Vardenis Medical Center was chosen by both the Armenian Ministry of Health and the center representative as a pilot medical center.It is located in a beautiful part of Armenia by Lake Sevan at the border with Azerbaijan.

Our first mission to Vardenis took place in April, 2019.

Vardenis /Lake Sevan

 OUR ACCOMPLISHMENTS IN VARDENIS:

Our New Solar Panel Station at Vardenis Medical Center

           

Returning from Medical Mission in Vardenis, Armenia: My Thoughts and Impressions by Maria Azizian MD FACS 

May 26,2019

I love hospitals. I love their smell, the atmosphere, rushing staff, generic art on the walls, lobby coffee, nursing stations, and starkness and no-nonsense of the operating room- I love it all. I even enjoy the hospital cafeteria food (and I am not alone in that- most people are just embarrassed to admit it). The hospital gift shop to me is like a Zen garden. I have many earrings that I had bought just because I felt purely happy to be there.

Of course, it started in my childhood, when my dad, a psychiatrist, would often take me on errands/ trips. However, almost invariably, during these father / daughter trips, once we would get into the car, my father would say, “I just need to see this patient, it will be really quick, 5, maximum 10 minutes”. We lived in Soviet Armenia, and there was no HIPAA then. I would sit with him in his office or by patient’s bedside, or at the hospital bench, while he would listen and listen, while the patient talked and talked. At best, one hour later we were on our way.  It felt like a burden at first, but, as time went by, I started feeling more and more involved. As a child, I soon started caring about the patients that I had met, and I would ask my dad of their progress. That further solidified the strong bond that we already had.

Fast forward, my own life: medical school, grueling surgical residency and current years as a surgeon- Yes, I still feel the same about the hospitals.

When I am at a new hospital, I feel like a lion in the savannah: I can sniff where everything is, and I know who is who before I am introduced to them. It is a wonderful generic place that feels like home. As an emergent general surgeon, this skill is very handy, as I do operate at several hospitals.

On a personal level, when I was pregnant with my first child, I knew that I wanted to have a natural no -epidural unmedicated birth. At first, I had thought that a home birth with a midwife would give me that experience. However, I suddenly realized that hospital was my true home. The hospital was my safe place, it was my stomping ground. It was more home than home. I wanted to be there when I was at my most vulnerable. Plus, there was no way I was going to give birth without the familiar hospital walls, without the nurses that I loved surrounding me, without my coworkers stopping to see me. No way. Over the years I had 3 natural unmedicated births at the hospital exactly the way I wanted, and I file these as the best memories/ experiences of my life.

To summarize, hospitals are my home.

When I decided to get involved in medical charity in Armenia, I was very drawn to the rural setting and what else? Renovation/ rejuvenation of rural Hospitals in Armenia.

Our medical non-profit, MedArmeniaPhilanthropy (501(c)3 non-profit organization with Federal Tax ID # 83-3391291), was established to serve and help rural hospital at Armenian borders specifically.

In conjunction with the Armenian Ministry of Health, Vardenis Medical Center was selected as a pilot project.

Why Vardenis?

Because it is remote, poor and located on the border with Azerbajian. It is out of the way from the common tourist paths.

Despite my intellectual understanding of the poor conditions, I was not prepared for the level of dilapidation and poverty that was everywhere.

Broken streets with no pavement, holes in the buildings plugged with plastic bags, overflowing trash bins- this is a reality of once beautiful town built with ubiquitous Armenian pink stone or lava, called tuff.

The shock of complete devastation was profound- that is how I imagined an area ravaged by the war would look like. And, indeed, as I had learned later, the war with Azerbajian devastated this area, and, additionally, poor economy prevented subsequent clean-up and rebuilding.

It was hard to believe that during the Soviet Armenia this area functioned as a resort.

The goal of this 1^st mission was to deliver some medical supplies that MedArmeniaPhilanthropy has purchased and received in donations. Also, to study the hospital, conduct interviews, and determine the level of assistance that would be needed.

I also received my Armenian medical license from the Armenian Ministry of Health, so could potentially do consultations/ surgeries at the Center. Additionally, I hired a movie crew to shoot a small movie depicting not only a poverty of the hospital, but the devastation of the whole town.

Below are the facts/ data and information collected during my time in Vardenis.

I would like to thank all of the employees for their help, and especially, HR director, Jemma Manukyan, who guided me and introduced  me to everybody, CFO, Robert Tadevosyan, and last, but not least, new CEO of the hospital, Dr. Shahen Shahinyan:

Here are the facts:

Vardenis Medical Center was built in 1986 during Soviet Era.

It serves population of 39,000 from 36 villages.

The number of visits is 1200 per year

Number of employees 93, with an average pay of $120 / month (the local population supports itself with small agricultural businesses)

(The needed survival wage is $420/ month)

The hospital was built as 320 bed facility, but now only 30 beds are utilized due to severe disrepair of the rest.

