An afterward...

We landed at RDU around 9:30 on Thursday morning. We’d been on planes or in airports for the preceding twenty four hour period, so I was extremely grateful to feel the wheels touch down below us. Julie was waiting for me, as close to the gate as homeland security would allow her. I’ve never been so happy to see her.

After collecting my bags, I said goodbye to my colleagues and headed home. We stopped at the Fresh Market and picked up sandwich components (rare roast beef, slices of luxurious provolone, fresh rolls) and got back to the townhouse. I decided it was close enough to lunch time to eschew Bojangles for later. Don’t worry - that Cajun Filet biscuit knows I’m coming for it sooner rather than later.

After a few days of recovery, I’ve had a little bit of time to reflect on the entire African experience. One of the reasons I wanted to go to Africa above some of the other outreach opportunities at UNC was its maximum exoticness. I didn’t want to just go to another country; I was hoping to see a whole other world. In this respect, I was naïve.

People are the same, whether they’re in Africa or America. They want to have the chance to live out their lives, raise their children, and find personal satisfaction. They like to go out, dance, and have a beer. They don’t like to go to the dentist. They don’t brush and floss as much as they should. They eat French fries at an alarming rate. The entire world delights in the culinary perfection which is fried chicken.

The differences are more superficial, and I felt like they were mostly economic. Malawians walk and ride bicycles, since they don’t have cars. They wash clothes in the river because they don’t have running water. They make their own charcoal from the surrounding bush because they can’t get it at the store. All-in-all, I felt like there were few, if any, significant cultural barriers to overcome.

They could certainly use a few dentists, however. The dentists we were with had a relentless schedule that was heavily weighted towards surgery. Dental therapists handled much of the more routine cases of restorative, periodontal, and extraction work. The dentists were relegated to jaw surgery, oncology cases, trauma work, and dealing with medically complex patients. It was eye-opening to see the scope of practice in Malawian dentistry.

I think we were able to help. By having a few extra hands on board, they were able to leave a skeleton crew of therapists and dentists behind at the Central Hospital while reaching out to meet the needs of more rural areas. I wanted to make sure that I was of use in Malawi, not a third wheel preventing the existing crew from doing its work. Our excellent preceptors, Dr. Mlotha in particular, created an environment where we could use our talents to maximum advantage without interfering with the operations of the local team members.

I am very grateful for the opportunity to have been part of the project. I found out a few things about myself in the process. Prior to dental school, my academic history had been a series of decisions where I consistently went against my own interests. Despite a lifelong interest in animals and healthcare, I decided to major in math, never taking a biology class in undergrad. Despite a love for working with people, I decided to pursue a career in computers. Once I decided to become a dentist, it was like slipping into a comfortable pair of slippers. Of course I enjoyed it – it’s the kind of thing I’ve been interested in for my entire life. The Malawi Project reminded me of the importance in seeking out things which are a natural fit.

Specifically, I realized that the times which were the most rewarding to me were those where I worked with children. I’ve worked with kids whenever my life would allow it. I’ve taught high school, worked with the church youth group, and coached little league basketball. I think I realized I should try to continue this trend in dentistry. If I find work with children to be personally rewarding, then I should try to find a dental career where I work with children. Malawi helped convince me that I need to look long and hard at the two most relevant branches of dentistry, pediatric dentistry and orthodontics. I’m not sure if I’ll have the academic chops to end up in either one, but it’s nice to feel like I have a tangible direction in my career path. It’s still way too early to say for certain (particularly without board scores in hand), but I’m moving forward with the intention of learning as much as possible about these two specialties.

I think I’ll end the 2009 Malawi Project blog on that note. I’d like to thank all of the readers who were willing to put up with numerous superfluous commas and incomplete sentences. Thanks to our preceptors both at home and in Malawi that helped to make the trip such a success. I’m looking forward to choosing next year’s team. I can only hope that they find the experience as rewarding as I have.

I’ve enjoyed the blogging experience, and I may add to this in the unforeseeable future. If I happen to come upon any strokes of genius, I’ll be sure to let you know. Don’t hold your breath, though, since I’ve never had any before.