Dental Professionalism

Eighth /n a series SERVING THE POOREST OFTHE POOR: THE STORY OF JEREMIAH J. LOWNEY

James T. Rule, DDS, MS, Professor Eryierltus University of Maryland Denial School, Baltimore

Muriel J. BebeaU, PhD, Professor of Préventive Soienoes University of Minnesota Sofiool of Denlistry, Minneapolis

Since 1966, Dr Jerry Lowney has practiced orthodontics in Norwich, Connecticut, where he has been active in both commLjnity and professionai organizations, including the University of Connecticut Board of Trustees and the Board of Governors for iHigher Education. Since his first volunteer trip to Haiti in the mid-1980s, during which he provided dental services for the poor, he has returned to that country at least three times each year Over time the nature of his activ- ities has changed. Through grant writing, personai influence, iiaison with a reiigious order, a huge investment ot time, successful fundraising, the seizing ot every opportunity, and the expenditure of iarge amounts of his own money, he has created a multimiilion-doliar general heaith facility in one oí the peores! areas in Haiti. Besides dentai treatment, the scope of his activities has ranged from creating centers for high-risi< pregnancy and malnutrition to the hir- ing of physicians, the training of local nurse practitioners, and an Adopt-a-Family program run by his wife, Virginia. His actions have been influenced by Virginia's caring attitudes and by his conviction that much is expected from those who have received life's bounties.

n August 198f Dr Jeremiah Lowney had been prac- to know him and like him, and respect him. So any- Iticing orthodontics for f5 years when he received a way I said, 'It sounds interesting.' ff he had said, 'I'm phone call that changed his life. Most Reverend going to Appalachia,' I'd probably have a health pro- Daniel Patrick Reilly, the Roman Catholic hishop of gram in Appalachia today. Haiti was chosen just Norwich, Connecticut, where Dr Lowney had his hecause he was going there." practice, asked if he would like to join him for a week Jerry said, "I had no idea of what I could do there. I in Haiti. Pope John Paul II had urged the Roman didn't want to go down and he a voyeur for a week—just Catholic hishops from the world's affluent nations to walk around and observe," To be of some practical use, encourage the people of their parishes to heip those he thought that if he took some exodontia instruments, less fortunate in Third World countries. Bishop Reilly there might be an opportunity to do some extractions, responded by organizing an eclectic group of some not withstanding the fact that he hadn't extracted a dozen people among whom Dr Lowney would he the tooth in 19 years. So he asked the help of an oral sur- only dentist. Jerry told me [JTR] fhat there was no par- geon friend in reviewing basics, such as the administra- ticular heahh care orientation to the group. It was tion of a mandibuiar block injection and the techniques merely a broad-hased exploratory trip to assess the of dental extraction. He borrowed some equipment and problems and perhaps to plan some sort of action to subsequently "spent that whole week taking teeth out help the poor. Jerry went mainly because of his friend- by the hundreds." His son, Mark, a pre-med student, ship with the bishop. "We're good friends. I had gotten went with him and served as a dental assistant.

Qu'- 309 Dr Lowney's introduction to to do was to call a week or two would do it. "We'd arrive at the air- Haiti was one of the most memo- before he came and they would set port, rent a car, and drive wherever rable experiences of his life. In Port an agenda. we were needed. The sisters set the au Prince, the group stayed in a 1981 to 1985: Working in Port au agenda, and we'd arrive at 7:30 in hotiie with no water and no bath- Prince. Six months later Dr Lowney the morning. We'd bring a little room. There was a latrine out back. returned to Haiti and has continued lunch from the hotel, and we'd By the end of the week, the rank to do so every 3 or 4 tnonths. On his bring water and all my instruments odors were pervasive. Jerry said second trip he was joined by the and we'd begin seeing patients. The that they were unprepared for what pastor of his church [St. Andrews in sisters monitored who wouid be they saw. "We got into these slums. Colchester, Connecticut], Monsignor treated." Jerry said that some We saw sights we had never ever Ted Malanowski, and Jerry's oldest patients were rejected, even though seen before. I was in an orphanage, daughter, Gail, who served as a den- tbey looked awful. Once, wben he and I picked up a little baby, and tal assistant. "We worked in different asked why a woman had been the baby died in my arms. Just places," Jerry said, "And I mean we rejected, Jerry said the sister died!" He visited a home for the worked. We were doing two or three replied, 'She's not poor enough." dying that was attended by the hundred extractions a day. It was He laughed and said, "She looked Missionaries of Charity, an order of difficult in that you didn't know any- pretty poor to me. But they knew nuns founded by Mother Teresa." thing about the health history of most people's situations and needs. The sisters brought in the patients these people. Nothing! We protected I don't know how they knew, but "either out of the streets or from the ourselves with universal precaution. they would select them. They general hospital in Port au Prince. [We used] cold sterilization. We would bring in six or seven patients The hospital would put the scruhbed the instruments and at a time. The others would wait patients, who were so sick they soaked them in germicide. They out in the street. They'd sit down in looked like they weren't going to would sit down and we'd ask them straight chairs, and I'd anesthetize make it, into a shed behind the which tooth hurt, and they'd say them all at once." On a piece of facility. The sisters would visit this 'Tout'-all of them. Then you'd have paper that he gave to the patients, shed, transport patients to their to do a survey of the mouth, a gener- he indicated the tooth, more often own building, clean them up, and al physical assessment of the patient, teeth, that were to be removed. feed them. Most of them didn't sur- and make a decision. The entire One by one tbey would get care. vive. But the whole theme of their rnouth qualified for extraction, but One volunteer would fill the outreach was to ailow people to die the patient could not be left medical- syringes, and another would scrub with dignity! [In addition] they all ly comprotnised and there was little the instruments. He used double had bad teeth. They were periodon- opportunity for follow-up." gloves as a precaution. Although taily involved or they were infected. On later trips he usually brought AIDS was not much of a problem So the day I showed up with the four or five people with hitn includ- then, he was concerned about hep- bishop and [ourj group, I had my ing, as regulars, Monsignor Malan- atitis. When I asked if he used a little kit. And I said to one of the owski and Sister Carla Hopkins, a mask, he said, "Most of the time. sisters, 'If you have anyhody here nun who ran a Catholic Charities But by the middle of the day, it that needs any teeth extracted, I program in Connecticut. She spoke would be so damn hot, I'd take the would like to help.' And she said, French and was therefore able to mask off and work with just a base- 'No one ever comes here. God must help communicate with the ball cap and a set of scrubs." have sent you.' ,., That was a heavy patients-a major advantage. She 1985: Long Distance with trip. That comment was a life- also scrubbed instruments. Dr Mother Teresa. At the end of each changing experience." Lowney paid all of her expenses trip to Port au Prince tbe sisters, Jerry decided to remain at the out of his pocket. The sisters in having provided him with Mother home for the dying and consequent- Port au Prince would tell him Teresa's phone number in Calcutta, ly spent most of the week extracting where to set up a ciinic, and be would ask bim to call her to convey teeth. Toward tbe end of bis stay be asked the sisters, if he were to come back in a few months, would they •The order oi the Missionaries of Charity was created in 1950 in Calcutta by Nobei Peace Prize winner Mother Teresa [1910-1997]. its purpose was to serve the poor, usuaily the be able to find any other places like poorest of the poor The order was inspired by her experience with a woman, haif-dead and this. They told him they had a clinic partly eaten by rats, whom she found lying in the streets. A nearby hospital was reluctant to in the slums that was very needy. In treat her, but because of Mother Teresa's insistence, they finaily treated the woman. From then on, it became her mission to create piaces where the poor couid die in peace and dig- fact they had many makeshift clin- nity. The functions ot the sisters in Port au Prince recapituiated Mather Teresa's originai ics in several slum areas. All he had experience