The hospital has a helicopter pad and was able to treat up to 300 patients during the war with Azerbajian. The helipad is still there and is being used rarely (see photos).

The hospital has NO central heating except for a few select rooms in Ob and Peds wing.

There are electric heaters from the ?80s located in most of rooms, including the operating room.

(In my several days in Vardenis I got used to staff reminding each other to turn off the heaters before leaving the room to avoid fire)

The 2 elevators have not worked since the building was opened in 1986.

The patients are being carried to the 3^rd floor for surgery/ birthing by the staff, that sometimes consists of all women.

There is no kitchen, and no food provided for the patients. (All food is brought by the families)

Most inpatient rooms have broken ceiling, floors, peeling paints, etc.

There is no rudimentary kids’  playroom stuff- no toys/ books/ etc

The basic labs, such as kidney and liver tests, can’t be performed due to the lack of a biochemistry analyzer.

I had also learned that the ultrasound machine is of a very high importance in Armenia, in general. At first, I didn’t understand that. In the United States ultrasound is used a lot, but it is secondary to the wide use of a more sensitive techniques, such as CAT scan and MRI. It was then explained to me that CAT scan is a luxury that most centers can’t afford. Thus, a modern ultrasound machine, especially, in the hands of a good ultrasonographer is considered a very desirable feature for the hospital.

By the way, in Armenia, an ultrasound is done by a specially trained physician, not by a technician. It is actually a separate specialty in medicine. The ultrasound is used widely for the diagnosis of cardiac (echocardiogram), gastrointestinal (gallbladder, liver, stomach, spleen), urological (kidney, ureters, bladder) and, of course, reproductive and gynecological conditions

Interestingly, but a lack of access to a reliable ultrasound machine was cited as one of the reason that prompted Vardenis patients to travel to the capital, Yerevan.

The operating room with electrical heater, minimal instruments, and barren anesthesia machine was the saddest site. I told Dr. Shahinyan, the new CEO and Ob/Gyn surgeon, that he and his colleagues who had operated there, were heroes. He smiled, and told me that they were actively hoping to get a general surgeon on staff to make general surgery more accessible to population. It would be very hard for an American trained general surgeon to even imagine operating under those conditions.

After the end of the tour, I suddenly realized that we didn’t see the ER.

Then it dawned on me, the first room with 2 desks that I was led to was the actual Emergency Room/ Department.

The emergency room was merely a reception room with 1 blood pressure cuff and one stethoscope.

Yet, in the middle of such a lack, people were lively, and kind, and engaging. Their warmth and kindness were invigorating.

I really don’t think that they realize the level of poverty that they are in.

At the same time, they are not complacent. It was incredibly impressive to see two patient rooms that were beautifully done with painted walls, and intact floors and ceilings-these rooms were renovated by the staff on their own dime. Taking into account their tiny salaries, their donations constitute truly heroic measures.

So how did I, the hospital lover, feel seeing this hospital in such horrible condition?

I felt like I was in the operating room when you open the abdomen in a patient with peritonitis with a lot of contamination. It looks bad, but you know there is a lot of work ahead: cleaning and restoring. It is a very satisfying work, albeit tedious, and you know that the patient will be saved.

I feel exactly the same in regards to Vardenis Medical Center: a lot of work needs to be done to restore and rebuild this hospital.

Broken elevators, lack of emergency room, no infrastructure for triage, no cafeteria, no central heating- the list goes know.

We already started this project with our first donations.

The staff at Vardenis, including both the administration, doctors, and other employees, are interested in putting their time to help their hospital.

They had already started doing that.

This very large project is the only project that MedArmeniaPhilanthropy will be developing and supporting in the near future.

We have 3 Phases of the Project:

Phase 1- Providing Heat and Diagnostic equipment

Phase 2 -Creation of Reproductive Center to ensure much needed perinatal care, Renovation of existing rooms, creation of cafeteria, kids Playroom.

Phase 3- Installation of new elevators, Building of an Emergency Department with an open access to the ambulance, nursing station with 5-10 bed by utilizing the existing building or adding the addition.

We already started with Phase 1.

• Lack of central Heating- need to purchase solar panels (up to $5000)
• Lack of ability to perform basic labs- need to purchase biochemistry analyzer ($3000)
• Lack of an adequate diagnostic imaging- need to purchase a 3D Ultrasound Unit. ($16000)

If you are interested in participating in this project, as a visiting physician, or a builder, or a fundraiser organizer, or just interested in donating-  please email us / use this site to donate.

To see our movie about Vardenis, please use the link below: https://drive.google.com/open?id=1kXbLbYJuTlcwiL9Ha21QvXdys0h7_SdB

To see a full set of photos from Vardenis, please use the link below:

https://drive.google.com/open?id=1DQjacLo8hBNUIBRxhzn25CEPrIcFZye_

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Here is the state of the center now: