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Indiana University and Kenyan dental schools develop student exchange program

Indianapolis—If an Indiana University School of Dentistry student says that he or she helped to structure a dentistry program while volunteering abroad, that student might have even helped to mix concrete.

IUSD has an evolving relationship and an academic exchange program with a relatively new dental school at Moi University in Eldoret, Kenya. IUSD faculty and students have witnessed and participated in the new dental school’s growth from the ground up, literally.

Image: Indiana to Kenya: A dental student exchange program brings together students from Moi University in Kenya and Indiana University. IU School of Dentistry student John Emhardt (right) and MU School of Dentistry student Anthony Kaleli talk with a young patient during a screening at a Kenyan primary school.
Indiana to Kenya: A dental student exchange program brings together students from Moi University in Kenya and Indiana University. IU School of Dentistry student John Emhardt (right) and MU School of Dentistry student Anthony Kaleli talk with a young patient during a screening at a Kenyan primary school.

“When we first got out there, we went to where the temporary dental school was, and we met with the dean of the school and some of the students that were there,” said fourth-year student Chris Kutanovski, who journeyed to Kenya before starting his second year at IUSD. “Right across the way they were building the site for the eventual, permanent dental school. At that time, they were basically digging out the foundation. We thought, ‘How neat would it be to actually be able to help with the construction of the new dental school?’”

Mr. Kutanovski and the two other IUSD dental students who made up that first exchange group pitched in to help one afternoon, hauling dirt and mixing concrete with the construction workers.

He marveled at how much the Kenyans did with a lot less equipment and materials than Americans are accustomed to seeing at a construction site. “We spent an afternoon working alongside the workers, just getting to know them and asking questions. We were really trying to relate to how they build and how they work out there without having heavy machinery,” he said. “Everything we did was basically with our two hands. It was really rewarding to be able to throw ourselves into it and really feel the hard work that goes into building a building out there.”

Mr. Kutanovski was among the first group of IUSD academic exchange students who traveled to Kenya for the three-week exchange program with Moi University School of Dentistry in 2010, while the new school’s six-story dental school was under construction, as part of the Indiana University School of Dentistry’s International Service-Learning Program.

Aside from experiencing the dovetailing of two cultures, IUSD students learn about how dentistry and medicine are practiced beyond America’s borders. IUSD student John Emhardt, who made the trip to Kenya in June 2011, was amazed at the five-year academic structure that allows Kenyan dentists to be educated with medical and nursing students for the first two years before separating into dedicated studies for their chosen fields—unless they decide to make adjustments.

 “What they can do in those first two years is swap,” Mr. Emhardt said. “If someone went in as a dental student and they’re doing really well in the classes, they can apply again for medical school and get switched. Or maybe it’s a medical student really interested in dentistry. They can switch. Or, a nursing student can switch in those first two years. They have a really close relationship.”

About 60 IUSD students travel through the service learning program each year, with students and faculty financially supporting their own way abroad. IUSD also has service-learning programs in Ecuador, Haiti, Mexico, Guatemala, Brazil, Honduras and Vietnam.

“The IU-Moi University partnership supports the IU dental school international service learning activities by providing a firsthand immersion experience for our students,” said Dr. John Williams, IUSD dean. “The learning experience by our students is leaving an indelible impression on their world view and will significantly influence their approach to patient care and practice throughout their professional careers.”

 IUSD faculty members Drs. Timothy Carlson, E. Angeles Martinez-Mier and Karen Yoder, Ph.D., have guided the development of IUSD’s International Service-Learning program since its inception in 2000.

Image:  Tooth and nail: Workers construct the Moi University School of Dentistry’s new building in Eldoret, Kenya.
Tooth and nail: Workers construct the Moi University School of Dentistry’s new building in Eldoret, Kenya.
“By the time they graduate, almost half of IUSD dental graduates have participated in one or more international service learning programs,” said Dr. Yoder, IUSD director of civic engagement and oral health policy.

Plans for the IUSD-MUSOD partnership took about five years to firm up, with talks beginning just after first discussions about establishing a dental school at Moi University in 2003. Because IU already had a successful academic exchange program between the Indiana University School of Medicine and Moi University, IUSD had extensive existing infrastructure to begin the relationship between the two dental schools.

