Interview with Dr. Rolfe

Questions for ADRP, Dr. James Rolfe

1. First of all, what was your initial motivation to begin your work providing dental relief to citizens in Afghanistan?
“I saw that little aid was reaching the people of Afghanistan, so I went there with a portable dental office to provide treatment. I saw many people dying because of their teeth; they could not access dental care because there was no dentist. At the same time, I saw forty orphans who had no future without education. Putting them together was natural. Now we train orphans and other underprivileged Afghans to be dental technicians. The practical training occurs in our modern shipping container clinic, which was built in California and shipped to Afghanistan.
We have six treatment rooms and three dentists, serving about 20,000 patients a year. Students training in our dental laboratory are learning how to produce the dentures and crowns that people need. We just produced our first class of professional dental hygienists, who provide hygiene supplies and training to people who have never had a toothbrush. All treatment and training is provided to the Afghans at no cost.”
2. Where did you come up with the idea to use a shipping container as your clinic?
“I had gone to Afghanistan twice with portable equipment, but I always felt badly about leaving. I could not treat enough people, and there would be no lasting benefit, once I was gone. Portable equipment allowed only very basic treatment options. I needed a modern clinic that was well-equipped and could be operated in any environment. I settled on a 40-foot shipping container. Over a period of eighteen months, I altered the container so that it had three treatment rooms with x-ray machines, self-contained with its own power and water system. The doors locked securely and the seven windows were all covered with waterproof plates. In the end, supplies were packed inside, and then shipped to Afghanistan. Land was located, the clinic was installed, and a modern guest house for volunteers was created. Now, the clinic is the focal point of the project. Our next phase is to build a permanent facility, and to move the shipping container clinic to another city, where we would repeat the process, and eventually bring modern dental care to all of Afghanistan.”
3. Along with the help you are providing the people of Afghanistan, you also provide a face which citizens can associate with the United States. Have you been able to see citizen diplomacy at work through your mission? If yes, how so?
“Many of the Afghans I have met tell me that they are still waiting for America to come help them. I am trying to do that myself. I am going there directly and giving them a small assistance, and I am dealing with them directly; I know their names and their families. They tell me their dreams. I feel that I am helping them to realize their dreams. Their lives are changing because of my interaction with them. And so my life is changing as well. We are saving people’s lives; those who would die from multiple teeth abscesses, a common cause of death there.
These people are so thankful that they have this resource. Such strong people, to have faced thirty years of war and to have survived! I feel the need to help these people, from the standpoint of responsibility; The richest nation actually helping the poorest. This sense of responsibility is what the Afghan people respect, and I will never forget their warmth and gratitude. I wish more people could experience the joy of this work. “
4. How has the recent tragedy regarding the American aid workers in Afghanistan this past summer affected your work in the country, if at all?
“I have read all the news releases about the deaths of the aid workers, including the dentist, Tom Grams. The Taliban allege that the group was teaching Christianity to locals, and that they had a bible translated into the local language. Last week while in Kabul, I had lunch with the director of the Afghanistan Relief Organization, which was their sponsoring organization. He told me just the opposite. I know that Christian groups often speak in a manner specific to Christians, and this may have offended someone.
Even Christian prayer would probably be offensive. Two years ago, a humanitarian aid worker was killed as she walked past our facility; she was not associated at all with our project, however. She was killed purportedly because she was giving bible lessons to Afghans after her work. At the same time, we are seeing people all day long in our clinic, without any barbed wire or armed guard. In fact, we have never had any incident whatsoever. Myself, I frequently go about Kabul on my Honda motorcycle, interacting with the people while searching for some service or product. I have never encountered anything but the warm Afghan people. However, all things considered, I narrowly avoided becoming “collateral damage” during a car bombing in 2006, by being somewhere else for just that day. We have all our volunteers sign a disclaimer that does not hold us responsible. We hope people will think twice. Still, we have never had a problem, and I tell people that.”
5. Can you describe a “typical” day at the clinic?
