REPUBLIC OF CAMEROON REPUBLIQUE DU CAMEROUN

Peace - Work - Fatherland Paix - Travail - Patrie

ST LOUIS HIGHER INSTITUTE OF MEDICAL STUDIES

DOUALA

DEPARTMENT OF DENTAL THERAPY

INTERNSHIP REPORT DONE AT BONASSAMA

INTERNSHIP REPORT DONE AT BONASSAMA DISTRICT HOSPITAL IN THE DENTAL
DISTRICT HOSPITAL IN THE DENTAL UNIT,
UNIT, EMERGENCY UNIT AND NURSING UNIT
EMERGENCY UNIT AND NURSING UNIT
From 1st August to 30th August 2019 st
From 1 August to 30th August 2019

By BEASSO FOZOCK AIME WILFRIED

MATRICULE: DEN/18/0020

LEVEL 100

Supervisor:

Professional; Mr. MFORMIH Hycinth

Academic; Dr. Derrick NGWA AWAMBENG

2018/2019
 Dedication

I dedicate this piece of work to my lovely

BEASSO family

i|Page
 Acknowledgement

I would like to give thanks in the first place to The Almighty God, who is so
beneficial and merciful. He guided me throughout the period I was in the hospital and
provided me with confidence, strength and stability to complete this internship report on
time.

For my first experience into a hospital setup, even dough it wasn’t easy, I was
grateful to the help given by the medical personnel who made the learning process easy.

I am grateful to my university for expanding my knowledge and experience with the

help of my supervisors

To my parents, BEASSO HONORE and BEASSO DELPHINE for financial and

moral support.

To my Brothers and Sisters, BEASSO GABIN, BRIST, MARIAM, DORA, LAEL

for being there when I needed their help the most. Especially to Brist who was there from the
beginning to the end of the exercise.

To my close colleagues who helped me in completing my work via encouragement

and in tools assistance.

ii | P a g e
 Table of Content

Dedication.........................................................................................................................................i

Acknowledgement...........................................................................................................................ii

Table of Content.............................................................................................................................iii

List of Tables...................................................................................................................................v

List of Figures.................................................................................................................................vi

List of Abbreviations and Acronyms............................................................................................vii

CHAPTER 1:...................................................................................................................................1

1.1. Introduction...........................................................................................................................1

1.2. Internship Period...................................................................................................................2

1.3. Internship Objections............................................................................................................2

1.4. Significance of the Internship...............................................................................................4

CHAPTER 2:...................................................................................................................................5

2.1. Literature Review.................................................................................................................5

2.2. Organigram of the Hospital..................................................................................................6

CHAPTER 3..................................................................................................................................17

3.1. Activities of the hospital.....................................................................................................17

3.2. Dental Unit..........................................................................................................................17

3.3. Emergency Unit..................................................................................................................21

3.4. Haut-Standing Unit.............................................................................................................22

CHAPTER 4..................................................................................................................................24

4.1. Conclusion..........................................................................................................................24

4.2. Recommendation................................................................................................................25

References......................................................................................................................................26

Appendix........................................................................................................................................27

iii | P a g e
 List of Tables

Table 1: Description of all the departments, their schedule and functions............................................8

iv | P a g e
 List of Figures

Figure 1: Levels of health organization in Cameroon...........................................................................1

Figure 2: Organigram of the hospital.....................................................................................................6
Figure 3: Local anesthesia accessories................................................................................................27
Figure 4: Oral exam and basic set-up..................................................................................................27
Figure 5: Oral anesthesia set-up..........................................................................................................27
Figure 6: Cavity preparation and amalgam set-up...............................................................................28
Figure 7: Cavity preparation and composite set-up.............................................................................28
Figure 8: Basic extraction set-up.........................................................................................................28
Figure 9: Sterilizers..............................................................................................................................29
Figure 10: Personal protective equipment (ppe)—clinic jacket/lab coat and gloves..........................29

v|Page
 List of Abbreviations and Acronyms

a. ANC: Antenatal Care

b. ARV: Antiretroviral drug
c. BDH: Bonassama District Hospital
d. Aka: Also known as
e. CHU: Centre Hospitalier Universitaire
f. CS: Caesarean section
g. CTC: Centre de traitement du cholera
h. DMO: District Medical Officer
i. GBHS Bonassama: Government Bilingual High School Bonassama.
j. GS: General Supervisor
k. SIDA: AIDS/ Acquired immune deficiency syndrome
l. S/P: scaling and polishing
m. TB: tuberculosis
n. UMCS: Unite de medicine conventionnelle
o. UPEC : Unite de prise en charge du VIH SIDA
p. VIH : HIV/ Human immune deficiency virus

vi | P a g e
C
k
M
d
Im
a
n
g
R
h
p
P
lo
v
e
L
c
r
t
is
D
1.1. Introduction
CHAPTER 1:

BDH is the only public institution in the Douala 4 subdivision Bonaberi. It’s in charge of
supervising Health status of all souls living in the area just after the Bonaberi Bridge living
town. It is assisted by other private hospitals, community labs, pharmacies and small health
centres found in the sector. Since it’s at the peripheral level, it provides monthly reports as
other district hospitals to the hospitals at the Intermediate levels. It’s headed by a DMO
(District Medical Officer) who is appointed by the minister of public health.

The National Health System is headed by the minister of public health whose office is in
the ministry of public health found in the nation’s capital. The system is divided into 3 levels
as shown in the figure below;

Figure 1: Levels of health organization in Cameroon

The Central Level of Health is headed by the Ministry of public health, who has at his head
Dr. MANAOUDA Malachie as the Minister. Examples of its Hospitals are, CHU-Yde, Yaounde
Central Hospital, General Hospitals in Yaounde and Douala, etc.

1|Page
 The Intermediate level is headed by the Regional Delegate of the ministry of public health. In
Cameroon we have 10 regional delegates because of the 10 regions composing the state. The
Littoral delegation is headed by Dr. Jean II Dissongo. Examples of the institutions include, The
regional hospital of Douala, Laquintini Hospital Douala, Buea Regional Hospital, Etc

The Peripheral Level is found at the smallest level and is the smallest representation of a
public health center. It is headed by the DMO who is in charge of a District Hospital. In all the
subdivisions of Douala, i.e. Douala I, II, III, IV and V, we have a district hospital. In Douala IV,
the district hospital located at Bonassama is headed by Dr. Dina Bell, Director and Oncologist.
Other Examples include, Bonamoussadi district hospital, Deido District Hospital, etc.

In this report I’m going to give in the following chapters details about what I learnt
during my stay at BDH.

1.2. Internship Period

My colleagues and I had our internship normally scheduled from the 1 st August to the 30th
of August by the Administration of St Louis Institution. Having all of us separated into
groups and sent to various hospitals in the country and also considering the host hospital’s
internal rules and regulations, everyone didn’t have his internship done as programmed.

My group which went to BDH had to start from the 29 th of July. BDH uniformised its
interns with cooperate attires for security and discipline with cleanliness. This included the
wearing of white trousers, white nurse shoes and white laboratory coat.

1.3. Internship Objections

Considering our different fields of training and site of internship, a series of objectives were
given which helped us to focus on our stay in the hospital as students willing to learn and having
and goal to attain. General objectives were given together with specific ones. They are listed as
follows:

2|Page
 a. GENERAL OBJECTIVES

These were to be known by all students irrespective of their field of studies;

a. To have an overview of the hospital environment in order to understand the

administration setup of the institution.
b. To acquire a basic notion of team and group work.
c. To acquire good working attitudes and respects for hierarchy
d. To keep good records and statistics

b. SPECIFIC OBJECTIVES

These ones listed are to implemented by the students in order to know what is been done in
their field (Selected from the format what was done by me is listed as follows) ;

DENTAL THERAPY

a. We were asked to identify and manipulate the various equipments used

b. To assist in dental care
c. To ensure hygiene of the working environment
d. Practice the various methods of sterilization of the various instruments
e. To take care of instruments etc

NURSING AND MIDWIFERY DEPARTMENTS

a. We were asked to carry out basic bedside nursing techniques

b. To monitor patients ( vital signs) and evaluate them
c. To know how admission/discharge procedures are been done
d. To carryout various sterilization, disinfection and decontamination techniques
e. To participate and observe the various routes of drugs administration.
f. To observe wound dressing, surgical procedures, paediatrics and obstetrics etc
g. To always educate the patient in the procedure been done on him.