“We knew that we really wanted to be a part of this partnership because it had become such a dynamic and important effort with such outstanding outcomes,” Dr. Yoder said. “So in 2003, Dr. Tim Carlson and I went to Kenya and investigated the possibility of our school of dentistry initiating a partnership with their new school of dentistry as well. And it was very welcomed.”

MUSOD ultimately was founded in January 2008. In June 2010, the first contingent of seven IUSD faculty and students traveled to Eldoret to found the academic exchange program—a rib of the IU-Kenya Partnership that the IU School of Medicine established in 1989.

The existence of the new school relieves pressure on University of Nairobi School of Dental Sciences, previously the only institution available to educate and train dentists in Kenya, Dr. Yoder said.

“There are about 700 dentists in Kenya for close to 40 million people,” she said. “Obviously, they need more dentists. So starting a new dental school was a part of approaching that problem.”

While IUSD, established in 1879, is one of the oldest dental schools in the United States, Moi University’s dental school is four years old, having started with 15 students. But that doesn’t mean the new school is short on educational opportunities for the IUSD students.

Though coming from the elder program, IUSD students are exposed to a different kind of academic rigor in the newer dental school. According to Mr. Kutanovski who wrote about his IUSD-MUSOD experience in the winter 2010-11 Journal of the Indiana Dental Association, IUSD students do rotations at Moi Teaching and Referral Hospital to learn more about the head and neck region. They accompany Moi University medical students on their rounds in the hospitals where they see conditions they would not likely see in the United States, such as tuberculosis and Burkitt’s lymphoma.

“A couple of the days we were there, we visited the wards with our dental student,” Mr. Emhardt said. “We went on rounds at the Eldoret hospital, and we got to see some pretty amazing pathology. It was out of our scope, but there would be some cases where there would be some oral pathology and the faculty member would then seek out the dental student and ask the dental student questions alongside the medical student. Everybody was equal. Everybody was learning together. I thought that was pretty neat.”

IUSD and MUSOD students and faculty worked together to launch Kenya’s first community-based dental sealant program. They took portable dental equipment to schools, orphanages and a drop-in shelter for Eldoret’s street children. They also collaborated on research to determine the effectiveness of autoclaves used in regional dental clinics and the concentration of natural fluoride in local water sources.

 “The relationship between the two institutions is important to both of us because of the impact it has on both groups of students through their interactions in Kenya and in the U.S.,” said Dr. Caroline Kibosia, MUSOD dean. “They learn so much from the other. They see very different conditions, diseases, learning and teaching environments. They experience life-changing events and open their minds to what is across each side of the Atlantic Ocean and how much they can learn from each other, especially the different cultures, technologies and community involvement.”
 
MUSOD students traveled to IUSD in 2011, with the Indiana dental community supporting their travel. “The Indiana Dental Association and the Northwestern Indiana component dental society foundation sponsored the Kenyan dental students coming to Indiana and have pledged their support again this year,” said Dr. Yoder.

Two MUSOD students visited IUSD as exchange students for five weeks last fall and two more have been selected for 2012. Dr. Yoder said IDA Foundation contributed $4,000 to $5,000 per student. It is money IDA Foundation considers well spent, said Dr. Raymond Maddox, president of the Indiana Dental Association Foundation for Dental Health, which has a long-standing supportive relationship with IUSD.

“It connects our dental students with a cross section of diverse cultures and learning situations that they don’t experience just by being in the ivory tower of the dental school,” Dr. Maddox said. “It helps them with their communities. It helps them with emergency care. It helps them in so many different ways.”

Dr. Kibosia is enthused about the partnership’s future and its possibilities for growth.

“My wish is that eventually we can teach and learn from each other across the Atlantic without leaving the continents,” she said. “It is also my wish that we develop and teach an internationally recognized postgraduate program for oral health graduates and carry out collaborative research and publish together.”

For more information about IUSD’s International Service-Learning programs and their role in the IU-Kenya Partnership, visit isl.iusd.iupui.edu and www.ampathkenya.org/our-programs/clinical-public-health-services/dentistry.