Face of Defense: Dentist Plays Vital Role in Afghanistan

By Air Force Airman 1st Class Tom Brading
American Forces Press Service

JOINT BASE CHARLESTON, S.C., Jan. 12, 2012 – In a remote valley of war-torn Afghanistan, an airman home- based here is playing a vital role enhancing the country's practice of dentistry.

Air Force Maj. (Dr.) Courtney Schapira is deployed to the medical embedded training team at Forward Operating Base Lightning as the chief dental advisor at Paktia Regional Military Hospital in Gardez, Afghanistan.

"Our team is made up of 21 medical advisers from different NATO countries," Schapira said. "We each have our own areas of expertise, such as internal medicine, nursing, pharmacy, etc."

Schapira deployed to Afghanistan in November and is the first and only dental adviser assigned there.

"The Afghan dentists that I work with are excited to have a U.S. dental advisor and are eager to learn from me," she said. "They are asking questions and taking the initiative to do things on their own."

Paktia Regional Military Hospital is an Afghan army facility that treats only Afghan soldiers, police and civilians with combat-related injuries. The standard of dental care in Afghanistan is much different from that in the United States, Schapira said, noting the clinic is not current with modern preventive dentistry.

Though the Afghan dentists are skilled and adequate at their profession, Schapira said, their techniques and materials and the thought processes behind their treatments are outdated.

"The dentists here used to rarely make patients numb prior to treatment," she said. "This is both painful for the patients and can turn what may be a single appointment in the U.S. into two or three appointments here, simply because the patients can only tolerate so much pain. Since my arrival, they now numb patients prior to any surgical procedure."

During her first few weeks in Afghanistan, Schapira said, she felt overwhelmed by the challenges facing her. Her efforts were divided in multiple directions. Supplies, broken equipment, outdated techniques, infection control and patient administration all needed her attention.

"I realized I couldn't improve everything at once," she said. "So I set goals for myself and for the clinic. After most of the equipment was modernized, I turned my focus to the supply inventory."

The 6-by-10-foot supply closet was full of unlabeled boxes filled with assorted dental supplies, Schapira said. It was overflowing with supplies, she added, and it was difficult for anyone to even walk in.

In addition, she said, she found the Afghans lacked a tracking system to monitor expiration dates or maintain inventories. "The disorganization made it very difficult to find any materials they actually have," she added.

Most of the supplies on hand were donated by various hospitals before Schapira arrived, but because the Afghans never had a dental advisor in the past, she said, the staff never was taught how to stock and inventory the materials.

Once she organizes the supplies, Schapira said, she'll be able to more accurately assess the clinic's real capabilities and needs.

"Organization has been our top priority," she said. "It has created a foundation for the clinic to grow. Now that everything is in order, training will become our top priority."

With most of the equipment now working properly and with the supply closet organized, Schapira said, she can start working more on infection control procedures, new dental techniques and patient administration.

"I've set the Afghan dental clinic up for success," she said. "I'm getting the clinic to reach its fullest potential. I have complete confidence in their capabilities."