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Washington State Dental Association

Dr. Michael Karr: 2011 Citizen of the Year

Each year, WSDA honors one of its own with the prestigious Citizen of the Year award, and this year’s winner Dr. Michael Karr was nominated by so many it made for an easy choice. WSDA Past Presidents Mark Walker and Jeff Parrish have volunteered with Karr for years, as has current Board member Mike Buehler. All spoke of Karr in the highest terms. Karr rejects a lot of the praise, pointing to fellow missionaries as the real heroes, but in truth he’s been the epicenter of activity all his own — organizing trips within his church, developing portable units to bring better care to those in need, and tirelessly refocusing his efforts to bring heathcare to Haiti, where crisis hit just one year ago in the form of a devastating earthquake. For that, and all of his efforts on behalf of the one of the world’s poorest nations, Dr. Michael Karr is the WSDA 2011 Citizen of the Year.
  For many, the idea of going to Haiti — or any other third world destination — falls somewhere between a bucket list item and a rush for the door. For Dr. Mike Karr, the island of Haiti is practically on his route home — since his first mission in the late 80s, he’s completed more than 40 trips to the island and other places, including, Tanzania/Uganda, the Philippines, Honduras and Nicaragua. Not satisfied to simply go on his own, Karr later formed an important international relief organization that today sends no fewer than six teams across the globe. That alone would be impressive, but Karr isn’t done by any stretch — he’s always looking for ways to better the lives of others. 
  Karr got roped in innocently enough: He’d done a pretty luxe exploratory mission trip (by Haiti standards) to Belgium and Spain with his church, and it got him thinking about other places in need. When he returned, he continued looking into giving back, and connected with a fellow parishioner named Ken Gaydos, who asked Karr if he’d tag along on his next trip to Haiti. Gaydos, a missionary who was Chaplain for the Edmonds Fire Deptartment, had visited Haiti doing construction and other duties, and thought it might be a good idea to have a dentist along. So, along with two other dentists Gaydos recruited, Karr made his first trip to Haiti, expecting to perform extractions. What he didn’t expect was to be so moved by the kids he met and treated there.

First visit

Upon landing, Karr and the other dentists were split up — he was shuttled far north to La Pointe, while the others stayed behind in Port au Prince. Armed with the basics — surgical instruments and a couple of boxes of anesthetic — and accompanied by an assistant, Karr was flown in a mission-owned Cessna to the small hospital there, and set up his makeshift clinic next door at House of Hope, a tuberculosis of the spine and malnourishment orphanage. Karr describes that first trip, “We pretty much were winging it, I brought supplies based on what I thought we would need. As it turns out, we got lucky and had just about everything, as long as we focused our efforts on the children.” he continues, saying “A couple of things happened to me – I kept thinking, Man oh man, if someone doesn’t come back, what’s the sense of even coming in the first place, and secondly, I got really invested in the kids. Some of them were pretty sick, he says, and some were on the mend, but all of them were in need. The two missionaries working there asked if he might commit to returning once or twice more, Karr agreed to return in a year and went back home. 

Returning home

Back in Washington a couple of things happened: Karr kept in touch with his new missionary friends in Port au Prince and La Pointe (relationships he’s fostered to this day); and the dire situation in Haiti continued to eat at him. He was determined to do more, and in the first couple of years he kept his promise —  and then some — returning four times and continuing the work he began on the first trip. Supported in his efforts by his friend Dr. Bill Mays (a PhD and theological doctorate, and Karr’s head Pastor for many years), Karr began to map out what’s become a lifetime of missionary work to Haiti. While fellow parishioner Gaydos was expanding his groups reach to other places in need, including the Philippines and Peru, Mike was resolute: he wanted to keep his sights on Haiti – he’d fallen in love with the place and its people, and there was plenty of need there. And while Karr’s generosity of spirit has lead him to many other places in the past 30 years, Haiti has always remained his primary focus. Karr and Mays began to organize their own trips, and Karr started taking his children along with him to expose them to humanitarian efforts. On each subsequent trip he saw more and more kids in need, and he came to realize the enormity of need in the tiny island, so he kept returning, sometimes three times a year. Over the years, as the kid’s needs began to be met, Karr and his volunteers would open up their clinic to the throngs of people needing emergent care. “If I was the only dentist on a trip I’d see 30 patients a day,” says Karr, “But I’d look out at the masses of never-ending people and realize it was just the tip of the iceberg.”
In fact, Karr says, that’s one of the obstacles faced by volunteers each time he takes a group to Haiti – “When people go their first time they get frustrated that we’re closing the clinic for the night when there’s a line out the door. The thing is, that line is never going away, so I teach them that we have to close for the night and rest – we’re no good to these people if we run ourselves down and get sick. It can be heartbreaking.” 
Karr says give him ten minutes and he can teach you how to assist (something echoed by fellow missionary Mike Buehler) “I’ll take anyone,” he says, “We can start by having you hold a bunch of cotton on a hemostat trying to dry the blood from extractions and teach you from there. I’ve taken people who have never worked a day in a dentist office, and they’ve been pros by the end of the week.” Bill Mays is a case in point: though not clinically trained in dentistry, over the years he developed a true fascination with dental appliances, which led him to work with Karr in developing a portable unit that can churn out as many as 40-60 strong flipper appliances in a week. — more about that later.

