The new home did not come easily. It followed the 2019 joint inspection reports from the East African Community Secretariat and the Uganda Medical and Dental Practitioners’ Council (UMDPC) that found the school operating with limited infrastructure and lecturers, among other challenges.
This was contradicting the minimum standards required for dental training in Uganda and the EAC, thus leading to the closure of the school until it conformed to the required standards. Two years later, the university has progressively worked on almost all the recommendations from the inspection reports.
On May 17, the first lady and minister of Education and Sports, Janet Museveni, officially opened the dental school and hospital located near the university’s Eastern gate. The new place is more spacious and dental students will no longer walk to Mulago for clinical training.
“I thank God for the new infrastructure at the school of Dentistry. As we all know, this is an answer to prayer because we were on the verge of closure by the East African Medical and Dental Practitioners Council,” Museveni said.
She added: “Please know that I pray for you daily. There is no situation that which prayer cannot change. Soon we shall have a teaching hospital and other crucial infrastructure with support from BRIDGIN Foundation. So, there’s nothing impossible with God.”
As more pressure mounted from the EAC secretariat based in Arusha, the university also suspended admission of both government and private students to the Bachelor of Dental Surgery (BDS) programme for the 2020/21 academic year.
“IT WAS TOUGH”
Now a fresh practicing dental surgeon, Dr Bruno Kyagaba Serunkuma is one of the 25 students in his class who was caught up in the mix. Speaking to The Observer last week, Kyagaba said “it was tough” studying from Mulago.
The effect of closing the dental department for the continuing students meant that upon graduation, one would not access the EAC for employment and their qualifications would not be recognized anywhere yet they had only two years to complete the course.
Generally, the first two years of the five-year programme are for theory with medical students. However, in the third year, students divert to dentistry and would go to the Mulago institute for clinical training.
“We were squatters at the dental unit of the institute for one year studying with diploma students of dentistry. It was until 2018/19 when the council closed the place and the university relocated us to the now new [dental] school,” Kyagaba, who proudly referred to himself as a pioneer of a proper dental school at Makerere, said.
At Mulago, he said all the 25 students shared 16 dental chairs, of which, three that were routinely maintained would be looked in a room for use by their lecturers for private work.
“First of all, the chairs were old and most were faulty. They had no suctions and whenever you could drill a tooth, they don’t bring water. Ideally, when you’re cutting a tooth and using metal, the handpiece is supposed to have water to reduce the friction,” he said.
Kyagaba added: “If you wanted to remove saliva from the patient’s mouth, you had to let the [sick] person walk elsewhere to spit since the suction systems that would keep the patient in one place were faulty. Some of the chairs would also not adjust to the back and front. You had to be in a very static situation from start to finish which strains the back of the practitioner or student.”
During the fracas, Kyagaba said whereas the university suspended admissions, studies of continuing students went on smoothly but the “public image for such a respected university was already dead”.
However, most students agreed with the council on the closure that yielded better fruits today.
NEW HOME
According to the Makerere University vice chancellor, Prof Barnabas Nawangwe, the dental school and hospital within the College of Health Sciences is a completely new home.
“The dental school is a miracle to the university. They had almost closed us but due to the intervention of many people including parliament and the minister of education, we got all the necessary resources to put up the biggest dental hospital in East Africa [although statistics point to Muhimbili University in Dar-es-Salaam, Tanzania as the biggest in the region]. We rose from almost being condemned to being the biggest with the best equipment,” Nawangwe said.
He said the facility has been equipped with specialized rooms for complicated dental cases. The project, fully funded by the government of Uganda, cost Shs 1.6bn (building) and equipment Shs 400m. At the time of the closure, the dental unit had only four teaching staff and 12 dental chairs.
Nawangwe said the school has increased to 32 chairs and 21 staff. Asked about plans to increase the student intake with the new home, Nawangwe said: “We have maintained enrolment at 50 students annually. We don’t aim at getting large numbers to compromise quality because that got us problems with the council yet we want to produce the best. We want to reach a point where every student is attached to one dental chair.”
The registrar of the UMDPC, Dr Katumba Ssentongo Gubala, said when the council first visited in 2015, the dental department, now a school, was in bad shape and it was shameful having only four teaching staff and about 20 students then.
“It was miraculous indeed that they woke up because the dental department has been there for 30 years and the story has always been that there’s no money for the infrastructure. However, out of the blue after the closure, the university got the funds to construct and equip the facility,” Katumba said.
He said the objective of the closure was not to make pain to the institution but to improve health training in the EAC.
RECOMMENDATIONS
Whereas Makerere has stuck to the student enrolment of 50, Katumba said the university needs to further revise the figure to at least 30 students.
“With only 32 dental chairs and 21 staff, we shall contest the figure of 50 in our routine visits because the facilities are still not enough. This is because the school will have two sets of people in clinical years yet some people are also joining in the third year. These are almost 150 students sitting on those 32 chairs,” Katumba explained.
He urged the university to create more space for expansion, recruit more staff to avoid exploiting lecturers, and buy dental chairs. To supervise clinical years [three to five], a lecturer is supposed to attend to only four students per class.
Kyagaba advised the university leadership to set up a scheme that retains at least two best students from the school annually and funds their further studies to build a strong capacity of staff.
While at Mulago, he said some departments operated without a single lecturer while others would teach from the third to fifth year which proved hectic in addition to supervising students. The university had also outsourced lecturers who weren’t specialists in some course units.
“By the time we left, the university had acquired a big OPG machine, digital X-rays, blue-cam 3D scanners with a camera that scans your teeth and gives instant results. All these good machines need specialists to maintain them,” Kyagaba said.
Dental training remains an expensive program – a reason fewer dentists are churned out from institutions, the world over. Statistics from the 2020/21 UMDPC report show that the dentist to patient ratio in Uganda is still unacceptable at one to 200,000.
“The new dental schools at KIU, UCU, and Equator universities will increase the production though it will take some time to achieve the desired numbers. Though the ministry of Health has offered sponsorship in oral and maxillofacial surgery, there is still a great need to train other dental specialties,” the report noted.
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