Business as usual

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Dental clinics across the country have been bombed or ransacked.

In the lawlessness, the usual rules of the consulting room have fallen away, turning doctor-patient frictions into aggressive confrontations.

Like physicians, dentists are tremendously vulnerable, because they are perceived as having more money than most Iraqis.

"When the anaesthesia is depleted, we are accused by patients that we are corrupt and stealing the materials," Mohammed explains. He has taken to buying anaesthesia himself, to ensure he can always treat emergency cases.

Still, Mohammed counts himself lucky, when compared to dentists in the private sector.

"They face the same troubles as we do...added to the dangers of being targeted, threatened or kidnapped, and the daily trouble of providing clean water and electricity."

Supplies and sanctions

The more mundane problems are no less serious. Decades of deficits have severed the supply chain, and clinics like Mohammed's face chronic shortages in equipment, intensified by government corruption. And of course the dentists keep leaving.

He and other interns have learnt to make do with little. "We are forced to used expired materials because we have no other option," he reports. "Every few months the anaesthesia disappears. Before the war we were under sanction, and after the war we are under corruption and the effect on our practice and patients is almost the same."

One of the biggest complaints among dentists is that they are not paid enough. Mohammed brands his salary "a joke". In the private sector, Aljobory believes the situation is slowly improving, with clinics seeing a gradual step-up in salaries. In a ripple effect, this is going hand-in-hand with a demand for better equipment.

"My salary, previously, was US$3 per week in a private clinic. Now it is about $400, monthly," he says. "We are seeking better supplies - not the best, because we can't afford the best, but better."

Dental firms, however, remain wary about resuming business with Baghdad. In talks with US and German brands Al-Huwaizi, who is chairman of the IDA's scientific committee, reports they have no plans to pick up ties with Iraq.

Pragmatically, he confides that most of them are too highly priced anyway. "Chinese firms are better suited for Iraqi dentists...or bargains at exhibitions."

Surprisingly, the lack of supplies has done little to drive down enthusiasm among patients. Those practices still operating boast an attendance level that would be the envy of most western practices.

Mohammed trades stories of patients braving bombings and checkpoints to keep appointments. "They are really committed to attend appointments, even in the most difficult situations."

Al-Huwaizi optimistically maintains that this is reflective of an improvement in the security situation. "A year ago, we would hear 12 car bombs a day - now we only hear one every two or three days. Every day there is something. Patients are coming back, asking about bleaching or ceramic treatments."

Dentists struggle to keep their doors open in unpredictable circumstances, conscious of the hardships their patients face in getting to appointments.

"[They] struggle to give their best to the people...to face the everyday difficulties to reach the clinic and quickly remove the impact, to be able to welcome patients with a smile," Mohammed reveals.

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