local hospitals aren't quite what you're used to! -

It’s definitely an intentional thing. Our overseas teams are amazing at being able to assess who needs what in the moment. If you need more support, they’ll be there for you. If you’re more confident and need a bit more space, they’ll give it to you.

Honestly, all I have is positive feedback about your staff. That’s why I wanted to do this interview as well, because I would recommend it to anyone and it’s not like it was compulsory. The whole experience was life changing.

As an undergraduate between years four and five, you’ve learned most of what there is to learn at that level of dentistry. But the trip overseas with Work the World was what gave us the push to become more confident in ourselves and our skills.

I think it gives you a bit of an edge as well. When you have interviews, you’ve got it there on your CV that you’ve done an elective overseas. It shows that you’re a bit of an adventurer and employers like seeing that you had the drive to travel all the way to Nepal because of your passion for your discipline.

That’s right. It’s all about adding value to yourself in a space where there’s such fierce competition.

Also, when you get older and you graduate, you don’t really have the time to do it. So, I would recommend doing it as an undergrad.

TRAVEL

- Chill out at Lakeside after a long day on placement -

So, you had this life-changing experience as you described it then came back to the UK. Did your experience overseas change how you saw things when you got home?

100%. The biggest thing was how much I value the NHS. In Nepal, if you don’t have the money for treatment, you’re not getting it even if you need it to save your life. In the UK there’s no discrimination and treatment. I had a greater appreciation for the standard of care we have in the UK too.

I also feel like my non-verbal communication developed a lot while I was over there. I could speak a little bit of Nepali thanks to the Work the World lessons in the house, but most of my communication with patients was non-verbal. I got better at having an open stance, maintaining eye contact — that sort of thing.

What happened after you graduated?

Bhattu, InderpreetIn 2015, I did what used to be called VT or Vocational Training. For everyone graduating now it’s called DFT (Dental Foundation Training).

Once you graduate you can work at a NHS practice where you’re supervised by a dentist. If you complete that year of training, you get what’s called a performer number and that number allows you to work for the NHS.

I spent that year in a dental practice in Basildon and got my performer number. 

During that year I also met my now husband who was buying a private practice at the time. Since then, our clinic, Viva Dental Studio, has become well established.

How has that gone for you?

Really well. We didn’t exactly start from scratch — it was a practice before, but there weren’t many patients. So, we rebranded it, changed the name and it was reborn!

We built our patient list from there, mainly through referrals from people who benefitted from our services. Social media helped quite a lot as well.

So, it has been a bit of a journey for you then!

It has! I’d do it all over again.

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