• September.2003 - Denver Post Mountain Bureau
• Autumn 2003 - Colorado Dental Association Journal
• April.2003 - CDA Update
• July.2003 - RDH
• November.2004 - Woman Dentist Journal
• December.2004 - Valley News Dispatch

Dentists fill a need in Nepal
Relief program serves kids in remote villages
By Steve Lipsher, Denver Post Mountain Bureau

Wandering off is normal behavior for a yak in Nepal. But when the yak is supposed to be carrying thousands of dollars worth of sorely needed dental equipment and supplies to remote villages in the mountainous country, that can be cause for concern, said Laurie Mathews, director of the Himalayan Dental Relief project.

"They would just disappear," she chuckled. "Every morning, we'd have to look for yaks for two hours. It's quite an experience."

Such are the travails on the three-day trek to the nonprofit group's camp in Khumjung, a village at 13,000 feet in the shadow of Mount Everest, where a changing cast of dentists and other volunteers bring free dental care to hundreds of poor kids.

There, at the school founded and named after Sir Edmund Hillary, a crowd of children - some of whom have walked for more than two hours - eagerly gather for their first-ever visit to the dentist's chair, crowding at the doorways and peering in through the windows until they are called.

"These kids crave the attention," said Mathews, 51, the former director of Colorado State Parks who founded the project with her dentist husband, Andrew Holecek. "They want to be next. They see all the shiny machinery and start whispering and giggling. Then, when the needles come out, it gets very quiet."

With a population of 24 million people but only about 165 dentists, Nepal has a shockingly high incidence of tooth decay: Many of the children in Asia's poorest nation greet Westerners with the word: "Bonbon!" and most adults beam with jack-o'-lantern gap-toothed grins.

That's what Mathews saw when she first visited Nepal in 1980 and later when she returned with her husband in 1996 as a volunteer for dental organizations in Asia, performing what she called "triage care."

"It was very frustrating, because all we were doing was pulling teeth. We pulled 90 in a day," she said.

Seeded with a grant from the Ronald McDonald Foundation and laden with toothbrushes donated by Colgate and other equipment loaned to the effort, the couple launched the Himalayan Dental Relief Project.

Focusing on youths 18 and younger, they committed to seeing the same patients every two years, emphasizing proper dental health and even visiting the schools in the region for tooth-brushing clinics.

Last year, Mathews teamed with Kim Balazs, an adventure-travel agent struggling for business in the aftermath of Sept. 11 who decided to direct her attention toward humanitarian efforts.

The travel agency recruits dentists and volunteers willing to pay $3,200 to $3,500 for a three-week journey and makes the travel arrangements; Himalayan Dental Relief Project organizes the clinics.

"I asked Laurie and Andrew what they needed," Balazs said, recounting that the wish list for a fast-approaching trip included five dentists, five hygienists and five non-dental volunteers to help keep the kids under control and assist with myriad other tasks.

Mathews was dubious that Balazs could pull such a group together on short notice. Only a few days later, she had.

"The type of person who goes on our trip is a different caliber completely" from typical tourists, Balazs said. "They're much more interested in interacting with the culture and the community. You really get an insight into a culture that, as a tourist, you never have."

Since 2001, the Himalayan Dental Relief Project has seen 3,970 patients, filling 2,922 cavities and pulling 639 teeth - work worth an estimated $646,390. And in its new partnership with Global Humanitarian Expeditions, the organization has set an ambitious schedule of eight trips for 2004.

Coloradans seem particularly attracted to the effort, said C.L. Harmer, a former spokeswoman for Denver Mayor Wellington Webb and president of the board for the dentistry organization.

"We've been able to connect with the affinity that Coloradans have for this region," said Harmer.

For information on supporting the non-profit Himalayan Dental Relief Project, view the website www.himalayandental.com or contact Laurie Mathews at holmath@earthlink.net . For information on volunteering at a clinic for a three-week work-and-tourism tour, contact Kim Balazs at kim@humanitariantours.com.

