The University of Rwanda graduated its first class of dentists on November 2, 2018, with its 10 students joining the approximately 40 other registered practitioners to serve the nation, which has a population of more than 12 million. Behind the scenes, volunteers from the University of Maryland School of Dentistry (UMSOD) supported the school’s development.
Valli Meeks, DDS, MS, RDH, associate professor in the Department of Oncology and Diagnostic Services, was instrumental in identifying the need for oral health education in Rwanda and in helping provide support as a founding member of the Human Resources for Health (HRH) Rwanda Oral Health team.
The HRH program was launched in 2011 by the Clinton Health Access Initiative and in partnership with the Rwandan Ministry of Health. Its goal is to strengthen the Rwandan health education and delivery system and build capacity for care. Although dental care was not part of the plan, Meeks advocated for its inclusion.
“Thanks to the impassioned argument of Dr. Meeks, oral health was incorporated into the HRH plan,” said Jane Barrow, associate dean for global and community health at the Harvard School of Dental Medicine (HSDM) and member of the HRH team.
After the initial planning, the dental school was established with support from a partnership between HSDM and the University of Maryland Baltimore. While HSDM took the lead in implementing the bachelor of dental surgery program, Meeks worked with her UMSOD colleagues to help enhance the curriculum and continuing education programs as well as donate equipment and supplies.
“The (UMSOD) faculty were very supportive in helping me review the University of Rwanda’s courses, particularly radiology, prosthodontics, and restorative dentistry,” said Meeks, who specifically credits Howard Strassler, DMD, professor and director of the Division of Operative Dentistry, with providing useful information on basic restorative preparation.
“We helped to update their instructional materials, as well as their instructional methods,” said Meeks, “which was critical because the students would often do numerous procedures in one clinic session since they weren’t always sure when the patient would return. Patients travelled from all over, and they may not always come back in six months.”
Meeks also provided hands-on clinical instruction in what she called her “efficiency clinic” to the students during her time in Rwanda, focusing on clinical organizations.
“Students would seat their patient first, then spend the next 20 to 25 minutes getting instruments, supplies, and setting up the operatory all while the patient was just sitting there,” Meeks said.
“I would remind them that before you seat your patient, you need to have your operatory set up and instruments in place ready to go, especially since most patients had already spent a significant amount of time traveling to get to the dental clinic and waiting to be seen,” Meeks said.
Meeks also collaborated with a variety of sources to get supplies such as dental operatory lightbulbs, blood pressure cuffs from corporate partners, and leftover instruments and supplies from UMSOD graduating seniors. She also was able to acquire and donate extension cone paralleling instruments so the students could learn how to take high-quality x-rays.
“Whatever resources we had available, we were able to put into Rwanda,” said Meeks. “Whenever we were asked to do something, we pulled through.”
Meeks continues to visit the school and help coordinate its continuing education programs. One of her long-term goals is to help HRH determine the scope of work for the new generations of dental therapists and dental surgeons who are graduating.
“The challenge is reconciling the two positions. We have to take it a step further to the governing levels and say we have these two groups of oral healthcare providers. How are we going to define their roles?” she said.