Hundreds of smiles reward thousands of miles of travel
While many seasonal residents enjoy the Vineyard in August, the Brede family of Wellesley will be far from their Tisbury vacation home.
Dr. Ratnam Voggu and Lynne Voggu, at center, with the Brede family on their visit to India last summer. From left are Joshua, Ashley, Debra, and Ken Brede. Photos courtesy of Debra Brede
From August 13-26, dentist Kendrick (Ken) Brede, his wife Debra and their children, Joshua, 17, and Ashley, 15, will be in Hyderabad, India, working as volunteers in a dental clinic for orphans.
"So we'll miss the fireworks, the Ag Fair and the Obamas," Dr. Brede said. Instead, he and his family, joined by his office assistant Pam Allie, friend Bob Lindley, and students Suzy Kia and Robert Ang, will spend marathon days attending to the dental needs of 225 children, ages 3 to 17.
In addition to the challenging variety of their dental problems, about one-third of the children have tested positive for Human Immunodeficiency Virus (HIV) or have Acquired Immune Deficiency Syndrome (AIDS).
Dr. Brede gives one of his patients some tooth-brushing tips.
The children live in an orphanage run by executive director Lynne Voggu for Agape International, a non-profit organization dedicated to caring for orphans and families devastated by AIDS.
"Lynne was my wife's assistant and was like a sister to me," Dr. Brede said. "She got the call to do missionary work, and about five years ago asked if I would consider coming to the orphanage to volunteer my time as a dentist."
Ms. Voggu left her job at Ms. Brede's investment management company in Needham to start her first orphanage in India in 2000.
The orphanage in Hyderabad has four residences with up to 45 children each, and a central school building and central medical clinic. The orphanage's medical director is Ms. Voggu's husband, Dr. Ratnam Voggu, a pediatrician and ophthalmologist.
Each residence has a live-in staff of at least five adults, including a married couple that acts as "house parents." It costs $625 a year to sponsor an HIV-positive child at the orphanage and $325 to sponsor one who is HIV-free.
Because of the stigma attached to AIDS and the special precautions necessary because of infection risk, the orphanage needed its own clinic.
As Dr. Brede said, "You can't have an AIDS orphans' bus show up at local dental offices."
About three years ago before his first trip to the orphanage, Dr. Brede sent Ms. Voggu a check for $10,000.
Who let the dogs out? Children at the Agape International orphanage in India proudly wear their Black Dog T-shirts generously donated by the Douglas family, owners of the Black Dog company. Photos courtesy of Debra Brede
"I told her buy what you need, and we'll be there in November," he said. "And you know, U.S. dollars go a long way there. For $10,000, they equipped, basically, a full, enclosed dental clinic, with two chairs and lights, suctions, a sterilizer, and an air-conditioner, which is imperative for our work environment."
As a result, he added, "We've got pretty much, for a Third World place, a state-of the-art dental clinic with everything we need to accomplish most treatments, except for an x-ray machine."
Teaching HIV-positive children about better oral hygiene and treating their dental problems can help improve their overall health, Dr. Brede said. Many of them also start eating better once their teeth no longer hurt.
Encouraging progress, however, may be offset by heartbreaking losses. One child died of chickenpox on Dr. Brede's first visit to the orphanage. "And the thought of that in America, it just wouldn't exist," he said. "They can't vaccinate HIV-positive kids, so they're living on prayer."
Dr. Brede and his wife also serve on the board for Ms. Voggu's ministry. In addition to their donation for the dental clinic, Ms. Brede bought the orphanage a bus, a minivan to take smaller groups of children to the hospital for their AIDS medications, and computers.
Their upcoming trip to India will be Dr. Brede's third and their second as a family.
On his first trip in November 2007, Dr. Brede said he became aware that in India, people's teeth could be an indicator of caste, their hereditary social class in Hindu society.
"The thing that surprised me is so many of the rural kids have brown teeth from excess fluoride - it's called fluorosis," Dr. Brede said. Excess fluoride can occur naturally in well water or in water sources with run-off from mineral-rich soil, he explained.