3|Page
1.4. Significance of the Internship

This internship was made for us to:

a. Know how a hospital functions

b. To see how patients are been treated into the hospital
c. To know the right treatment attributed to the patient
d. To know the different basic departments a hospital possess
e. To know the types of assistance given to a patient
f. To know the procedures of personnels in charge of patients
g. To know the various prevention measure taken to treat a patient
h. To know how wastes are being disposed fro better management
i. To know the appropriate method of hygiene and sanitation in order to prevent the spread
of diseases.

4|Page
 CHAPTER 2:

2.1. Literature Review

BDH was at first a Dispensary till 1995 when a Presidential decree transformed it to a
District hospital. It has a capacity of 78 beds so can hospitalize about 60 patients per week.

Bonassama District Hospital (BDH) is Public institution that is found in the Bonassama,
in Douala 4th municipality ( a.k.a Bonaberi), located in the Douala, the economic capital of
Cameroon. It is precisely found behind the Sub-Divisional Officers building which is located
at Bonassama Junction Just where the new and old River Wouri Bridge meets. The hospital is
surrounded by the Small Bonassama market and the GBHS Bonassama.

BDH is headed by a Director which is a medical doctor and is greatly assisted by the
Econome and the General supervisor. The Econome takes care of the logistics and financial
transactions o the hospital meanwhile the GS is in charge of all the personnel being it staff,
workers, interns, patients, visitors and sick guardians.

In the Republic of Cameroon’s health system, BDH is categorized as under Peripheral

level of Hospitals.

Its activities are being supervised by the Regional level and then the Central level. They
possess District Hospital Labs which supervise the work of peripheral communities based
laboratories, testing referred specimens and performing a range of tests compatible with the
work of a district hospital.

Some of its main functions are as follows:

a. Perform a range of tests relevant to the medical, surgical, and public health activities of
the district hospital.

b. Support the work of the community-based laboratories by testing referred specimens,

providing reagents, controls, standards, specimen containers, and other essential
laboratory supplies.

5|Page
v
R
y
t
u
i
s
r
a
l
C
-
e
m
n
o
c
E
S
G
O
M
D c. And also visit each primary health care laboratory in their area to inspect and discuss the
investigations being performed and, comment on their quality assurance system, safety
procedures, as well as the status of equipment maintenance.

d. Refer cases to the regional laboratory for test (s) that cannot be handled in district
hospital.

e. Notify the regional laboratory of any result of public health importance and to send
specimens for confirmatory tests.

f. Participate in the external quality assurance program organized by the regional

laboratory.

g. Prepare and send periodical reports to the regional laboratory.

2.2. Organigram of the Hospital

BDH has 10 buildings identified by letters from A to J.

At the top of the hospital we have the DMO

Figure 2: Organigram of the hospital

6|Page
 The Hospital is blessed with health personnel working in all the different fields the
hospital offer as services. Its made of;

a. 12 Specialists
b. 136 Regular staff
c. Nurse attendant
d. 4 Dentists
e. 2 Medical Lab Technicians
f. 2 Mortuary attendants
g. Nurse Principal. Commonly called, MAJORS
h. Nurse Supervisors
i. 2 Pharmacists
j. 2 Social workers
k. 5 Hygiene personnel
l. 5 Security men
m. 3 Branquardier

The Buildings allocated letters from A to J are shown in the table below;

Table 1: Description of all the departments, their schedule and functions

Letter Units/ Description Work schedule Daily Activities

Departm
ent
A Reception This is the unit that is Works 24/7 from Vital signs.
unit and concerned with the 7am to 5pm for Registration of
Orientat registration of patients, those working patient.
ion taken of vital signs and in the day and Treatment of
orienting the patient to the 6pm to 6am for urgent cases.
unit that can properly those working Orientation of
handle he/her case. in the night. patients to
It can hospitalize serious cases other units.

7|Page
 and treat it immediately. Consult with the
help of Medical
Doctors.
Antenatal This Unit is composed of 2 This is a Service . supervises the
Care main midwives working that works development of
(ANC) together with during the day. the fetus in the
Unit Gynecologists of the So its working womb
hospital. The unit is in time is from . Consult married
charge of Pregnant women 7am to 5pm couples to test
and answers questions every day. their fertility
relating to fertility of the levels
woman. . Can also help in
family
planning.
Maternity This unit is in charge of This unit works in . Management of
Unit pregnant women who are the day and women during
going to deliver their new night. labor
babies, women on labor 7am to 5pm and . Administration of
and also give first 6pm to 6am medications to
treatment to baby and respectively. difficult cases
mother. . Management and
appropriate
disposal of the
placenta
. Registration of
vital signs and
parameter of
the newborn
baby
. etc
Paediatric Made of 6 rooms, where we This units works . Takes care of
Unit have some for the only during the children from 0

