In the long, dimly lit hallway outside the makeshift dental clinic recently put together in her Damascus nursing home, Elham Ayash, 77, sat with nearly a dozen other elderly women in silence, patiently awaiting their appointments. Her face would occasionally twist with the throbbing pain that had become all too familiar to her.
Ayash and the other residents of Dar Al-Karama Nursing Home are among Syria’s 709,000 elderly women, mostly plagued with poverty after a 12-year civil war that has left them unable to afford dental treatment in a country where 10.4 percent of the adult population suffers from edentulism.
Many of these women have opted to have their ailing teeth extracted as it appeared to be the most practical option given their age and lack of financial resources.
According to one resident, however, this often “expensive” solution did not always relieve their long-standing pain, and often left them “emotionally devastated.”
A right that has turned into a luxury
In Syria, rampant inflation has caused the U.S. dollar to trade at a rate of SYP 13,000, making several services including dental healthcare unattainable to the average citizen, whose average monthly income stands at SYP 200,000 ($15.38).
According to an anonymous source in the Syrian Dental Syndicate, treatment costs in clinics vary depending on the location and are heavily influenced by the materials used by the dentist.
“A root canal costs SYP 150,000 ($11.54), while dental extraction is around SYP 50,000 ($3.85). As for the price of planting a single tooth, it could reach up to SYP 2.5 million ($192.28),” he says.
“Even the cost of dentures has risen significantly, with prices ranging from one to one and a half million Syrian pounds ($76.91-115.37).”
"Today, patients bear costs of several thousand Syrian pounds, covering necessities like anesthesia, gloves, plastic cups, saliva ejectors, and tissues. And that's all before the dentist even begins their work"
Majd Abeesi, an economic journalist, notes that affluent Syrians are increasingly turning to loans to finance their dental work, particularly for costly procedures such as dental implants or veneers.
“A growing number of Syrian poor, who are ineligible for loans, however, is starting to rely on painkillers instead of fillings,” he tells The New Arab.
"Many seek treatment at universities offering free dental services as part of student training, but this can turn the patient into a testing ground for inexperienced hands."
But as dental care shifts from a right to a luxury for Syrians, initiatives led by volunteer dentists are aiding those suffering in silence.
Volunteers are stepping up
The organisers of one initiative, Asnan Al-Lolo, roughly translated in English to pearly whites, are teaming up with clinics and medical centres to offer free dental consultations and treatment one day a week.
“Today, patients bear costs of several thousand Syrian pounds, covering necessities like anaesthesia, gloves, plastic cups, saliva ejectors, and tissues. And that's all before the dentist even begins their work,” explains Daniah Subh, a fixed prosthodontics specialist and co-founder of the Asnan Al-Lolo initiative.
Since 2019, the group has successfully treated 922 patients in total, often targeting groups at a disadvantage including people with a visual or hearing impairment, with many dentists undergoing sensitivity as well as sign language training to help them better communicate with their patients.
In their first year, the team faced challenges in earning the trust of medical centres, who initially refused to provide free access to their clinics. As a result, a significant portion of donations went toward renting these spaces.
“We have since succeeded in partnering with several centres, which now donate their clinics for free,” Subh says adding that the initiative, whose main source of funding is donations, is always looking for different financiers to be able to compete with the rising costs.
"The effort wouldn’t have been possible without the veteran doctors and dentists who decided to waive their fees to provide life-saving procedures to anyone who needs them"
In 2017, Ahmed Al-Ahmed, an otolaryngologist and cosmetic specialist, founded the Doctors for All organisation, which over the years has launched a number of initiatives to help Syrians grappling with the rising costs of treatment.
In one of these initiatives, titled Ahmed’s Humanitarian Project, 600 medical volunteers executed over 15,000 surgeries, including over a thousand dental procedures over the course of four years.
“We wanted to provide dental surgeries at significant discounts,” Al-Ahmed tells The New Arab. “The effort wouldn’t have been possible without the veteran doctors and dentists who decided to waive their fees to provide life-saving procedures to anyone who needs them.
“If you’re scheduled for surgery and cannot afford it, just call us on any of our numbers shared on social media. We don’t need any guarantees because we know what everyone is going through.”
Back at Dar Al-Karama, some are beginning to hope now that volunteer dentists from the Salma initiative, a mobile, non-profit dental treatment unit, have begun visiting their facility, offering oral healthcare services free of charge.
“Our services are not just for the elderly. We try to help vulnerable individuals who are unable to travel and pay to see a dentist,” Masa Ayoub, the project’s coordinator, tells The New Arab.
“Salma is expanding to bring dental healthcare to the differently abled in their homes or care facilities as well.”
In October 2023, the initiative made its inaugural visit to the Dar Al-Hannan Assisted Living Facility on the outskirts of Damascus.
"We are in desperate need of cardiologists, as almost two-thirds of our patients require consultation before having their dental procedures"
There, a team of 24 volunteering dentists assisted 10 elderly women with new fillings. A few months later, in Dar Al-Karama, the number of those benefiting from the programme exceeded 50.
"We've noticed a shortage of toothbrushes and toothpaste as well, so ensuring their availability is now a top priority whenever we visit an assisted living facility," Ayoub says.
One thing that has been preventing them from expanding outside of Damascus is the relatively low number of volunteers and the rising demand.
“We are in desperate need of cardiologists, as almost two-thirds of our patients require consultation before having their dental procedures,” she says. “Expensive dental prosthetics are also highly requested, which are not always affordable.”
Dreams coming true
As the day draws to a close after hours of hard work, the room fills with hope as the women celebrate their successful dental procedure. One woman claps with joy upon seeing her new teeth, while others shower the dentists with prayers for good fortune.
Amidst it all, a smile of relief betrays Ayash’s solemn features, as she holds a mirror to check the new filling, she just had free of charge.
“I can’t believe that I won’t be in pain anymore. This is a dream I never thought would come true,” she says.
This article is published in collaboration with Egab
Mawada Bahah is a freelance Syrian journalist based in Damascus who focuses on environmental and society issues
