Dr Jilen Patel’s career as a paediatric dentist was shaped by volunteering with the Kimberley Dental Team in outback Western Australia. By Frank Leggett
Gazing at his crushed, fractured and de-gloved hand, Dr Jilen Patel is wondering if he will be able to continue working as a dentist. He needs to go to hospital immediately but that’s easier said than done. In fact, it will be 72 hours before he is admitted into an emergency department equipped to deal with his injuries.
In August of 2013, Dr Patel was on a journey with the Kimberley Dental Team to provide dental care to remote Aboriginal communities in the East Kimberley. The team had just left the small West Australian town of Halls Creek when the vehicle carrying Dr Patel and other team members rolled over. Along with Dr Patel’s crushed hand, the team also sustained broken collar bones, facial fractures, deep bruising and skin lacerations.
Luckily, the crash occurred just outside of Halls Creek. If they had travelled for another five minutes, they would have been beyond mobile phone signal range.
“I was able to phone the rest of the team in town, who picked us up and took us straight to the small hospital in Halls Creek,” recalls Dr Patel. “Unfortunately, being a satellite hospital, they weren’t equipped to deal with the extent of our injuries. Issues with the Royal Flying Doctor Service planes meant we had to stay in the hospital overnight. The next day, we had no choice but to pile into a little Hyundai Getz and drive four hours to Kununurra.
“We then spent another couple of hours getting hospital clearance to fly to Broome. Once in Broome, the plane to Perth was delayed so we sat in the airport for a few more hours and finally arrived at the hospital 72 hours after the accident.”
What followed was multiple surgeries, splints and many gruelling months of dressing changes and rehab to get his hand moving. Nearly seven years later, the accident continues to have a lasting impact on Dr Patel but he considers it a turning point for his career and aspirations. Fortunately, he is still able to perform dentistry.
Dr Patel finished high school in 2005 with a desire to study something health related. He was attracted by the hands-on, artistic and scientific aspects of dentistry.
“When I was in my final year of dentistry, I had an opportunity to volunteer with the Kimberley Dental Team (KDT) founded by Dr John and Jan Owen,” says Dr Patel. “Not only was it the start of my journey into dentistry, but I got to spend two weeks in the Kimberleys as an intern. Everything about the experience appealed to me—the team, the values, the passion and the realisation that through dentistry I could genuinely improve the quality of life for vulnerable individuals and communities.”
Thanks to the leadership of the Owens, Dr Patel continues to volunteer with the not-for-profit team every year. The team’s focus on improving the health of children and managing the complex health needs of vulnerable cohorts, sparked Dr Patel to pursue specialist training in paediatric dentistry. He subsequently completed his training through UWA and the Princess Margaret Hospital for Children under the guidance of A/Prof Robert Anthonappa and Dr John Winters. Dr Patel is now a consultant at the new Perth Children’s Hospital (PCH) and a senior lecturer at the UWA Dental School.
Dr Patel’s volunteer work takes place in one of the world’s most remote areas. With no phone signal and sparse amenities, the people who live there face a multitude of barriers for optimum care.
“The KDT complements existing services and extends care to these hard to reach areas,” explains Dr Patel. “There are also a lot of upstream determinants that have a significant impact on the burden of dental disease. Sugar is everywhere and soft drinks are cheaper than water. Toothbrushes cost seven or eight dollars each—if you can find one—and there’s a general lack of oral health promotion.”
During the KDT’s first visit in 2009, a screening of the children found almost 70 per cent suffered from acute dental disease and pain. Of course, this adversely impacted on their nutrition, sleep and school attendance. Ever since then, the KDT has been fighting to improve oral health standards.
Perhaps their greatest legacy is the Strong Teeth for Kimberley Kids school toothbrushing program. The program fosters habits that help prevent dental disease while the team provides a voice to advocate for the needs of vulnerable children. Through the toothbrushing program, the team annually distributes several thousand toothbrushing kits to schools across the Kimberley.
