Dentistry in Africa

Dentistry in Africa

Local father-daughter duo fix teeth in Jewish Ugandan village

Dr. Robert Grunstein and his daughter Kayla with a young patient in Uganda.


Kayla Grunstein’s parents, Shira and Dr. Robert Grunstein, didn’t want her to “be a brat,” Kayla said.

They wanted her to learn something about the world and her place in it, about the importance of work and the satisfaction of a job well done, about gratitude and generosity and giving.

They also were not adverse to allowing the 14-year-old some excitement and adventure at the same time.

In fact, a lot of excitement and adventure. With the Abayudaya in Uganda.

This is how it happened.

Her father, Dr. Robert Grunstein, is a dentist. He lives in Teaneck but has spent his career working mainly with lower-income children in Passaic and Paterson. He had the brilliant idea (yes, this is journalism, but some things are so clear that they just must be said, so brilliant idea it is) of buying an old fire truck and turning it into a mobile dental office. “Kids love fire trucks, and they are ambivalent at best about going to the dentist,” he said. “If you mix the two, it becomes more palatable. Kids love coming on the fire truck, so they will open their mouths and let me look inside because that is the price of being in a fire truck.”

Once he has made the preliminary on-the-truck assessment, he can talk to the child’s parents, and if necessary do dental work in a more conventional office.

How do you buy a fire truck? You go on eBay. “They’re very cheap,” Dr. Grunstein said. His was excessed by Newton’s fire department, and cost just $5,000; on the other hand, “it cost over $50,000 to retrofit it to make it useful,” he said.

Also, he said, it is hard to park. “I had to get a tractor-trailer driver’s license. It is 35 feet long, almost eight feet wide, 38,000 pounds, and I can’t tell you how many times I knocked down the driveway gate with it.

“It’s fun to ride on in parades,” he added. “We stand on top, blast music, and when everyone else throws candy, we throw toothbrushes.”

From the time she was 11, Kayla has spent time in her father’s office; the first year, she shadowed him. “I looked at everything, and I enjoyed it,” she said. Since then, “I have been going back to his office for summers and winter breaks, and I do whatever a normal dental assistant would do,” she said. “I suction, I clean instruments, I help calm the patient.” You do not need a license or specialized training to do these tasks, she added. (Her younger siblings, Liel and Judah, will do the same things when they are old enough.)

Dr. Grunstein is very serious about his need to give back. He has gone on dental missions “for five or six years, to Peru, Guatemala, and a bunch of countries all over South America,” Kayla said. The trips, which he undertakes as a volunteer, have been organized by a New Jersey-based group called KinderSmile.

In the last two years, Kayla accompanied her father on similar trips, closer to home – one was in Kentucky and one in Virginia – and well as to Nicaragua. A video from one of those trips and a Facebook tag brought him to a retired dentist, David Abromovitz, who often volunteers in Uganda, and that connection eventually brought the pair to another dental trip, this one to Jews. In Uganda.

The Abayudaya people converted to Judaism in the early twentieth century, and have lived as Jews ever since.

The Abayudaya (the name is said to mean “the Jews” in Luganda, a local language) are not a long-lost tribe, people whose storied ancestry begins with King Solomon, say, or the Northern Kingdom. Instead, they became Jews because of their leader, Semei Kakangulu, an early-20th-century warrior who converted to Christianity in order to win favor with the British and become king of at least part of Uganda.

When that didn’t work, at least according to legend, he shed Christianity for Judaism, and that conversion stuck. The community grew, and sporadic contact with the Jewish world gave it the background that until it had lacked. In the 1970s, the despot Idi Amin, the murderous strongman who was responsible for his country’s debacle at Entebbe, outlawed Judaism. But the Abayudaya outlasted Amin, and today their numbers are back up.

Only their religion differentiates them from their Christian and Muslim neighbors; they are mainly subsistence farmers in a lush, spectacularly beautiful but impoverished countryside, in a country that is at least so far unaffected by the Islamism that is rampant and violent in next-door Kenya. (“The Ugandans are a lot less militant in personality than the Kenyans are,” Dr. Grunstein said; many Kenyans belong to the warrior Masai tribe, he added.)

So just before Pesach, Kayla and Robert Grunstein went to Uganda. “The kids would be lined up outside by grade, and we would put them into groups,” Kayla said. That triage work ensured that they would see the children most in need of dental work – “some of them in massive pain” – and get to the ones who needed little attention later. The children came from miles around; not all were Jewish. The Grunsteins and another dentist saw everyone.

Communication wasn’t difficult. “Most of the older kids knew English very well,” Kayla said; that is because “English is Uganda’s official language,” her father added. That is because Uganda, like India, has so many tribal languages that it was necessary to import one that would begin as equally foreign and could become equally familiar to everyone.

“We were there for 10 days,” Kayla said. “It took us one day to get to the plane and one to get back. We did three days of dentistry, half a day to set up and half a day to clean up, and one day at a tourist place, Sipi Falls.” And then there was Shabbat.

“It really is a privilege to go on these trips with my father,” Kayla, who is an eighth- grader at Yeshivat Noam and will begin high school at Frisch next year, said. “I get to see things in real life that I ordinarily would see only in a textbook in school.

“They are eye-opening things.

“I met this girl, named Binah – everyone has Jewish names – and she took me to her school. We were talking and talking and getting to know each other, and I’m like, ‘Do you ever miss things? All these thing that you see in magazines or in movies? Do you see things you want?’