8|Page
 specialist, Major, Nurses day i.e. from to 10 years.
office, wards, etc 7am to 5pm Administers
The unit is in charge of medication
treating patients of age only to infants.
between 1 and 18yrs of all Ensures infants
pathologies. with certain
conditions
takes proper
diet.
Oncology Composed of the Major’s This unit works in . takes care of
Unit/ office, Doctors office, the day and patients
Palliativ nurses hall and male and night. suffering from
e care female wards. This unit 7am to 5pm and cancers of all
takes care of patients 6pm to 6am sorts with
suffering from cancer and respectively. tumors
tumors. . Help to
administer the
right
medications to
the right cases
on cancer.
Vaccination This unit is in charge of Its only opened . vaccination of
Unit vaccinations in the during the day infants
hospital setting i.e. from 7am . Gestating women
to 4pm . Vaccination of
new born
babies
B Physiothera This unit is controls by Its only opened . Rehabilitation
py Unit physiotherapist. The block during the day services
is composed of the i.e. from 7am . Massages
children playing center to 4pm . Ensure right
and the physiotherapy posture by

9|Page
 room for treatment. patients with
walking
problems
Oxygen This center controls the supply No schedule Supplies O2 to the
Center of oxygen in the theater theatre room
for surgical interventions for operations.
C Hygiene This unit is in charge of Its only opened .Provide all
and maintaining cleanliness of during the day services with
sanitatio all the hospital services. i.e. from 7am containers for
n It’s also in charge of to 4pm disposition of
services keeping and storing dirts be it sharp
CTC/ archives or the hospital. objects, glass
Archive bottles, soiled
s materials
(gloves, tissue,
etc) and normal
dirts disposal.
Isolation This hall is used to treat Only used when . appropriate for
room patients suffering from there’s a case the proper care
for TB tuberculosis (TB). of TB patients
Isolation This hall is used to treat Only used when . appropriate for
room patients suffering from there’s a case the proper care
for Cholera. Here beds are of Cholera
cholera being adapted for easy patients
passage of feaces out.
X-Ray This room possesses a big This unit works in . Provides
room modernized scanner and the day and radiographs to
an X-ray machine. night. patients.
7am to 5pm and . provide scans of
6pm to 6am fractures
respectively
except during
weekends

10 | P a g e
D Radiology This unit having its extension This unit works in . provide
unit as the X-Ray room is in the day and sonographs and
charge of giving night. radiographs of
radiographs of internal 7am to 5pm and patients
tissues. 6pm to 6am
respectively
except during
weekends
Emergency This unit is in charge urgent Doesn’t close. In . wound dressing
Unit/ cases. It takes care of the day it runs and healing
Intensiv accidentals, in short from 7am to . Application af
e cares patients with a high level 5pm and in the first aid to
(PC/SI) of trauma. night it’s from patient.
6pm to 7am . takes care of
patient
hospitalized
under their care
. Taking vital signs
everyday to
monitor the
evolution of the
patients
situation and
administering
the right
medication.
Bureau This office is in charge of Its opened from . ensures these
UMCS( patients with insurance Monday to specials
Unite de cards Friday from patients don’t
medicin 8am to 4pm pay a certain
e extra amount of
conventi money since all

11 | P a g e
 onnelle) has already
being paid
Anaesthetist This is where the anaesthetist This office is . Maintains the
office stays. They are 3 them in opened patient
the hospital. They ensure everyday from unconscious
appropriate control of 7am to 5pm throughout the
patient under surgery to and 6pm to the surgerical
remain in state of 6am in the day intervention by
unconsciousness and night. administering
throughout the operation the right
amount of
anesthesia.
Operating This service is also controlled This unit doesn’t . Carry out
Bloc by a major. It’s the main close. From CS( Caesarian
and place where we have 7am to 5pm section)
reanimat major surgical and from 6pm . Circumcisions
ion unit interventions been done. to 6am in the . Fracture
day and at operations
night . etc
respectively.
E Medical This unit is having mix rooms, This unit doesn’t . Hospitalization
Unit male room, female room, close. From . Vital signs taking
nurses room and toilets. 7am to 5pm . Administration of
This unit is in charge of and from 6pm prescribed
patients who are under to 6am in the medications at
hospitalization. day and at the right time
night to the patients
respectively.
Laboratory This unit is there to carry out This unit doesn’t . Blood type
analysis of patients close. From testing.
samples. It’s does analysis 7am to 5pm . Blood group
in immunology, and from 6pm testing and