Building a clinic

Early on, Karr enlisted the help of his friends in Haiti to build a clinic there – stocking it with donations from the states and storing with a local Kirkland dental repair company. He used every connection he had to facilitate putting the clinic together — including an executive at a shipping company who was a fellow parishioner, and folks in Haiti who knew that by shipping to the northern port or Port de Paix they could save hundreds, if not thousands, in tariffs. In the end, Karr oversaw the construction of two clinics – one at House of Hope and one in Port au Prince, but both are now gone. He explains, “One was destroyed in the earthquake, the other was pillaged by an itinerant Cuban dentist occasionally running the facility.” Karr understands the plight of the people, though, saying, “None of us condones bad behaviors like stealing and cheating, but it happens everywhere. And in a country like Haiti, it truly is survival of the fittest. Most of these people, even those who do bad things, are good people just trying to survive. If you have a family that you have to take care of, you’re going to do what needs to be done.” 
Karr and others knew that looting was always a possibility, but counted on the occasional young Haitian dentists at the clinics to attend to things properly — in hindsight, it was flawed reasoning. Additionally, Karr quips that “there is no word in Creole for maintenance,” and says the humidity does tremendous damage to dental equipment left there. It wasn’t uncommon for hand pieces to corrode and bearings to freeze, rendering them worthless. 
Still, the experience with the clinics was invaluable, as it forced Karr and Mays to reevaluate their efficacy. In the end, they realized it was better to bring everything they needed with them rather than relying on the locals for maintenance. “We knew that if we couldn’t get back to Haiti frequently, we might lose everything. Because of that experience we no longer build clinics — we’re highly mobile with really great delivery units – we’ve got it down to a science on how we pack, ship and so forth. We bring the equipment, we maintain it, and we know exactly what we have – there are no more mysteries. In the past we’d go over and find out that equipment was either broken or missing.  It usually worked out okay, but we’d sometimes have to spend a day jimmy-rigging things to get them working again.” Today they use high-tech units weighing just eight pounds each, units that can recharge by either solar panels or human power, if necessary. “We can hook them up to a bicycle pump and have one of the local kids pump it up and keep us running if we have no access to electricity or sun.”

Including students and forming a non-profit

In 2003, while Karr’s daughter Stacey was a student at UNLV’s dental school, Karr approached the university and asked for permission to bring dental students with him, in part to expand his reach while in Haiti, but primarily to teach students to be humanitarians at the same time they were learning to be dentists. The school agreed, made Karr an adjunct Professor in the Department of Professional Development, and he began including students in his twice-yearly trips. Later, he expanded the program to include students from the UWSoD (Karr took four UW students this past March and three before that, and he hopes to continue to expand the program, citing its success at producing globally-minded dentists.) But he and Mays found themselves faced with a new dilemma – how to manage all the activities of their burgeoning missionary empire, such as it was.
In 2005, they formed Medical Relief International (MRI), a 501c3 nonprofit organization which “…exists to provide dental, medical and humanitarian aid, or other services deemed necessary for the benefit of all people in need, and to network with other agencies to help them fulfill this vision.” Today, while still a small group in comparison to other international aid organizations, MRI is an important player in global relief, equipping as many as six teams a year to serve in Africa, Central America, Haiti, the Philippines and Cambodia. Having the formal structure has helped Karr and Mays consolidate their efforts, and allows them to fund-raise more effectively. In the beginning, Karr oversaw every trip the group made, but since that time they’ve streamlined operations, and made Karr the Field Director for Haiti, which allows him to focus on the country he knows so well. 

