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Patients
awaiting treatment at the new mobile eye hospital. |
One person is getting a diagnosis, another is
being examined, a third is being operated on and
three others await their turn while a team of
doctors rush into tiny rooms. It might be a common
scene in a regular hospital.
But not on a truck. And not in the backyard of
an apartment building. And not in Ashtarak, Armenia.
Not until three weeks ago might such a sight
be imagined in such a place. But the Armenian
Eye Care Project (www.eyecareproject.com)
is about vision. And this is the realization of
such foresight.
On July 7 the Mobile Eye Hospital of the AECP,
a 48-foot tractor-trailer truck equipped with
fully sterile and self-powered operating and examination
rooms, made its maiden voyage from its home base
at Malayan Ophthalmic Center (Republican Eye Hospital)
and anchored in Arshtarak. Working seven days
a week for the next three weeks, ophthalmologists
from America and their Armenian colleagues performed
about 200 surgeries and laser treatments, screened
some 5,000 patients and referred 500 to the rolling
hospital. About 90 percent of the surgeries were
done by local doctors.
The vehicle (including equipment) is believed
to be the first of its kind in the world and was
created at a cost of about $1 million. It arrived
in Armenia last November. After months of final
preparation and testing, the truck was readied
and AECP founder Roger Ohanesian of California
came to Armenia for its inaugural run. Doctors
Richard Hill, from the University of California
Irvine, and John Hovanesian, a partner in Ohanesian's
California clinic donated a week each of their
surgical and training services.
Ohanesian founded AECP 11 years ago and, after
twice-yearly visits for teaching and supplying
updated equipment, the surgeon created the mobile
hospital, realizing a dream to make 21st Century
eye care available throughout all of Armenia.
The AECP initially came to Armenia to assist
in surgeries that local doctors had little experience
performing. Over the years they trained local
doctors and took some to the United States for
training. And, significantly, donors to the organization
provided more than $5 million in equipment, spent
to upgrade hospitals in Yerevan, Gyumri and Stepanakert.
"We soon realized that every eye clinic
in Armenia needed the same kind of attention we'd
devoted to the Malayan Center, the main hospital
in Yerevan," Ohanesian said. "Of course
it would be impractical, if not impossible to
try to renovate hospitals in every region.
"So we decided that we could build one hospital
for all regions, put it on wheels and take it
to those who for whatever reasons could not come
to us in Yerevan."
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Staff
intend to take the hospital to every region
of Armenia. |
The project chose Ashtarak to launch its program,
since the town is close to Yerevan and doctors
could commute from the Malayan Center. Eventually,
however, the hospital on wheels will be spending
several weeks a year in each of the 11 regions
of Armenia, plus Karabakh.
The initial phase of treatment is a series of
screenings, in which doctors gather information
and determine what treatment patients will require
when the truck arrives in a certain place.
Part of the screening is also to learn if a patient's
social status corresponds with the "socially
vulnerable" eligibility criteria established
by the government. Those who meet that requirement
are given free treatment, including surgery.
The Mobile Eye Hospital's first mission found
that most patients are the elderly, some of whom
have never sought treatment either because they
could not pay for it, or because many did not
trust the health care system in Armenia.
But even the mobile hospital did not remove skepticism
in some, as some would-be patients still do not
trust doctors - a suspicion left over from Soviet
times. Others are afraid of what doctors might
say about their health.
But Nune Yeghiazaryan, AECP country director,
says that eye care in Armenia is mostly hampered
because people do not realize the importance of
preventative-care examinations.
Heriknaz Mkrtchyan, 75, has never been to an
eye doctor and only now, being examined by the
staff of AECP, she discovered she has a cataract.
Because her family was deported to Siberia under
Stalin's regime, Heriknaz is eligible to receive
free treatment.
But even though she is aware that her eye surgery
will be done by highly-skilled doctors, and for
free, she says that her destiny is in God's hands
only.
Suren Aramyan, 72, who was also appointed for
a surgery, found out about the hospital from his
neighbors. Unlike Mkrtchyan, Suren believes that
exceptionally trained doctors can make a difference
and save his sight. He knew he was suffering from
cataracts for more than four years but he never
went to a doctor because he couldn't afford an
examination of $20-30 or a surgery of $100-200
on his pension of 6,000 drams ($10) a month.
Ohanesian says that Armenian doctors working
for this project are extremely talented and well
trained. He says the assumption that only Western
doctors can do complex operations is not only
a false impression, but is damaging to overall
healthcare. If before such surgeries were impossible,
it was because proper equipment and training didn't
exist. Now, they do.
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Roger
Ohanesian (right) examines a patient. The
needy receive free treatment. |
Local doctors working with AECP can perform up
to 12 surgeries a day on the mobile unit. They
say that even though the work is exhausting, the
activity creates energy far more intense than
in a stationary clinic or hospital.
"We are getting very tired but the work
we do is not complicated," says Hovik Simonyan,
one of the mobile eye hospital's doctors. "Each
doctor provides much more services here than in
any other hospital, therefore we get better qualified."
Dealing with an extensive load of work is also
a great experience for residency students. Knar
Sahakyan, a 24-year-old medical student, says
it is very important for her to work side by side
with knowledgeable physicians - a chance that
she might never be granted within a simple hospital.
And, as the hospital travels throughout Armenia
and Karabakh, doctors will have the possibility
to carry out a very complex study of the incidence
of eye diseases among the population of Armenia.
AECP drafted a questionnaire, which is filled
out by people being screened and which includes
questions about each patient's health problems.
Ohanesian says that the situation of health care
in villages is very poor and that many people
turn blind because they do not treat problems
in time. He adds that it is not easy to identify
either what causes so many eye disorders in Armenia
or why so many children suffer disease.
It is hoped that the work of the Mobile Eye Hospital
will provide essential data currently lacking
in Armenia. The government says it does not have
the means to do nationwide canvassing, so AECP
will share its information as a service to the
government.
While free surgeries are only for the indigent,
all applicants are eligible for other services,
including screening and diagnosis, which should
help in providing thorough research.
After three weeks in Armenia, Ohanesian said
that if subsequent missions are as successful
as Ashtarak, the Mobile Eye Hospital will have
serviced the whole country in about three years.
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