Ukrainian minister: We need dentistry at the frontline

Oksana Dmytriieva, a former dentist, is the deputy Health Minister of the Ukrainian government. As the war with Russia continues in Ukraine, Leo Jurkiw, talks to her about how it has impacted the dental industry and how dentists can help.

Oksana Dmytriieva, a former dentist and deputy Health Minister of the Ukrainian government, talks to Leo Jurkiw about how the war with Russia has impacted the dental industry, what she is doing to help and how dentists can support Ukraine.

Before we begin, I would like to express my gratitude to you for agreeing to speak with me. I cannot even imagine how busy you must be at such a critical time.

Firstly, please can you introduce yourself, your professional experience and your current professional occupation. Also, most importantly, your current political position and responsibility.

By profession I am a dental surgeon, currently working in a restorative practice. Up until I became a deputy in the Ukrainian parliament, I was the owner and principal of my own dental clinic. But upon my election, I passed over the running of the practice to another individual, though I do continue to work there.

In parliament (Verchovna Rada) I am a deputy health minister with special responsibility for organ transplantation.

From 2019, large numbers of these procedures have been carried out. Even now in this time of war they haven’t stopped. For example during the month of October we performed 35 transplants. This is even though there are interruptions in the electricity supply. By employing generators, our surgeons continue to work and save lives.

Regarding dentistry, in parliament my colleague Artem Dubno (also a dentist) presented a proposal for a change in the governance of dental surgeons.

At present, licences are granted to dental clinics, not to individual dentists. We would like this to change so that each dentist can be licensed as it is in other European countries, and so that governance can be conducted by their peers – not by officials at the ministry who are not qualified to make judgements about dentistry.

‘Dentistry gets forgotten’

We also wanted the dental profession to have mandatory indemnity as you have in the United Kingdom. Unfortunately, parliament didn’t pass this proposed new legislation.

We were to represent modified legislation, but we were overtaken by events with the outbreak of hostilities. Now our patients have spread all over the world and so must rely on professionals in those countries to provide their treatment.

But these international colleagues have also been helping us financially, which has enabled me to create a mobile dental clinic which has been sent to the front. Our soldiers and citizens in these areas, because of their current circumstances, are unable to go to a dentist. So, the dentists need to go to them.

We calculated that we need 40 such mobile dental surgeries to provide essential services in the areas affected by the war. I personally have just returned from Kherson. There is no electricity supply at the moment and the clinics aren’t working. We urgently need more of these mobile clinics.

You understand how it is, other medical specialities seem to get all the attention, but dentistry gets forgotten because too often it is considered to be simply a matter of cosmetics. But actually, dental pain and the complications of dental disease can be extremely serious. So the provision of these type of emergency mobile dental vehicles is another of my current priorities.

How has the war affected you personally?

Well, we may be weary but no one is giving up the fight.

On my recent visit to Kherson where the people had been occupied, they recounted the dreadful experiences which they had to endure for nearly eight months. What struck me was they don’t have water, they don’t have light, they don’t have heating, but they are so happy to no longer be under occupation.

They are still being continuously shelled, but they just carry on – even the children! And this resolve to achieve victory gives me strength. This is because there are times when you witness these bombardments and deaths, and the deaths of children.

There are times when you do get weary. But then you see these people who have and are enduring such terrible things, and yet they are happy and they believe in victory.

This lifts your spirits and makes you stronger.

We were even laughing when they told us about two Russian soldiers who turned up at a local shop asking for vodka. The lady behind the counter said to them, ‘So are you lot back again?’

They said, ‘What do you mean back again?’, to which she replied, ‘Well, you Russians retreated and our Ukrainians came three days ago!’ They had got so drunk they didn’t even realise that their army had retreated!

What are the urgent needs of dentists in Ukraine now and how can the British government and British dentists help? How are dentists from other countries helping?

First of all, when I went to America I went there not to ask for help, but to thank them for the help they have already given. I’m sure that you are aware of the massive amounts of assistance which they, the British government and many others have given Ukraine from the perspective of medical assistance.

When it comes to dental assistance, this has tended to be on more of an individual basis. Dentistry is considered to be a highly specialised profession which ought to be able to provide for its own needs on a dentist-to-dentist level. As I have previously said, we need to provide emergency dental provision to the front lines.

But military and civilian casualties are brought away from the conflict zones and are treated free of charge at, for example, my clinic. And oral surgeons from many countries have been coming to perform complex reconstructive surgery for us.

Also, we have been employing video conferencing systems where overseas surgeons offer guidance in the planning and performance of surgery. You need to understand that we have little prior experience of facial injuries which require this degree of reconstructive surgery and rehabilitation.

Therefore, we urgently require people to share their knowledge with us both in the practical surgical field as well as with organisational matters such as licensing and indemnity.

What work is being done with international partners to plan for the rebuilding of dental services in the country once the war is over?

When it comes to reconstruction, over 900 dental clinics have been destroyed.

This number rises each day because medical facilities in general are being specifically targeted. Where damage is minimal, these facilities are even now being repaired. We carry out an audit to see if reconstruction or rebuilding is necessary in each case.

We have also discussed the development of ‘modular’ clinics which could quickly be erected in areas of greater destruction. But then, for example, in liberated Kherson the clinics aren’t destroyed, but they don’t have enough medical personnel.

This is because they have fled – they don’t have heat, light or water, so we have provided facilities to one clinic for the whole area.

Rebuilding there is very risky because the city is still under artillery fire, and any new construction is purposely targeted. We once put up a temporary field hospital and they immediately concentrated fire upon it.

Consequently, it is extremely difficult to talk about rebuilding today. We need to wait until we have been victorious. Fortunately, the number of destroyed dental clinics is far fewer than medical ones because many of these are small, privately owned ones.

For example, at my clinic we still treat our remaining patients, military personnel and refugees completely free of charge.

Looking forward, we will need to see how many refugees return from overseas, how the internally displaced population redistributes itself after the war and then we will be able to gauge where new healthcare provision is required.

We need dentistry at the frontline, says Ukraine’s deputy Health Minister