Volunteers set up dental clinic ‘on top of the world’
By Colette Knittel

Most dentists are accustomed to the creature comforts the traditional dental practice provides: central heat and air, ergonomically designed furniture, efficient lighting, pleasant music. However, the more adventurous types are willing to pack up the bare necessities and set off down the road. Or up the mountain, as the case may be.

That’s what a group of five dentists, two dental hygienists and three non-medical volunteers did late last year on a three-week dental relief mission to Nepal. California dentists Frank Grimaldi, DDS; Barry Shaffer, DDS; Hai Tao Loo, DDS; and the rest of the volunteers, organized by Global Humanitarian Expeditions, headed off to the remote village of Khumjung, which is almost halfway up the Everest trail.

“In Khumjung, we established the highest dental clinic in the world, at an elevation of 12,500 feet,” Grimaldi explained.

The mobile clinic was set up in a local school donated by Sir Edmund Hillary, one of the first two men proven to have reached the top of Mt. Everest. Over the span of six days, five dentists, two hygienists and three non-medical volunteers provided free dental care to more than 450 children.

After the clinic portion of their trip, the group met with local community elders and medical providers to create a long-term oral health education and care plan for the community. Public health issues discussed included fluoride, oral hygiene instruction in schools, and diet. Another trip organized through Global Humanitarian Expeditions is planned in two years to provide ongoing oral health care.

The true challenge in providing care and education to these villagers was getting there. The group traveled to Kathmandu, Nepal, by way of Osaka, Japan, and Bangkok, Thailand. After an acclimatization day in Kathmandu, the group boarded a small propeller plane and flew up into the Himalayas, landing in Lukla, a small village at an elevation of 9,400ft famous for being the trailhead for expeditions climbing Mt. Everest.

In addition to food and general supplies, the team had a portable dental clinic with four portable dental units to transport. The gear was loaded onto yaks for the trip into the high country. After many days of trekking along the Everest trail, and a few lost yaks, the caravan finally ascended to Khumjung.

The trip was a cooperative effort between a pair of non-profit organizations -Global Humanitarian Expeditions and The Himalayan Dental Relief Project. Global Humanitarian Expeditions sends non-medical and dental volunteers abroad to provide humanitarian assistance in Nepal, India, Vietnam, Cambodia and Thailand. The Himalayan Dental Relief Project is dedicated to providing first time dental care to the neediest children and families of Nepal and surrounding countries.

Dentistry at the Rooftop of the World
By Heidi Baier
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It was more adventure than I ever imagined. Last fall, I joined 10 other volunteers on a trip halfway around the world to work at a dental camp at 13,500 feet in the Everest region of Nepal. The group included five dentists, two hygienists, and three non-medical workers. We were led by Global Humanitarian Expeditions, a
nonprofit organization that offers humanitarian service tours to remote parts of the world. The group’s founder and president, Kimberly Balazs, joined us for our adventure to the rooftop of the world.
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Our journey begins with a dazzling flight from the capital city of Kathmandu deep into the highest mountains in the world. As we fly, we see mountain villages and lush foothills terraced for farming. Gradually, the landscape changes as massive, white-capped mountains appear through the clouds and we see our destination — the inch-long landing strip against a steep mountain
slope in the village of Lukla. This airstrip is the closest entry point for trekkers traveling to the Everest region of Nepal.

After landing, we meet our sirdar (or guide) Ang Nima Sherpa, and his Sherpa crew. After greeting us, they load our luggage and 12 bags of dental equipment onto the backs of waiting dzos. Dzos are the domesticated version of wild yaks, bull-like creatures with flowing black hair and cruelly pointed horns. In the course of trekking, we learn to give dzos a wide berth. These creatures always get the right of way on narrow trails and cable bridges!

