Armenia

Background

Accessibility to free, quality health services for children and mothers in rural Armenia is extremely limited. It is estimated that 42.9% of the country still live below the poverty line, which has led to a drop in immunization by 42% in 2006.  The Shinuhayr Primary Healthcare Clinic is the only comprehensive clinic available in the region servicing its surrounding seven villages with a population of over 6,500.  There is a great need for perinatal, pediatric, cardiovascular, infectious disease, orthopedic, and geriatric services in this region.  Approximately 352 families fall under the ‘socially vulnerable’ category and benefit from the services of RMF’s project. In addition, 256 disabled persons, 524 children ages 0-7 years and 1,382 school children ages 8-17 years, and 52 single mothers benefit from improved healthcare services.

Photo: Students at the local Shinuhayr Secondary School

Working closely with our program partner, the Armenian Relief Society (ARS), RMF supports the Shinuhayr Primary Healthcare Clinic to provide the clinic with critical medicine inventories and medical supplies.  This project indirectly impacts all members of the eight communities it serves.  It directly impacts those socially vulnerable individuals, including members of large families, pensioners and children, who present with acute or chronic illnesses during a clinic or house visit.  RMF also provides these patients with free medications and makes sure that patients are followed up on by RMF staff to assure their continuum of care.  Special attention is provided to chronically ill patients with cardiovascular disease, hypertension and diabetes.  These patients are seen every month by our nurses to assess their health status and to ensure medication compliance.

Project Objectives:

• Provide free medications to all in need, especially to chronically ill patients;
• Continue provision of quality medical services;
• Provide prenatal education and vitamins to expectant mothers;
• Educate parents about the importance of vaccinations and provide free childhood vaccinations;
• Promotion and utilization of the RMF ambulance as a tool for the community to facilitate their access to care;
• Continue support of Mariam’s scoliosis treatment;
• Identify and meet with new patients seeking care through our project;
• Conduct needs assessments, focus group studies and meetings with various organizations to seek funding to scale up current project.

Summary of RMF-sponsored activities carried out during the reporting period under each project objective:

• A total of 200 patients received free medication: this includes the patients we support on a monthly basis as well as first-time beneficiaries of the project;
• 88 children were vaccinated;
• 68 house calls were made using the RMF ambulance to visit and treat patients too ill to come to the clinic; the conditions of patients seen included diabetes, heart disease, hypertension, gastroenteritis, asthma, arthritis, hyperpyrexia, paralysis, stroke, and pneumonia.

Results and/or accomplishments achieved during this reporting period:

• 15 births registered in the eight communities;
• 88 children vaccinated;
• 68 home visits performed;
• 200 patients provided with free medication;
• 26 deaths registered in the eight communities;

Number served/number of direct project beneficiaries:

The total number of directproject beneficiaries that received free medications during this time period was 200: specifically, 86 from Shinuhayr; 13 from Halidzor; 31 from Tatev; 44 from Svarants; and 26 from Tandzatap.  Of the total, 64 were male, 99 female and 37 were children.

During the First Quarter of 2012, a total of 618 patients visited the Primary Healthcare Clinic in Shinuhayr to seek treatments and check-ups for various conditions specified in the chart below.  Of the 618 patients, 557 were registered patients with RMF while 61 were new patients.  A peak in new patients visiting the clinic to seek care demonstrates the birth of a system in the region that is promising and delivering free access to healthcare and instilling trust in the people toward the services provided by us.

Success story(s) highlighting project impact: 

Photo: Clinic patient, Martik Ghazaryan

• A previous patient of RMF’s, 75-year old Martik Ghazaryan, whose family consists of two disabled adults and two minor children, fell ill a few months ago with ischemia.  RMF provided all the care and medicines and Mr. Ghazaryan’s health improved and stabilized.  However, soon thereafter he fell ill with cerebrovascular disease and the RMF ambulance transported him to the hospital in Goris and provided the care he needed.  Upon his discharge, he was prescribed with the necessary medications.  On January 9^th when RMF staff Stella visited Mr. Ghazaryan, she found him ill in bed.  As it turned out, Mr. Ghazaryan was too ashamed to bring in his prescription to receive his free medicines.  Stella spent some time with the patient explaining the true nature of RMF and that when patients seek care it is perceived as a “success story” for RMF.  Stella made the necessary arrangements and Mr. Ghazaryan received his medicines the very next day. 

Photo: Clinic Patient, Lusik Stella

• We paid a follow up visit to Mr. Ghazaryan a week after he received his medicines and found him strong and doing well.  While there, his neighbor, 72-year old Lusik Vardanyan came to visit.  She was very happy to see Stella as she had been suffering with hypertension for many years but was too scared and ashamed to ask for care.  Scared because she could not afford it and ashamed because she couldn’t ask for “pity” she says.   Stella spent quality time assessing the needs of this patient who is now an RMF beneficiary and receiving her anti-hypertensive drugs and follow-ups.  Mrs. Vardanyan is very happy and she feels blessed to be cared for by RMF. 
• Follow up on two stories which were reported previously:
• During the end of 2011, the dedicated and sole nurse of Svarants village, Astghik Grigoryan, fell ill and was diagnosed with several conditions. RMF took on the responsibility of her care and followed through until Astghik was fully recovered.  In January 2012, RMF paid a visit to this dedicated nurse to find her doing very well and working hard at assisting patients.  Astghik expressed her heartfelt gratitude to RMF as her eyes filled with tears. 

Photo: Long Term Care Patient, Mariam Tevosyna in her corset

• Mariam Tevosyan’s case of corrective surgery for her spinal deformity is pending further medical evaluation. However, RMF continues to follow Mariam and ensures that her periodic check-ups and corset adjustments are completed.  In January 2012, RMF received a call from Mariam’s mother who said that her daughter had alienated herself and was not communicating with anyone.  RMF representative Stella, upon receiving permission from Mariam’s school in Halidzor, paid her a visit at school.  As soon as Mariam saw Stella, she smiled full of joy and hope.  Stella spent 3 hours with Mariam trying to understand why she has been somber and unresponsive to her parents. Mariam shared that she is extremely worried about her condition and is apprehensive that her treatments with corset adjustments may not continue and she may be denied surgery due to funding.  Stella promised Mariam that her treatments will be provided for the full 2 years and that RMF will do its best to also pay for her surgery.   On February 7^th, RMF transported Mariam to Yerevan for her regular quarterly examination and X-Ray checkup.  The results were very positive and demonstrated that Mariam’s corsets and therapy has prevented the increase of her spinal deformity.