12 | P a g e
 bacteriology, to 6am in the rhesus factor
microbiology, day and at . ASLO, Full blood
biochemistry, night count, Widal
haematology, respectively. test,
parasitology, mycology, . Rapid diagnostic
etc tests, Wet and
dry mounts
F Waste This unit possesses an This incinerator is . help to eliminate
manage incineration room with a put on when all dirt in the
ment by incineration. This the waste has hospital
Unit machine helps to burn out been
all the wastes of the accumulated to
hospital especially glasses, a certain
sharp objects and quantity.
materials soiled with Waste cant be
blood. Meanwhile normal burnt anyhow
wastes are collected by since it
HYSACAM daily. releases toxic
gases that are
dangerous to
the human
system.
G Econome’s The Econome is the person in He works from . He knows all the
office charge of all the Monday to materials been
expenditures of the Friday from present it the
hospital. 8am to 4pm hospital.
Director’s This where the director stays He works from . Supervises the
office in order to handle all the Monday to activities of the
activities of the hospital. Friday from hospital
8am to 4pm
I Canteen This is where food is been Its opened Provides food to
prepared for all the staffs everyday from medical

13 | P a g e
 of the hospital. 7am to 7pm personnel
especially to
those who are
on night duty
Laundry This unit possesses washing Opened everyday . It helps to clean
room machines and all the from Monday soiled dresses
necessaries for the to Friday from instead of
cleaning of all 7am to 6pm throwing them.
contaminated clothes. . Collects dirty
ward clothes
and clean them.
J UPEC Unit This unit takes care of HIV Opened everyday . administration of
(Unite cases. It provides moral from Monday preventive
de prise support and care to HIV + to Friday from treatment of the
en patients 7am to 4pm of AIDS
charge . Ensures the test
du VIH for HIV is free
SIDA) . In charge of
providing ARV
Drugs to
patients.
Ophthalmol This specialty unit is in charge Opened everyday . Cataracts
ogy of patients with sight from Monday . Provision of
unit. disorders to Friday from medicated eye
7am to 6pm glasses
. Advices on the
right on how
limit eye
disorder by
adjusting some
lifestyle habits
like abnormal

14 | P a g e
 exposure to
light.
Dental unit This is in charge of disorders Opened everyday . Tooth extraction
related to the dentition. Be from Monday . Tooth cleaning
it aesthetic, functional or to Friday from and flossing
results from poor hygiene. 7am to 5pm . Scaling and
polishing
. etc
Cardiology This unit is in charge of Opened everyday . attain to patients
Unit diseases related to the from Monday suffering from
heart to Friday from heart disorders
7am to 4pm . Manages patients
having
Hypertension,
Stroke,
Diabetes, etc
affecting the
heart
ENT (Ear It’s a specialty office where Opened from 8am . Does
Nose the specialist takes care of to 4pm from tonsillectomy
and disorders related to the Mondays to . Cleans blocked
Throat) ear, nose and the throat. Fridays ears
Speciali He usually carries out . Repares fractures
st office surgical interventions that of the sinuses
are most of the time very . etc
delicate.
Blood bank This service is in charge of Opened everyday . Provide sacs of
unit testing blood and storing it from Monday blood for
in good conditions. to Friday from transfusion
7am to 4pm . Test for
compatibility
K Mortuary This service is in charge of Opened everyday . Keep and stores
dead bodies. It’s from 7am to corpse using

15 | P a g e
 controlled by a Mortuary 6pm embowment
attendant. Its composed of methods
a Funeral hall, cold room, . Prepares corpses
preparation room, etc for funerals and
for exit
Cashier This is a vital service. It is Never Closes. . Sells medical
where patients pay all bills Works from booklets
in the hospital. 7am to 5pm . Sells medical
and from 6pm certificates
to 6am during . etc
the day and
night
respectively.

16 | P a g e
 CHAPTER 3

3.1. Activities of the hospital

The internship was full of activities of all kinds. The GS sent me to 3 different units were I
stayed for 2 weeks. This was to permit me to mostly observe the first week and take action on the
second week. Without forgetting my goal of learning by asking whatever question crossed my
mind to the practitioners.

