Reflections on my Second Medical Mission

Dr. Ferman, center, with Armenian medical colleagues at Health Center, Lori marz

By Debra Ann Ferman, MD

Armenian summers are often hot and the medical facilities have no air conditioning. The remote villages at times have limited water and electricity, which affects the local health center. This year I worked at medical clinics in six different Children of Armenia Fund (COAF) villages. Three talented COAF physicians organized the clinical portion of the trip and prepared a group of patients for each physician.  I mainly saw patients in my specialty of hematology and oncology.  I also performed screening breast examinations and gave a lecture to the local nurses on the subject.   Each day we worked at a different clinic.  The local physicians were kind and welcoming.  It was a pleasure to work with them and also to reconnect with the staff from the previous year.  I also had the privilege of seeing a patient I had initially evaluated a year ago, who is now under the care of a Yerevan specialist.

Working in the clinic gave me the opportunity to interact with local Armenian villagers and learn about their lives.   The migration problem to Russia became more real when we saw young brides eagerly waiting for their husbands.  The uncertainty of their return had resulted in health problems.  I made a house call along with a local Armenian physician, and the patient’s son picked us up in a well maintained, old Russian Lada car.  A grateful patient brought us freshly picked blackberries from her garden.  They were organic and delicious.   This is a classic example of traditional Armenian hospitality.

This year, I became more aware of the burden of economics on medical care.  One cancer patient on active chemotherapy came in with an obvious infection.  In my practice, such a patient would have been referred to the emergency room for urgent evaluation and likely intravenous antibiotics.  This patient had to decide whether the proposed medical care was worth the expense.  Another patient could not afford the requisite laboratory monitoring and stopped taking his medication.  Even teachers, who have some form of medical insurance, are not covered for screening mammograms.  A screening mammogram may cost half a month’s salary.  One patient never had a follow up mammogram after breast cancer treatment because of the cost.  One newly diagnosed cancer patient could not afford testing for both pathology and imaging.  I was asked which test was more important. These are commonplace problems that are faced by the patients and physicians of Armenia.   Armenian physicians are very resourceful and give the best medical care possible under the circumstances and in such difficult situations.

The medical mission offered a nice mix of patient care and sightseeing.  We had the opportunity to visit a COAF art school.  We also were treated to an Armenian folk dance class with young teenagers at the local COAF school in Lernagog. After our stay at Dsegh clinic, we visited the home and birthplace of the great Armenian poet, Hovhanness Tumanyan.   On the way back to Yerevan one evening we stopped by Zvartnots cathedral.

The Medical Mission provides a slightly less than touristic perspective on the country.  It gave me an appreciation for the wealth of resources for both patients and physicians in the West.  It sometimes also makes me wonder, have we gone too far the other way?  To work as a doctor in Armenia is difficult. The earning potential in the West or Russia is greater, even if one works as a day laborer or home health aide. I hope that each health care professional in Armenia is able to live well and be successful both economically and professionally.  We must support our compatriot healthcare professionals who choose to stay in Armenia and provide much needed medical care.  The Armenian American Health Professionals Organization (AAHPO) already provides vital continuing medical education for physicians in Karabagh and Javakhk.



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