Reaching the furthest from help through mobile health teams

UNICEF continues support to remote villages in Armenia cut off from the main roads due to the Nagorno-Karabakh conflict.

Gor Petrosyan
ՅՈՒՆԻՍԵՖ-ն աջակցում է սահմանամերձ գյուղերին:
UNICEF Armenia/2022/Martirosyan
24 May 2022

Before the 2020 escalation of the military hostilities in and around Nagorno-Karabakh, it took 20-30 minutes to travel the stretch from Goris to Vorotan in Armenia’s Syunik region. Today you’ll need hours to do that. The situation on the border has drastically changed the life of children and their families in Syunik, leading to serious access and mobility issues to Vorotan, Bardzravan and Shurnukh, as well as access to basic social services, shortage of food and non-food items, affecting mental health and sense of security. Families are scared to get on the road with their children; alternative roads are longer and, in many cases, not yet paved all the way through, which add to travel and transportation costs.

As Syunik is also home to families displaced from Nagorno-Karabakh that need support and easy access to services, UNICEF had set up mobile teams of doctors with the support of the Government of Japan, in order for regional health services to be able to reach all families in need who cannot take the road to main healthcare institutions throughout the marz. In addition, UNICEF provided essential supplies and equipment to the ambulatory services in Vorotan and other bordering communities, including medical beds, folding ward screens, automatic tonometers, first aid bags, rolling medical stands, stretchers, medical masks and gloves. The medical center in Goris was also provided with a paediatric scale and a vital sign monitor for patients.

UNICEF strengthens health services in remote villages of Armenia.
UNICEF Armenia/2022/Martirosyan

“There are 72 children in our village. The visits of mobile professional teams are like a safety net for parents. They would come twice a month, examine both children and adults, prescribe medication and treatment, where necessary, and answer all questions and concerns from parents,”

shared Sveta Mkrtchyan, paediatric nurse at Vorotan ambulatory service.

She recounts how the new equipment they have received from UNICEF has helped them to improve the ambulatory conditions and, as she puts it, “see patients in a civil environment and carry out examinations and medical interventions in accordance with accepted standards.”

“Both old and young know that if in trouble, they can come to the ambulatory and get first aid right away. In cases where it is impossible to get the patient to the ambulatory, we do home-visiting,” said Sveta.

“As a result of the road conditions and reduced access and mobility, we are most concerned about keeping the routine immunization rates for children. Children in Vorotan have always gotten their vaccines in Goris medical center and now that is under risk. We try to facilitate car-pooling or other solutions so that parents feel safe to get on the road.”

Mher, 10, and Narek, 9, are from Nagorno-Karabagh and have now settled in Shurnukh village
UNICEF Armenia/2022/Martirosyan
Alex is from Nagorno Karabakh, now settled in Shurnukh.
UNICEF Armenia/2022/Martirosyan

Mher, 10, and Narek, 9, are from Nagorno-Karabagh and have now settled in Shurnukh village with their mother Hermine at grandma Manya’s house. Fully concentrated on homework, the boys did not pay attention to us. As Hermine explained,

“They have always loved school. Classes and homework help my sons to take all the difficulties more lightly, give them something to do and distract their attention from the negative feelings and longing for our neighbourhood and their friends in Nagorno-Karabakh. Here there are only a few kids their age, there isn’t much to do, so they mostly spend time at home. My sister’s son Alex is only five months and we cannot wait for him to grow up to play with them. There is a field in the village where they sometimes play football with other boys. But they always mention how they would have liked to play with their old friends back at home. You see things changed too quickly and drastically for us.”

Hermine Hayrapetyan, who is the paediatric nurse at Shurnukh ambulatory, says that the village ambulatory mostly deals with the seasonal flu or issues related to hypertension or alike. “We have only 23 children in the village and as is always the case in summer and playing outside, we do expect to deal with a few injuries. One of the boys was recently stung by a bee. The paediatrician prescribed the treatment, and I administered the medication. For more specific issues, we keep an updated list and request doctors to pay us a visit on quarterly basis. The mobile teams have been indispensable in this regard.”

Hermine Hayrapetyan, who is the paediatric nurse at Shurnukh ambulatory, is doing home visiting.
UNICEF Armenia/2022/Martirosyan

Today, Hermine is doing home visiting and has come to see how grandma Manya is recovering from surgery. “Mrs Manya underwent surgery in Kapan. Another intervention is needed yet again, for which the family needs to go to Kapan again and I know it is a real challenge to organize the travel in these times,” says Hermine.

Mobile health teams visiting Shurnukh village with support of UNICEF.
UNICEF Armenia/2022/Martirosyan

“We usually stay for up to three hours in each village, as we also need to get to other nearby villages as well as manage to do home visiting, if necessary. As doctors, we have to continue carrying out our job and our duties even in times of hardship, so I would not like to complain about the road conditions, lack of resources, or other things. We are continuously motivated by the gratitude of our patients and feel self-sufficient when we are able to help.”

explains Romela Sahakyan, paediatrician and family doctor from Kapan medical centre
Mother took her daughter for check up to the ambulatory.
UNICEF Armenia/2022/Martirosyan

Towards end of the day, we are in Bardzravan, another small community left cut off. There are only 12 children in Bardzravan, and the ambulatory clinic is on the first floor of the village kindergarten, so the children have developed a habit of dropping by to see the nurse before going home. Nara Mikayelyan, the paediatric nurse is working her way through making sure that all children get to see the doctor – seven-month-old Arpi, Erica, 7, who has checked-in with a cough, Mariam, 3, and her 6-year-old sister Victoria who have tummy ache.

“The mobile health team visits are of great help for me. I am a nurse and I am not mandated to diagnose or prescribe treatment. In addition, travel to Kapan nowadays is an unallowable luxury for many fellow villagers,” said Nara.

“Nara and the doctors from Kapan are caring and very attentive. Along with medical examination and instructions, they also pay a lot of attention to the information and skills we have as mums,” shares Arpi’s mum Tsaghik Muradyan. “Dr. Romela explains everything to us in detail - how to feed, maintain good hygiene, what to do in case of specific symptoms. We meet with them twice a month but make use of the knowledge they have shared with us every day.”

Mobile health teams visiting Bardzravan village.
UNICEF Armenia/2022/Martirosyan

From 2021 to 2022, in Syunik, as well as in Ararat, Kotayk, Armavir, and Vayots Dzor the mobile health teams have identified and visited over 10,000 children and women, including those displaced from Nagorno-Karabakh, tending to their health issues, providing reference for additional check-up where necessary, and following up on treatment processes.