Considering my internship period, I did 6 weeks altogether instead of 4. Then I spent my

trime in the Dental Unit, Emergency unit and the Private ward (Haut Standing) unit. This
experience helped me to touch and feel the conditions under which my seniors are constantly
working.

I learnt a number of procedures and in the ones I mostly observed, I did participate in them.
The Various activities are listed and explained as shown below;

3.2. Dental Unit

My stay in the dental unit was from the Monday 29th July to Saturday 10th August.

3.2.1. Activities observed

a. Consultation
b. Scaling and polishing of teeth
c. Tooth extraction
d. Mixing of the ZOE paste
e. Cleaning of used materials
f. Preparation of mouth wash solution
g. Preparation of the Decontamination and sterilization solution
h. Cleaning of dental table after usage
i. How to set-up the dental tray for extraction, filling, S/P, consultation, etc

17 | P a g e
 3.2.2. Instruments used

a. Mirror, Mouth: To view tissues of the oral cavity and reflect light for better visibility
b. Explorer/ Probe: To examine tooth surfaces for caries, calculus, or defects using sense of
touch (tactile)
c. Cotton Pliers: To place and remove small objects from the oral cavity (i.e., cotton pellets,
root canal instruments, wedges)
d. SALIVA EJECTOR TIP: To remove saliva and maintain dry field using low-volume
evacuation
e. ANESTHETIC SYRINGE: To deliver local anaesthesia to intraoral site
f. LOCAL ANESTHESIA ACCESSORIES include: Anaesthetic needles, Anaesthetic
cartridges, Recapper, Sharps container,
g. ORAL EXAM AND BASIC SET-UP include: 1 Mouth mirror, 2 Explorer, 3 Periodontal
probe, 4 Cotton pliers, 5 Air/water syringe tip, 6 Oral evacuator tip, 7 Saliva ejector tip, 8
2*2 gauze
h. SPOON EXCAVATORS: To remove soft decay and other materials such as temporary
restorations and cement from tooth
i. ENAMEL HATCHET: To remove decay and refine cavity preparation
j. AMALGAM CONDENSERS: To compact amalgam in the cavity preparation
k. CAVITY PREPARATION AND AMALGAM SET-UP: To provide instrumentation for
removing decay and shaping a cavity to hold a restorative material. This material is
contoured to restore normal anatomical form. Includes: 1 Basic set-up, 2. Local
anesthesia set-up, 3 Tofflemire matrix band, retainer, and wedges, 4 Amalgam well,
5.Amalgam capsule, 6 Cavity preparation burs, 7 Spoon excavator, 8 Binangle chisel,
enamel hatchet (preference of dentist), 9 Amalgam carrier, 10 Amalgam condenser, 11
Hollenback carver, 12 Discoid/cleoid, 13 Ball burnisher, 14 Hemostat, 15 Articulating
paper forceps, 16 Handpieces (high and low speed), 17 Cavity base/liner, 18 Mixing pad
and instrument
l. CAVITY PREPARATION AND COMPOSITE SET-UP: To provide instrumentation for
removing decay and shaping a cavity to hold a restorative material. This material is
contoured to restore normal anatomical form.: 1. Basic set-up, 2 Local anesthesia set-up,
3 Cavity preparation burs, 4 Spoon excavator 5 Binangle chisel, enamel hatchet

