The request from CSIH came in 1997 – could I go to Armenia to review the hospital system and offer advice as to how they should proceed to make improvements?
I must confess I knew little about Armenia as a country. But it sounded fascinating and I accepted. I landed in Yeravan, the capital, at about 11pm and then spent the next three hours trying to clear customs. This country had only regained its independence from Moscow a few years before and systems were slow.
My host and interpreter, the Deputy Minister of Health, was waiting and I was dropped at my hotel at 3am with a promise to pick me up for my initial introduction to the Department of Health on Monday morning.
My assignment was unlike any other I had ever had. Most of the staff spoke basic English but I was dependent on my interpreter and he did his best to be there when I needed him.
I soon learned that in Canada we are very lucky to have such an affluent health system, something we so often take for granted.
There are some very large hospitals in Yerevan and the wish to provide quality care was apparent. Unfortunately there were many “holes” in the system; the Russian era rules and guidelines were still in place; and there was little money in the system. One reason for this Canadian visit to Armenia was that the World Bank had decided to invest some money in the country, and the Government was trying to determine where best to use it.
The Armenian Government, relatively new to independence, was committed to establishing its place in the world and I marvelled at the tenacity and courage of the people. I have wonderful memories and each one was an expression of a people determined to succeed.
The Deputy Minister of Health had a car but could not afford the gas or repairs to visit the countryside. I wanted to see a rural hospital so I contributed some money for gas to take us up into the mountains to see a rural hospital with 310 beds.
I spent several hours listening to the administrator/physician relate his concerns about the state of the hospital and saw firsthand many of the issues he spoke of. As in most of Armenia, electricity and water were only available at certain times of the day so staircases were dark and there was no working elevator. We climbed to the third floor so see a patient the doctor was concerned about. In a 4-bed ward lit only by the windows we found a 4-year-old boy with a nurse kneeling on the floor beside him, bagging his respirations by hand because this hospital did not have a respirator. This was the third day he had been cared for like this and they were worried for his survival.
The same doctor then took us into the hills and led us up to a hermit’s cabin. The man gathered an armful of wild flowers for me as we walked down. That sort of kindness was everywhere in Armenia. It was apricot and cherry season and each day when I went to work there was a bag of fresh fruit waiting for me. This from employees who had meagre salaries but who appreciated all of life and nature’s little gifts.
One morning, on my way to work, I was replaying a presentation in my head—one that I was supposed to make to a group of Government officials—and I forgot to watch where I was going and got lost. The couple who I approached on the street spoke no English but with the help of the Deputy Minister’s business card I managed to get through to them. The lady took me to a bus stop and rode the bus with me until I was safely back on the right street.
The area is full of history, much of it sad but also amazing: the Cathedral church in Etchmiadzin built in 301 AD but still in use; a library with ancient books and documents, including the world’s largest and smallest books; Armenian khatchkars, intricately carved crosses, are everywhere, each with its own pattern. The people’s needs were great but they were determined to remain independent and to preserve their history and culture.
I fell in love with Armenia and am so grateful to CSIH for granting me this wonderful opportunity. I sincerely hope that I and others who followed me in this work helped the Armenians achieve their goals.