The dental camp is three days’ walk from Lukla and an elevation gain of 4,500 feet. This, we learn, is misleading as the trail dips to make every river crossing and rises to reach ridge-top villages. Our trekking days are long but thrilling. We walk along turquoise rivers churning with
glacial silt and in the shadow of massive peaks. On the second day, we see Ama Dablam, often called the world’s most beautiful peak for its graceful summit. We even glimpse the distinctive, pyramid shape of Mount Everest in the distance.

Each day seems to make us stronger and more confident. But late afternoon still brings a collective sigh when we spot the evening’s destination, a cluster of yellow mounded tents at the side of the trail. We spend evenings nursing sore feet, eating lots of food, and sharing in the
camaraderie of fellow travelers around a fire.

We reach our destination on the third day when we crest a steep ridge and see the twin Sherpa villages of Khunde and Khumjung below us. To our left, we make out the location of our dental camp — the Khumjung school. Built and funded by the Sir Edmund Hillary Foundation, the school provides education to more than 500 children in nearby villages. In Khumjung, we meet Laurie Mathews, project director of the Himalayan Dental Relief Project and organizer of our dental camp. Mathews and her dentist husband, Andrew, founded this nonprofit organization to
provide dental care to the children and families of Nepal and surrounding countries in Asia. They work in partnership with Balazs, who organizes groups of volunteers to work in their dental camps.
Laurie and Andrew are from Colorado but are based in Nepal six to eight months a year. There, they organize volunteer dental clinics in charity schools and orphanages in the Kathmandu valley and in schools in the remote villages of Nepal and India. In alliance with volunteers from Global Humanitarian Expeditions, they bring dental care to more than 2,500 children each year.

Our first clinic begins on a windy morning. As we walk to the clinic, we see the schoolyard filling with children accompanied by a parent or grandparent. School is out for the month-long Desain holiday, an exotic and colorful sight, so many of these groups walked two to five hours to reach the clinic today. A teacher devises a system for signing up and keeping track of patients. The dental camp is limited to the treatment of children, because we reach many of them in the time it takes to treat one adult with no previous dental care. The last few days, however, we hope to open the clinic to senior citizens and those in acute pain, and, of course, we plan to treat
our wonderful Sherpa crew and volunteer teachers.

This morning, we join several new volunteers at the clinic. Dr. Tom Grams, a dentist from Colorado, helps us prepare treatment plans for patients as we adapt to our new surroundings. He tells us to do as much work as possible on each child, because it may be his or her only access to dental care until our group returns in the future. We also meet Bimal and Rochak, two Nepali-trained dental assistants who prove invaluable over the coming days, and Raju, a 16-year-old orphan from Kathmandu who is fascinated with dentistry and assists in Mathews’ clinics whenever classes let out. Since our trip is during school holidays, Raju joins us for the trip of his lifetime. His impish sense of humor quickly makes him a favorite.

The dental camp is set in the school’s geography classroom and on the auditorium stage next door. We use beds from the school dormitory for patients. Dental workers sit on wooden stools, while mobile dental units, instruments, and supplies perch on desks covered in dental bibs.

The clinic contains many modern conveniences. Each dentist has a portable unit to perform amalgam restorations. Two units have venturi suction, but the rest are served by spit buckets tucked next to the bed. The two rooms have an amalgamator and a set of surgical instruments
for extractions. One lucky dentist has a headlight similar to those used in the most modern dental offices back home. The rest use hook-necked halogen lamps or, during the regular power failures, camping headlamps.

The clinics lack amenities we are used to in the United States. The toilet is in an outhouse behind the building. With no running water, we wash our hands using buckets with spigots and a basin below. We sterilize instruments in pressure cookers boiled over propane stoves in the schoolyard, tended by the loyal Sherpa crew.

Hygienists have one Cavitron to use on buildup in patients who have never seen a dentist. It operates with compressed air from a tank manually pumped by the Sherpa crew. The hygienists are the most popular visitors. Everyone — especially young bachelors — wants his teeth cleaned for the first time!