18 | P a g e
 (preference of dentist), 6 Composite placement instrument, 7 Applicator for bonding
agent, 8 Acid etch, 9 Plastic matrix band, 10 Bonding agent and disposable well, 11
Articulating paper forceps, 12 Abrasive strip, 13 Abrasive discs and polishing points, 14
Handpieces (high and slow speed), 15 Composite compule and dispensing gun
m. HIGH SPEED HANDPIECE, CONTRA ANGLE: To hold and rotate cutting instruments
(bur, diamond) for removal of decay and tooth structure to form cavity preparations and
crown preparations. Accepts burs and other rotary instruments with friction grip (FG)
shank
n. IMPRESSION PASTE SPATULA: To mix elastomeric impression materials (vinyl
polysiloxane, polyethers, rubber base/polysulfide, silicone, zinc oxide eugenol) and bite
registration materials on paper pad
o. STRAIGHT ELEVATORS: To loosen tooth or root from bony socket prior to placement
of the extraction forceps
p. BASIC EXTRACTION SET-UP: To provide instrumentation for surgical removal of
tooth/teeth. Includes:1 Local anesthesia syringe, needles, and cartridges, 2 Sterile gauze,
3 Surgical aspirating tip, 4 Cotton pliers, 5 Mouth mirror, 6 Periosteal elevator, 7 Straight
elevators, 8 Surgical curette, 9 Hemostat, 10 Extraction forceps (selected for specific
tooth/teeth)
q. IRRIGATING SYRINGE: To deliver irrigating solutions to the root canal(s). Also used
to deliver irrigating solutions to a surgical site and for postsurgical at-home irrigation
r. STERILIZERS: To destroy all microbes on dental instruments
s. PERSONAL PROTECTIVE EQUIPMENT (PPE)—CLINIC JACKET/LAB COAT
AND GLOVES: To protect health care workers’ skin from contact with pathogens and
chemicals during treatment procedures, treatment room decontamination, and instrument
processing
t. GLOVE FEATURES:
u. JACKET FEATURES: Moisture resistant disposable or cloth Long, cuffed sleeves Crew
neck with snap or button closure
v. Exam gloves Latex, nitrile, or vinyl Powdered or powder free Sizes: XS, S, M, L, XL, 2
Surgical gloves Sterile latex, nitrile, or chloroprene Right/left hand specific Powdered or
powder free Sizes: 5 1/2, 6, 6 1/2, 7, 7 1/2, 8, 8 1/2, 9, 3 Utility gloves Heavyweight

19 | P a g e
 nitrile for sterilization and disinfection procedures Sizes: S, M, L, XL, 4 Overgloves
Disposable clear plastic Sizes: S, M, L

3.2.3. Activities performed under supervision

a. Decontamination solution supervised by the Major of the unit

This was done by mixing 1 volume of Eau de Javel with 5 volumes of water in a clean basin.
This solution is valid only for 24hours and is been replaced every mornings.

b. Sterilization solution supervised by the Major

This procedure was done by mixing 500ml of water with 100ml of Steranios Concentrated
(only provided by the hygiene and sanitation unit). It is been replaced every Mondays.

c. Sterilization of metal instruments

This is done by putting them in an autoclave and heated at a temperature of 100C for 1hour.
Its done every morning. Before usage all the instruments be them plastic or not they are well
cleaned.

d. Filling of patients information into the register and installing him on the dental chair
e. Preparation of the Composite paste for filling of tooth cavities.

3.2.4. Activities performed personally

a. Cleaning of the office by sweeping and dry-cleaning it morning before 8am

b. Preparation af all the dental trays for either consultation or any medical intervention for
the doctor to use.
c. Assist the doctor in any help he needs.
d. Ensure that all the equipments are ready before usage.

20 | P a g e
 3.3. Emergency Unit

3.3.1 Activities observed

a. Taking of vital signs

b. Sterilization and decontamination of instruments
c. Cleaning of the department setting
d. Grande Ronde coordinated by a medical doctor
e. Administration of drips and drugs to patients
f. Cleaning of Accidental person from road accident
g. Wound dressing and cleaning
h. Stitching of opened wounds
i. Medical intervention towards fractures
j. Identification of instruments and drugs used in the unit

3.3.2 Instruments used

a. Blades for cutting, incisions and excisions

b. Straight Mayo scissors
c. Curved mayo scissors
d. A Hemostat used to clamp blood vessels or tag sutures.
e. A Kelly used to clamp larger vessels and tissues
f. A right angle used to clamp hard-to- reach vessels and to place sutures behind or around a
vessel
g. A Foerster sponge stick used to grasp sponges
h. Pickups, thumb forceps and tissue forceps
i. Mayo-Hegar needles holders used to hold needles when suturing
j. Cannula used to create a permanent pathway to a vein or artery for the purpose of
repeated injections of infusion of IV fluids
k. Gauze sponge used to absorb blood and other fluids as well as clean wounds
l. Kidney dishes used as a tray for instruments, gauze, tissue, etc
m. Sphygmomanometer used to measure the patient’s pressure
21 | P a g e
 n. Stethoscope used to hear sounds from movements within the body like heart beats,
intestinal movement, breath sounds, etc
o. Thermometer used to record body temperature
p. Transfusion kit used to transfuse blood and blood products
q. Weighing scale used to measure weight

3.3.3 Activities performed under supervision

a. Cleaning of patients wound

b. Placing the cannula on the patient’s hand
c. Administration of medications via infusion drip set

3.3.4 Activities performed personally

a. Taking vital signs of all patients every morning and evenings. i.e. Blood pressure,
Temperature, pulse, etc
b. Ensuring that the patients are feeling comfortable in the hospital.
c. Bed making of beds
d. Cleaning of the wards every mornings
e. Washing of used instruments immediately after used

3.4. Haut-Standing Unit

This unit takes care of all patients who are hospitalised and want to in their own rooms.

