Tufts University

River of Hope

Daniel LeeDaniel Lee serves as an emissary of health - and hope - in one of Europeís poorest nations

Though many would argue that the United States still has a long way to go in caring for and accommodating its disabled citizens, we take for granted our rows of handicap-accessible parking, our equal-opportunity laws, our emerging lexicon of sensitivity. Which is why Daniel W. Lee - a 1978 graduate of Tufts School of Dental Medicine - was so shocked by the conditions he encountered on his first dental outreach mission in the former Soviet republic of Moldova: Physically handicapped patients shared chaotic wards with the mentally ill. Many had no blankets and shared filthy, stinking mattresses on the floor. They received minimal medical treatment, no psychiatric help and little stimulation or human contact.

"In the clinic we visited," he recounts, "I saw a girl with an infected cleft palate. I gave her some amoxicillin and told her to take it four times a day - breakfast, lunch, dinner and bedtime. But at the end of the day, the interpreter told me she didnít understand." He pauses, shaking his head. "They only get one meal a day. I was really crying!" he continues. "How could I be so insensitive? This is something I will never forget. Never."

The orphanages Lee visits as part of the Moldova Dental Team sponsored by Grace Chapel, a nondenominational evangelical church he attends near his home in Lexington, Mass., are not much better.

Though Lee seems almost overwhelmed when asked to describe conditions in the childrenís institutions, David Jebaratnam, Grace Chapelís director of missions, brings home the stark realities: "There are one or two government workers caring for 400 or 500 kids. In winter, itís colder than it is here, and they have no heat. The food is not nutritionally balanced or healthy. I have no doubt that they go hungry sometimes." The childrenís mattresses, too, are dirty and bug-ridden; there is little medical help, and as for counseling, homework assistance and structured play time, Jebaratnam says there is "absolutely none available."

What is available, he adds, is discipline. "These kids are punished by being beaten," Jebaratnam continues. "And here they are without parents. You really feel for them."

Moldova, which is about the size of Maryland, consistently ranks among the poorest countries in Europe, with a per-capita income of about $300. With 85 percent of the population living below the poverty line, alcoholism, drug addiction, domestic violence, prostitution and divorce are rampant. According to the international relief organization Save the Children, about 14,000 Moldovan youngsters have lost both parents; but up to twice that number spend winters institutionalized and summers working on their family farms - if theyíre lucky.

"Not all the orphans are orphans in the American sense," Lee says. "But, like in Romania and many other former Soviet states, the parents donít have any financial resources. There is much more freedom, but the factory buildings are deserted. Because there are no jobs, the men go elsewhere to work, and the women have to survive in their absence."

Though Grace Chapel had been working since 1990 with the orphanage ministry Little Samaritans and the Jesus Savior Church in Chisinau, Moldovaís capital city, it wasnít until 1997 that the urgent need for dental care became clear. When Lee - who had done similar work in Chinaís impoverished Yunnan Province - heard about Moldovaís hardships, he quickly volunteered as the chapelís primary emissary for oral health.

Daniel Lee

"Not all the orphans are orphans in the American sense," Lee says. "But, like in Romania and many other former Soviet states, the parents donít have any financial resources. There is much more freedom, but the factory buildings are deserted. Because there are no jobs, the men go elsewhere to work, and the women have to survive in their absence."

Triage, then care

Each year, usually in April or May, Lee travels halfway across the world with a team that includes hygienist Pat Jacobsen; dental assistant Cindy Nigro; Jenny Deng, the assistant at Leeís Chinatown dental practice; and three Bible teachers, including 18-year-old Dan Lee Jr., who has accompanied his father four years in a row.

With 50 or 60 children to see in each of the two orphanages visited every day, the first order of business is triage, in which Lee specializes as a clinical faculty member at Tufts School of Dental Medicine. Each of the children receives a colored sticker in the shape of a smiling tooth: green for cleaning, red for extraction, blue for restoration and yellow - meaning "good checkup" and a gift of a toothbrush and fluoridated toothpaste - that every kid hopes for but few receive. Those who need work done then line up, four to a bench, and lean their heads against the wall for their Novocain shots.