Getting there: the logistics and realities of work overseas

Stateside logistics present the biggest headache for the group - with so many years under their belt and connections with missionaries in Haiti, once they’re on the island things run pretty smoothly.  Getting their equipment there is costly, though, and can be problematic. “We have serious weight restrictions,” Karr says, “That has been the biggest logistics issue. For a while, we had a very close relationship with a vice president of American Airlines, and he opened a lot of doors for us, but that ended when Delta merged with Northwest Airlines, so we’re back to scratching the earth trying to find alternatives.” Careful packing and newer, ultra-lightweight portable units help things, but volunteers are still only allowed to bring one backpack or carry-on for the entire time they are in Haiti. “We need the weight allotment for all the equipment we’re bringing on. That’s getting harder and harder with the airlines. So if we have five people going on a given trip, that gives us about 700 pounds of equipment we can load in tubs to bring along.”
Furthermore, getting anesthetic to the clinics can mean fast talking at customs, where agents routinely look for medicines to confiscate, to take to their families or sell. Karr’s developed a mindset over the years that involves some serious parsing: “I don’t consider anesthetic to be medicine,” he says mischievously, “So when they ask if we have medicine, I tell them no, that we have just what we need to perform dentistry.” Over the years, he’s always been successful at getting through customs, but acknowledges the inherent risk. But that’s what Karr and Mays are there for – they, along with others at MRI, attend to the logistics side of things so volunteers don’t have to – they have enough on their plates. Other than that, MRI’s primary focus is the safety of all volunteers serving under their auspices, and it’s for that reason that they limit their volunteer efforts to missionaries where they know all the players. “Sometimes,” Karr says, “Locals have a very different idea of what constitutes safe. For example, safe drinking water. We make sure all of that is satisfactory according to our standards, not theirs.” 
And make no mistake, Karr says that volunteering, while extremely rewarding, is physically punishing and can be emotionally brutal, “While we’re not sleeping in tents or drinking polluted water in Haiti, the places we stay in are missionary compounds with a ranch or bunk houses. We’re safe, but have no air conditioning or hot water. We do occasionally have cold water for showers — a bonus when you come home from a long day and you’re drenched in sweat and dirt. We have safe meals and filtered water, but at night you’re sitting around without electricity or phones.” 
In fact, Haiti can be so tough that Karr often suggests volunteers start in the Philippines and “graduate” to Haiti. Karr says, “I encourage a lot of people to go to the Philippines first, especially when they approach me with fears about Haiti being a little “too third world.” In the Philippines, our accommodations are often three- and four-star hotels by western standards. During the day, we’re out in the slums and barrios that are much like Haiti — but at night, you sleep in an air-conditioned hotel, have a hot shower, a decent meal and can regroup for the next day.”

After the quake

When a level 7.0 quake razed much of Port au Prince last year, Karr wasn’t sure what he would find. One thing he knows for sure: there is little, if any, accountability for the billions of dollars that have supposedly poured into the area. No accountability, and no real evidence of any good it has done. “I’m fully convinced that some of that money is gone forever,” says Karr, “I suspect that a lot of the stuff is sitting in warehouses and can’t be released simply because there is too much corruption. There are still huge tent cities all over the country. The last time we went, Jeff Parrish’s team went just outside of Port-au-Prince where living conditions are pathetic still – we’re up north, and while the earthquake had no real effect there, the poverty is immense. It looks a lot like the same Haiti as before, only now we have rubble and tents.” Karr paused, then continued,  “Jeff Parrish said it best, ‘The good news is that Port-au-Prince appears to be functioning as well as it was before the earthquake. The bad news is that Port-au-Prince appears to be functioning as well as it was before the quake.’ That’s it in a nutshell, although I might amend that to say that things were really pathetic before, but I’m amazed after all these years at how people live and get by.” 
Today, their standard of care continues to be extractions, with some restorative work – but only if certain criteria are met, “We can do a filling if we’re 100 percent sure that it will not be so deep that it abscesses — because if it does, we’ve just created a worse problem. So quite frankly, when we go to Haiti it’s about 85 percent extractions and 15 percent restorations.” He continues, saying “We’re not doing anything heroic though – if we can do a small, one-or-two surface composite we’ll take care of it. Heat and humidity wreak havoc on amalgam, so it’s not usable.” Karr’s focus remains pain relief, but acknowledges the role aesthetics play, “In a lot of these countries, the young lady’s marriage potential depends a lot on her facial features, particularly her smile.’ He says, “So we do what we can to give them every advantage — Dr. Bill Mays’ portable dental lab has worked wonders in that regard.”

Future plans

Karr’s work in Haiti isn’t limited to just delivering care to thousands of people in pain. He’s also working to secure their future. With his good friend, Dr. Bruce McMartin, head professor and Dean of Students at STEP (Séminaire de Théologie Evangélique de Port-au-Prince), and his wife, Cindy, Karr has been working since 2003 to establish a university in Haiti for the express purpose of developing the country’s future leaders. Karr and McMartin, along with Jean Dorlus, a brilliant young man who obtained his PhD in the US, are working tirelessly to make their vision of a world-class university in Haiti a reality. To date, they’ve purchased land, and while they acknowledge the slow pace of change in Haiti, they are steadfast in their resolution to see the project through. Karr admits he’ll likely not see it in his lifetime, but he remains undeterred. 
Additionally, Karr and McMartin are fostering a program to develop coffee trade between Haitian coffee growers and distributors here in the US. And Karr wants you to help, too — in any way you can. Volunteering, of course, is extraordinarily helpful, but even just giving money or donating supplies can help to continue the good work being done in Haiti and around the world. “We’d love to have you come along to any of MRI’s upcoming trips,” says Karr, “For more information, please go to and fill out a traveler’s profile — it will help us determine where you’d be most useful, and will include you in our quarterly newsletter mailing.”
The WSDA is proud to call Dr. Michael Karr one of our own, and are happy to honor his commitment to so many less fortunate people by naming him the WSDA 2011 Citizen of the Year!
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