Dr Patel’s long-term association with the KDT has seen him become a director and senior dental officer with the team. Earlier this year, Dr Patel was named the 2019 7NEWS Western Australian Young Achiever of the Year. His volunteer work with vulnerable communities has also seen him awarded the Masonic Care WA/Freemasons WA Community Service and Volunteering Award.
Despite being extremely busy with his full-time job at the UWA dental school and the Perth Children’s Hospital, he insists that it’s volunteer work that inspires him. “When I was training as a paediatric dentist, I became involved with refugee health,” says Dr Patel. “All newly arriving refugee children go through a medical assessment as part of the refugee health service at PCH. An audit of the first 1000 children found that dental caries was the second most common diagnosis. Additionally, a lot of the kids are dealing with extremely difficult issues—family separation, torture, severe psychosocial problems and significant trauma. Many had seen their siblings or parents killed. To exacerbate their pain with untreated dental problems so severe they couldn’t eat, sleep or concentrate at school is unconscionable.”
Often, these children present to the emergency department in distress with facial cellulitis requiring hospitalisation and treatment under general anaesthetic. “It is not uncommon for five-year-olds to have between five and 20 teeth extracted,” he says.
Having witnessed the plight of these children, Dr Patel sought the mentorship of Dr Sarah Cherian, paediatrician and clinical lead of the Refugee Health Service. With the support of Dr John Winters, head of the PCH Dental Department, and his fellow registrars, he was able to plan and implement an integrated, multidisciplinary oral health education and prevention program for refugee children and adolescents. The program was adapted from the KDT care model and includes tailored oral health prevention and education through the use of interpreters. Working alongside paediatricians, social workers and dieticians, the program facilitates community linkage so families are able to have stable dental care in a community setting.
Helping others help themselves
“Every family that comes through the refugee health service leaves with enough oral hygiene materials for the whole family,” says Dr Patel. “One of the most useful things I was taught by the Kimberley Dental Team was to listen to the families. We had to go beyond ‘Which tooth is hurting?’ to ‘Is there anything we can do to help?’
“I remember giving one family a box of Colgate toothpaste. When I asked if they needed more, they politely declined. They had kept the previous box and had taken it to their local shopping centre where staff showed them where to buy more toothpaste. Having open communication and the ability to think around problems is essential when dealing with vulnerable families.”
Wi-fi causes caries?
Dr Patel’s work led him to pursue a PhD on dental care in remote communities. While speaking with Aboriginal elders as part of his PhD, he uncovered an unusual problem in one remote community—the elders claimed that free wi-fi was affecting the kids’ health and teeth. Surprisingly, Dr Patel found this to be true.
“Teenagers would hang around the visitor centre—where there was free wi-fi— sipping sugary drinks and eating chocolate until three or four in the morning,” he says. “Changing the free wi-fi hours to finish at 8pm went a long way to solving the problem.”
Dr Patel’s volunteer work with remote Aboriginal communities, refugee families and medically compromised children has had a long-lasting impact on his career choices. “I’ve chosen to work exclusively in public practice and teach at the dental school,” he explains. “It would be much more difficult to undertake translational research and implement community oral health programs if I chose to focus on a career in private practice.”
The KDT has provided over $3 million worth of free treatment with the help of over 300 volunteer dentists and allied health professionals.
But why do it? What do you actually get out of volunteering?
“You get much more than what you put in,” says Dr Patel. “Being part of the Kimberley Dental Team has shaped my whole career, my values and the way I approach dentistry. I owe everything to my mentors and that first visit as an intern. I was taught to value community, patients and people as a whole—as opposed to subscribing to the old paradigm of drilling, filling and billing.
“If you’re thinking about volunteering, just put your hand up. Not only will it change the way you think about dentistry, it may also change the way you think about life. The benefits are endless—from the altruistic side of things to meeting other people, networking, and being part of something bigger than yourself.”