310 Number 4. 2002 messages-usually requests for there would enahle them at more supplies. Phone calls some point to see the fruits of hetween Calcutta and Haiti their labors because the scale were usually impossible for the was small enough to he man- sisters to arrange, so Dr ageable. Despite the fact that Lowney would pass the mes- travel to Jeremie was difficult, sages on to iVIother Teresa, and Jerry said that the tremendous before each return visit, he need for health care made the would call her again and ask if decision easy. To put his plans she had tnessages for the sisters into action, he asked Sister there. Carla if she wanted to remain in During a 1985 phone con- Jeremie and build a small dental versation. Mother Teresa told clinic to provide permanency. him, "'I'm making arrange- She received permission from ments to send four sisters to a her superiors and hegan to very remote area called work, Dr Lowney made ar- Jeremie,'- Interesting, [That'sj rangements for an apartment in my name in French," Mother With ishop Daniei P. Reiliy at the dedication of e town for Sister Carla, and she Teresa said that there were no Haiti Heaith Foundation Clinic in 1988. made arrangements to clear the health facilities there, but sick land and build the clinic. The people were plentiful. Her plan source of the funding for tbese was to open a small orphanage for met a Haitian anesthesiologist, Dr activities was Dr Lowney's personal sick babies and children, Jerry said Julian Joseph, at the local hospital money. she had asked him, "Do you think in Norwich, They met in a dental Beyond 1985: Expanded Scope you could go there and help them? office in Norwich where hotb were and Structure. The scale of Dr They need more help there than in patients, Jeremie, as it turned out, Lowney's activities in Jeremie Port au Prince," He joked that there was Dr Joseph's hometown, and he underwent a significant expansion, was no way he could turn down the became excited upon hearing what primarily because he had the good requests of a living saint for fear of Dr Lowney was doing. As a result, sense to listen to Sister Carla, divine retribution, "Anyway," he Dr Joseph, wbo for political rea- Whenever he visited Jeremie, Sister recalled, "I went to Jeremie, The sons could not return to his home- Carla would talk to him about their whole country is mountainous. The land, offered Dr Lowney a 10-acre desperate need tor comprehensive first time we went there was an piece of land in Jeremie to use to health care. Their dental problems adventure, Tbere was no way of get- deliver health services. At that were ¡ust one aspect of their over- ting there except to rent [an all-ter- time, Americans were prohibited whelming needs, Jerry told me, "So rain] vehicle. It took 12 hours to go from owning land. On his next trip I said, 'Well, we'll build a little big- 140 miles. The roads were just Dr Lowney visited the hishop of ger clinic here."' He decided to add awful, and we didn't speak the lan- the diocese of Jeremie and arranged on to the building and create space guage. When we came to a river, for the bishop to accept the land for some medical examining rooms. we'd have to ford It-no bridges and and in turn provide Jerry with a 99- However, the construction of the no idea of the depth," When tbey year lease. To formally receive the clinic had been done without a arrived, they found the sisters leased land, he created a new orga- written architectural plan. There- already at work, building a small nization, the Haitian Dental Foun- fore, when the time came for a sec- temporary facility, Dr Lowney and dation, having no idea that he ond story, they needed to get a his helpers set about tiieir usual would ever have broader health structural engineer from Port au routine of taking out teeth. interests. By that time Dr Lowney Prince to make sure that proper Not long after Dr Lowney had already concluded that the structural loads could he supported. returned from his first visit to idea of becoming permanently The engineer's fees also came out of Jeremie, his wife, Virginia, in an located in Jeremie was appealing. Jerry's pocket, Wben asked ahout exceptionally fortuitous encounter. He felt that a concentrated effort the support that he and Virginia had given to the project, he said that hy that time, "She and I put about $300,000 into this adventure, •With a population of 50,000, Jeremie is one of the largest cities in the Grand Anse, which maybe more, I don't know, I has a population of 600,000. It is looated 140 miies southwest of Port au Prince, oiose to the stopped counting at 300," end of the narrow f-faitian peninsuia, not far south of Cuba.

311 Because the project was growing With that conversation, Jerry them as health agent-.. I send rapidly, Jerry realized tbat he need- took the first transforming step from them back to their cm . jiunities. ed more than his own funds to clinician to grant writer. Immedi- Jerry said they are excellent. They assure its completion. His fundrais- ately upon returning home, he understand the essentials of ing efforts launched happily after a approached the University of medicine, and they are known and serendipitous introduction to a Connecticut for help in putting trusted by the villagers. Through Connecticut husinessman. The together a proposal. His request their combined efforts, they have result was a check for $200,000, received instant attention, quite pos- immunized 60,000 young children. and 2 months later, another for sibly because he was a member of This is 88% of the child population, $50,000, It was an auspicious start the Connecticut Board of Gov- which Jerry said is a higher propor- to a successful and continuing pro- ernors for Higher Education. The tion of immunizations up to the age gram of raising money. Every dollar collahorative result was a 3-year of 5 than in Connecticut. they received was important, Jerry child survival grant for $850,000, Its Meanwhile more and more vol- said that he had heen way off on primary focus was to establish out- unteers arrived, most of them stay- his budget projections. The total reach medical programs for the vil- ing for brief periods: construction cost to build the structure was SL2 lages around Jeremie that would workers, plumbers, electricians, and million. At every step of the way provide such aspects of the standard others. Of great importance were there were costly problems: embar- tbree new requests from Franciscan goes, changing governments, new sisters who wanted to join them requests for permission to build, permanently. They are members of escalating costs, the greasing of the Hospital Sisters of the Third palms, and more. The clinic was When Jerry made his Order of St. Francis from Spring- completed in 1989, after 4 years of field, Illinois. One was just return- construction. It stands three and a first trip to Haiti, ing from India, Another was a half stories high, one of largest he was looking pharmacist working in Illinois. The buildings in town. The third floor, third was an intensive care nurse with 13 rooms including a living for something that who had worked in Taiwan, Their room and kitchen, is essentially for collective experience was phenome- the volunteer residents. Sister Carla went beyond his nal. Their Order operates hospitals among them. own self-interest. that are as large as Hartford Dr Lowney's program began to Hospital in Connecticut. Within a assume its present dimensions as a few months the clinic was function- result of another unexpected oppor- ing as an integrated medical unit. tunity. Word of his eftbrts had got- The sisters remain there today, still ten around Connecticut, and he running the clinic. Their timely was beginning to be known as the USAID program as immunizations arrival coincided with the expan- state expert on Haiti, Shortly after and the teaching of oral rehydration. sion of the program and with the the new building had been complet- Jerry made sure, however, that his fact that Sister Carla was starting to ed, he received a call from a neigh- operations at the new clinic also get tired. Sister iVIaryann Berard, bor who was also the district con- received some benefits, such as a the nun from India, became the gressman, Jerry was asked to go to couple of vehicles, a physician, and administrator. Haiti as a guide for a congressional a few nurses. Because of the new Soon Jerry began to embark on visit. Having now been inserted comprehensive medical orientation, additional projects with funding into a different social group, at an Jerry decided that it was time to from other sources. One of the first ambassador's reception Jerry talked restructure his foundation. In doing was the huilding of a piggery. On an with a man who happened to be so, the Haitian Dental Foundation earlier trip, Jerry had heard from the the physician in charge of the medi- hecame the Haitian Health sisters that an epidemic of swine cal operations of the United States Foundation [HHF], At first serving fever had wiped out every pig in Agency for International Develop- 20 villages, Dr Lowney's program Haiti, The poor asked for his help. ment [USAID], After describing has expanded to cover 98, each vil- He came to understand that the vil- what he was doing in Jeremie, Dr lage with its own health agent. The lagers were indeed suffering, Lowney learned that USAID might Foundation provides health care to "because the pigs were their bank be looking for someone like him to 200,000 people in the rural villages account." USAID had tried previ- put together a grant on child sur- at $3 per person per year. The idea ously to replenish the breeding vival for that area. is to find intelligent viflagers, train stock, but their efforts failed: the

