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Thomas Grams, 51, quit his dental practice in Durango, Colo., four years ago to work full time giving poor children free dental care in Afghanistan and Nepal. His twin brother, Tim, said Thomas Grams wasn’t trying to spread religious views.

“He knew the laws; he knew the religion. He respected them. He was not trying to convert anybody,” Tim Grams said, holding back tears in a telephone call from Anchorage, Alaska. “His goal was to provide dental care and help people.”

Khris Nedam, head of a charity called Kids 4 Afghan Kids that builds schools and wells, said Mr. Grams and the others were “serving the least for all the right reasons.”

“The kids had never seen toothbrushes, and Tom brought thousands of them,” Ms. Nedam said Sunday. “He trained them how to brush their teeth, and you should’ve seen the way they smiled after they learned to brush their teeth.”

Ms. Nedam said the medical group never talked of religion with Afghans.

“Their mission was humanitarian, and they went there to help people,” said Ms. Nedam, a third-grade teacher from Livonia, Mich.

Dr. Karen Woo, 36, the lone Briton among the dead, gave up her job with a private clinic in London to work in Afghanistan. She was planning to leave in a few weeks to get married, friends said.

“Her motivation was purely humanitarian. She was a humanist and had no religious or political agenda,” her family said in a statement.

Another victim, Glen Lapp, 40, a trained nurse from Lancaster, Pa., came to Afghanistan in 2008 for a limited assignment but decided to stay, serving as an executive assistant at IAM and manager of its provincial eye care program, according to the Mennonite Central Committee, a relief group based in Akron, Pa.

“Where I was, the main thing that expats can do is to be a presence in the country,” Mr. Lapp wrote in a recent report to the Mennonite group. “Treating people with respect and with love.”

Cheryl Beckett, the 32-year-old daughter of a Knoxville, Tenn., pastor, spent six years in Afghanistan and specialized in nutritional gardening and mother-child health, her family said. Ms. Beckett, who was her high school valedictorian at a Cincinnati-area high school and held a biology degree, also spent time doing work in Honduras, Mexico, Kenya and Zimbabwe.

“Cheryl … denied herself many freedoms in order to abide by Afghan law and custom,” her family said.

The group’s attackers, her family said, “should feel the utter shame and disgust that humanity feels for them.”

Elsewhere, an American service member was killed Monday in a bomb attack in southern Afghanistan, and an Afghan child was shot dead the day before during a gunbattle between NATO forces and insurgents in Kunar province in the east, the alliance said.

NATO did not provide further details on the death of the American.

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