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'It was the right thing to do'

California dentist reaches out with care, education in Afghanistan

Kabul, Afghanistan—Since 2003, a dentist based in Santa Barbara, Calif., has spent much of his time, most of his money and all of his compassion establishing a dental clinic and education program in war-torn Kabul.

A crane supports the ADRP shipping container clinic as it is moved into position onto its foundation

A crane supports the ADRP shipping container clinic as it is moved into position onto its foundation.

On his first trip to Afghanistan, Dr. James Rolfe lugged 500 pounds of portable dental equipment to an orphanage in the mountains of the Wardak province. The need he saw—from overwhelming dental disease to orphans with no chance to improve their chances for a better life—compelled him to begin his ambitious project.

At a time in his life when he should have been planning his retirement, Dr. Rolfe founded the Afghanistan Dental Relief Project and focused his energies on practicing full time in Santa Barbara to help finance the charitable work done through the organization.

"I did it because it was the right thing to do," said Dr. Rolfe. "These people need help. There are only 134 dentists in Afghanistan, so most of its 30 million citizens don't ever have the chance to see a dentist, and there are people dying from preventable or treatable dental problems."

ADA resource emphasizes safety for international volunteers

The ADA Division of Global Affairs' International Dental Volunteer Guide, a comprehensive resource for dental professionals, emphasizes personal safety for dental professionals traveling outside the U.S.

"The primary goal of every volunteer should be to return home safe and sound," says the guide.

The 56-page guide is a resource that offers both seasoned and aspiring volunteers a comprehensive look at the world of volunteering and practical advice on how to meet the oral health needs of people in developing countries. Safety information covers topics like personal safety considerations, transportation safety, safeguards for personal health, protecting personal effects and more.

Last month Dr. Thomas Grams, a dentist from Durango, Colo., was reported killed by the Taliban while on a health care mission trip in Afghanistan.

"Tom embodied the highest ideals of the dental profession. He provided volunteer dentistry to children in remote areas in the Americas, Nepal, India and Afghanistan, and he put that care ahead of his own safety. His untimely death, therefore, is not just a tragedy, it's an outrage," said ADA President Ron Tankersley in a letter of condolence to Dr. Grams' family.

"Tom's dedication brought hope and healing to patients, and I am proud of his courage and commitment. Tom will be remembered and missed by all who knew and loved him."

Dentists considering an international volunteer experience can receive the ADA guide at no charge. For more information, or to receive a copy, contact the ADA Division of Global Affairs by calling toll-free, Ext. 2726 or e-mailing international@ada.org.

There is also information about personal safety issues, as well as a directory of more than 100 organizations with international volunteer opportunities on the ADA International Volunteer website, http://internationalvolunteer.ada.org.

Dr. Rolfe said he felt, after two mission trips, he could help more people by establishing a permanent site for a clinic, so he devised a novel way to create a clinic while back in the U.S.

With the help of local craftsmen in Santa Barbara, Dr. Rolfe spent 4,000 hours over an 18-month period building a fully equipped three-chair dental clinic in a 40-foot shipping container. The clinic includes a sterilizing room, X-ray equipment, a complete dental laboratory and a self-contained water system and generator. Its windows and doors seal securely to help keep desert sand out of the clinic and the dental instruments.

His first attempt in the summer of 2006 to ship the container and place it on land obtained from the Afghan government failed, and the container was stuck in Pakistan. So he shipped it back to the U.S. and started a search for a new clinic site.

After securing a donation of land in a suburb of Kabul from an Afghan-American family, he shipped the container clinic and 60 tons of dental supplies to the site at his own expense. The shipment, due to arrive in August 2007, was again held up at the Pakistan/Afghanistan border until November.

"I had lined up many volunteers to help with getting the shipping container set and up and running, but by the time it arrived there was just me and one very dedicated volunteer, Mark Couturier, from Michigan."

Mr. Couturier said he had been hoping to experience adventure and service and aspired to join the Peace Corps but being legally blind and having other medical issues had put his plans on hold. He said he had a desire to volunteer in Afghanistan.

"I was searching for NGOs (nongovernmental organizations) that worked in Afghanistan and that is how I met Dr. Rolfe," said Mr. Couturier. "My main task at the clinic site was to assist Jim in unloading the containers and taking things to the house [in the compound]. I also helped put in shelves and plumbing—things I had never done before in my sheltered world in Michigan. Within a few days of my arrival in Afghanistan, I realized that humanitarian work in war zones was not as romantic as it had once seemed. But ultimately I found my experience to be extremely rewarding."

Dr. Rolfe made five trips to Afghanistan last year and when he's on-site he spends his time administrating. ADRP's clinic employs three local dentists, four dental hygienists, two dental assistants, two laboratory technicians, a teacher, a cook, a housekeeper, a mechanic and two guards. The clinic is now providing free dental treatment to about 20,000 patients a year.

"I'm 71 years old now and still going strong," he said. "I still do all my own lab work for my California practice, and I live very frugally—on $10,000 a year—so I can continue to support and expand the Afghanistan program. I've invested about $750,000 of my own money into the project, but there’s so much more we want to do."

In the future, Dr. Rolfe plans to expand his reach by replacing the shipping container clinic with a brick and mortar facility, and moving the portable clinic to another site.

Dr. Bahauddin, an ADRP staff dentist
Dr. Bahauddin, an ADRP staff dentist, treats a patient in the clinic.
ADRP also held a three-day dental clinic at the Kabul women's prison last year, treating incarcerated women and their children who had acute dental problems.

In 2007, ADRP also established the Kabul School of Dental Technology, where disenfranchised citizens—orphans, widows, handicapped, single mothers and others—can study at no charge to be dental assistants, laboratory technicians or dental hygienists.

