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Armenian Weekly On-Line (AWOL)
The Armenian Weekly On-Line (AWOL)
80 Bigelow Avenue
Watertown, MA 02472 USA
(617) 926-3974
[email protected]
http://www.hairenik.org
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1. Life and Death in Armenia
Text and Photos by Onnik Krikorian
Editors' Note: This article and the photos accompanying
it will be published in the February 19, 2000 issue of
the Weekly; this is the first of a multipart series of
articles on social conditions in Armenia.
Mher Engibarian hands me a surgical gown and tells me to put it on
before showing me the delivery room in the maternity wing of the Masis
Hospital some twenty kilometers outside of Yerevan. He wants me to see
the conditions that his doctors and nurses have to operate in, he
says, and the environment in which expectant mothers bring a new
generation of Armenians into the world. Rusty buckets, cracked walls,
and peeling wallpaper, combined with a delivery table that would not
look out of place next to an iron maiden, makes the miracle of
childbirth seem like something that is best avoided in Armenia.
Engibarian is the Director of the maternity ward, and gestures for the
gown back. He explains that he had only asked me to wear it so that I
could see that even the gown's condition would provoke an outcry from
general practitioners in the West in even the most regional of
hospitals. "Sometimes, staff have to provide their own," he adds, the
frustration on his face obvious, and his voice accelerated by a rush
of adrenaline now that he has a journalist on his ward. It would
appear that he has been waiting for the opportunity to warn someone
that the medical system in Armenia is crumbling. "I may lose my job,"
he jokes, "but it doesn't matter."
In the next room, two mothers wearing equally sub-standard dressing
gowns are standing. They seem happy enough to receive visitors, and we
continue on to where one baby lies in the only oxygen tank available,
and others lie attached to what looks like a makeshift attempt to
supply oxygen to tiny lungs. To the side, one five month old baby
smiles and gurgles in a cot.
Lusineh was abandoned at the hospital by her mother, just one of the
annual one to two percent of babies that are similarly discarded by
families unable to provide for them in the severe economic conditions
that define life in the country. Some mothers are unable to afford,
unaware of, or unwilling to use the variety of contraception that
international organizations have brought into Armenia, Engibarian
explains, while others are simply unable to abort the child during
pregnancy.
Engibarian says that in the gynecological wing of the hospital more
than thirty percent of pregnancies are terminated, but he adds that
humanitarian assistance is not necessarily the answer to the problem.
"Some hospitals in Armenia are even worse," he says, "and humanitarian
aid is only temporary. The country needs to improve. If the economy is
bad, then humanitarian assistance can really do little. So far, most
assistance comes through the Ministry of Health, but it is not
enough."
The Armenian government is obliged to pay between $55 and $70 a birth,
but the money is not always forthcoming. Although the ward performed
700 births and 140 pathologies last year, expectant mothers sometimes
have to pay for the birth themselves. Certainly, they have to supply
their own food and medicine, and in some cases, the hospital has no
other choice but to waive all costs.
Because of the lack of finance, mothers stay for a maximum of four
days and although Engibarian resigns himself to the fact that
conditions at home are probably better than in the ward, seventeen
babies died in this hospital alone last year because their mothers
were unaware of the need for consultation with a doctor. Infant
mortality combines with other factors such as the conditions in which
many women live and a lack of equipment in the ward to make an already
serious situation even worse.
Last December, the Armenian Parliament approved a new health care
strategy, and the Minister of Health, Hayk Nikoghosian, identified the
need to allocate sufficient funds drawn externally from the national
budget to the task of providing medical treatment free of charge. He
also promised that wage arrears for medical staff, which currently
totals 2.5 billion dram, would be settled.
More recently, the Hayastani Hanrapetutyun newspaper reported that the
birth rate in Armenia had actually increased, along with a very
welcome decline in the rate of infant mortality. However, Engibarian
points out that as in other areas, statistics and records are
difficult to authenticate or analyze because there is no effective
means by which to record them. The maternity wing has no computer, he
points out, and as a result, it is difficult to even check the medical
records of patients, and to cross reference data for identifying
trends in the nation's health.
The situation is the same at the pediatric wing of the hospital. On
the floor below the maternity ward, Dr. Harutiun Balasanian--the head
of the department--may be more jovial in conversation than Engibarian,
but the story is the same. Indeed, he says the situation is getting
worse. Admittedly, the heating in each room for the winter months is
sufficient, but during the summer months, there is no air conditioning
and the whole region is particularly affected by the problem of
mosquitoes and resulting cases of malaria. Three years ago, the
department was situated on the third floor of the hospital where
conditions were better, but now the children aged between newborn and
fourteen stay in situations very similar to the maternity wing above.