“And she’s like, ‘No, I am so happy.’ And I was thinking to myself that I always want more, but they are happy with what they have.

“I was asking her questions – they are such happy and welcoming people. We were walking around and everyone was saying hi to us, even though they had no idea who I was. They were giving us hugs. The kids were surrounding me.”

The town may be poor in many material things, but not in the ability to use social networking. “They love it,” Kayla said. “Someone donated 20 computers to their shul, so they have computers. Dells. And they have wifi. It isn’t the best wifi – it is very slow – but they have it. And they all have Facebook, and I’m Facebook friends with them.”

“They might not have reliable electricity or safe drinking water, but they have wifi because it comes from a mobile hotspot,” Dr. Grunstein said wryly.

“Yes, and every time the rabbi leaves, he takes the hotspot with him,” Kayla added.

“There would be a power outage, but their wifi was okay, my phone had power, and we’re all sitting there by the light of the phone,” her father recalled.

Shabbat was in many ways similar to Shabbat at home, but not in all ways, the Grunsteins said.

Dr. Grunstein wanted to sponsor a village kiddush, he said. He asked what to bring, and he was told a goat would be good. He brought two of them.

“We were sitting around on Friday afternoon, and the rabbi said, ‘Do you want to see the schechting of the goat?'” Kayla said. (Schechting is performing ritual slaughter.) “So we all huddle around a tree and someone brings in a goat, and I’m like, ‘What?’ Because I don’t walk into a store and see this.’

“The kids huddled around the tree like it was a show.” It is unusual for them to have meat, her father explained; that would happen only occasionally, on Shabbat afternoon, particularly if a guest like Dr. Grunstein brings them a goat. “They usually have only carbs – rice, beans, mango, sugar cane,” he said.

“At first I was a little scared, because I am watching a goat die in front of my face,” Kayla said. “And then it got skinned. It was all bloody. There were two goats – the second time it wasn’t as scary to watch, but it was an amazing experience.

“We watched a goat get schechted, and then I ate the meat an hour later.”

The meat they ate, her father clarified, was a small chunk, barbecued just for them. The rest of it was made into chulent for lunch the next day. Chulent? That seems very Askenazi – but, as Dr. Grunstein said, they adopted Judaism, with many customs intact. “When they imported Judaism, they imported chulent,” he said.

Kayla isn’t sure if she wants to be a dentist when she grows up, but if she does, she will have come by it naturally. Her grandmother is a dental technician, and her aunt, like her father, is a dentist. “I enjoy dentistry,” she said. “And I love helping people.

“It is such a rewarding experience. And even in my father’s practice here, in New Jersey, there are kids who don’t have a ton of money, or who are poor. Even in America, there still are people who need help.”

Dr. Grunstein said that he is gratified by being able to help people. “It’s what I do,” he said. He was drawn to inner-city dentistry because “I saw a huge underserved population that was sorely in need of care.

“So much of dentistry is about making good-looking people a little better looking. That never interested me. I wanted to be involved in health care, and this is basic bread-and-butter health care. That makes me feel good as a doctor.”

His clientele’s parents are just one generation removed from the patients he sees on his Latin American trips, he said. “They literally come from the same countries – Guatemala, Nicaragua, the Dominican Republic.”

But this last trip was new for him, just as it was for Kayla. It was the first time he had worked with underserved African Jews.

“I never before saw a mezuzah on a mud hut,” he said. “I have seen a lot of mezuzot. I have entered a lot of Jewish homes. But I have never seen a mezuzah on a mud hut.” The first hut he saw was “not wider than 10 feet, probably 5 by 10 feet.”

Not only is the village poor, its people are not healthy, he said. “There is a huge amount of malaria. People suffer from all sorts of preventable diseases – but in Africa, that is a way of life.”

The village has a Jewish school, he added. “The Hadassah School. They all learn parashat hashavuah, and they know some Hebrew. They are proudly Jewish, and they coexist with the Christian and the Islamic school down the street.” It is a boarding school; even very young children are sent there, if their parents can afford it, because a school – any school, much less a Jewish one – is a rare commodity.

The community is known for its music; in fact, in 2005 one of its two CDs, Abayudaya: Music from the Jewish People of Uganda, was nominated for a Grammy in the traditional world music category. (It lost to Ladysmith Black Mambazo.)

The synagogue’s rabbi, Gershom Sizomu, was ordained at the Conservative movement’s Ziegler School of Rabbinic Studies in Los Angeles in 2008; he was the first black rabbi from sub-Saharan African to have American smicha. He grew up in the Abayudaya community; despite many people’s assumption that he and his family would not return to the village once they had lived in the West and knew what they were giving up, they came back.

Men and women sit separately at the village shul, but services are egalitarian – both men and women are counted, and women, like men, can read Torah.

Shabbat comes with a sense of occasion, Dr. Grunstein said. “People wear the same outfits every day, and they are very dirty. You can’t imagine that they are the same people on Shabbat – they wear fine fabrics, silks, satins.” They dance at kabbalat Shabbat, to welcome the Sabbath Queen, he said.

There are no musical instruments allowed on Shabbat. But the bimah is made of very thin wood – because it’s cheaper than thicker boards would be – and “when the chazzan davens, he bangs on it with an African rhythm,” Dr. Grunstein said. It’s not a musical instrument. “It is not a drum.

“He is just tapping it. He is drumming the bimah. And it sounds amazing.”

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