Dentistry on the front line
Jack Losh reports from Ukraine, explaining how dentistry is being offered to people on the front line.
Inside, the clinic feels as familiar as ever. Dentists in pristine scrubs tend to patients reclining in padded chairs. Next to them, cabinets are filled with syringes, scalers, probes and pluggers.
But outside, the sound of explosions are a powerful reminder that this is the middle of a war zone.
This extraordinary dental surgery in eastern Ukraine lies close to the front line between government forces and Russian-backed separatists. It is run by Ukrop Dental, a local non-governmental organisation that was founded by a dentist-turned-activist called Igor Yaschenko. Two years ago, he was transporting supplies to Ukrainian soldiers only to discover that many of them were in severe pain, blighted by tooth decay and gum disease.
He and a band of volunteers converted an old truck into a mobile clinic and Ukrop Dental was born.
‘In the beginning, we planned to donate [the truck] to the army,’ says Igor. ‘But we realised they wouldn’t do the job properly so we decided to do it ourselves. Our troops are in serious need of dentists. We need to cure the cause of their pain, not just dole out more painkillers.’
Igor has since dispatched two more mobile clinics to the conflict zone and renovated a vacant waterworks, making it his permanent base in government-controlled Karlivka, a battle-scarred village on the road to separatist-held Donetsk.
This building houses a modern surgery with equipment donated by colleagues across Ukraine and western Europe. Volunteer dentists sleep upstairs in comfortable bunk beds, although some windows remain shattered from fighting, with outside walls scarred from shrapnel.
A divorced father of two, Igor is short, balding and buzzes with energy. Every day, he races between his various frontline clinics in his four-by-four to ensure everything is in order. In this war-weary region, he is something of a local celebrity and greeted warmly by soldiers. ‘He’s a kind man with a big heart,’ says Mayya Pelip, 62, a volunteer cook for a pro-Ukrainian militia, welcoming Igor to the group’s shabby barracks with an affectionate kiss on the cheek.
The group’s name means ‘Dill Dental’ and its logo features a blue molar flanked by two green sprigs of the herb. Not only do Ukrainians love dill and serve it with practically every dish, pro-Russian separatists call Ukrainian loyalists ‘Ukrop’ and this is Igor’s way of reclaiming the derogatory nickname.
The subdued routine of dental surgery is punctuated by the sound of shooting and explosions. Many stories are told of coming under fire while working in mobile clinics, where black plastic sheets are taped over windows so as not to betray their positions at night. These are ordinary people operating in extreme circumstances.
‘If we hear shelling, we head into the basement,’ says Igor. ‘Once we were working in a village near the front and shells began closing in on us. The clinic was shuddering from the explosions. It soon became too dangerous so we went underground to shelter then quickly evacuated.’
But for Igor, the risks are worth it. His organisation is his unique way of boosting morale and supporting his country in war time. ‘This is our philosophy: cure the pain and you’ll fight better in battle. Healthy teeth make for stronger fighters.’
I first learned about the group during an earlier assignment in 2016. Photographer Pete Kiehart and I were embedded with the Ukrainian army in Avdiivka, an industrial town regularly hit by intense fighting. One night, we were sheltering in an abandoned, nine-storey apartment block. Artillery barrages had caused the building’s civilian inhabitants to flee so medics commandeered it as a makeshift hospital. There, we encountered a friendly, Ukrainian man in his late 20s who had Ukrop Dental’s cartoonish logo emblazoned on his T-shirt. He spoke perfect English and explained the group’s activities. We were astonished – this was the first we had heard of these frontline dentists.
The story was irresistible and we returned several months later, living for five days at the main clinic in Karlivka.
Inside the surgery here, hard rock and 1980s disco blares from the radio. Due to limited running water, the sinks don’t work so patients spit into plastic bags instead.
Volunteer dentist, Vasily Stoyan, is giving a soldier a check-up. Behind them, an icon of the Virgin Mary is pinned to the wall alongside military insignia and flags signed by patients. ‘If a soldier’s tooth is decaying, there is constant pain and only a dentist can help,’ Vasily says. ‘This is how I serve my country.’
Next to him, Alla, a mother-of-two in her early 40s, bobs her head in time to the music as she inserts a pair of forceps into a serviceman’s mouth and extracts a decayed molar.
This pair are among scores of volunteers who have swapped the safety of their clinics across Ukraine to work two-week shifts in Ukraine’s embattled east.
On a busy day, dentists in this one clinic see up to 15 patients. Last year alone, Igor’s entire operation treated more than 9,750 people. Demand is massive: many conscripts are from poorer backgrounds, meaning they have never been able to afford adequate dental care.
Outside, camo-clad patients arrive in jeeps and vans and head in. The main corridor is fashioned into a makeshift waiting room where men wrap their muddy boots in plastic and kill time sitting on a wooden bench, stroking the odd stray kitten or watching Hollywood films on a laptop.
Miner, 42, a major with Ukraine’s national guard, came in to have a cavity treated. ‘I saw the Ukrop Dental’s adverts and just heard about them by word of mouth,’ he says afterwards. ‘Their work is very important. How can we do our job when we have painful teeth?’
Winning the war
After their shift, the dentists relax in the kitchen, where rocket launchers hang on the wall above jars of tea. They tuck into steaming bowls of borsch, meaty risottos and fresh salads, before unwinding with a glass or two of samogon (Ukrainian moonshine).
Despite the dangers, the dentists remain upbeat. ‘I have to work here – it’s my duty,’ says Oleksandr Kolomiyets, 43, a volunteer from Poltava region who mans a mobile clinic in Avdiivka. ‘How can I stay at home and watch the war on TV while this is happening? It’s a matter of conscience.’
Oleksandr is typical of Ukrainian volunteers who embrace their country’s ‘Cossack spirit’, which also helped fuel the rise of irregular, pro-Ukrainian militias when war erupted in 2014. This call to arms has roots in the country’s medieval history, when self-governing, martial communities would unite to fight a common enemy.
Ukraine’s now-simmering conflict has devastated communities and overwhelmed healthcare services across the country’s industrial east. Likewise, when war broke out in 2014, Ukraine’s army was in a terrible state due to corruption and mismanagement. Many servicemen rely on Ukrop Dental but so do vulnerable civilians who have no access to state support. This is not just about rotten teeth; the system itself is rotten. While Igor is scathing about Ukraine’s infamously crooked officials, he hopes in time to share what he claims is an effective, transparent model of healthcare with the country’s defence ministry.
‘Ukrop Dental works. We’ve proven so and want to share it with the army. The goal is to save soldiers from pain and minimise the opportunity for officials to steal money,’ says Igor. ‘You have to help others in wartime, to use your professional skills for the greater good. If every Ukrainian offered their time and talents, we would be a much stronger people. We would win this war.’