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.”