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My Journey from Dentistry to Maxillofacial Surgery

My Journey from Dentistry to Maxillofacial Surgery to improve patients lives, Dr Adrian Kamulegeya

For me, the dream of becoming a doctor began at a young age as doctors were seen as something special. At the time there was only one medical school in my country and getting a place there was considered an achievement and I wanted to be in that category.

Starting in Dentistry

However, my journey to becoming a doctor wasn’t as straightforward as it might sound. While many might have taken the direct route to medicine, my path started in an unexpected place — dentistry.

In high school one of the few people who saw me as an equal was the son of a dentist, and it was through him that I first learned about dentistry. As I explored it more, I began to see the profound impact it could have on people’s lives. Despite having the grades to pursue medicine, I decided to stick with dentistry even when I got a chance for an exchange program at the University of Dar es Salaam.

Discovering Maxillofacial Surgery

It wasn’t until my time at the University of Dar es Salaam that I encountered a field that would forever change the course of my career: maxillofacial surgery. While at the university, I met Dr. Arabat Kasangaki, a maxillofacial surgeon who had studied in China. He became a close mentor and encouraged me to take up maxillofacial surgery. At the time, both Uganda and Tanzania were facing economic struggles, and oral and maxillofacial surgery was one of the few fields with opportunities.

The Challenges of Maxillofacial Surgery

Maxillofacial surgery often involves complex, high-risk surgeries, especially when treating children with severe facial deformities or trauma. But what I love most about this field is the challenge of performing what can appear to be mutilating surgeries on children, only to see them heal and regain their quality of life. The change in the quality of a patient’s life is so big that you just can’t help but feel elated when a good surgery changes one’s life.

I see a lot of children with large fibro-osseous tumours as the growth of the child also promotes their growth. Additionally, the financial requirement to get to big centres to access treatment is inhibitory to many parents hence delay in coming for treatment. The trust in cheaper, herbal remedies also plays a role in the delays. 

A Memorable Case

A particular operation I remember operating on was a three-month-old baby girl who had a huge teratoma extending to the neck. It would be a risky operation. As the patient was being wheeled into the theatre a very senior head and neck surgeon turned to me and asked “Adrian do you want to try heroics operating on this child?” It was one of those moments you feel being second-guessed by a person you regard highly professionally.

I went ahead with one of the head and neck residents and a team of anaesthesiologists and worked on the child for a cool 10 hours until we successfully came off the table! The girl did so well although it had been a complex operation. It’s a kind of pillar of faith that I look back on when the case seems too hopeless to operate on.

The State of Maxillofacial Surgery in Uganda

Maxillofacial surgery in Uganda is still a relative niche specialty in Uganda, with only around 20 maxillofacial surgeons practicing in the country. This number is small when you consider the growing demand for specialised care in the field.

Life Outside Surgery

When I’m not in the operating room I like to take time for myself and indulge in some of life’s simpler pleasures. I enjoy eating delicacies from different parts of the world and I also love jogging along forested and swampy areas!

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