Afghans’ Dental Disaster

An Antiwar Dentist’s Work in Afghanistan

In September 2003, Dr. James Rolfe, a successful Santa Barbara dentist, traveled to Wardak, a remote mountain province in war-torn Afghanistan. Arriving at the grounds of a boys’ orphanage, Rolfe set up a homemade, portable dentist’s office and base camp, and word that an American doctor was offering free dental treatment spread quickly. People came from miles away and waited patiently for a full day, or longer, to be seen by the dentist. In a country of some 30 million, reports Rolfe, the number of people who have seen a real dentist, even once in their lifetime, is miniscule. What passes for dental care often amounts to a barber ripping out sore teeth without anesthetics. Lack of healthful food — 70 percent of Afghans are malnourished — aggravates dental problems. Abscesses can cause septi­cemia, which can be lethal without antibiotics. For three weeks, Rolfe worked up to 18 hours per day, relying on orphans as his assistants.

With a busy office near the Lobero Theatre, Dr. James Rolfe was by all appearances about as far removed from Wardak as any of his neighbors. But after reading a 2002 news story about a boys’ orphanage in Wardak, Rolfe said, “I felt a bell ring inside.” In an effort to reach out to children traumatized by an American-led war increasingly perceived at home and abroad as unjust, Rolfe founded the Afghanistan Dental Relief Project (ADRP).

According to a Red Cross study done in 2002, one in four Afghan children suffer from post-traumatic stress disorder (PTSD) while a recent UNICEF survey found 80 percent of all children in Kabul regarded life as “not worth living.” Many of the worst cases, naturally, are orphans. Some of these children were abandoned due to extreme poverty, while others lost their parents to wartime violence. As a victim of PTSD resulting from a chaotic family background, Rolfe said he could relate. Rolfe’s parents were divorced and remarried three times — to each other. A sense of helplessness, said Rolfe, brought him destructive behavioral problems and low self-esteem; he imagined similar conditions were likely occurring on a mass scale in Afghanistan.

Rolfe’s long-held concern for the Afghan people stems from U.S. action during the Soviet-Afghan War of the 1980s. (The U.S. supported the Taliban in those days, supplying Afghan rebels with weapons and supplies to fight against the Soviets.) “We confronted the Soviet Union — using the Afghan people — and then we abandoned them,” Rolfe said. “If we had helped the people after the Russians disbanded, there would have been no Taliban, no Osama bin Laden.” Given U.S. troop withdrawals and massive cuts in aid during the coming year, even as Taliban school burnings and suicide bombings persist, it appears the U.S. is poised to repeat this disappearing act.

Rolfe said he saw plenty of evidence the U.S. had fulfilled its oft-repeated promise to bomb the Afghans back to the Stone Age. Double amputees begged on the side of the road. Buildings ripped apart were home to numerous families. Diesel generators made lighting a crapshoot. Intermittent electricity reaches only about 10 percent of the population.

If You Build It, They Will Come

Rolfe returned to Afghanistan last May, this time setting up his mobile dentist’s office at a women’s clinic in Kabul; while at the orphanage, Rolfe learned that the only way he could offer treatment to women was by turning away men. And because under the Taliban women were forbidden to see male physicians — and barred from working themselves — most Afghan women had never seen a doctor.

Becoming ever more convinced that Afghanistan needed more than a temporary dentist, Rolfe resolved to set up a permanent facility, which he — a natural handyman — is currently building. His vision is to provide free dental care to the Afghan poor, subsidized by fees from foreigners who currently must fly to Qatar for dental treatment; to train orphans and widows — who traditionally have no economic means — in dental assisting, hygiene, and lab technology; and to provide housing for international dentist volunteers who will oversee the clinic on a rotating basis. Rolfe has connected with several dentists waiting to volunteer once the clinic is finished.

The clinic will be a quadrangle of converted shipping containers with a security fence around it, which Rolfe’s welder friend constructed out of discarded clothing racks and pieces of steel. The Afghan government donated a lot in Kabul for the facility, along with electrical needs and a nearby building to accommodate volunteers. Rolfe has assembled 15 complete treatment areas — including pump chairs, lights, and X-ray machines. Driving throughout California in his ’62 GMC, Rolfe collected most of this equipment from dentists who heard about ADRP at a 2003 American Dental Association (ADA) convention in San Francisco. He recently completed one shipping container — including a lab, sterilizing area, and pressurized water system — and is currently trying to raise $20,000 to have it shipped.

While Dr. Rolfe has gotten many donations of goods — 7,000 toothbrushes from the Orange County elementary school where his daughter teaches and $122,000 worth of dentures from American Tooth Industries of Oxnard — he has received little financial support. In 2004, he hosted two local benefit concerts, but the money raised didn’t cover the cost of the events. ADRP has been featured in the Los Angeles Times and on CNN, but so far generated little response. Rolfe feels this may be partly due to the fact that media coverage has tended to laud his project without emphasizing the plight of those he’s moved to help.

Briana Lawrie, who founded RAWA (Revolutionary Association of the Women of Afghanistan) Supporters Santa Barbara in 2000, said the flux of donations hinges on media attention. After 9/11, fundraising was relatively easy, she said, but has decreased significantly since the start of the Iraq war. The limited press Afghanistan does receive is framed as a success story, and Defense Secretary Donald Rumsfeld recently touted the country as a “model” of progress in the War on Terror. In fact, there were 31 terrorist attacks, mostly Taliban-related, between January and May 2005, and at least 25 people were killed in suicide bombings last January alone.

Marathon Man

Rolfe’s dentist office is filled with conga drums and guitars, remnants of his past hobbies. These days, ADRP is his whole life. “There is an incredible temptation to do those things,” he said, “but I’ve found that any time I do, I feel badly later.” At 67, Rolfe works about 115 hours per week and lives well below the poverty line in a low-income condo. All the money he makes, after basic needs, goes into ADRP.

Rolfe’s devotion does come at a price. His girlfriend speaks with unhidden discontent of dealing with the emotional stress he’s under. “He’s been overwhelmed,” his adult daughter echoed. “This has not been easy.” During construction of the clinic, Rolfe was hospitalized with broken ribs and several times acquired cuts requiring stitches — which he gave himself, after self-administering an anesthetic. “It’s 500 bucks to go to the hospital,” he said. “No way.”

Rolfe’s longterm goal is to find a retired Afghan dentist living in the U.S. who can take the baton. In the meantime, he focuses on the people’s response during the darkest moments of the project. While they were certainly thankful for the dental treatment, Rolfe said their gratitude ran deeper than that. “Just the fact that I would go there at all, that I would think of them,” Rolfe said. “People all over the world hate us. This is much bigger than a few teeth.”

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