The sprawling metropolis of Buenos Aires is home to 13 million people, many of whom live in shantytowns, existing on the fringes of the city and the outskirts of society.
Fiona Ambrosi arrived from the UK in 2003 to research the recycling workers, locally known as cartoneros, who live in these marginalised areas. Walking through the streets of José León Suárez, one of the many shantytowns in Greater Buenos Aires, there was one thing among the many obvious signs of poverty that made a lasting impression – the local children’s teeth.
“It was awful, the teeth were either just not there or rotting in the children’s mouths,” she describes.
Ambrosi decided to take action by setting up ‘Todos Juntos’, a foundation that helps children receive dental treatment. The goal is not only to treat rotting teeth and gum problems, but help improve overall oral health through education.
A System in Decay
For years, the residents of José León Suárez, in the San Martín department just north west of the capital, had been using public dentists, which provided free treatment, but did not include any level of education or preventative care.
“When we started, the patients told us they would go to see a dentist, he would tell them the tooth is rotten and to come back in six months to get it pulled,” explains Ambrosi. “Nobody had any teeth!”
As a result, Todos Juntos worked to generate funding for a dental clinic in the San Martín area. The first clinic, called ‘Sonrisa’ (Smile), opened in 2006 with 400 children registered as patients. Each child is entitled to full, free dental treatment until they are 18 years old.
On top of the modern, reclining chairs, overhead lights and full cleaning instruments, the clinics focus on educating each patient on the prevention of cavities and the importance of maintaining a clean mouth.
The programme has grown considerably since then: last year, Ambrosi estimates that they registered 5,750 children for treatment at the three clinics Todos Juntos now runs.
But the clinics themselves are just the first battle won in an on-going struggle.
The dentists in the clinics do not only fix teeth, but try to reach out to the children and their families in order to change the pattern of behaviour behind tooth decay. Walking around Sonrisa III, there are posters for healthy eating, and information about which things are good and bad for teeth.
But posters cannot compensate for a broader lack of education in the area. Though there are three schools around the shantytown of 40,000 residents, they do not run to a regular schedule. Often, the electricity is out, or the teachers cannot make it to class.
Going Beyond the Smile
Without the support of local schools, there is no infrastructure for education on the basics of nutrition. Although the dentists and those working with Todos Juntos try to distribute information about healthy eating and talk with parents about high-sugar diets, the clinics are run out of a neighbourhood where poverty is rife, and there is scant access to a healthy, balanced diet.
Such is the level of poverty, some residents of the San Martín area comb the nearby landfill once a week, looking for extra food. The things they find are generally non-perishables that are high in sugars.
Rodrigo is one of the dentists working for Todos Juntos. He says that the mothers put cola in the bottles of their infants “because it’s cheaper than milk”. He also explains how the sugar keeps the babies quiet when they are hungry, offering a quick short-term solution but generating serious tooth problems down the line.
Of course, drinking water instead of cola would greatly reduce the rate of decay but access to this most basic and essential of commodities is also difficult. According to Aguas y Saneamientos Argentinos (AySA), the water works of the Greater Buenos Aires, this area of the city is supposed to receive potable water. However, the current infrastructure and supply is not able to sustain the number of residents for the area.
As a result, only 68.1% of houses in the metropolitan area have access to water, and shockingly, just 39.2% receive sewage services. Ambrosi explains that in San Martín, where the Sonrisas clinics operate, water is not accessible in many houses due to a lack of adequate internal plumbing. The main source of water is a system of pipes and interconnecting hoses that lead around the housing complexes.
Without ready access to potable water or proper education about its advantages over fizzy drinks, the challenges facing Todos Juntos are great. But these obstacles seem much smaller when there are individual success stories. Ambrosi recalls a 14-year-old who arrived over a year ago with just ten of his 32 teeth and a face that was swollen due to infection from the decay. Over the past year, Todos Juntos has implanted four front teeth with polymers and dentures.
“He had no teeth and … he got a job within two or three days of getting his front teeth. He was so excited that he came back to tell us,” Ambrosi says.