312 hJLinitier 4. 2D02 people merely ate the pigs instead of their medical problems to the proper in Haiti, and I think many of these encouraging them to reproduce. use of pig manure. Everything they people, especially with some of Furthermore, USAID denied Dr were taugbt was based on what was these agencies, would say, 'This Lowney's request to start bis own available locally, and the feed was man's a dentist, be's an ortbodon- pig project, so he began checking free. In return, the villagers agreed tist. What does he know about pub- around. "Why the hell did they eat to give back one female pig from the lic health?' The MPH degree gave the pigs? They told me (that first litter. Project staff recorded me additional credentials that said, USAID] didn't give them any food everything on a computer. Usually this man has a degree in public for the pigs, and the pigs were grain- the sows were pregnant when the healtb; he must have some exper- fed sows that would cat only corn villagers received them, and the tise in health care," Jerry said the and soy. The pigs were going to staffers knew to the day when the iV!PH helped in other ways too: the starve to death, so the people fig- litter was expected, Jerry said the vil- epidemiology, the statistics, the ured they might as well eat them." lagers were usually compliant about nutrition, "All of that adds to your Jerry found a local expert on agron- returning a piglet, HHF would reservoir of knowledge," omy to run bis project and wrote a choose a baby sow, then raise it and A public health project of which funded grant for $40,000 from a breed it, "That's how we ended up he is proud was the building of Buffalo, New York, foundation to with 9,000 pigs," Eventually the pro- latrines in the villages, which was build the piggery. The keys to suc- gram became self-supporting, so it initiated as a strategy to prevent cess, he thought, were the condi- was terminated. Jerry said, "The pigs worms and other coHform disease, tions under which the villagers have been returned to the area of "There was a tremendous number of would be given the pig and provid- the Grand Anse," kids with worms," Jerry said. "In our ing tbe means for feeding it. His Jerry's grant writing continued. clinic we'd clean them up, deworm course of action was to bring in an Although he had received external tbem, and 2 weeks later they'd be animal nutritionist from the help from the University of full of worms again. They'd go hack University of Connecticut to develop Connecticut for his first grant, he home and walk through their own silage.'^ He also sent a Protestant was now fully immersed in manag- feces," A different approach was missionary from Jeremie with an ing tbe process bimself, with occa- necessary, Tbeir idea, made possible agronomy background to the sional skillful help from his youngest with Rotary money and matching University of Connecticut to learn daughter, Marilyn, who also was a Rotary grants, was that if villagers how to do artificial insemination. frequent companion on his trips to would dig a 25-foot hole, the project The latter was necessary because the Haiti, By this time, money was com- would give them the materials to utters of the locally available pigs ing in from various sources. build a latrine and a plan to do it. were too smail and the project need- Meanwhile, thinking that it might All went well until a serious and ed better bloodlines. Semen was broaden his perspective for his work unexpected problem arose. After brought from tbe States to improve in Haiti, be began to pursue a mas- giving the latrines a try, the villagers the breed and was administered by ter's degree in public health [MPH] gradually stopped using them, iTiey the newly trained agronomist from at tbe University of Connecticut complained that they could not Jeremie, Jerry's role was to raise the with his daughter Jennifer, Like her move tbeir bowels. The problem money and provide leadership. He father, she had become a dentist, existed even though the village decided to ask Rotary Internationai completed her orthodontic training, health agents had promoted the use for assistance in buying the pigs, and joined his practice. They both of the toilets and the dumping of which cost $180 each. Some Rotary became part-time graduate students asbes from their charcoal fires into cluhs bought one pig; others pur- and attended classes together, tbe toilet pits to cover the effluent. chased as many as 10. They almost Jerry said that his MPH not only The team investigated the problem. all participated enthusiastically. The changed bis perspective, it altered It turned out that the standard toilet project was a huge success. the way that others looked at him seat, which was set at a 90-degree Meanwhile, the villagers took cours- as well, "More than anything, when angle, was excessively high for es from the agronomist on the prin- I went to the USAID, it took me Haitians, who were used to squat- ciples of silage and the essentials of out of the mouth, I would write ting in the bushes, Tbe seats were caring for pigs, including everything grants or go to see somebody about lowered, and tbe use of the latrines from how to pen them and manage the public health work I was doing resumed. One of his other successful pro- grams stemmed from a grant Dr Lowney had received from George- •Silage is the conversion of fodder (corn, grass, clover etc} into feed for livestock by an acid fermentation process that retards spoilage. The process usually takes place m siios. town University to do a breast-

313 Qui" — IIUJ.UJMJ-.IJJ-

heat. Turning a failure into an opportunity, he transformed the poultry coop, located on the same land as the clinic, into an eye elinie with money from a foundation grant. Previously there had been no place between Jeremie and Port au Prince to get an eye examination or have an infection treated. A Lion's Club from Alexandria, Virginia, donated equipment worth $20,000, including an automatic refractor, so that one of the sisters can per- form eye examinations witiiout waiting for a visiting optometrist. With a volunteer al a "Happy House" Ifiat Jerry buill for fhis Haitian family. Jerry has also estahlished a source of thousands of eyeglasses through the cooperation of an opticians' feeding program. To instruct the village 6 months later, the house training program and the support of villagers, they paid trained women, had aiready been built. He said that the Lion's Cluh. Although they are monitrices, who, as Jerry said, it was a nice house, made of not able to treat cataracts at the "have breast-fed their nice fat cement, on a slab, with a tin roof, clinic, Jerry is trying to arrange care babies themscivcs." The project doors, and windows. He took a with some volunteer ophthalmolo- generated phenomenal data, aii photograph for the monsignor. As it gists from Connecticut. Patients are stored on solar-powered comput- happened, a couple of Rotarians charged a fee for any care they ers. It has attracted visits by groups were with him. Jerry said that one receive. Jerry said, "We started off from other universities to look at of them remarked, "Look how not charging, but found it to be a this data and other health data that happy these people are." Another mistake because, if you don't had accumulated. In addition, dis- said, "Let's start a program called charge, there is no vaiue to what sertations for four or five master's Happy Houses," and Happy Houses you are doing. Patients don't value degrees and several PhDs have they became. Jerry said, "We got the services. And there's also a cer- been written based on this and about 125 of them going out of that tain dignity with paying a little bit. other data from various projects. one house. It just caught on. You If they don't have anything, of Of special interest was the finding know, for $500 you can build a course, we don't deny them." It is that participants in the program house for a family here. These the same with the extraction of showed a longer period between Rotary clubs were all donating teeth or any other service. pregnancies than did other pro- $500, Non-Rotarians as well. New initiatives continue to grams, even those specifically Others heard about it in the [HHF] appear. Based on an analysis of the designed to lower the birth rate. newsletter. One woman sent us unmet health needs of the Jeremie The reason was that aggressive and $l,500-far 3 houses," On each population, the HHF has started to exclusive breast-feeding results in house they place a plague with the address malnutrition and high-risk lactationai amenorrhea, which sup- name of the donor and a little smiie pregnancies. Previously women presses ovulation. on each side. They take a picture identified as having high-risk preg- Another hugely successful pro- and send it with a thank-you note nancies and requiring carefui medi- gram is called Happy Houses. On a back to the donor. The donors tell cal supervision as they approached visit to the villages, the monsignor, others, and the contributions esca- term had nowhere to stay. They, or onee again with Jerry, was shocked late. Jerry said, "It's a lot of work, their unborn children, often died. by a wretched house made of sticks but it puts a family into something Now Jeremie has a 15-bed lying-in and a cardboard roof that was that ean be called a home, not a center for women with high-risk occupied by nine people. After hovel." pregnancies. In addition, a malnu- learning from a heaith agent that it Not all of his projects worked as trition center has been buiit for the would cost approximately $300 to well. His attempts to raise poultry, rehabilitation of children in stages build something respectahle, the for example, fizzled because he of second- and third-degree malnu- monsignor gave them the $300, could not control the death of trition, primarily with kwashiorkor When Jerry returned to the same chickens that succumbed to the syndrome." Previously there had

314 been no place for them to receive Every time Michel flies to Con- photographs [of kids and their fami- 24-hour feeding services. The center necticut, he is followed by television lies], I'll bring tbem back, and I'll also has 15 beds and a place where newspersons. One even accompa- ask people if they want to sponsor mothers can be involved in tbe nied him as he returned to Haiti. tbem.' I don't know how many 1 child's rehabilitation. Another nutri- Jerry weicotnes the media coverage, took, maybe a dozen or 20." As a tion program feeds about 1,400 which helps the foundation, but said result, Jerry organized a program to children and perinatal women twice that the real satisfaction came from which donors could contribute $25 each week. Much of the food comes saving his life and probably his a month to the poorest families in from Catholic Relief Services, and future. Whenever Jerry returns to Jeremie. The money is distributed tuna and spam are often donated by Jeremie, Michel visits him, often according to the needs of the family, individuals in the United States. coming to tbe clinic for breakfast but most offen the families use it for The clinic also provides immuniza- with his friend. food, shelter, tuition, funerals, and tions, administers vitamin A, and In many important ways Virginia seed money for self-supporting busi- gives lectures by a Haitian nurse on Lowney has made the Haitian nesses. Jerry said, "We put some breast feeding, oral rehydration, Health Foundation her life as much brochures together, and the whole batheing, and general hygiene. as has Jerry Lowney. Of special thing was the $25 for a family. Dr Lowney's programs are all ori- ented toward caring for large num- bers of people, one person at a time. However, now and then the plight of a particular unfortunate Haitian Jerry Lowney's most admirable quality youngster attracts the attention of is perhaps his ability to inspire others the HHF staff. Such is the case with a little burned boy named Michel. and move them to moral action. He was 6 years old when he was severely burned after a kerosene lamp fell from a shelf and landed on him as he slept. The fire also result- importance, Jerry said, "We have the Nobody in the middle-no overhead. ed in the total loss of the family's Save a Family project that Virginia People liked that and supported it." possessions. When Michel arrived at runs. It's a phenomenally successful The donors loved the program the clinic 6 months after the fire, his project. 1 think she just enrolled and often sent clothes, food, and chin was fused to his cbest, bis right 1,100 kids in school in that project. other things in addition to their hand was missing, and he was suf- This is the eleventh year that over monthly $25 donations. Jerry said fering from third-degree malnutri- 1,000 children have been enrolled. that in every container that they tion. Through the efforts of an HHF It probably started in 1988-89, ship to Haiti, they now have per- board member, his story appeared in before the clinic was opened. People haps 50, 100, or even 200 boxes the Boston Globe newspaper. would come to the gate of the that people have brought to his Because of that article and other clinic—Sister Carla was there at that house to send along. In fact, during coverage that unfolded from it, the time-and they'd have problems, my visit to their home, Virginia HHF raised about $30,000 for the needed money-tuition for a child to took me on a tour of their three- child. In addition, Michel received go to school, or somebody died, or level barn, which was filled witb extensive care during multiple hos- was sick and had to find medicine." everything from the aforementioned pitalizations at Shriners Hospital in Sister Carla had a limited budget boxes to scores of bicycles awaiting Boston for the managetnent of his and couldn't really help too tnany transport south. In any event, it is burns. Virtually every aspect of the people. So on one of Jerry's trips, ciear tbat the donors relate strongly care was free. With donations from she told him, "'With so many of to their adopted families. Initially, the public, the HHF bought the fam- these poor fatnilies, it would be nice the program was run by a volunteer ily a house in Jeremie for S10,000 if somebody could help them.' I said, in Jerry's office, but it was more and established a $20,000 trust fund, 'Why don't we start a little family than she could handle. As a result, which Virginia Lowney manages. sponsorship program. I'll take a few Virginia stepped in and then, Jerry said, "It really took oft. I think she has about 1,100 families now. 'Kwashiorkor syndrome is severe malnutrition in intants and children marked by tailure to That's $330,000 US going into thrive, apathy, and other serious findings, including fatly degeneration of the iiver and those slums in Jeremie. A phenome- severe edema. It is caused by a diet that is excessively high in carbohydrate and extremely low in protein. nal amount of money."

Quintessence international 315 In addition to these special pro- jects, the daily work of the people of the Haitian Health Foundation con- tinues. This includes the dental care that is now being regularly provid- COMMENTARY ed. Although the removal of infect- ed teeth remains the primary ser- Dr Lowney's story extends the concept choice: to continue to accumulate per- vice, they are now gearing up to of service to society beyond the com- sonal wealth or to share. At this point, provide restorative care, especially munity in which he practices. In fact, he his concept of service underwent an for children, A young dentist from argued that the service he gave to his early transformation: "to share my Boston will he volunteering her ser- immediate community was not "real good fortune somewhere else," service," When he assessed his work in Dr Lcwney's choice was not, as vices. Outreach programs that pro- professional organizations, in politics, some have done, the provision cf a bit vide fluoride therapy and emphasize and in his community, he said, "I never of service in some exotic place. caries prevention through education really Icoked at that as a major contri- Neither was it a place of poverty in his have already been started. Med- bution to anything. Seme of that you own country, where his presence ically, the work is done by two could look at and say, 'well, if you were could make an impact, in fact he on the cancer board, you certainly got attributed his decision to provide "real" physicians, two nurse practitioners, some notoriety out of it, and if helped versus "self-interested" service in Haiti several locally trained nurse practi- your practice,'" When Jerry made his to pure happenstance. He went tc tioners, and a Franciscan sister who first trip to Haiti, he was looking for Haiti not because of his awareness of sees patients. Most of the patients something that went heyond his own its overwhelming needs, but ohiy are children, but many adults are self-interest. "Real service," in his view, because a respected friend had asked IS the kind of giving for which the only him to go. Indeed, he noted that if the seen as well, especially those with return is the personal satisfaction bishop had been going to Appalachia, prenatal and emergency needs. derived from helping someone who is he would undoubtedly have developed Altogether the clinic employs more truly in need. In providing service to the a program fhere. than 60 Haitian professionals with destitute, Jerry willingly immersed In engaging himself with the poor- an annual budget of approxi- himself in what many would est of the poor, Dr Lowney dispels a mately $500,000. In 1992, find to be unbearabiy popular stereotype associated with his squalid conditions. discipline. Orthodontists typically serve Alvin Adams, US ambas- Whereas today he the esthetic needs ct families with dis- sador to Haiti, called it "a s not directly cretionary ihcome. Critics suggest that principal agent for involved in the for dentists aspiring to a life ot ease change-and for hope." provision ot and high income, orthodontics is the dental care, specialty of choice, Lowhey's view is he is totally different. He sees his specialty prac- immersed in tice as a means to an end, the means Sowing the Seeds an extensive being financial security, the end being humanitar- to serve the needs of the people of ian effort to In 1981, when Dr Jeremie, The practice of his profes- improve the sion, initially a major source of satis- Lowney received the health and faction, is no longer his primary source Haiti invitation from welfare of a cf contentment. Even when his daugh- Bishop Reiliy, he large segment ter joined him ih his practice, besides already believed that his of the Haitian the pride of having her follow in his population. range of activities would footsteps, he viewed it as a means tc his primary goal. Her presehce allows extend well beyond the As with other exemplars, Lowney's him to spehd more time sustaining the walls of his practice. By that :;oncept of service un- work of the Haitian Heaith Foundation, time he had heen active in the folds as he moves through Let's examine Dr Lowney's activi- Connecticut Dental Assoc- the various stages of life, As a young- ties in fight of the selection criteria for iation, had held offices in the ster, he was the recipient of the gen- moral exempiars,^ His work in Haiti Connecticut and Northeast So- erosity ct a Roman Catholic priest whc "shows a sustained commitment to cieties of Orthodontics, and had provided tuition tc fund his early edu- moral ideáis and principles that cation. During the practice-buiidihg indudes a generaiized respect for heen chief of dental service at phase of his life, he engaged in local humanity"(crtlenon 1), In approximate- Backus Hospital in Norwich, service to his community and profes- ly 20 years of service there he has Additionally, he had been thorough- sion. It was not until midlife, however, functioned on many levels. Initially he ly invested in his community, when he had satisfied basic needs, worked as a dehtist, primarily remov- whether it was tbe city government, that he saw himself as having a ing teeth, A shortwhiie iater he became the town Board of Finance, or the Cancer Society Board, Another

316 Volume 33, Number 4, 2003 A focus for his energy was Democratic state politics. In the mid-1970s he had held fund-raising parties on the lawn of his home for then guberna- a lactlitator tor the work of the nor to proselytize. This same respect torial candidate Ella Grasso, who Missionaries of Charity serving in Haiti must be extended to those whom he arrived dramatically by helicopter by making calls to Mother Teresa in asks for money. He is very conscious Calcutta, Next, responding to Mother of his need to be viewed as authentic, right behind his house. When he Teresa's request to establish a heaith not as a hustier, (We will return to this iater found that he was being con- taciiity in Jeremie, he funded ttie theme later.) sidered for a state position, he told design of a health clinic and raised We also see persistence in his Governor Grasso that the job he funds to build it. During its construc- efforts to respond to the human condi- would prize most was that of com- tion, he began to eniist the help of tion in the region he works and a "con- physicians, thus completing the clinic's sistency between actions and inten- missioner on the state dental board. shift in emphasis from dental care to tions and between Ihe rneans and Finding that request impossible to evermore inclusive medical care. ends" (criterion 2).' He seems to turn meet, the governor instead appoint- Experiencing success in the achieve- each of his talents, politicai ccnnec- ed him in 1976 to the University of ment of these objectives, he temporari- tions, and financiai assets tc achieving Connecticut Board of Trustees. ly shifted his focus to include the eco- his ends. This is net to say that every nomic issues in the community. effort to imprcve ccnditions resulted in Subsequently, in 1983 he was Responding to the epidemic of swine success, but he demonstrates an appointed to the state's newly creat- fever, he brought in experts to reintro- uncommon persistence to resolve ed Board of Governors for Higher duce pigs to the region, an accom- problems. For exampie, when the ini- Education, a position that he still plishment of vital economic signifi- tial USAID effort to replenish the pigs holds, and would serve as its chair cance. Again addressing health issues, was not successful, Dr Lowney he implemented public health pro- recruited an agronomist (using his uni- for 4 years. Jerry said his failure to grams in sanitation, childhood immu- versity connections and his personal become a dentai commissioner was nizations, infant survival, and nutrition, resources) who is willing to go to Haiti the best thing that could have hap- A key factor in the success of these to work on the silage problem. When pened to him. His entire tenure at programs was the training of Haitian the effort to introduce chickens into the University of Connecticut "was villagers to act as medical personnel. the economy failed, he turned the very, very positive for the Haiti Turning back to basic survival chicken coop into a much-needed eye needs, he facilitated the building ot clinic. When he needed creditjility to experience because it gave me cred- houses in the villages and found indi- promote his programs, he obtained a ibility. Resources were there that I vidual donors to fund the construction master's degree in public health. could tap into for information. If I of each house. His wife, Virginia, aug- When he saw the need for housing, he didn't have that connection, I don't mented this effort with her "Adopt a implemented a fund-raising strategy to know whether [the resources] Family" program, which provides a buy the houses. When an ally had helping hand to families with short- trouble shipping goods to Haiti, he would have been that accessible to term needs. At each phase, Dr involved his political contacts to help me." For example, it was a Board of Lowney immersed himself in the prob- her resolve her problems. Governor's member who helped lems of the community. As goals were Sustained by his own good fortune, him become aware of the need for a realized, new goals were set. Each his supportive famiiy, and his personal tax-exempt foundation and then challenge gave new life to his commit- faith, he seems more than "wiiling to ment. Through sustained commitment risk his creature comforts, his person- helped him organize it. In addition that included fund-raising and grant al well-being, and personal assets to he became chair of the Health writing, he established a stable base experience the joy ol sharing" (criteri- Affairs Committee, which oversaw of funding for the Haitian Health on 3),' Dr Lowney sees his bout with the University of Connecticut Foundation—at ieast as long as the cancer as an event that changed his Health Center, a position whose Franciscan order continues to supply outlook on the risks associated with management of the facilities. Currently, humanitarian efforts, though it didn't contacts at the dental and the medi- his efforts are directed toward estab- particularly influence his decision to cal schools proved to be very help- lishing an endowment to sustain and engage in them. He sees himself as ful in planning and executing pro- assure the future of the program. less fearful of the ever-present illness grams In Haiti. Coupled with his sustained com- or adversity that accompanies work in Despite his rich array of activi- mitment is a generalized respect for a third-world country. He also willingly recruits family and friends to join in his ties, Jerry indicated that he was humanity. His respect for the Haitian looking for something else. He said, people is exhibited in his oft-stated efforts to bring hope and help to oth- concerns for treating people with dig- ers. "At that time, I think 1 was looking nity, regardless of their circumstances, Perhaps the most admirabie quality for something to do that would be as well as a generali?ed commitment of Jerry Lowney is his abiiity to of interest and would maybe-1 hate neither to criticize cultural practices "inspire others and thereby move to use the words 'pay back' because it's sort of a cliche-share some of Continued on page 318 my good fortune somewhere else.

Quintessence Internationai 317 So many wonderful things had hap- pened to me-at that time I was in Cuiiliiiued iniiii fJiiii 5i 7 my mid-40s-maybe it was time to give back," As to his work in profes- them to moral action" ¡criterion 4),' their cuitural or religious vaiues on sional organizations, politics, and The story is (illed with examples of them. Add to this someone who realiy his community, he said, "I never individuals who were moved by his iistens, without reservation or judg- example and became involved in the ment, to anyone who has something really looked at that as a major con- work of the Haitian Health Foundation, to say. When Virginia gave him an "F" tribution to anything. Some of that Consider Sister Carla, who was the tor child rearing, he iistened and modi- you could look at and say, well, If initiai contact, or the three Franciscan tied his werk iife. When Virginia exem- you were on the cancer board, you nuns, who were inspired to run the plified caring tor others in aii aspects certainly got some notoriety out of clinic, or the hundreds of health care ot her iite, he was open to her influ- workers who volunteered their ser- ence and adopted her as his own it, and it helped your practice," He vices, or the thousands of people who moral exemplar. When the bishop said was looking for something that sent money to "Adopt a Family" or to he needed help in Haiti, he listened went beyond his own self-interest. buiid a house, or those who continue and responded. When a child died in In October of 1981, 4 months to contribute mere extensive financial his arms, he was moved to help. When support. Consider also those who Sister Carla told him where he was before tbe first scheduled trip to were moved to use their vacations to needed, he went. When she needed a Haiti, an event occurred tbat per- provide physical labor to accomplish place to stay so she could continue to haps sharpened Jerry's desires to be the various projects. Finally, consider work, he provided it. When she said of use to others, "I was running a Dr Lowney's daughters, who are so someone wasn't poor enough to lot at that time," he said. "In fact, I inspired by their father that one joins receive his services, he respected her his practice and the other becomes his judgment. When Mother Teresa said ran tbe Boston Marathon in "79. I successor. she needed him in the remote village was starting to get hematuria. I Finally, in keeping with criterion 5— of Jeremie, he made a commitment. went to a urologist and he found a "a realistic humility about one's own When the pigs were eaten rather than tumor in my biadder," It turned out importance reiative to the world at used to repienish the supply, he was to be a very rare, but very aggres- iarge. impiying a reiative iack of con- moved to iearn why and then to solve the problem. When Haitians said they sive carcinoma of the bladder cern for own ego"'—let's consider the personal qualities of this exempiar. couldn't use the latrines because of called urachai carcinoma with a Humble? Compassionate? He says he the seats, he made modifications. bad prognosis, A big man, over 6 is not. Modest? No. Generous? He We see in his actions an cpen-mind- feet tall, he had lost more than 30 says, "not partioularly." Aggressive? edness about new tacts and their impli- pounds after surgery and radiation impatient? Dominating? Persistent? cations. We see an ability to endure cir- treatments. Nevertheless, going to Unyieiding m his conviction? All ot the cumstances that wouid be dispiriting to above. Yet these seeming detractors others. We see a capacity for tinding Haiti in February became a goal to are the entrepreneurial quaiities hope and joy even when faced with strive for, despite Virginia's concern essentiai tor accompiishing his ends. dreary truths. It is not that his orientation and the negative opinions of his Whereas Dr Lowney, like the exem- was so ditterent trom the morai con- physicians. As a compromise, his plars interviewed by Colby and cerns of others, including the many vol- son, Mark, went with him, "He was Damcn,' does not see his moral choic- unteers who ccntributed time and eftort es as selt-sacritice, most wouid judge to the projects. It is the range ol his con- sent along to sort of watch me. In his contributions as extraordinary gen- cern, the vastness of his engagement, case 1 fell, he'd pick me up," erosity of time, talents, and resouroes. and the single-minded ness ot his com- Jerry is uncertain exactly how his In addition, he is unyielding in his con- mitment that sets him apart from the experience with cancer shaped viction Ihat respect for persons, no many good people who give of them- matter how destitute the person may selves for the benefit of others. what he ultimately accomplished in be, is a primary value. Furthermore, Jon Hassler,^ in a recent book enti- Haiti. On one hand, he said, "I had whether cultivating a donor or treating tled "Good People," distinguishes a crisis in my life, but I don't think a destitute patient, no one has a right dispos it I o nal goodness from goodness tbat that had a lot to do witb it. The to tell others how tc live or to impose of activity. Hassler draws on his per- foundation was tbere before that, because I was involved with other things locally." He said that if he had not developed cancer, he might have gone to Haiti, looked around, was told I wasn't going to live. And Lowney's receptivity to tbe possibil- and returned home to do nothing, I kept thinking, 'Gee, I really ity of doing more-much more-to but he doesn't think so. On the haven't done enough.' I kept think- belp others. But why did he feel other hand, it was clear to him that ing that, because [the cancer] hov- thai way in the first place? A look the cancer "definitely made a posi- ered over me like a sword" at his background and the people in tive influence in my life, because I Thus a variety of circumstances his life will provide additional didn't think I was going to live, I converged to set the stage for Jerry understanding.

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"didn't go to church except to sweep it," although he nonetheless got the children out of hcd every sonal encounters ot a litetime, includ- find deflating? He said, "It is very Sunday morning to go to church ing characters developed for his nov- important that you don't iook at the big with tiieir mother. Chailenging the els, to describe persons who were picture in Haiti or in Jeremie, You have habitually kind, caring, and cheerful in to concentrate on the faot that you are family's empiiasis on religion was their interactions with others. He dis- dealing with one person at a time. One the neighhorhood they lived in, tinguishes them Irom individuáis who person who will nol be in pain where tiiere was a lot of trouhle for were engaged in many activities that because you removed their infected chiidren to get into, ¡erry was a benefited others, hut possessed less tooth. One person for whom you built ready participant. He said, "1 cer- admirable personal quaiities. Like or repaired a house, it is not saving Coiby and Damon, Hassler seems to the whole country, not even saving the tain iy wouldn't be ciassified as a admire dispositional goodness—it is whole village." The magnitude of the reai good kid." He had even been nice to be around people who exhibit problem is such that Jerry has come arrested once or twice "for doing this habitualiy—but he sees the altru- to see his sense of humor as his crazy things iike iiids do" Both par- istic nature, which distinguishes good- greatest asset. "I've been reduced to ents, however, preached with great ness of activity, as the quaiity he tears many times in the third worid. admires most. [You] have to look at things through success to their chiidren ahout the It strikes us that Jerry Lowney is an the funny side, or if will get to you. I vaiue of a good education, neither exemplar because he is aitruistic. An wouldn't be me without my sense of having had mueh themseives. act is considered aitruistic when it bene- humor. It's a way of coping and it's a Therefore, it was as clear to Jerry as fits another and is performed uoiuntarily stress reiiever. And it's my personality," it was to his hrothers and sisters for its own end at some cost to the self, Despite his extraordinary commit- that he was expected to go to col- without expectation of personal gam. ment, he is not a perfect person, per- However, onoe someone is iabeied as haps too aggressive for some tastes. iege. Woriiing in one of the Fall an exemplar, there is a tendency to Yet there is a modesty in his denial of Rivers textile mills was not a happy inflate expectations about ali aspects of his generosity and oompassion, and in alternative. The result was that vir- a person's behavior. We not only expect the reoognition of his iess admirable tually every one of his siblings exemplars to be paragons of virtue, dis- traits. There is generosity of spint in the achieved a university education, and playing dispositional goodness, but we way he acknowiedges the contributions tend to devalue their achievements if of others, particularly his wife, to his five became physicians. they have not personally suffered to personal deveiopment. His seif-discio- Why did he want to be a dentist? achieve them. As Colby and Damon' sure reveals insights about his motiva- Jerry said, "I just thought that it point out, "We confuse altruism with tions and convictions. What stands out would be a pretty good profession. I self-denial." We expect our exemplars to for Dr Lowney and other exempiars, iiked [my dentist]. He was a very iead grim lives of suffering to achieve and what sets him apart from ordinary their morai ends, and "we take personai good people, (s a unity of the self with decent fellow. He was nice to me. I suffering as the truest sign of moral morai concerns, it is a unifioation that is was sort of intrigued with his office, commitment."'p^"'Yet none of our exem- directed by his faith and his conviction with the things in his office and the plars or those studied by Colby and that his responsibility in iife is to mobi- mechanicai part of it. He looked Damon saw 'iheir moral choices as an ilze his muitifaceted taienls and ener- like he was doing pretty well and exercise in self-sacrifice" This mindset gies in the service of others. is only possible when there is a syn- was happy in his iife." In addition chrony between moral goais and per- References he said, "My father thought it was a sonal goals. 1. Colby A, Damon W Same Do Care Contem- great idea to become a dentist, Whiie Jerry Lowney has not ied a porary Liues of Moral Commitment. New York: because it was a wonderful way to grim life of suffering and seif-sacrifice Free Press, 1992. make a living. He didn't say to himself, he is intimately invoived in the 2 Hassler, J. Good People. Chicago: Loyola Press, 20111. become a dentist so you could go circumstances of the impossibly grim lives of others. How does he sustain out and heip people. He was just a himself In situations most of us would poor guy with a big family. He'd go out on Saturday night to the Corky Row Club, have a few pops with the boys. That's what life was like in those days" Jerry said that he came from a church." He grew up with more or Thus Jerry applied to Tufts just as poor Irish famiiy in Fail River, less constant exposure to religion, his dentist had done. He was admit- Massachusetts. It was a iarge famiiy: mainly because of his mother, who ted, worked 40 hours a weeii in a Jerry is the oldest with S brothers was a daily communicant at Mass. supermarket in Medford, Massa- and 2 sisters, "At that time my His father, on the other hand, was chusetts, and earned grades that father was a church sexton, which is mainiy preoccupied with taking were acceptahie for dental school. a faney name for a janitor in a care of his family. Jerry said he He met Virginia early in his denfal

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school career while she was more of a humanitarian in nurses' training at a small than I am. I just ride on her hospital. They married as coattails. Wben you start soon as he graduated. talking about Haiti, she'll Together they went to the get so intense she'll take Pensacola Naval Air Station you out to the barn to while he served in the Navy show you [all tbree levéis for 3 years as a dentist packed full of supplies that aboard a carrier. After his are ready to be shipped to discharge he enrolled at the Haiti]. She calls Haiti her State University of New fifth child. She's very com- York, Buffalo, where he mitted. In Haiti, she goes acquired his training in down to the slums, the orthodontics along with an homes, and talks to tbe MS degree. Jerry reflected women, gives them a few on the way his life has gourdes, and listens to developed since then, "We Jerry and Virginia at a dinner tor the Crder of ''' them. And she goes up in ehre in New York. have passages in life. The SephLí the hills and takes blood first part of your life is spent pressures, takes things and with accumulation. You money to the people. She accumulate an education. probably spends 5 or 6 You accumulate ways of hundred dollars in five-dol- making a living, either with a busi- Jerry said, "She is a very spiritual lar bills given to mothers in the ness or a profession. You accumu- person. Just her inftuence in a very houses as she goes along. That is late a family, accumulate a house. I gentle way convinced me that there her pleasure. She writes to a lot of think most people experience this is a joy in sharing and that tbe the people and their families. at one level or another. Tben the things we have are really things that Really, It is now the tail wagging next phase of your life Is a sort of we are stewards of. Our possessions the dog" floating with these things you've are a stewardship. They are not Sometimes Virginia's influence accumulated and maybe just tuck- given to us to keep. Even our chil- has been less gentle and very direct. ing them together and making them dren are given to us to share with Jerry said, "When I first went into a iittle more secure. And then you others and to share with the world practice, my wife gave me a report have a choice. You can continue or to share with people who are card one day, and ft said: Provider- along that way, or you can say, needy. Interestingly enough, she 100; Parent-0. I said, 'How did 1 maybe I should share some of it. I said, 'I would rather give witb a flunk?' She said, 'You're in the think maybe I took the road of warm hand than with a cold hand office too much.'" He listened, and sharing. from the grave.' Most people deal their life changed, "I was a worka- with tbe cold hand from the grave holic. She made me aware that after being attacked by the various there were other things in life. I Husband and Wife taxing agencies and probate court. knew that there were other things, You don't get to experience the joy but I wasn't practicing the game fhe "It is interesting to consider what of sharing. And there is truly a great way 1 should have been." influences you to do certain things. joy in sharing." I think what influences me the Jerry said that when he returned most is my wife." Jerry said the day from his first visit to Haiti, so Acknowledgment he married Virginia and his exper- enthusiastic about what he wanted and Appreciation ience with cancer were the turning to do and wanting to commit some points in his life. The experience of their personal resources to it, For the sharing of his talents and with cancer was abrupt and dra- "there was never a moment's hesi- energy, Dr Lowney has received matic; his marriage with Virginia tation from her about it. She's more much recognition, both from his was gradual but more enveloping. generous toward it than I am. She peers and his community. He has He thinks that his accomplishments is very compassionate, works even been knighted twice by tbe in Haiti would have been consider- extremely well with old people. She Pope. The federal government has ably different, perbaps nonexistent, volunteers in the summertime in a awarded him its Congressional had it not been for Virginia. hospice in Massachusetts. She's Certificate of Merit, and Connec-

320 Vnlume 32. Number 8. 2001 ticut has presented him its Jefferson professional standpoint, he said that no question ahout that, I can get Award tor humanitarian efforts. He what ranks highest is his choice of emotional, I've heen reduced to has received Honorary Doctorate practicing orthodontics rather than tears many times in the third world, of Humane Letters degrees from anything else. The context of this I have to look at things sometimes the University of Bridgeport and observation appears to be related to through the funny side of something Quinnipiac University and an the dominant passion of bis profes- that is happening. You have to just award for humanitarianism from sional life: his work in Jeremie, He have a sense of humor, or it will get his classmates at Coyle High said that he feh very fortunate that to you, 1 wouldn't he me without my School, class of 1954. He has when he was introduced to Haiti, sense of humor, It's a way of coping received distinguished citizen he was young enough to respond and it's a stress reiiever. And it's my awards from the Connecticut vigorously and was sufficiently personality It's me; I am not a seri- Chamber of Commerce and the secure economically to be able to ous guy with people," University of Connecticut Alumni take time off and to put financial Association and a merit award from From a moral standpoint, he said resources into his work in Haiti, he takes seriously the moral values his fellow members of the Board of Also from that standpoint he said Trustees, Rotary International has exemplified in the Gospel of that he is hoth proud and privileged Matthew, chapter 23, in which "we twice cited him for meritorious ser- that his daughter Jennifer has fol- vice, and he has received a variety are charged with reaching out and of other awards from local and helping others, helping neighhors. state organizations. Those are values important to me. We are not aione in this world, and His profession has also recog- "Virginia's influence we do have an absolute responsibil- nized Dr Lowney for his work in ity to look to what we can do to Jeremie, This has included the in a very gentle way make someone wbo is not as fortu- American Dental Association convinced tne that nate as others, either health-wise or Certificate of Merit and election economically. It is our responsibility into both the American College of there is a joy in shar- to reach out and help them, 1 think Dentists and the International we have a responsibility to show by College of Dentists, In addition, ing and that the example to others. Sometimes our recognition has come from both things we have are actions are tbe only Bible [lesson] dental societies and auxiliary educa- other people need," Fven with those tional institutions within the state, really things that we strong beliefs, Jerry said, "I couldn't A different kind of recognition say that my [essential] characteristic has also provided Jerry with a great are stewards of." is that i am generous or overly com- deai of satisfaction, even though passionate or anything of that there is no plaque to show for it: nature. There is a little bit of that USAID has modeled some of its there, but it isn't overwhelming," programs after the successes of the lowed him into the profession and Also, he said, laughing, "Humility is Haitian Health Foundation, has been able to assume some of the not there-modesty and humility," obligations of the practice. He said More to the point, Jerry com- that often people have to delay the mented, "I am aggressive in getting Reflection, fulfillment of a special interest until things done that I want done, I am Resonance, Reasoning their retirement, sometimes not a hard charger, I'll work to accom- being able to do it then, "I was for- plish something, for sure. I suffer Dr Lowney appreciates all the tunate that I was able to do it at the people who are wrapped up in recognition that has come his way young age of 45," For this early bureaucratic red tape with very lit- for his work in Haiti, However, he start, he thanks orthodontics. tle patience, I don't think this pro- said, "I don't think there is any For sustenance in difficult ject in Haiti would ever have gotten question that the fact that I have a moments, he thanks his Irish sense to the point that it's at without loving and caring and compassion- of humor, "[It] has really supported somehody being aggressive. You ate family is my greatest achieve- me. Even with the experiences In can't he a shrinking violet and let ment, 1 have been fortunate to have Haiti, you know, 1 can find humor. people push you around, because a good wife and good family, and Sometimes, it's gallows humor, 1 can you wouldn't get anything done, I those family values have been a find humor to take some of the sad- think 1 am respected by the people high priority with me," Speaking ness out of my life, or the sadness I that 1 work with in Haiti and here, about his accomplishments from a encounter in my life, I'm emotional. hecause they know that I don't take

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Stay on the line and I'll put a con- ference call in,'" The result was pre- dictable. Senator Dodd introduced the Treasury Department official to Dr Lowney, one of his dearest, clos- est friends, and with great assur- ances that the license would he sent by fax that afternoon, the business was completed successfully, Dr Lowney enjoys the influence that he is able to wield that is usual- ly associated with affluence and social status. However, he said that his experiences in Haiti have con- siderably altered his and Virginia's point of view about material things, With an ambulance crew at HHF Clinic in Jercm f "We don't spend a lot of things on ourselves. We have a nice car and a house. But when you go into the third world and see how little peo- ple have, I can't get excited whether anything out of this. They know states. Jerry offered to help her the stock tnarket goes up or down, that all my wife and I get out of it is work through the Treasury even though I have some stock, I'm satisfaction. We put a lot of our Department to obtain the license still better off. I'm better off than so own time and money into it, so peo- that was necessary to ship the con- many other people," He said that his ple respect that. They say the guy's tainer. He submitted the applica- experiences with cancer also height- not a phony, I really never have tion, but nothing happened. He ened that perspective. Parenthe- asked anybody for anything for called but got nowhere. He said, tically, Jerry said, "It also changed myself, but I am not shy about call- "The peopie at the Treasury my outlook. In that I am not fright- ing and asking someone for some- Department seemed always to have ened of anything anymore. Nothing thing that somehody else needs," an excuse, I was documenting this bothers me. Worrying about AIDS In fact, when confronted with a whole thing-the day and time I never bothered me after that, I don't problem, he appears willing to called, and what was said. So one feel like I'm invincible, but nothing extend himself as far as is neces- day I said I realiy want to taik to worries me anymore. I can't get ner- sary. He told me about an incident the person in charge of this. This vous about issues like that." that was particularly annoying to arrogant guy gets on the line, and I Jerry said that the Haitian expe- him. During one period when the said it has been two and a half rience "has been phenomenal for US government was placing an months trying to get this license. my family and my kids. They have embargo on exports to Haiti, he He said to me it takes quite a while ail been inoculated with the impor- received a call from a woman in a to get these things done, and Pm tance of serving others. They all go Baptist mission who was finding it quite busy you know. He was down at least once a year. And so impossible to ship containers of telling me all the prohlems involved many other friends and acquain- supplies to Haiti, Dr Lowney had on his end, giving me the usual gov- tances have brought their children encountered no such difficulties, ernment litany, the usual line that along with them to Haiti," He said primarily hecause of assistance he 'I'm doing the job six people used that it has been a positive thing for had received from Senator Chris- to do before the cutback,' So I said, everyone who goes there. topher Dodd of Connecticut, In 'You know, the time you used in There is no problem in finding earlier days, Jerry and Chris fre- explaining this to me, you could people who want to volunteer. In quently had lunch together when have typed that license out and sent fact, Jerry said that he has a waiting Chris was an attorney in Norwich, it to me.' He said, i suppose 1 could list of all types of people who want and Jerry was on Dodd's first cam- have, hut I'm not going to!' And he to volunteer their time in Haiti. paign committee. Jerry's caller had hung up on me. So, I called Dodd. I "There are so many people out no such assistance; her organiza- always keep him in reserve. there that I've met who want to do tion had been in Haiti so long that [Senator Dodd] said, 'So, what's something. They're dying to do they had lost their contacts in the the phone number down there? something positive for others, A

322 Voiume 33, Number 4, 2002 man that was here this morning-he will be not be in pain because you funds altogether. However, Jerry just retired as a poiiceman-is going removed their infected tooth. One said, "Our program is one of two down there for a month. He used to person for whom you built or premier programs, so we would he go down for a week," That man, like repaired a bouse. It is not saving the the last to shut down because they all the others, wants to make a con- whole country, not even saving the use us as a model. You know, when tribution, Jerry said, "My experience whole village. But it's important to a congressman or senator comes is that there are tremendous num- that one individual you're dealing through Haiti and USAID wants to bers of good people who want to with. It's a lot of work, and it builds. sbow off something, they take him get involved with something. And There is a vast ripple effect," up to Jeremie to see HHF," it's too bad that there are not more The other admonition he gives to Over time, however, USAID has avenues for them to wander down, volunteers about working in Haiti increased the number of people because everybody doesn't bave to has to do witb respecting tbe peo- that tbe HHF takes care of from go to Haiti or sbould go to the third ple who are being served. Jerry said, 50,000 to 200,000 witbout increas- world. When you are involved with "In tbe tbird world this is very ing their budget very mucb. He something like this, you flnd some important. You can't invade anoth- said, "I'm fighting with them all the great friends, because these are peo- er person's culture with yours. If time. They baven't given me a new ple who have the same values that you have money, and you're giving vehicle for 5 years. We've been buy- you have and feel the same as you them things, they're going to agree ing our own vehicles or getting peo- do. So you form relationships with witb you. And they're going to take ple to donate vehicles. One of our nice, solid people," what you've got." It is the same main problems for the future is sus- Jerry is particularly struck by tbe with other cultural issues. When tainability," He worries about how number of dentists who want to Jerry goes into the villages, people to keep all of his programs going volunteer their services in any num- often asked him wbat he is doing and tears that some will have to be ber of places. He said, "I think that about population control. Although cut back. Some agencies, such as people in the dental profession he privately agrees with their con- CARE and UNICEF, upon which don't have the opportunity to inter- cerns, he tells them he is not doing he had depended for funding, no act with people's lives to the point anything about it. "You don't walk longer provide financial support. where they can say they've made a into somebody's village and say to Therefore Jerry has no choice but to major difference, I'm talking about them, 'You've got too many kids. search for new money, the life-cbanging differences that You're going to have to stop having "They say Jeremiah is a propbet, maybe people in medicine or in law children,' No one counted my chil- and a prophet is someone who can make. Dentists are confined to dren. .,, It's the same when you're makes the comfortable uneomfort- a narrow area of interest and exper- going in and proselytizing with reli- able, and the uncomfortable com- tise, and I think tbat might be why gion, from day one, tbat was some- fortable. So I go cut there and tell many dentists are interested in vol- thing 1 said I would never, ever do," them what tbey are missing and tell unteering. It gives them an opportu- The HHF board is a mix of people them I have the answer for them." nity beyond dentistry," Jerry added, and is deflnitely nonsectarian. ¡eremiah J, Lowney said he has "If you have that nature of wanting become a fundraiser, and he spends to do things and you are not able to much of his summers raising money, do them, you reach outside the pro- Preparing for the Future "I do raise quite a bit, maybe fession and do tbem somewhere $50,000 in the summer [speaking else, even in politics," In his experi- Jerry said, "In the beginning I was a at] churches," He arranges to be an ence dentists tend to be involved in clinician. I don't do mucb of that invited speaker on Mission Cooper- many more community-oriented anymore. Most of the time I am in ative Sundays, On that day, each activities than physicians. He noted administration, The personal rela- cburch in every diocese invites a thai ten times more dentists than tionsbip with the poor has changed speaker from the mission field: a physicians have volunteered to go from my being a dentist for them to priest in Africa, a nun from the to Haiti through his organization. being more of a program coordina- Philippines, or perhaps Dr Lowney When Jerry talks to bis volun- tor. There is a different type of satis- from Haiti, At the end of tbe talk, teers, be teils them, "It is very faction." tbe congregation takes a collection; important that you don't look at the There are also major challenges, the amount "depend[s] on how con- big picture in Haiti or in Jeremie, and they all involve the future of the vincing you are, how well your ser- You have to really concentrate on HHF, Mostly tbey involve finding mon goes, and the financial ability the fact that you're dealing with one money. There is, of course, always of those attending," He covers the person at a time. One person who the risk that he might lose USAID diocese in Norwich, the archdiocese

323 Quintessence International IIIJJ.L-lil.lW^IJX

in Hartford, and the dioceses in funding deteriorates. In 2001, as of to maintain on-sitc personnel, Bridgeport and Fall River, Mass- this writing, Jerry, now in his mid- which continues to this day. This achusetts. "My weekends arc pretty 50s, has cut his practice hack to problem gives him sleepless nights. much taken up in the summertime. T three days a week, but stili spends The Franciscan order, which go to four or five masses on a week- many hours each week on HHF administers the program in Haiti, is end and give the same talk at every business. having "the same problems every mass. So I'm just loaded with sancti- Three years ago, at the time of religious order is having: they don't fying grace." this interview, his concerns about bave many new vocations. They Occasionally he gets invited to a the sustainability of the program don't have many sisters that they different part of the country. Once were even deeper than they are can say can take over this project. when he was in Springfield, Iliinois, now. He was preoccupied with They don't know how long they where the sisters in Jeremie are finding a successor, Jerry iinew that will be able to continue sending sis- from, he was asked to speak to the it would be impossible to find ters to Jeremie." To aileviate part of hospital staff. Jerry said that among someone like himself who would the problem of finding staff to work those attending was a man seated eievafe the Haiti experience to the in Jeremie, Jerry has been encourag- way in the back, who "had been self-sacrificing position that it ing more full-time volunteers who interested in how we concentrate occupies in his iife, presuming of would like to spend a year or two our efforts on child survival and course that he or she could afford there. As an inducement, the HHF maternal care. HHF couid not he to do it in the first place. In the has huilt a separate house for them everything to everybody. The future future, the person who runs the to live in. The effort continues. of Haiti was the children. As a program wouid have to be paid, group in 1989, the HHF directors that realization being part of the decided on this policy." Jerry dis- need for the endowment. Jerry said, Continuing Efforts covered iatcr that, based on his pre- "The problem is, beyond the pay sentation, this man made a trip to you have to have someone who The Haitian Health Foundation Haiti, fell in love with the program, really wants to commit to do it. If occupies most, but not quite ail, of and gave $1,000,000 to the someone is doing it just for a pay- the Lowney's attention. They share Franciscan Sisters for their use in check, it isn't going to work. We their good fortune in other ways as Jeremie. Jerry said, "That's how need someone who is committed to well. One of the great debts that things happen. Strange isn't it? wanting to do this type of work." Jerry owes is to his mother-for Maybe I might have blown it if I His hope at that time was that his many reasons, but in particular for had known this gentleman was so youngest daughter, Marilyn, would her persistence in finding a way for wealthy, I might have tried to pol- do it. She knew the program, hav- him to go to parochial school. He ish him up a bit, and he might have ing previously been active in grant has always felt that the quality of mistaken me as [a hustler]," writing. Furthermore, he said, the educational experience, if not Often, as with the man who "She's been going to Haiti since the discipline, made the rest of his donated the million dollars, the use she was fourteen. I can groom her life possible. "There is no question of the money is designated by the to do it. I'm waiting for her to say that my mother did me a great donor. Otherwise, Jerry said, "I'm she wants to do it. I hate to say to favor. She didn't have any money, building an endowment now with her that this is what I want you to though it wasn't very expensive, ... any funds I can get my hands on do. I have a strong influence with We could walk to Catholic gram- that isn't designated for something [all the chiidren], and she probably mar school, but high school was 15 specific. I've been building it over would do it to piease me. But I miles away. She had the money for the last 8 or 9 years, and I've been wouldn't want that. I'd liiparish my own, so HHF has a fair amount wants to do." church, and he gave her the money in the investment account. His goal The probiem of Dr Lowney's for tuition. A few years ago they is to acctimuiate an endowment of successor is now resolved. Marilyn asked me to give the commence- $5 to $8 miiiion. The purpose of Lowney is already at work as an ment speech at this high school, the endowment is to sustain the employee of the Haitian Health and there was a whole iist of Haitian Health Foundation after Foundation, serving as its executive awards named for different peopie. Dr Lowney is no longer in the pic- director. This does not mean that And when I perused the list i ture. It is intended to be a reservoir the HHF personnel prohlems are noticed memorial awards, hut there of money to keep the programs resolved. At the time of fhe inter- was nothing for the priest who had going in ease the environment for view, Jerry spoi

324 Volume 33, Numoer 4, 2002 to this high school. Virginia and I time there were three or four of us seem to avoid looking for problems set up a scholarship in his name. It in high school." that need resolution, particularly was a way of giving something back One gets the impression that those where he can make a differ- and honoring somebody itnportant. even in the few moments when ence. And when he finds one, he 1 wouldn't have gone to this school Jeretniah Lowney is not directly steps in fo fill the void. without him. There wasn't just one involved with the concerns of tuition either. At any given point in Jeremie and the HHF, he cannot

A Note from the Authors

In 1996 we embarked on a project to identify dentists to that prompted their peers to nominate them as exemplary serve as models of commitment to professionai ideals. professionals. For a detailed description of the selection We hoped their stories would evoke a fuiier understand- process, interview questions, consent process, and analyt- ing of professional reËponsibilities for young persons ical methods, see Bebeau and Ruie (1999). entering the profession. We also thought such stories could serve as a source of inspiration and renewal to those who are established in their professional lives. Criteria for moral exempiars To identify exemplars, we engaged in a national nomi- nation process using criteria developed by Colby and • Shows a sustained commitment to morai ideáis Damon (see box). We selected 10 individuals who nof or principies ttiat inciudes a generalized respect only fit the criteria bul exhibited exceptional commitment tor humanity to one or more of the ordinary responsibiiities of the den- • Dispiays a disposition to act in accord witii morai ideáis or principies, wiiich wouid impiy a consis- tisf. We attempted to make selections from a diverse tency between actions and intentions and the group of nominees from the standpoint of gender, race, means and ends of actions and religion. We also looked for diversity in professional • Expresses a wiiiingness to risii seif-interest for activities and seiected a mixture of practitioners and aca- the saiie of morai vaiues demics. Each of these individuals will be featured in ' Shows a tendency to be inspiring to others and Quintessence international. thereby to move them to morai action In-depth interviews were held in each exempiar's com- • i-ioids a sense of realistic humiiity about own munity, usually over a period of 3 to 5 days. The interviews importance reiative to the worid at iarge. imply- ing a reiative iaci< of concern for own ego followed a pattern of ethnographic conversations to explore the nominee's conception of the factors fhaf influ- enced his or her development. Our methods of analysis took seriously our nominees' conscious articuiation of their Coiby A, Damon W. Some Do Care: Contemporary Lives of beliefs, values, and life histories. Our interest was in fhe Moral Commitmenf. New York: Free Press, 1992. meaning they assigned to events in their lives. Thus each Bebeau MJ, Ruie JT. Morai heroes in dentistry: A work in progress. Presented at a conference entitied "Roie-Modeling version of the story was returned fo the nominee for com- and Mentoring in fhe Formation ct Vaiues, Attitudes, and ments, corrections, and final approval. In the accompany- Character ot Heaifh Professionals," sponsored by the Division ing commentaries, we share our impressions of the partic- of Medical Education, Daihousie University, Halifax, Nova ular virtues that define their character, as well as those Scotia. 3-5 June 1999.

325 Quintessence Internationai