Taken With the Need by Chelsea Knorr, Associate Editor, Dentaltown Magazine

In 1985, Mother Teresa herself asked Dr. Jeremiah Lowney to go help in the town of Jérémie, Haiti. “You don’t say no to Mother Teresa,” he said, “so I went.” Lowney, awarded with this year’s Humanitarian of the Year Award from the ADA, reflects back on what is now 30 years of humanitarian work in Jérémie, Haiti. Jérémie is home to 40,000 people and an additional 200,000 in the surrounding villages. Before Lowney, health care in the area was minimal.

Prior to Mother Teresa’s request, Pope John Paul II appealed to bishops in the first world to consider using some of their resources to help the poor in the third world. Bishop Daniel P. Reilly, the Roman Catholic Bishop of Norwich, Connecticut, asked Lowney and a group of nine others to go to Haiti, just to survey. “I’d never been to a third-world country before,” Lowney says. That week, Dr. Lowney set up a clinic in the courtyard at a home for the dying run by sisters of Mother Teresa, hundreds of patients came to visit him.

“After the week was up I was very taken with the need. I saw some of the most infected and diseased teeth I had ever seen. I asked if I could come back in three months. I went back to Haiti three months later and have gone back to Haiti every three months for 30 years.” Infected teeth may have been what initially attracted Lowney to Haiti, but the progress he sees is what keeps him coming back. “Jérémie is a small enough area that we can really see the fruits of our labor. We see progress,” Lowney says. Dr. Lowney established the Haitian Health Foundation (HHF) in 1982 to help alleviate the dental need, and has since expanded into many areas of health care.

Lowney had no shortage of schooling. He earned a liberal arts degree at Tufts College in Boston, Massachusetts, then went on to dental school at Temple University, graduating in 1961. Serving three years in the Navy led him to orthodontics at the State University of New York at Buffalo. In the 1990s, after more than a decade of work in Haiti, he returned to school part time to get his master’s in public health.

Lowney founded the HHF with a different philosophy than many charitable organizations. “We’re not looking to change the world,” Lowney says. “And I’ve never had a plan. If you look at the spectrum of problems, you might as well just pack up and go home. They’re overwhelming. So we just take one person at a time and pretty soon you’ve helped a family, then a village, then five villages…” Lowney’s now-established medical teams rotate through the many villages of Jérémie. HHF has an outpatient medical clinic that sees about 400 patients a day, and a dental clinic that treats around 20 per day.

In the dental sector, the most common dental problems are caries and periodontal disease. “We usually treat adult perio with a pair of forceps because if we take the tooth out, the perio goes away,” says Lowney. He adds that many patients have just stubs or roots and many of them come in with severe infections because they don’t know not to put heat on the outside of their face when they have a toothache. Luckily, the clinic is able to treat patients who come in with very serious life-threatening infections by inserting drains and prescribing antibiotics. The clinic hired Haitian doctor, Marie Ramlyne Cherilus – better known to patients as Dr. Ramlyne – three years ago. Lowney comments on her eagerness to learn from other volunteer dentists who come to Jérémie. “She and I try to limit her practice to children between three and 16 because if you start getting into adults, you could spend a week on one patient,” Lowney says. Ramlyne spends much of her time performing fluoride and hygiene treatments on children. She gives them toothbrushes and teaches them prevention techniques.

The clinic is able to perform a range of procedures, but can’t offer prosthetics. He notes, there is a young dentist in town who does offer prosthetics and who is trying to make a living. Lowney says it is very hard for a dentist to make a living in private practice in Haiti, so the clinic doesn’t take any patients who look like they could afford to go see a private dentist. “In every society there are the ‘freeloaders,’” he says. “And when we see them we refer them to the doctor in town.”

Extractions are by far the most widely practiced procedure by the clinic. Lowney calls charitable dentistry “crude dentistry” because it often results in extractions, one of the differences between practicing in a third-world country and practicing in the first world. For a long time, Jérémie didn’t have access to X-rays or other diagnostic tools, so they would just take teeth out. This is how most dentistry problems in third-world counties are dealt with. “It upset me terribly when a pretty 14-year-old girl would come up to me with caries in her two central incisors and the only thing I could offer her was the extraction of her front teeth,” he says. Now, with Dr. Ramlyne on staff, Lowney can write a referral and Dr. Ramlyne can perform a root canal. “Now we don’t have to remove the teeth!”

In noting other differences between charitable and non-charitable dentistry, he adds, “and, of course, with non-charitable dentistry I guess you get paid.” But this seems only an afterthought for Lowney.

Lowney doesn’t take a salary, and he and his wife have personally given around a half a million dollars over the lifetime of the foundation. But money for the foundation is a struggle to come by. “I have to raise $4 million this year,” he says. HHF operates on only eight percent overhead and has been rated on CharityNavigator.org with a four-star (the best) rating for five years in a row – a feat that only four percent of charities that it evaluates can claim. Lowney says 70 percent of donations come from individuals, 30 percent from foundations, civic clubs and church groups.

It didn’t take Lowney long to realize Haiti’s lack of health care beyond just dental needs. “It was a terrible situation. It was obvious that these people needed more than just dental care, so I branched out,” he says. HHF opened the first outpatient medical clinic in the area in 1987, now they can perform everything from optical exams to sonograms, and is the only facility in the area that can do so. Now, the Haitian Health Foundation runs the Center of Hope and has developed a public health network that practices the “Chinese Barefoot Doctor” model, where residents from villages are trained and act as health agents for their village. HHF’s work extends into house building projects and animal distribution.

The two most vulnerable types of people in any population are perinatal women and children at risk. To meet the need for these two groups, HHF built an inpatient facility called the Center for Hope.

Many of the villages are an 18- to 20-hour walk from Jérémie’s health facilities, so when these pregnant women would come to term or have an emergency, they would start to walk in to seek help or medical care and many would die on the road, or lose the child on the way. With the Center for Hope, HHF can identify these women and bring them to the clinic before they come to term. The center has 50 beds designated for this purpose.

The other 25 beds in the clinic are designated for children at risk. Children at risk usually have one of two issues – poor hygiene or poor nutrition, and in some cases, have both. Protein disorders like kwashiorkor and marasmus are common for children in Haiti since their diets consist of high-starch foods, or, in some cases, no food at all. “Too often we see children who eat mud out of the rivers because their hunger pangs are so bad, so they fill their bellies with mud to get temporary relief,” Lowney says.

Brendon, a Haitian baby, came into the Center of Hope severely malnourished. Lowney says he looked like F. Scott Fitzgerald’s Benjamin Button, the baby who was born looking old and wrinkled. The nurses didn’t think he was going to live the night, but he did, and then he lived the next night. At the end of the week, he was still there. “I went back three months later and Brendon was being discharged and he looked like a million bucks,” says Lowney.

HHF has established a whole public health network based on the Chinese Barefoot Doctor model. When you have a billion people – like in China – in order to get health care out to rural areas, you take a capable person out of a village, who has the ability to work and you train him or her for a year to become a health agent. HHF practices this and sends the trained patrons back into their villages. “We pay them and they become the medical care for that village,” Lowney explains. Health agents trained by HHF have immunized about 200,000 children against all the “usual” childhood diseases. In fact, they have a higher rate of immunization for children ages one to five than most U.S. states do. Health agents are taught how to deal with most of the ailments for that area and each agent is responsible for 4,000 to 5,000 people. They call the ambulances when needed and also let villagers know when a clinic rotation will be in town.

Not only does the Haitian Health Foundation depend on money to stay afloat, they also depend on donations. Every year Lowney sends four 40-foot containers to Jérémie. It costs $10,000 to ship a container from Connecticut (the location of the HHF headquarters) to Jérémie, so they put only the most useful supplies aboard. These specifically include tuna in oil and Spam, for the animal fat content. “Spam is the world’s worst food,” Lowney says, laughing. “It’s full of fat and salt. But these people need fat and salt because they’re eating mostly starches like corn and rice and bread.” The tuna in oil also helps children’s development due to the Lysine.

The HHF is feeding 1,100 kids a hot meal at school each day and feeding hundreds in the villages every day. In order to keep costs down, HHF buys products at wholesale and does a lot of negotiating. They also accept donations from church groups or civic club drives.

Aside from building all of the clinics, HHF has built a residence for the volunteers who come to help. HHF gets volunteers from Temple University and University of Connecticut, among others. There are two types of volunteers – short-term volunteers who stay between one and two weeks, and long-term volunteers who commit two years. Ninety percent of volunteers are short-term.

Animal distribution has become a large part of HHF’s outreach. Lowney and his team replaced all of the pigs in their part of Haiti that were lost to the peasants by the swine flu that struck in the early ’70s. They replaced 8,000 sows, and have been giving out goats and chickens for years.

Lowney believes in people reaching beyond themselves. “I believe we are all stewards of the gifts that we’ve been given, stewards of our professional gifts, talents and financial gifts. As a steward, we are responsible to share these. I’m not talking about everyone going to Haiti or going to Africa, but there are certain things people can do in their own areas. There is a joy that you experience when you reach out and help others. Those who can’t work with the poor, broken or the disabled, should support those who are.”

Right now, Dr. Lowney does mostly administrative work. He makes trips back to Haiti every three months for a week or two at a time, and works with the administrator and the director of finance to ensure they stay as close to their budget as possible and everything is running smoothly. Before Lowney retired, he worked at a practice in Connecticut, which his daughter now runs. When he takes the occasional break, he enjoys traveling with his wife and children. He also enjoys spending time with his 10 grandchildren. “I don’t play golf,” Lowney comments, contradicting the stereotype often held about dentists’ out-of-office activities. But then again, Lowney isn’t your average dentist.

“When I was in college we used to have to take the Kudor aptitude test. Everybody had to take it,” Lowney says. “I got called into the counseling office. The counselor said my aptitude was for animal husbandry and ministry.” Lowney laughed. He was working toward his pre-dent requirements adding, “I wasn’t going to church and I don’t even like cats!” But as he reflects back, he says there was something deep in his psyche even then that led him toward Haiti, since, it seems, animal husbandry and ministry are exactly how he has spent his life’s work.

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