Once the anesthetic takes hold, Lee sets about his work with a jury-rigged system that is worlds away from his gleaming modern office back home.

In place of his high-wattage tilting operatory light, for instance, Lee straps on a spelunkerís headlamp that he picked up for a few bucks at a discount store. The tiny spotlight is especially important when there is no electricity. "Sometimes the village weíre in just doesnít turn it on," he says. He assumes a back-breaking position over the patient, who may be reclining in a $12 folding beach chair with his feet held aloft by an assistant as the headrest is propped on Leeís knee. Or perhaps, particularly in the case of the handicapped clients, the patient is lying on the floor, sitting in a wheelchair or braced by the strong chest or outstretched arms of one of Leeís associates.

The exigencies of traveling rugged terrain to the far countryside and the shoestring budget of the church ministry make it impractical to carry a mobile dental unit, which can weigh around 50 pounds and cost upwards of $6,000. Without the proper equipment, however, it would be impossible to do anything but extractions. So, necessity being the mother of invention, Lee constructed a scaled-down version of the modular components sold in catalogs. Tipping the scales at 11 pounds, it contains a drill, a compressor and a hookup to a small plastic jug from which a hand pump draws water. Everything fits into a sleek metal cosmetic case the dentist purchased at his local drug store.

Because time is so tight, each child receives only one 15-minute procedure, despite the rampant decay Lee often sees. He tries, of course, to save as many teeth as possible, but still feels that his efforts are a raindrop in a river of need.

"It can be fairly depressing because of the constraints," he says. "In one sense, I say Iím blessed to be able to do all this, but what Iíve learned is that Iím still limited. You can go to Moldova, but can you go to Africa? Can you go to China? Iím learning to rely on the strength from above that allows me to continue, even though I donít see the results of our work."

The human touch

While the dental team takes care of physical needs, the other Grace Chapel missionaries tend to the spiritual, conducting what the church calls a "mini-VBS," or Vacation Bible School, consisting of sports, crafts and Bible stories told through a translator.

Prior to Communist rule, Moldova was overwhelmingly Christian, with 98 percent of the population calling itself Eastern Orthodox. Though the Soviets demolished or converted most churches and monasteries, many Moldovans secretly held onto their beliefs and kept alive the rites of their ancestors. When the country declared its independence following the 1991 coup that eventually unseated Soviet leader Mikhail Gorbachev, many began to openly affirm their hidden devotion.

"Weíre not there to convert them," says Lee, who was raised a Christian in his native Hong Kong. "Weíre just there to remind them. Most Orthodox havenít read the Bible; they were fed religion or, under Communism, fed atheism. We believe you can have your own personal relationship with God."

That personal relationship is what fuels Leeís passion to help. "I donít want to be overly religious," he says, "but in this world, there are so many miserable things, you need a way to deal with your problems. I tell the children, ĎYeah, you have me now, but over the winter, you have to rely on strength from above to get through your pain. Thatís what I do.í Weíre not there to preach, per se. Itís the relationship, the sharing. When people are in need, we want to show weíre there to help. And fortunately, weíre in a position where we can help."

The children, however, are not the only ones to benefit from the exchange. The younger Dan Lee has learned, he says, "to value the stuff I have here more." A pharmacy-tech student at Bunker Hill Community College, Dan teaches the Moldovan children to play kickball, football and soccer. He brings them jump-ropes and hula hoops, shows them how to make origami bunnies and plays violin to sooth them as his father does his work. In trade, he has felt the kind of gratitude few American children would bestow on him: "The kids are so friendly," he says. "They run right up and hug you. At first, I thought that was kind of weird, but..."

"A Russian guy kissed me one day after church!" his father interrupts. "That was startling!"

"The reward," he adds, "is not a check from Delta Dental. Itís the human contact."

Profile by Elizabeth Gehrman.

This story originally appeared in the Winter issue of Tufts Dental Medicine. Photos of Dr. Lee by Mark Ostow. Moldova photos courtesy of Daniel W. Lee.

This story originally ran on March 21, 2005