3.4.1 Activities observed

a. Administration of Cimetidine, Trabar, Artesunate, Paracetamol drip.

b. Cleaning of wound of a diabetic patient
c. Cleaning wards together with Major and nurse offices every morning

22 | P a g e
 3.4.2 Instruments used

d. Sterile gloves
e. Gauze
f. Decontamination solution
g. Drip or infusion set
h. Eau de Javel

3.4.3 Activities performed under supervision

a. Administration of drugs via infusion drip

b. Collected of blood via IV route
c. Bed making
d. Installation of new patient

3.4.4 Activities performed personally

a. Cleaning of wards and offices before 8am

b. Decontamination of room just left by patient
c. Taking of vital signs
d. Ensuring that patients follow the prescription of the doctor as long as they stay in the
hospital

23 | P a g e
 CHAPTER 4

4.1. Conclusion

This is an internship report on BDH. During this internship my primary focus was to
study the overall performances on the health services provided by the institution. BDH is a
hospital that is very important to the lives of people living in the Douala 4 section. If the quality
of health services is improved, it will surely be a reference in the town. SWOT Analysis

SWOT means Strength, Weaknesses, Opportunity and threats

4.1.1 Strengths;

Good infrastructure, an ambulance car of mark Mercedes, a secondary power generator in

case of power shortage, well organized buildings, good system of waste management, a working
manpower of specialists, physicians, nurses and interns of various fields, provide good quality
medical attention by well trained professionals, cost of services are very affordable.

4.1.2 Weaknesses:

It still has old procedures being done there. Relationship between doctor and patient is
that very effective because of factors like language and money driven minds. Interns are been
exploited in return of false illusion of internship attestations. Corruption is still very exposed in
certain parts of the hospitals.

4.1.3 Opportunity

BDH can increase customer loyalty by taking in consideration the the nurse patient
relationships. Also by improving more of hygiene and sanitation carried out by all.

4.1.4 Threats

Poor economic condition of the country is a major threat to the hospital in terms of
revenue. Many private hospitals around BDH are a dangerous threat when dealing with medical
care and clients availability. Not enough practitioners and equipments are available to proved
adequate care.

24 | P a g e
 4.2. Recommendation

4.2.1 Recommendations for organization

Assigned supervisor should make a proper schedule for internees regarding their
movement in different departments. Employees must be properly trained. Managers should keep
an eye on works of employees on daily basis. BDH should lower their prices for the services so
that its perception may be improved in general public. The difference between the behaviors of
the contractual, permanent employees was quite obvious to say that permanent employees should
review their behavior at work. Feedback and proper guidelines should be given to employees by
their managers to encourage them.

4.2.2 Recommendation for University:

As I observed, field work is quite different from theoretical studies I just want to give
suggestion to university that beside these theoretical work department must organize study tours
for students in different health institutions, for their better understanding.

25 | P a g e
 References

Textbook

Dental Instruments A Pocket Guide to Identification

Wheelers Dental anatomy, physiology and occlusion

Website

http://bohatala.com/hospital-internship-report/

http://www.google.com/search?client=ms-opera-mini-
android&channel=new&q=sterilization&oq=sterila&aqs=mobile-gws-lite.0.0l5

http://www.google.com/search-bonassama-district-hospital/

26 | P a g e
 Appendix

Figure 3: Local anesthesia accessories

Figure 5: Oral exam and basic set-up

Figure 4: Oral anesthesia set-up

27 | P a g e
Figure 6: Cavity preparation and amalgam set-up

Figure 7: Cavity preparation and composite set-up

Figure 8: Basic extraction set-up

28 | P a g e
Figure 9: Sterilizers

Figure 10: Personal protective equipment (ppe)—clinic jacket/lab coat and gloves

29 | P a g e