Final Project Report for Shinuhyr Healthcare Program
July 17, 2013
We are very proud of all that we have accomplished together since our program started in 2008 and hope to one day return. For now, our lack of sufficient and consistent operational funding support or grants directed towards Armenia mean that we will be supporting only through the end of this month. If we are able at any point to find a source of funding that covers a minimum of 1 year of clinic/staff operations then we will be happy to restart this project.
We want to wish Anna and our partners at Armenia Relief Society all the best and thank you for your wonderful partnership over these past few years. We would also like to thank Stella for her dedication to this clinic and community, Margarit and Kristine for their recent efforts to find new support, and Nairy for all her support and commitment here in the US.
To increase access to healthcare and continuum of care in Shinuhayr and its surrounding seven villages by providing comprehensive healthcare services, maternal-child healthcare, childhood vaccinations, pharmaceutical and medical supplies, emergency transportation services and community outreach and education to a population of 6,809, with the long-term goal to rebuild the Shinuhayr primary care clinic back into a fully functioning hospital and add a community center.
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.
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 seven 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.
- Continue providing high standard medical services;
- Extend the provision of medical services;
- Increase the project capacity in the communities served;
- Observe the impact of the project;
- Continue providing free medications to all in need, especially to chronically ill patients;
- Cooperate with schools to identify the problems of disadvantaged children
Summary of RMF-sponsored activities carried out during the reporting period under each project objective:
- Patients visiting the clinic are addressed with care and receive high quality medical services, treatmentand prescription medicine. RMF provides these patients with free medications as instructed by the doctor on their prescription; they are followed up by RMF staff to assure their continuum of care and road to recovery.
- To increase the project capacity, problems in each community served by our project are studied and addressed.
- Each month the impact of the project has been observed and the following results were recorded:
- Number of visits to the clinic increased as a result of the fact that patients receive free medication. This is substantial aid to vulnerable families, since the prices of medicine are not affordable for them.
- The access to free medical services improved the overall psychological situation in the communities, since people of these distant villages don’t feel isolated from the center anymore. These positive changes impact the condition of sick patients as well and are beneficial on their road to healing.
- Mothers more actively visit the clinic and bring their childrenfor medical examinationsand free vaccinations. The medicine distribution listindicates the increased number of children, whoreceived vitamins.
- The medicine distribution listalso indicates the overall increase of the number of project beneficiaries.
- Patients from disadvantaged families with health complications, who needed thorough and professional examination of their health condition, were guided to health clinics and hospitals in Yerevan, where they were diagnosed and further treatment needs were identified.
- In February a LOI was submitted for USAID/DIV. We conducted research on the Armenian Immunization system to put together the LOI. The goal of the LOI was to increase mothers’ awareness on the importance of vaccination and to educate them through online means as well as by involving NGOs and other organizations in raising public awareness on vaccination. Second goal of this project was to improve the effectiveness of scheduling a vaccination date/time and recording system through developing a website for parents about vaccination and providing evidence-based information through text messages to mobile phones, and online interaction opportunities between parents and health care professionals. The reply from USAID is supposed to come in the fall of 2013.
- During the reporting period RMF affiliated local non-governmental entity registration was initiated. The organization charter was developed and translated. But since at the end of March a decision was made to put the Armenia program on hold on 30 April 2013, the registration process was paused as well.
Number served/number of direct project:
163 women, 129 men and 53 children were treated
Melsik Khazaryan is only 37 years old, but for years he has had complaints about his heart. When he visited a doctor in Goris, he was diagnosed with possible status post heart attack and was prescribed corresponding treatment, but the prescribed medicine didn’t help him and his condition didn’t approve. Because of his heart condition he was unable to work and was given disability and received pension.
On January 2nd of this year the RMF nurse received an alarm call from his family that Melsik’s condition had sharply worsened. She immediately visited him with the doctor but they couldn’t help him, and the medicine given didn’t help. A decision was made to take him to Yerevan for examination at Nork Heart Surgery Center.
After a thorough examination he was diagnosed with neurosis, and it became clear that there was no heart problem. Currently Melsik has received corresponding treatment and feels very well. Melsik lives with his wife, two children and his father, who is a pensioner. His wife and father are also on disability. Fortunately now Melsik feels well and can go back to an active life and take care of his family.
While RMF’s Project Coordinator Stella was in Svarants delivering medicine, she was informed that one of the older villagers, Manya Hakobyan, 83, had asked to visit her. When she entered the house, she found the woman in bed, crying of pain. Stella found out that she had Herpes Zoster and her entire skin was covered with a rash and blisters. She immediately called a dermatologist in Yerevan and received consulting and prescriptions.
The prescription was not only medicine but also food rich in vitamins. When Manya was informed of the prescription, she silently turned to the wall without a word. That was a known story. Manya lived with her son, his wife and two underage grandchildren. No one in the house had a job. The only steady income was her pension. Two years ago her son took an agricultural loan to start his small farm, but hail storms ruined his crops, and now he has to pay back this loan with interest. The family could hardly take care of the minimum of daily food, never mind vitamins. Stella gave the prescribed medication without charge and also had a long conversation with the patient, to soothe her.
Sonik Manuntsyan, 78, lives alone in Svarants, although she has 5 daughters and a son. She has a heart condition, but most of all she needs emotional support. She always is sad and often tells stories of the hard lives of one of her children. RMF’s Stella tries to spend time with Sonik during each visit to Svarants and to listen to her stories, find out how she does and deliver the medicines she needs.
4 year old Vrezh Tigranyan from Tandzatap fell down the stairs in the family’s house and became very agitated and confused. He was taken to the Gorsi Hospital, and then to Yerevan. The examination showed that he has damages to his sitting nerve. After the prescription he was taken home, but day after day the child’s pain became stronger. RMF brought the child back to Yerevan and this time the doctors diagnosed cancer (pictured above).
Unfortunately this was the program’s last day, and we were not able further to help the child. The family consists of 6 members, the parents, the disabled grandmother and three children. They live in dire condition and have no means for the child’s surgery, but there’s a hope that the state will cover the expenses.
Mariam Tevosian’s Story
In 2011 Mariam Tevosyan’s parents heard about RMF’s program and visited the RMF representative to present their daughter’s story and ask for help. Three years before that, when their daughter was 8 years old, they noticed that she had a back problem. They visited a doctor who diagnosed that Mariam’s spine had a 32 degree scoliosis deformation and she was prescribed to wear a corset, but after three years of wearing corsets, the parents noticed that their daughter’s condition has worsened. The new examination through RMF revealed that Mariam’s spine deformation had reached 78 degrees, as a result of carrying improper corsets. Since then Mariam was taken under the control of RMF’s program and for about two years, once every three months, Mariam visited Arabkir Medical Center in Yerevan, where she was being examined to get a new corset.
This was until Mariam reached her adulthood. At the end of 2012 Mariam’s doctor informed us that she is now ready to have a surgery on her spine to correct it. This operation is extremely important for the girl. The operation is planned for mid-2013, when Swiss professors will visit Arabkir Medical Center to operate Armenian children. Since then RMF volunteer Nairy Ghazourian started a fundraising campaign to raise funds for Mariam’s operation, which, as recently was announced, will cost 6,000 USD. All the remaining funds raised for RMF’s Armenia program will be applied to Mariam Tevosyan’s spine surgery. We all hope this surgery will help Mariam to have a normal and happy life.