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Toothaches no more: Providing dental care for all at SEMAFI

By Vanessa Paolella June 27, 2026
Five people, including four students, sitting in a waiting area at the dental office.

Vanessa, center, sits with four students as they wait for their turn at the dentist in May. From left to right: Faneva (age 9), Lynda (age 24), Sylvio (age 11) and Diary (age 18).

The reaction was immediate when the 8-year-old girl opened her mouth.

“Oo la la,” the dentist said with a grimace as he began counting her rotted teeth.

For years, the girl had neglected to brush her teeth. She came from a family which considered toothbrushes and toothpaste a luxury, one they couldn’t afford. For years, chronic toothaches had made her miserable and she often missed school.

Over her next three visits to the SALFA dental clinic in Fianarantsoa, the girl had five baby teeth pulled and two cavities filled. Although she had never been to the dentist before, she bravely allowed the dentist to numb her gums and pull the teeth. Both her dad and I were impressed.

Now, for the first time since the girl was little, the painful toothaches are gone.

She was one of the 34 students at SEMAFI who received dental care this year as part of Meylou’s new medical and dental support program.

A middle-aged man examines a young girl's teeth at a dental office.
Seraphine, 13, is examined by the dentist at the SALFA dental clinic in Fianarantsoa in February.

Months ago in August, I was talking with SEMAFI director Jean Donatien RANDRIANTSOA about what should and shouldn’t be included in our growing student sponsorship program. I asked him whether we should begin offering dental care this year or wait for the future.

“We should include it,” he said without hesitation. “Dental care is really important.”

Without a doubt, he was right. Dental health in Madagascar is very poor due to a shortage of dental clinics, a lack of knowledge about dental care and insufficient financial resources. Many children and adults in Madagascar live with chronic dental pain, persistent infections, or gum disease.

So when Feburary rolled around, we decided to take every SEMAFI student to the dental clinic to be examined, not just our students with sponsors. For virtually all of our students it was their first time seeing a dentist.

Over the next four months, we took small groups of students to the dentist two times per week. Some students were curious, and others, terrified. We tried to bring students to the dentist with their friends to help give them confidence.

We spent $966 to provide dental care to 34 SEMAFI students, an average of $28 per student.

In total, students had:

49 cavities filled
43 teeth pulled
14 root canals
14 cleanings

I was amazed to learn one of our older students had nine cavities and needed a cleaning, root canal and two teeth pulled! He needed the most work out of any student, but it still cost just $98.

While the dental work was important, we felt that educating students and their families needed to be a priority, too. During the parent sign language training in March, we invited one of the students’ dentists to speak with parents about dental care and answer questions. Many parents and SEMAFI staff members raised their hands to ask questions.

Members of the SEMAFI community listen as a dentist speaks to them.
Dr. Fanoela from the SALFA dental clinic speaks with SEMAFI students, staff, and parents about dental health. Out of view, a SEMAFI teacher interpreted the forum in Malagasy sign language.

Last week when students packed their bags to head home for the the 10-week end-of-school break, they received a toothbrush and a tube of toothpaste to take home, courtesy of Meylou. This way, every student has what they need to care for their teeth until school begins again in September.

We plan to continue providing dental care to SEMAFI students in the years to come. Next year, we plan to expand the program to include support for braces.