"We have only had about two dozen students train here so far," said Dr. Rolfe. "It's a token effort designed to show people what is possible. We have empowered people to find a way to take care of themselves. I feel this is the solution for Afghanistan. People need to get on the ground there and help establish manufacturing, education and science infrastructure."

The compound where the clinic and school are housed, he added, also has a secured guesthouse with accommodations, meals, laundry, hot showers and Internet access. ADRP volunteers pay a small fee to stay in the compound.

"Many dentists have journeyed to the clinic from all over the world, paying their own travel expenses, to serve as teachers or dental volunteers," he said. "In addition, other dental assistants, hygienists and lab technicians also volunteer."

The compound also features an organic garden that helps feed the clinic's employees, students and volunteers.

"One of our guards is also the gardener. He carries a shovel instead of an AK-47," Dr. Rolfe said with a laugh. "The garden was in the field next to the house. It was filled with rocks when we first came. We worked hard to remove the rocks and brought in truckloads of topsoil so we could grow our own safe, healthy vegetables and salads. It's quite an operation to feed that many people every day."

Dr. Rolfe also invests a great deal of his U.S. time in outreach and fundraising, speaking at dental meetings, ADRP fundraisers and even at a booth at the Santa Barbara farmer's market. Next month he will have a booth at the ADA annual session at the Orange County Convention Center in Orlando, where ADA members and other registered attendees can learn more about his organization, programs and plans for the future as well as become donors or volunteers.

Since he established ADRP, Dr. Rolfe estimates he's had nearly 3,000 volunteers who have helped not only in Afghanistan, but also with efforts at home to collect used dental equipment, dental supplies, scrap metal and monetary contributions.

Currently, Dr. Rolfe and other volunteers are working with private dentists and dental manufacturers and dealers to secure enough equipment and supplies to fill another shipping container that can be sent to the clinic site.

Jeff Klein of J & J Instruments in Linden, N.J., said he met Dr. Rolfe at a California Dental Association meeting in Anaheim last spring where the two had adjacent booths during the meeting's exhibition.

"I was impressed to see what he's already accomplished, and I tried to find out how our company could help," said Mr. Klein. "He works in Afghanistan for the right reasons. It's so important to offer hope to those who have less than none."

Pictured outside the ADRP clinic are Achmed; Shafi; Dr. James Rolfe; Dr. Paul Sommer; Taiba Abduljalaal, R.D.H.; Brenda Manookin; John Waskey; Dr. Sedique; Julia Zhogina, R.D.H.; Dr. Sami Azizi; and Dr. Sedique's driver
Ready to help: Pictured outside the ADRP clinic entrance in October 2008 are, from left, Achmed, day guard and gardener; Shafi, mechanic; Dr. James Rolfe, ADRP founder; Dr. Paul Sommer, volunteer dentist; Taiba Abduljalaal, R.D.H., dental assisting instructor; Brenda Manookin, photographer; John Waskey, videographer; Dr. Sedique, guide; Julia Zhogina, R.D.H.; Dr. Sami Azizi, ADRP managing dentist; and Dr. Sedique's driver.

The company donates some instruments to ADRP and offers deep discounts on special order items. It also offers the organization returns, old instruments and scrap metal.

"It elevates my spirit to know that we cohabit the planet with people who have this kind of moral fiber and enthusiasm," Mr. Klein said. "He puts himself in danger with absolute enthusiasm and a smile."

Dr. Paul Sommer, a Tulsa, Okla., dentist, used frequent flier miles to offset his travel costs for two trips to volunteer at the ADRP clinic.

"I had volunteered in Guatemala, Sri Lanka and Lithuania in the past," said Dr. Sommer. "I also volunteer at clinics in Tulsa and participated in the Oklahoma Mission of Mercy. I saw the listing describing ADRP in the ADA International Dental Volunteer Guide, and I was intrigued."

This spring, on his second trip to Kabul, Icelandic volcano ash disrupted his flight, and it took him four days to arrive in Afghanistan.

"I got stuck in Spain and then I had to go back to Dallas, then I got a flight from Atlanta to Dubai," he said. "Then when I arrived, my cell phone was dead, and it took me awhile to find a way to call the clinic to get a ride to the compound.

"Kabul reminds me of Berlin after World War II," he added. "There are a lot of bombed out buildings and rubble. But the people who come to the clinic for treatment are so appreciative. I can't wait to go back again."

Dr. Sommer also spends time volunteering for ADRP in the U.S. by calling dental suppliers to obtain donations of dental equipment, supplies and toothbrushes.

Dr. Ike Rahimi of Placerville, Calif., volunteered for ADRP. An Afghan native who left at age 7, Dr. Rahimi said he felt compelled to provide hands-on help.

"I believe in giving back to the world, and writing a check just doesn’t do it for me."

He said he was amazed by the Afghan people's spirit. "They are happy, yet they don't have simple things like light switches or indoor toilets. We just don't realize all the wonderful things we have here in our country. When you leave the hustle and bustle of your dental practice to help others, your life becomes 10 times better."

In addition to many dental professionals, a host of other volunteers have come from all walks of life—construction, gardeners, photographers, videographers, translators, computer programmers and general volunteers. "I'm just trying to help people," Dr. Rolfe said. "There is no religion or politics involved. This is a moral mission."

Dr. Rolfe learned last month that he is one of seven honorees chosen by the U.S. Center for Citizen Diplomacy who will receive the 2010 National Award for Citizen Diplomacy at a ceremony Nov. 17 in Washington.

For more information on ADRP or to find out how to volunteer or to donate funding, scrap metal or used dental equipment, visit the website, www.adrpinc.org.

For information on other international volunteer opportunities, visit the ADA International Volunteer website, http://internationalvolunteer.ada.org.