"That's one of the things that distinguish different castes, because if you're from a rural, agricultural area and you have these brown spotted teeth, you're a lower caste person."
With that in mind, Dr. Brede brought bonding material with him on his next trip. "I did some cosmetic work to take kids with literally these shoe-leather brown front teeth and made them look normal again," he said. "They started to smile, and their whole demeanor changed. They moved up a caste by getting their teeth fixed."
Thinking of items to bring on their trip to the orphanage last August, Ms. Brede called the Black Dog Tavern and asked if the company might have a few children's tee-shirts to donate. Two days later, 225 shirts arrived in boxes at her office.
"I couldn't believe it," Dr. Brede said. "They were so generous. We sent them pictures of all the kids in their Black Dog shirts."
The shirts brought a few cultural differences to light, however. "It took a little selling, because a black dog isn't universally accepted as something positive in India," Dr. Brede said. "When we explained it to the kids, we had them singing, 'Who Let the Dogs Out?' and they got into it."
The girls were not allowed to wear the T-shirts out in public, but were happy to use them as nightshirts instead.
Both Joshua and Ashley put their time in India to good use. "Last summer my son did some filming and entered a documentary into the Wellesley High School film festival, and won first prize," Dr. Brede said. "It was a documentary fundraiser, basically, for the orphanage."
Ashley received training on infectious disease precautions in Dr. Brede's dental office in Needham before the trip so she could assist in the clinic. Keeping a watchful eye on the first day, she alerted her dad that a local oral surgeon he hired for extra help was not giving children enough Novocain and not waiting long enough for it to take effect.
Dr. Brede learned that the oral surgeon had been trained in a hospital where he was taught to work quickly because most of his cases were accident victims. "I had to pull him aside and say, look, in America, in my clinic my patients don't cry, and they're not going to cry in my clinic in India," he said. "I had to teach him how to give anesthesia properly and wait for it to work."
Dr. Brede also trained two 15-year-old girls in the orphanage to work in the clinic. Things got off to a rocky start when they arrived for their first day of work without shoes, an unsafe practice in an AIDS environment. "We had gloves, we had masks, we had eye protection, we had all that stuff - I just didn't think to bring an extra pair of shoes," he said. Last summer, however, he brought Crocs for everyone to wear as their "clinic shoes."
This time around, Dr. Brede does not plan to hire any extra local help. With a bigger crew, he plans to get all of the children through the clinic for dental exams and cleanings, as well as sealants, fluoride treatments, and extractions.
"With the group we've got going now, we can staff this clinic pretty much dawn to dusk," he said. "The plan is once the kids are done, to open it up to the staff, the teachers, the house parents, and then their families."
The Bredes and all of the dental team members are paying their own way and volunteering their time.
Mr. Ang, a graduate of McGill University in mechanical engineering, is a pre-dental student who has been interning in Dr. Brede's office. Ms. Kia currently is a dental student at McGill University Faculty of Dentistry in Montreal.
As an experienced Sunday School teacher well-versed in songs and games, Mr. Lindley's role will be to keep children in the waiting room entertained.
The dental team will pack all their supplies in suitcases and arrive ready to start in the clinic the next morning. Dr. Brede expects they will work seven ten-hour clinic days.
As an avid fisherman, Dr. Brede said the experience would provide him with good training in sleep deprivation in preparation for the Martha's Vineyard Striped Bass and Bluefish Derby. He has put in a lot of Island fishing time since he and his wife bought their home in Tisbury in 1991.
Dr. Brede also has donated his services as a dentist on trips to Brazil, Peru, and Africa with Bread of Compassion, a Christian mission associated with Celebration International Church in Wayland, which he attends.
"I'm hoping to get other dentists that are interested in going to India, because I need other teams to rotate in," Dr. Brede said. "I'm hoping they might send an assistant some year or a hygienist or come themselves."
For more information about the trips or to make a donation, contact Dr. Brede at 781-444-1505. Information about Agape International is available on the website agapeintl.org.
