Deah Barakat’s death brings Syria’s dental health crisis to light

The murder of Syrian-American dental student Deah Barakat cast a shadow over the fourth annual Syrian-American Medical Society (SAMS) fundraising conference, held this past weekend in Arizona. Since last summer, Barakat, 23, had been working with SAMS to raise money for a relief trip to Rihaniya, Turkey, where he and 10 other dentists planned to volunteer at one of the group’s clinics for Syrian refugee children.

“When we last spoke on Tuesday, he’d only raised about $15,000. I told him we had to push the trip back to August,” said Mohamad Nahas, who founded the SAMS dental relief programs in Turkey in 2012, speaking from the conference in Scottsdale.

But in the week since Barakat was shot dead in North Carolina at his Chapel Hill apartment — with his wife and her 19-year-old sister — an outpouring of support has seen to it that the trip will be funded, and then some. As of Tuesday, the YouCaring.com fundraising page Barakat set up last year had raised over $441,000. The influx of cash is unprecedented for dental relief, an oft-overlooked dimension of the refugee response that does not command the urgency or fundraising appeal of a food shortage or disease outbreak.

But the need is great. The volunteer dentists of SAMS say that while medical services for Syria's four million refugees tend to be adequate, there is absolutely no money in tight budgets for non-essential services, which includes most dental work. Major defects like cleft palates that do not fall under the category of “war injuries” often go unrepaired, while nerve inflammation leaves others in severe but not life-threatening pain.

Nahas, a Syrian-born dentist in Florida, launched the SAMS program in 2012 with a mobile chair and some suitcases filled with supplies that he used to perform emergency extractions and other urgent pain-relieving procedures for Syrians in Turkey. Due in part to volunteers like Othman Shibly, the program has since expanded its services to include 24 fully functional dental clinics in refugee camps and host communities in Turkey and Jordan, each of which treats up to 60 patients per day.

Shibly, the associate director of the University of Buffalo’s Center for Dental Studies, first got involved in the SAMS effort after visiting a camp in Turkey in July 2012. “People were showing us infections in their mouths, teeth that were broken when the army invaded villages, or when they were hit in the mouth by the butt of a gun during demonstrations," Shibly said. He has since managed to raise tens of thousands of dollars in his community and from a Canadian NGO and set up clinics in southern Turkey and in Jordan's Zaatari refugee camp.

Then in December, Shibly traveled with a team of maxillofacial surgeons to Jordan and Turkey, where they performed complicated surgeries beyond the clinics’ regular capacity, procedures such as those to repair cleft lips and palates.

“These people are like us,” Shibly said. “They need more than just emergency treatment."

Apart from occasional volunteers like Barakat, SAMS staffs the clinics by drawing from the pool of Syrian dentists living in the camps who are anxious to help and grateful to earn up to $1,000 per month. The last time Nahas put out a call for a dentist at a new clinic, there were so many responses that he had to narrow the field by holding practical interviews during which each candidate performed a simple procedure.

“I could only pay one dentist, so I had to tell the rest I couldn’t help them,” Nahas said. “It all comes down to dollars.”

Qahtan Akra, a dentist from Syria's Aleppo suburbs, was one of Nahas’ first hires. Since arriving in the Turkish town of Killis in 2012 as a refugee, Akra has been working at SAMS clinics in nearby camps almost every day. When he began just a few days after his family crossed the border, the clinic had just a single chair. “Now we can handle maybe 40 or 50 patients daily,” he said. “But way more than 50 people put their names on the list every day. The need is enormous.”

While SAMS has made an impact where it can, the dental health crisis in the camps is also a direct consequence of the total destruction of medical infrastructure within Syria. That shows no signs of slowing down. According to UN estimates, roughly half of Syria's hospitals are out of commission, many flattened. Well over half the country’s doctors have left the country, in addition to the thousands of medical aid workers been killed on duty. Surgical supplies and drugs are scarce.

The situation is most grave in rebel-held areas, where the Syrian government is accused of intentionally targeting the medical sector, and where groups like the Islamic State in Iraq and the Levant (ISIL) kidnap and behead foreign aid workers — forcing aid providers like Doctors Without Borders to pull staff out of the country. 

SAMS helps run a handful Syrian clinics in rebel-held parts of Aleppo governate, as well as mobile units that reach Homs, Reif Hama and Idlib. But staffing and supply routes for these clinics are touch-and-go. According to Nahas, there are only five dentists still in Aleppo, out of some 600 to 700 practicing in Syria's largest city before the war. “It’s hard to keep people there,” he said. “They’re performing root canal under shelling.” As a result, SAMS clinics say they often treat recent arrivals from Syria who were forced to have crucial procedures done by undertrained amateurs with disastrous results.

But the clinics in Turkey and Jordan cannot pick up all the slack. At the end of each day, clinics are forced to turn away many people, including some who are in acute pain, because they have run out of sterilized instruments. Dental supply companies have donated toothbrushes and toothpaste, but other supplies, including painkillers and anesthesia, are often unavailable. “Sometimes people are crying because of the pain, but there’s nothing we can do,” said Shibly.

SAMS said it hopes to use some of the more than $400,000 raised by Barakat’s campaign to fill these gaps, as well as to meet requests for over 60 new clinics across the region. In the meantime, it has already found a way to honor him. On Thursday, the dental facility at the Rihaniya school where the slain 23-year-old was due to help out in August was renamed the Deah Barakat Clinic.