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Civilian Health Care Workers Sign Up For Humanitarian Service Overseas

Dr. Irvin B. Silverstein, a La Mesa-based periodontist, as well as dental director and adviser for the UC San Diego School of Medicine, is a man possessed.

It began a few years back when he was asked to speak to a group of students on periodontal disease. As it happened, these students also supported a free clinic in Pacific Beach and needed an adviser.

“It was the biggest mistake of my life,” Silverstein joked. “It was supposed to be a four-hour lecture.”

Instead, Silverstein ended up visiting the clinic and found “utter chaos and disaster and nothing getting done.” Since then, he has devoted countless hours to providing free dental services to San Diego’s under-served communities, as well as signing on with the military for a humanitarian mission abroad.

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Some history: About three years ago, Silverstein had been invited on a tour of the Navy’s USS Ronald Reagan and USNS Mercy hospital ship to encourage the pre-dental students to enlist. He was impressed by what he saw and floated an idea: His pre-dental students could volunteer for humanitarian missions and find out for themselves about Navy life.

“I was kind of joking, but I put it out there,” he said.

But, he later got a call from the head of the medical fleet, inviting Silverstein and a group of his students to volunteer on the Mercy for a mission that included stops in Bangladesh, Indonesia, the Philippines, Singapore and the island of Timor.

“My students outshined themselves,” said Silverstein. “The Navy got great kids, who helped them with X-rays and emergencies and were put in all types of situations.”

One-third of them, he added, decided to apply for military scholarships.

“The students got a wonderful experience and a lot of them changed their idea of how the military functions , the good side of diplomacy,” he said.

Silverstein recalled that, “When we arrived in Bangladesh, they were not very pro-U.S. when we arrived. By the time we left, they wanted us to come back. It was a great partnership.”

Other participants on the Mercy were Operation Smile, which worked on cleft lip and cleft palate repair, Project Hope and Aloha Medical Mission, as well as doctors from Canada and several Southeast Asian countries.


Mission Of Mercy

The students had to pay their own way, ranging from $1,000 to $1,400 each, but no one was complaining.

Consider Kristen Whetsell, a UCSD senior now busy applying to dental schools, who was among those pre-dental students assisting on the Mercy mission and volunteering at the program’s three free dental clinics. In addition to the Pacific Beach facility at the United Methodist Church on Thomas Avenue, there are two others , one at Baker Elementary School on T Street and one at the First Lutheran Church on Third Avenue, both in the San Diego area.

“It was an incredible experience,” said the Del Mar resident and longtime volunteer at the program’s three free dental clinics. “There were so many different teams. It was really very cool to see how the civilians and the military came together and contributed. They wanted to build ties across the world with these nations and organizations. It was a very successful mission.”

It left a mark.

“The culture over there is so different,” said Whetsell. “People have so little. They don’t have anything in comparison to our standards. We aren’t satisfied unless we have the biggest iPod.”

Now, said Whetsell, when she becomes a dentist she will always be available to lend a hand.

“I have fallen in love with this and will do this forever,” she said. “I don’t think I could feel complete if I’m not doing things like that.”

This year, eight pre-dental students from UCSD signed on for a four-month mission on board the USS Peleliu, which returned to its San Diego home port Sept. 20. Medical and dental care was provided in Papua New Guinea, the Philippines, Solomon Islands, Vietnam and the Republic of the Marshall Islands. The Naval Construction Force’s Seabees also were on hand to build critical medical and community facilities.

Aspiring dentist Diana Lin, in her final year at UCSD, where she is taking courses for a minor in public service, recalled her time on the Peleliu as “an amazing experience.”

“I went to places that I never imagined going to,” she said. “I never knew the Marshall Islands even existed. It’s amazing that we were able to help people in a world that is so untouched. The people that I met were the most appreciative people I have ever encountered.”

Lin, who also volunteers at the free clinics, said the experience will be helpful in her future dental career.

“Every day I was assisting and getting a lot out of it , the different procedures and instruments, and working with so many doctors,” said the La Jolla resident. “It gives you a perspective of the work that I hope to be doing. I feel really lucky to have been chosen to go on that trip. I learned that I like giving back to the community and traveling abroad and seeing what I can do out there.”


Giving Back

Silverstein is proud of his prot & #233;g & #233;s.

“I created in them the need to be able to help their fellow human beings,” he said. “They will make very good livings, but they also can donate their time to help people in need.”

On the home front, Silverstein and the program’s founder, Dr. Ellen Beck, serve as faculty advisers to the UCSD Student-Run Free Clinic Project.

“It’s a unique model,” said Silverstein. “People are looking at us all over the United States.”

