Zealous litigation by Partnership for Human Rights (PHR) urged the state to create a new service granting people with disabilities, behavioral challenges, and communication difficulties free dental services under anesthesia without delay. PHR litigated the case with support from USAID’s Rule of Law Program and Promoting Rule of Law in Georgia Activity.

In March 2021, PHR applied to Tbilisi City Court as a special litigant requesting immediate access to urgent services for persons with disabilities (PWDs). PHR asked the establishment of a mechanism that would immediately fund all cases where PWDs with behavioral challenges or communication difficulties require dental procedures under general anesthesia and a 30-day case processing period. PHR believed that the pain experienced by people with disabilities, including children, caused by the inability to treat toothaches was a clear example of cruel, inhuman, and degrading treatment. Three days later, Tbilisi City Court issued an interim measure in favor of PHR and ordered the government to establish a mechanism that will immediately fund all cases where PWDs with behavioral challenges or communication difficulties, require dental procedures under general anesthesia.

Before PHR started this litigation, PWDs with behavioral challenges or communication difficulties were effectively left to suffer for protracted periods of time without any resources to address their dental needs. Many PWDs are unable to timely communicate the medical issue, resulting in treatment being given at a stage of severe pain. Moreover, since PWDs are often unable to use standard dental services – it can be difficult to put them in a dental chair and perform dental manipulations – the only means of providing dental services may be under general anesthesia, which is much more costly. PWDs overwhelmingly live in difficult socio-economic situations, making such services unaffordable. In addition, the state insurance did not cover this service, and there was no specific program to address this need. The only possibility was applying to the State Referral Service Program, where applications take 30 days to process and not all cases are funded.

After the interim measure was granted, PHR continued the litigation regarding the creation of a special mechanism for the provision of dental services for PWDs. The state created a new service and therefore the court proceedings were successfully finalized in March 2023. According to the newly established state program, children and adults with medically documented behavioral challenges and/or communication difficulties, both with disability status and those without this status, can receive dental services for free based on factual costs, without any delay. According to the Ministry of Health, two clinics in Tbilisi and Batumi are registered as service providers.

Tina Parkadze, the mother of one of the children said: “First of all, what this decision changed is that my child, and other persons with disabilities, don't have to tolerate toothache anymore. Secondly, and equally importantly, the parents have been relieved of the huge financial burden of dental treatment under anesthesia. Sometimes the families had to take loans, sometimes - even sell their property to afford the treatment. It is excruciating to even think that your child has to tolerate pain because you don't have the money to take them to a doctor to help them. Now we don't have to worry about finding the finances and that is such a relief for all.”

Despite the fact that in March 2021 the Court ordered the Government of Georgia and the Ministry of Health to immediately create a mechanism to provide dental services for persons with disabilities, it took more than a year for them to do so. During this period, R.K, a child with a disability, applied twice to the Ministry of Health to receive funding for dental services with anesthesia, waited 11 months for a decision, and was ultimately denied. During this period, RK's condition worsened, the tooth had to be extracted, and the mother was forced to borrow money to have the procedure performed.

On November 30, 2022, R.K., with PHR’s help, applied to the Court and requested compensation for material and moral damages caused by the non-enforcement of the interim measure. On November 7, 2023, the Court granted R.K.’s request. According to the Court, it was unreasonable to take more than a year to implement its ruling and ordered these government entities to pay for the child’s dental services. The Court also ordered them to pay moral damages to compensate for the unnecessary suffering. They ordered 7130 GEL be paid to the child.

The USAID Rule of Law Program continues to support PHR and other civil society organizations in their efforts to improve access to justice for vulnerable people in Georgia.