“I often stay in our guest house, which is near the clinic. Many people come to the clinic at dawn, in pain and wanting treatment. We have painted a sign on the door in Dari that “this is not the clinic; go down 100 meters to the gate” with an arrow. Still, every morning, the people are pounding on the door, because they cannot read; eighty percent of Afghans cannot read. The first of the staff arrive before 8:00, and the clinic is prepared for use. All of the dental chairs are utilized in providing treatment, and trained dental assistants move patients around as they are being treated and released. The day guard is working in the kitchen garden, watching with one eye the flow of people. The cook has arrived and is making tea for everyone. The housekeeper has removed her burka and is sweeping the floor. The students begin to arrive and start their classes. The staff and students often travel for two hours across Kabul in order to be to work or school ontime. Teachers gather the students and begin the day’s lesson. From the dental laboratory come the sounds of plastic being shaped. Suddenly the power goes off; everything stops, then it comes back on. The dogs have been barking all night, fighting over who will be the Top Dog of the huge trash heap on the street. Once a month, the city comes with trucks to carry it off. Now, there is a herd of sheep foraging through the garbage for anything edible. In trees overhead, mourning doves sing their songs. The girls’ high school students walk past the guest house, one of five classes that will go to school that day, each one for only an hour and a half, due to a shortage of teachers and classrooms. The average age in Afghanistan is only fourteen. The raggedy man pulling the cart calls out for scrap metal. The smell of fresh bread comes from the nearby bakery. The shadows of the nearby bombed-out building shorten as the sun rises. Kabul is alive with activity.
6. What kinds of lasting relationships have you built since the onset of your work?
“Thousands of people have contributed to this project. Each of these people as individuals saw for themselves that Afghanistan needed help, and they chose our organization to work through. Whether they donated money or dental equipment, helped with the many needs of the project, or supported it to others, all of us have become a great family, with the common goal of doing the right thing. These people for the most part were specifically interested in the welfare of the Afghan people, and we all share this connection. The many and diverse abilities of these people have made our organization what it is: a movement of energy designed to help the Afghan people.
Without every person, we might never have been able to accomplish what we have. This is our common bond, and we all share in the good feelings that our efforts are successful. The proof of our success is brought forth in the gratitude and appreciation that we see from the Afghan people. We have a special relationship with many Afghan people, who have come forward to assist us from the surrounding area. I am constantly amazed by the warmth and generosity of the people, who have endured over thirty years of war. Each of sixteen employees has his own story of tragedy and survival. Each endures great sacrifices in order to work daily at our facility. They do this because they see the value in their work, and so much want to help their country. I am inspired by these hearty and spiritual people.”
7. Have you observed any lasting changes in Afghan’s opinion of Americans as a result of citizen diplomacy, both yours and others work?
“Afghanistan is a very dysfunctional country, having had over thirty years of war. When the Soviet Union invaded, it was a democracy, with electric buses and girls in miniskirts. Now it is mainly populated by citizens who have never known peace. This has changed people to cause them to think about themselves first. Because there are few resources, people often go without. This affects transactions, where people will try to take advantage. But amazingly, people who know about our project are exactly the opposite: they want to assist us in every way. Each of these people knows that our project is funded by Americans, not AMERICA, but Americans. Most of the poor of Afghanistan have never received aid from the government of America, because it often disappears and seldom reaches its intended goal.
This is a fact. Our organization is entirely volunteer; we have no operating expenses, and as a result we are on the ground there, directly involved with the people. We know them as people, and we are doing our best. They realize even the potential that this holds for their lives, bringing far more potential students and patients than we can handle. But each person we help becomes a walking recommendation for the Americans who cared about them enough to actually come to help them. Their very lives have been changed for the better, each one. And with it, the infrastructure improves; women feel empowered to be authority figures; people live longer and are healthier. All because some Americans worked together for common good.”
8. What is your favorite Afghan dish? Tell us about it!