The days pass in a blur — a mixture of exhilaration and hard work. We see as many patients as possible each day— prioritizing those who need cleanings — with many more pressing at the door or peering in the windows. We fill and extract teeth, and spend time talking about oral health and the causes of decay. Each child receives a toothbrush donated by Colgate, along with instructions.

The children are the true highlight. They peek into the clinic to see the high-tech, glittering equipment and the masked, important-looking dentists and hygienists. Their mouths open in big grins from the moment their names are called. Afterwards, they are the center of attention as friends gather to discuss their experiences and, mostly, their injections. We are in awe of these children who accept injections and dental work with big smiles and murmured thank yous.

Every day brings unexpected challenges. On the second day, we split into teams and go to the village of Thami, two hours away. The hospital staff and teachers tell us we can reach another group of children who live beyond this village. We divide our equipment and supplies and send Dr. Frank Grimaldi and his team down the trail. The same day, the power fails and work is limited to cleanings and extractions in the soft glow of battery lamps. Patients stack up, and we are anxious to get back to work. Once the power is reinstated, we discover that it is too weak to support power handpieces on the dental units. Frustrated, we decide to move part of the clinic to a new location, spreading the demand on the power grid. This solution seems to work most of the time.

Our annex clinic, as we fondly call it, is in the home of a school parent who is also the town electrician. I get the best location of all — the hygiene station is set in a sunroom surrounded by windows, where patients gather to watch and comment on my work! The bright sun lifts the chill of the unheated room, and the smiling faces of children fill the windows as they peer in. Above their heads are views of magnificent mountain peaks.

On the rooftop of the world, I am having some of the best days of my life. Our backs are sore, our eyes feel strained, and we dream of hot showers and soft beds. Yet the immediacy of what we are doing and the vibrancy of these tough kids touches each of us deeply. It is wonderful work.

My personal high point is an evening hike we take to view the golden glow of sunset on the slopes of Mount Everest. At this incredible spot, my fellow volunteer, Dr. Bill Mulliken, drops to one knee and proposes. I am speechless and teary-eyed as I hug my new fiancée and know that life gets no better!

Our clinic lasts for six days, during which we see 442 patients, fill 298 teeth, extract 144 teeth, and provide 118 cleanings. The volunteer work exceeds $63,000 U.S. dollars.

We worry about the disturbing oral health of the children we see. Many have multiple problems that require extractions and fillings. This unusually high incidence of decay in Nepali children seems to result from the many sweets trekkers give them and which are now sold in the village stores.

On our last night, we meet with five members of the school’s Parent Committee. With the help of Rochak and Raju as translators, we discuss the need to limit sweets and change the children’s diets. Education seems to be the key, and the group is quite receptive.

We brainstorm ideas. Raju volunteers to have students at his school in Kathmandu make posters in Nepali about oral health to display in the Khumjung School. Parents agree to make toothbrushing part of the school activities to encourage compliance.

Volunteer doctors from Khunde Hospital, also operated by the Hillary Foundation, offer to do a school assembly on oral health once the children return to class. Our group of dental volunteers agrees to supply the school with fluoride pills. It is a productive, amazing cross-cultural exchange, and we leave the meeting encouraged and excited. All great things must end and so does this amazing experience. After six wonderful days in Khumjung, we load up the dzos, say heartfelt goodbyes to our many new friends, and head back down the trail to Lukla and Kathmandu.

As we walk, the children who were our patients wave and shout, “Goodbye, goodbye, goodbye!” Several even say, “Goodbye, Heidi.” It is a bittersweet moment. I will forever remember this adventure in Nepal and the warm smiles of the children of Khumjung!

Heidi A. Baier, RDH, practices dental hygiene in Mill Creek, Wash. She has a bachelor’s degree in communications with a minor in psychology from Washington State University. In 1997, she received an associate’s degree in dental hygiene. Ms. Baier serves on the board for Global Humanitarian Expeditions.

Dr. Bill and Heidi at Mount Everest
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