The program, which was recognized with the American Dental Association’s 2005 Golden Apple Award, draws on pre-dental students to help run and manage the clinics under the auspices of about 60 licensed dentists in San Diego who provide the primary care.

The students who participate in the free clinics get training as dental assistants and X-ray technicians, and attend weekly workshops to learn about the different fields of dentistry, along with the intricacies of being accepted by a dental school.

The training that the students get at the clinics and the humanitarian missions have translated to high acceptance rates at the highly selective U.S. dental schools, said Silverstein.

“The neat thing about it is watching these kids,” he said. “They have such a passion. They put in 20 to 30 hours a week, in addition to a heavy course load.”

Silverstein spends quite a bit of his time writing grant applications, and has secured some funding, along with donations from dental supply companies and assorted patrons. But, he said, “We need somebody to adopt us. I could do so much more good, but I can’t expand it.”

Financial angels will have to forgo conventional naming rights, though.

“Instead of naming buildings, I’d like to name patients, and have a living testament, instead of in stone,” said Silverstein.


Saving Lives

Good dental health goes beyond having a pearly white smile, said Silverstein.

“If you don’t have good dental work, you don’t have good health,” he said. “It saves a lot of lives and a lot of agony. A lot of people think that dentistry is a luxury, but it affects our ability to think and work. It affects our internal organs, and women who are pregnant have more chance for preterm babies. There is a huge population in the United States who are under-served, and even here in San Diego with its affluent community.”

El Cajon dentist Sussi Yamaguchi, one of Silverstein’s former students, helps run the free clinics, and serves as the program’s first dental fellow.

“I think that it’s wonderful, giving back to the community,” said the Hillcrest resident.

While Yamaguchi hasn’t yet served on one of the ships, it is her goal one day to participate in one of the humanitarian missions.

“We have such special skills that only a certain percentage of people in the world have, and there are so many people who are under-served,” she said. “They deserve this dental care and don’t have the means and access to it.”

The tsunami that hit Indonesia and surrounding areas in 2004 spurred a new era of medical humanitarian aid, with civilian medical personnel joining with military efforts. In January 2005, the USNS Mercy was dispatched to the Indian Ocean to aid the tsunami victims.

During that period, Rear Adm. Christine S. Hunter, now commander, Navy Medicine West/Naval Medical Center San Diego, was serving as chief of staff at the Bureau of Medicine and Surgery in Washington, D.C., organizing support for relief missions. That effort included tapping civilian resources.

“If we were going to send a big ship like the Mercy, we wanted to take advantage of all of our resources,” said Hunter.

It was new territory.

“We hadn’t done that on a large-scale basis, and didn’t have the pathway for making arrangements for taking civilians on ships,” she recalled. “But, there were so many countries affected that we determined that a longer term, large-scale relief effort would be appropriate. The military looked at that as an opportunity for us to assist the nations in need and help them with economic recovery.”

Helping Third World countries through hard times like these, she said, contributes to a more stable future, “so they don’t lapse into civil unrest.”

“We wanted to reach out a hand of friendship,” said Hunter.


Sharing Skills

The Department of Defense was open to this collaboration with so-called “nongovernmental organizations,” or NGOs, she said.

“NGOs often have unique expertise, in different ways than we think of military and combat care,” she said. “It was an attractive opportunity and expands our ability to help. We wanted to be able to respond to this overwhelming disaster.”

In order to help this military/civilian collaboration, a memorandum of understanding was developed, covering everything from chain of command to liability coverage.

“It was all worked out over a period of just a few days,” said Hunter. “We went ahead with the first tsunami relief mission, and it turned out to be a great success. Our skill sets were complementary.”

And some gaps were filled.

“We in the Navy don’t have veterinarians,” Hunter observed. “This is a big issue, because many countries rely on animals.”

Overall, she added, “We learned from each other. People shared their skills and knowledge. We saw many types of diseases that you don’t see in the West, such as tsunami lung from inhaling seawater. We made contributions to the world’s medical literature. It was a very positive collaboration, and it was recognized up to the level of the White House. This allowed Americans to extend the hand of friendship and take advantage of all our resources.”

While these humanitarian efforts began as emergency relief missions, these days there is greater focus on providing medical care to under-served native populations , everything from major surgeries to making eyeglasses, said Hunter.

Based on what was learned from the recent Mercy and Peleliu missions, the military will continue to plan humanitarian trips, said Hunter. As for any potential danger that the civilians might face, risk assessments are done beforehand to keep them out of harm’s way. Once on board, medical personnel are given shipboard training.

“We can create a safety net around them,” she said. “We were initially concerned about levels of fitness, because there are no elevators. We were pleased to find that the types of people who volunteer know they are going into more austere conditions than they find in civilian hospitals. They tend to be those who are fit and more vigorous.”

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