The pediatric wing can accommodate up to twenty-eight children from a
local population of 70,000--although it also serves patients from
Ararat and Yerevan--and has a staff of eighteen. One doctor and two
nurses stay on call for twenty-four hours operating in shifts of one
day on, and three days off. The average monthly salary is 35,000 dram
(about $70)--when it is paid. As with the maternity wing, money from
the government is not always available, and last year the department
received less than half of the government's obligation to pay 65,000
dram for each child treated. Parents instead have to purchase and
provide their own medicines themselves, and to supply their own food
and bed linen. They also have to provide round-the-clock supervision
for their children--the morale and staffing levels are that bad.
"We are in a very serious situation," explains Balasanian. "Heating is
very important, but it is not the most important thing. The department
needs disinfecting and repairing, and we need surgical equipment.
Medicines are bought by the patients?even the bandages." Balasanian
also explains that although there is an emergency ambulance service,
few use it, deciding to bring their children to the hospital
themselves. This he attributes to an unsatisfactory telephone service,
and the close proximity of the villages. However, many are also well
aware that the ambulance service itself is ineffective, with Armenian
radio recently reporting that three people died unnecessarily of heart
attacks in one night alone because the ambulance service could not
afford petrol.
There is also the problem of doctors finding alternative employment
unrelated to their profession simply because conditions and salaries
are inadequate in a country where the average salary of $30 a month is
insufficient to provide even the barest minimum of food for a family,
according to UN statistics. Indeed, in the pediatric wing, one
five-month-old baby girl lay attached to a drip feed after poisoning
from contaminated milk. Because of malnutrition and nervous anxieties,
her mother was unable to produce milk herself in order to breastfeed
her baby.
That is not to say however, that life is difficult for everyone
employed in the medical sector. As in every occupation, corruption
exists in this sphere as well, with some doctors selling humanitarian
aid allocated for free distribution, even if that means eventually
dispensing medicines that exceed their life expectancy. Balasanian
admits that this is a huge problem in Armenia, even if he has not
experienced the situation himself. However, one student recently
described a situation where after complaints that a doctor was selling
medicines illegally to her disabled patients, two journalists from a
local newspaper visited her clinic to expose the practice, but were
instead paid off with $50 to write a complimentary article that turned
the doctor into the Florence Nightingale of Armenia.
While the rich get richer in the former Soviet republic of Armenia,
many would argue that little else has changed. While westernization
has engulfed the center of Yerevan with its proliferation of casinos,
strip bars, and expensive shops catering for few customers, there has
been no sign of improvement or modernization in the Armenian health
system. Indeed, the latest news is that one Yerevan doctor is
currently in the United States learning the "art" of plastic surgery,
presumably because of Armenian television's preoccupation with
liposuction and breast enlargement, despite the social and economic
reality of the country. One doctor at the hospital simply described
the situation in the country as being immoral.
"Its somehow difficult for me to explain," adds Balasanian. "I just
hope that conditions will improve, and that one day we will be able to
serve our children. We must pay more attention because the children of
this country are its future citizens."
2. Hairenik Association Relaunches Armenian Weekly Web Site
WATERTOWN, Massachusetts and YEREVAN, Armenia--The Hairenik
Association, which has been publishing the Armenian-language Hairenik
newspaper since 1899 and the English-language Armenian Weekly since
1934, recently relaunched its Web site at www.hairenik.org.
The Armenian Weekly online magazine was initially launched on Armenian
Christmas, January 6, this year. In what may have been linked to the
recent series of international Web-site hackings, the site was
temporarily unavailable but is now back in a new, improved format.
The site features original and insightful articles and photographs
from the Weekly's Armenia and Artsakh correspondent, photojournalist
Onnik Krikorian. In addition, the site features useful links, the
monthly ANCA publication "Transcaucasus: A Chronology," background
information on Armenia and Karabagh, audio samples from contemporary
musicians in Armenia, and an area to register for updates and provide
feedback to the editors.
The Web site is presented in an online magazine format. The Articles
address historical, social, scientific, political, youth, human
rights, arts, and other areas of the Armenian experience. The paper
version of the Weekly addresses issues of Diasporan identity,
religion, genocide and historical revisionism, human rights,
nationalism, gender, and political issues such as democratic socialism
and self-determination.
The Web site is a natural compliment to the Armenian Weekly, which
provides a forum to place the experience of the Armenian Diaspora into
the context of the new pan-Armenian reality.
The site has been featured as "site of the day" on the internationally
renowned RussiaToday.com; it has been added as a link to the Amnesty
International site; and it has generated a positive international
response. Visitors are encouraged to register for free at the site in
order to remain informed of periodic updates.
In the near future, the site will provide the opportunity to purchase
books from the Hairenik Bookstore online.
Anyone who needs to stay informed about Armenian affairs should
bookmark the site: www.hairenik.org.
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(c) 2000 Armenian Weekly On-Line (AWOL). All Rights Reserved. The
Armenian Weekly provides this news service to the Armenian News
Network/Groong. AWOL materials are for academic research and personal
use only; they may not be otherwise reproduced without the written
consent of the Armenian Weekly.
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