In the Ltchashen village of the Gegharkunik Region, some 100 kilometers eastof Yerevan, 65 year old Paytsar Grigoryan runs from house to house administering vaccinations to children before the medicine can spoil.

The "clinic" at Ltchashen.

She has no way of keeping it fresh, and there is not even a window in what used to be the village medical outpost.

Paytsar has been a nurse for 50 years, and remembers when the Soviet system managed an efficient clinic in Ltchashen. But while those days have gone, Paytsar has stayed, as her village’s link to medical care.

“Since 8 o'clock in the morning, I'm working,” Paytsar says. “I beg the head of the village to at least put in a window that I could give injections to patients here.”

But without so much as the light by which to aim a needle, the senior nurse instead goes from house to house.

“Now I open a medicine and begin visiting people's houses as I must manage to vaccinate everyone within two hours,” Paytsar says. “If (authorities) wanted, they could reconstruct the clinic. But they know that I run and manage to visit all houses alone and that's why they don't rebuild it.”

In small villages like Ltchashen, lone nurses administer vaccinations and injections prescribed by doctors, deliver babies, and are on call for emergency.

As the village health-care provider, 65-year old Paytsar Grigoryan with 50 years nursing experience is paid 5000 drams (about $9) per month.

The Belgian division of “Medecins Sans Frontieres” (Doctors Without Borders) has begun a five-year program aimed at improving the state of ambulatories and medical treatment. It also includes providing hospitals and polyclinics with medicines and medical equipment.

But, waiting for those improvements, Paytsar’s situation is not unique.

Nurse Nune's apartment has become an ambulatory.

ArmeniaNow visited four villages in the Vardenis district and found, at best, dilapidated clinics. In two villages, Aghbiuradzor and Kakhakn, nurses use their homes as medical stations.

The list of vaccinations is attached to the wall of the house of Kakhakn nurse from Nune Vatyan.

“I give injections to little newborn babies at their homes but injections to one-two year old children I give here,” says Nune.

Refugees from Azerbaijan live in Kakhakn, which has a total of about 530 residents.

“When a patient visits my home and I must give injection to him I tell my husband to go out of the house. My home turns into a hospital ward,” says Nune. “Many patients cannot come here and I visit them myself. I walk a lot. I have a hard time. It’s ok if I have difficulties with my work I just want them to send medicines to me so that I could render first aid, so that if someone visits me I could give a tablet to a patient and tell him to put that pill under his tongue. I have to buy medicines myself with my money as I don’t want to tell patients, ‘go, I have no pills’.”

Nune also delivers babies. This year she has delivered three babies out of five that were born in the village. The two she didn’t deliver were first-borns. She believes the mother’s first child should have a proper delivery, so she insists that her patients go to the nearest hospital, 10 kilometers away in Vardenis.