Pictured above: Aurora Johnson and classmate Kimberly Baldwin are seen in New Zealand in 2005 during their training as dental health aide therapists. Both continue to practice in rural Alaska.

“Each of you are heroes. You’ve dared to dream. You’ve taken action. And you know that you are working as a team.”

Rasmuson Foundation Vice Chair Cathryn Rasmuson delivered the keynote address at the 2013 Dental Health Aide Therapist (DHAT) Graduation and Transition Ceremony on June 6. The event was held at the Alaska Native Tribal Health Consortium in partnership with the University of Washington, MEDEX Northwest Physician Assistant Training Program and Yuut Elitnaurviat Dental Training Clinic in Bethel, Alaska.

Here are her remarks:

Good afternoon to the faculty, staff, to the graduates, to all the families and honored guests.

My first words should be about how honored and humbled I am to be here, and I do feel that, but you know what I really feel? It’s excited. Because I’ve been here since the beginning. I was here for one of the first DHAT graduations and it was very, very moving. Everybody was crying and I had dried tears on my sleeve because I didn’t have Kleenex, but the next year I remembered my Kleenex and I have that for today too.

DHAT.  Dental. Health. Aide. Therapist. What does it mean to me?

– Dare to Dream.

H – Heroes.

A – Action.

T –Together/ a Team.

Daring to Dream – and that’s what you’ve done. You want a better life for yourselves, you want a better life for your community and for your family.

Heroes – The big decision was to finally decide you were going to apply to the DHAT program. Writing the application was the easy part. The next thing was the interview, and that must have been a little bit scary. But you are heroes to us today because you have shown discipline, perseverance, and courage these past two years.

What to heroes do? They take Action. No committees are formed to talk and talk and talk, and write position papers that are put on shelves to gather dust. You don’t shift the blame to another person. You don’t shrug shoulders and say, “It’s not my problem,” or bury your head in the snow. You walk the talk. You left the comforts of home, traveling to Anchorage and Bethel for two years of your life. You have worked diligently to achieve your goal, and today you graduate.

How did you get here today? By working Together, as a team; with the faculty, with the staff, with each other, with your village, and with the funders – together, a team.

Your dream is now a reality.

My husband is a banker, and so everybody always put me on the treasury committee because they think if he’s a banker I should know how to count. But numbers have never been my strong suit, you’ll have very few of them in my talk today.  But here are a few dates that we need to remember to get a sense of history, and to see how those that went before you paved the way. Your foundation is built upon their strengths.

1923 — 90 years ago! New Zealand decided to start their first dental therapist curriculum. Back in the U.S., between the 1940’s and 1970’s, mid-level dental programs were planned but were terminated before they even began because of the immense pressure from dental associations.

Now back in Alaska, we do things differently, and the story continues… with a happy ending.

In 2001, not knowing any better, the newly formed Alaska Native Tribal Health Consortium designed a program very similar to the principles of the Community Health Aide Program. At this time, there were about 52 countries worldwide had a dental therapist program — the U.S. had zero.

ANTHC came to the Rasmuson Foundation and asked for $1 million to send Alaskan students to New Zealand for training.

We replied, “A million dollars? To New Zealand? Are you crazy!?”

However, the stars and planets were aligned – a social change was about to occur and none of us knew what we had unleashed!

ANTHC was a new organization, they acted together, and they united to look for solutions to a major health problem in rural Alaska. They didn’t know that the first answer out of agencies mouths is, “Nope. Can’t do it. It’s impossible!” They didn’t know that a fierce tiger of outside pressures would soon be unleashed upon them. They did know that tooth decay was a major problem in Alaska. They did know there was an almost total lack of access to dental care in the rural villages.

The Rasmuson Foundation, at this same time, was going through major changes too. My father-in-law, Elmer Rasmuson, was born 1909 in Yakutat, the son of Swedish missionaries. And he left the bulk of his estate to the family foundation – the Rasmuson Foundation – and it was to be spent in Alaska on Alaskans.

So here we have two young organizations who believed that there was always a solution to a problem. So ANTHC came to our office an gave us a presentation of their idea. We saw that they had come together as a group, they had defined a major problem, and they felt they had an answer.

It was audacious. It was wonderful. And we said, “Yes. Go for it.”

In 2003, just 10 years ago, the first set of Alaskans left for New Zealand. So we’re all connected to one another today.

Daring to dream – for real dental health care in rural Alaska.

Heroes – these first heroes left their homes, their families, friends, and culture, and they went from here to way over there in the world for two years.

Action – at home, we were finding more partners to help fund this project, such as the Robert Wood Johnson Foundation, the Ford Foundation, the W.K. Kellogg Foundation, among others. The students were succeeding in their studies.

So what happens when the first group proudly comes home with a diploma in their hand? They were slapped with a lawsuit! Scary? You bet!

What do heroes do? They stand together and they take action. The ANTHC spent a bucketful of money on a public relations campaign and protecting their new students. The Rasmuson Foundation and its partners held firm and steady through tremendous pressure. The Congressional Delegation of Ted Stevens, Lisa Murkowski, and Don Young were getting enormous pressure back in Washington, and they stood strong. My husband was even sitting in a dentist chair when he was asked his opinion on this. Do you feel a little vulnerable there?

The lawsuit was settled, and there was finally a dental therapy program in the U.S. — but only in Alaska. Today, there are 14 other states that are working towards programs of their own. Did we even dare to dream this far out?

Look at the changes in dental care in the bush in only 10 years. We’ve gone from “a dentist is a man in a mask with no face” to now: weekly fluoride treatments and regular visits to schools; from the trauma of papoose-board teeth extractions for little babies to now: children anticipating a dental visit and calling it fun. There was a time when dental problems always seemed to be an emergency; a patient needed days of strong antibiotics to reduce the swelling before the dentist could even look into a patient’s mouth for three days. Today, 35,000 people now have regular accessible dental care.

This has happened in one decade. Can you imagine the changes in the next decade? Someday, when you have a reunion, you’ll scoff at all these new students and say, “Well, in my day it was so different and it was so hard.” But you are not going to an easy life in a fancy office with patients lined up at the door. No, you are itinerants – packing and hauling heavy equipment and supplies on boats, on airplanes, on 4-wheelers from village to village; you need to be strong. In fact, if I could make one recommendation to add to the curriculum it would be a weight-training class. These kids need to be strong.

Remember this: No matter the problems that will come up in your new job, that is a part of life, but you are not alone. You have your tribe behind you; your fabulous faculty and staff have faith in you and they are a phone call or email away to help you with your concerns; you have foundations, both in Alaska and Outside, supporting you. We are still working at leveraging funds; we’ve had an evaluation team come and demonstrate the excellence of the program; and you have your proud families that love and support you; you have villages that you are serving, who want to make the changes you suggest.

My heroes today, include everyone from ANTHC to the many foundations involved, to our Congressional delegation, your faculty and staff, and the 31 previous graduates — you are still pioneers and can make big changes.

Each of you are heroes. You’ve dared to dream. You’ve taken action. And you know that you are working as a team. I see you as fearless and determined (at least on the outside). You have an education. You are role models in your community, and you are our promise to the future.

I wish you all congratulations and good luck.

Class of 2013 DHAT graduates are Cora Roberts, Southeast Alaska Regional Health Consortium (SEARHC); Melanie Kerschner, Yukon-Kuskokwim Health Corporation; Savannah Bonorden, SEARHC; and Elsie Pelowook, Norton Sound Health Corporation.