“I really like the creamy spinach and the homemade yogurt. Our cook is a widow with ten children; her husband and his other wife died and left her with all the children. She feeds about thirty people six days a week by herself. While setting up the clinic in the dead of freezing winter, I survived without heat or running water for two months while eating granola bars. Whenever I go there to visit, I always buy some lamb or chicken for meals. For most of our staff, our mid-day meal is their sustaining meal. Malnutrition in Afghanistan is around 70% on the average. Our organic kitchen garden provides our cook with fresh vegetables, which she uses to produce some fine salads. This rarity in Afghanistan is better understood when contemplating the use of human fertilizer in the vegetable fields of Afghanistan. Eating a fresh salad anywhere else in Afghanistan would be very dangerous, maybe even moreso than the Taliban.”
9. What advice might you give others who are looking to make a difference like you have but might are a bit more apprehensive?
“Many organizations are looking for support, and running a large organization requires people who are interested in making a difference, but who feel that they cannot actually go there and do the work. These organizations cannot exist without this support. This includes fundraising, management, packing and shipping, arranging transportation for volunteers, communications, website development, speaking engagements, and other domestic activities that keep an organization going. Some people might feel more comfortable about going further if they were to accompany a group of more experienced volunteers.
Efforts to assure others can include an assessment of past times which includes actual incidents, and how they were resolved. Many people are apprehensive, and might otherwise freely contribute. Much of this apprehension is developed by media information intended to be sensationalistic rather than realistic. Little attention is given to the actual conditions affecting the people, leaving out the humanistic aspect. Few people are aware that the people are friendly, warm, and kind, and basically have the same values that we do. A great disservice has been committed by the popular media, who portray Afghanistan as a poppy- growing American-hating bunch of religious extremist militants. This is not even remotely accurate. These people are peace-loving and just want to live their lives. So, people can also take courage in this fact, and just go there and see for themselves. Our guest house receives and cares for many dental professional volunteers from around the world, throughout the year. These people can truly testify to the joys of directly experiencing the interactions between these wonderful but neglected people.”
10. How might we create a lasting peace in Afghanistan through the use of citizen diplomacy?
“Our project has existed in the public eye of Afghanistan for three years. During that time, over 30,000 patients have benefitted from our services. In providing this treatment, we have not only improved individual health and longevity of these people, but we have actually raised the infrastructure of Afghanistan. People with little hope for their future are now professionals and authority figures, free to build and shape their own lives and the lives of others. People who can make their own way in life are not subject to radical philosophy or religious fanaticism. They are free to create their own future. All Afghans deserve to have this freedom. Millions of Afghans have died to make our nation the superpower of the world. We could have helped when the Soviet Union was defeated, but we did not. Instead, Afghanistan slipped into a bloody civil war, which caused huge damage. America could have stepped in at this point, did not. Even with the Trade Center Bombing, the Afghan people watched as the war began between the United States and the Taliban. The more fierce the American troops fight, the more resistance comes from the Taliban. Now, authorities are beginning to see that the war cannot be won. But, during this time, our project has been helping people to have better lives, and we have won a piece of the hearts and minds of all these people. Of course, we are in Kabul, where security is provided for the city in general. But we could do even more if some wartime resources were made available for projects like ours, with administrators directly on the ground, making sure that resources were properly allocated, and that objectives were being met. I can imagine that such projects would be met with support from the Afghan people, much as in the acceptance of our project, which has no armed security or barbed wire at all.
In essence, Afghanistan has to be put back together one person at a time, and we have neglected to even begin this process in the last thirty years. People on the ground are absolutely essential to the success of restoring Afghanistan. By giving people back the power to govern their lives, they will be able to make correct decisions, and they always will appreciate the help and concern of the people who were involved. The Military can provide support where necessary, but the Afghan people will be the ones that will ultimately make the project succeed, because they are very intelligent and will see the value in it. Now they are weak, and the longer we wait to do this, the harder it will be. It should have been done years ago, and would have been much easier. But it is the only way, and we owe it to the Afghan people. So we should get started, don’t you think?” The Project

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Afghanistan Dental Facts


65

Average Afghan life expectancy

4

Dentists in our clinic

200

Number of dental assistant graduates

300,000+

Number of people we've helped