After posting a link to Arsineh’s recent post on her experiences with the medical system in Armenia and subsequent comments before I had to close that section, she’s responded back at home base on Cilicia.com. Given that I’ve had so many bad experiences with hospitals and doctors here I’m glad this conversation in the Armenian Blogosphere is continuing.

Another fellow blogger commented on his blog and I’d like to respond. He said to go to another hospital. I went to the hospital recommended by everyone: Markarian on Mashtots. I spoke to a couple people there who were very helpful, but the nurse who came to my house to draw blood and yelled at me for wasting her time (even though I paid her) came from there. The sonogram experience took place there as well. Behavior aside, when blood tests come back and say different things, who do you believe? I got a completely false test result and thus an unproductive diagnosys from the doctor. By the way, I wanted to take Advil to reduce my fever and the doctor sorta laughed at me and said, “Oh, all you Americans love your Advil. Don’t take Advil, I’ll recommend antibiotics that will work.” It didn’t work. I didn’t get better. The second I spoke to my father on the phone for 5 minutes describing my condition, he said to take Advil. It worked. As he says, most of his work is listening to the patient. You could recommend Madzoun to improve my fever, or you could do the proper tests to prescribe the proper antibiotic to combat the infection causing the fevers in the first place. That’s the difference.

Anyway, as I said before the problem is really quite serious in Armenia and the reasons for that are quite varied. In many cases, knowledge is still out of date, is infrequently updated, and resources are severely limited. In most hospitals in Armenia, for example, not only are patients meant to invite their families in to stay with them in order to receive round-the-clock care and attention, but they are also meant to provide their own bed linen, medicines and syringes.

Knarik Meneshian, a reader of this blog, sent me a comment to post after shutting down the page, but I think it fits in nicely here.

This topic reminds me of the time I was living and teaching in Jrashen, a village next to Spitak, in 1991, and became seriously ill with typhoid. In the cluster of drafty and cold temporary homes situated on the side of the mountain where I along with a number of families lived, mothers and grandmothers didn’t know what to do when their babies and children developed severe intestinal problems. Sadly, some died. There was no doctor in the village so people relied on one another for help. Generally, the treatment pretty much was to gather around the ill person’s bed and pray (and remain at the bedside for hours), and to cover the stricken person with blankets and more blankets despite the fact that one was half-delirious with high fever. In Yerevan, a specialist wearing a white coat and a tall white hat said that to cure my illness all I had to do was put my feet in hot water and I would be fine…Another said sternly, “…It is unbecoming for you, a young woman, to be ill…”

In 2003, one of my students in Gyumri, where I was living and teaching at the time, came to me and said, “Deegeen Knarik, the doctor told me that in order to cure my sinus infection (it was a very serious infection) I must collect my urine and drop it into my nose, but I cannot do that. The thought of doing such a thing makes me feel even worse…” And the cause of head lice, according to the same doctor, was due to the use of shampoos… For illnesses such as pneumonia, the doctor tells the patient to go to the pharmacy and pick up some antibiotics—no prescription needed. At the pharmacy, if one tells the pharmacist that they are having what they believe to be stomach, heart, kidney, liver or some other sort of pain, the pharmacist sells them medication for their particular symptoms–no check-up by a doctor or prescription needed.

At some hospitals, one must bring one’s own shots and have a family member administer the injections to control pain after surgery. Such injections are also purchased at the pharmacy—no prescription needed. If you can afford some sort of medical care you get it, if not, you’re on your own. Medical care is not free no matter what is said. According to a Yerevan physician I recently interviewed, she says that the doctors will treat the sick person once for free, but then if the patient returns because they are still very ill the doctors will make the patient feel so uncomfortable and ashamed for coming again that the poor soul won’t return suffering with their illness or worse. This is from a doctor that comes from a family of doctors. She’s been practicing (and still practices) for 50 years.

And in addition to my own experience with corrupt and incompetent doctors here — including one that told me my son would die in less than a week even though he only had a mere stomach bug — I have more stories to tell. Like, for example, the time when I had a mallet finger and one hospital wanted to charge me $250 to operate on it when all it needed was a simple splint — cost 5,000 drams. And herein lies the problem. Patients should not need to seek treatment from hospitals without referral from a General Practitioner.

This theoretically reduces the risk of misdiagnoses or incorrect treatment, the argument being that as patients have the right to change their GP and as the GP’s income is based on results and patient satisfaction, narrow specialists do not enter into the equation until a patient is referred to them. As it is, when hospitals and narrow specialists are reliant on formal and informal payments in a cash-strapped sector it is not in their interest to turn away potential “customers.”

Currently this system of Family Doctors, or GPs, is or was being piloted in the Erebuni district of Yerevan as well as Vanadzor.

Anyway, Arsineh has more to say on her experience now this conversation has been started, and I hope that a friend will add her two cents when she can find the time. I know that this is an issue very close to her heart as both she and her family have had constantly bad experiences with the Armenian medical system. Until then, I’m leaving the last word with Arsineh — and I mean that literally as no comments will be possible here.

Now this is my situation as a Diasporan in Armenia. Since I am fine now with the fortune of US medical attention, I’m not worried about myself. This is more an issue of proper care for the citizens of Armenia. I am an economy loving capitalist when it comes to business and competition. It’s been a positive change in Armenia. But I will forever believe that proper health care for all people regardless of their life situation should be available to them no matter what. Call me a socialist, but it’s one of the problems I have with the US system. Even if a lazy villager complains that they have to work and contributes nothing to the world, they should still have access to medical attention if their limb is falling off. Laziness or complaining is not a reason to deny medical attention to someone.

As for doing something about the problem, I am not a doctor. But my father is, along with all his friends who decided to start an organization that sends medical supplies to Armenia while training doctors and funding clinics there. This concern is not coming from nothing, my family is trying to do something about it. But beyond what they are capable of, one of the most important things to do is to inform the world of the problem. If the world doesn’t know what’s going on there, how do they know to address the problem at all? From this experience, many people have asked me about the system there. Interest has been sparked.

I’m not one to settle for low standards, even normal standards. If one Armenian gets improper treatment, the problem should be addressed.

So, if you have something to say on this issue please say it over at Cilicia.com. Arsineh’s full post is here.