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  • Health: Bringing Sight to Armenian Eyes

    BRINGING SIGHT TO ARMENIAN EYES

    USAID.gov
    http://www.usaid.gov/press/frontlines/fl_mar12/FL_mar12_PPP_ARMENIA.html
    March 15 2012

    March/April 2012
    Jeffrey Paretchan | PARTNERSHIP

    "Imagine a crowd of doctors busy around my kid. They tell me that he
    will go blind if not operated on immediately," said Maqruhi Raganyan.

    "It was terrible, and I was in panic," said the mother of 50-day-old
    Hakob Raganyan, recalling her visit to a hospital in Yerevan, Armenia,
    during the summer of 2010.

    Raganyan confessed that she calmed down only after Dr. Thomas Lee,
    a visiting physician and director of the Vision Center of Children's
    Hospital in Los Angeles, Calif., approached her and explained in
    detail all possible consequences of the disease for her son.

    "I really trusted them, because they seemed very experienced people,"
    she said. "Finally, I understood that no matter what I feel, I am not
    a specialist and I may make a mistake. I will never forgive myself
    if my child goes blind because of my mistake."

    In the post-independence years of the early 1990s, Armenia
    was described as a "beautiful and tragic place" filled with
    bombed-out hospitals, injured people from the war with Azerbaijan,
    and disintegrating infrastructure. Cats roamed hospital corridors to
    catch mice, and basic medical instruments like scissors were too dull
    to cut tissue. If a patient was facing vision loss, there was little
    that could be done.

    Still today, many Armenians living in the marzes, or regions, outside
    the capital city Yerevan are poor. Patients frequently cannot afford
    care. And even when care is available in Yerevan, people from the
    regions are often unable to travel there. Armenia's mountainous terrain
    and extreme climate reduce access to many parts of the country. Quite
    often people are literally stuck at home without help.

    In response to these challenges, Dr. Roger Ohanesian organized what
    would become the Armenian EyeCare Project (AECP). The Armenian EyeCare
    Project Charitable Foundation, an Armenian-American diaspora-led
    organization, launched a program called "Bringing Sight to Armenian
    Eyes" in 2003 to strengthen the eye-care system and reduce preventable
    blindness in the country.

    In October 2004, USAID and AECP joined forces. Through the partnership,
    USAID/Armenia helped the AECP roll out and scale up a program that
    complemented the mission's goal of strengthening primary health-care
    programs in Armenia. The project ended in 2011.

    The AECP doctors and the project's state-of-the-art Mobile Eye Hospital
    (MEH) traveled countrywide to provide high-quality eye care in the
    regions, covering 90 percent of Armenian's communities. The MEH is
    a semi-truck consisting of two exam areas, a scrub and prep room,
    and a surgical room along with state-of-the-art equipment. Patients
    can be screened for diseases and undergo cataract surgery and laser
    procedures. Since 2004, the AECP has examined 245,000 people, provided
    laser treatment or surgery to nearly 10,000 patients in the MEH,
    and distributed 36,000 eyeglasses to vulnerable populations.

    "We Will Try to Save Your Daughter's Eyes"

    Gevorg Avetisyan recalls the day he brought his daughter Ani to visit
    the eye doctor at the Malayan Ophthalmic Center in Yerevan.

    "On that day there were a lot of people on our floor in the corridor.

    'Americans are here! They examine patients!' people were whispering
    all around," he said. "When we entered the screening room, we saw
    one tall American guy with his shorter colleague examining patients
    surrounded with a crowd of Armenian doctors. Our ophthalmologist, Dr.

    Anna Hovakimyan, introduced Ani to them.

    "After they examined my daughter, I heard the best words of the recent
    years: 'We will try to save your daughter's eyes. There is a special
    artificial retina prosthesis, which we will implant.' We were very
    lucky on that day."

    Sixteen-year-old Ani now has 30-percent vision in both eyes, attends
    school to learn to read and write, and has discovered a passion for
    her new hobby-sewing.

    The project not only brought American doctors to Armenia, but
    provided medical education and training for Armenian physicians in
    the United States. These doctors returned to Armenia and became heads
    of departments and conducted training for other doctors in country.

    According to Dr. Hovakimyan, Ani's physician and a doctor at the
    Malayan Ophthalmic Center: "The major success was the combined hard
    work performed by the [Malayan Ophthalmic Center] medical staff in
    restoring the [patient's] eyesight. It is very noteworthy that all
    doctors were AECP fellows trained in the United States. This is really
    a great investment and contribution from AECP."

    AECP organized intensive professional re-training of 61 regional
    ophthalmologists, as well as training in the basics of ophthalmology
    for 57 family medicine doctors and 773 nurses. More than 1,600 primary
    health-care providers in Yerevan and the regions have been trained,
    which enabled practitioners to diagnose sight problems at an earlier
    stage, thereby preventing longer-term vision issues.

    "The best thing we've gained from this project is confidence," said
    Dr. Alex Malayan, director of the Malayan Ophthalmology Center.

    In the past, difficult patients would be sent to Moscow; now patients
    come from Moscow, as well as neighboring countries, to get eye care
    in Yerevan, he said. "There is no other program like this in Armenia,"
    he added.

    Overall the project cost $10 million with the USAID share at $1.5
    million, leveraging $6 of funding from partners for every dollar put
    in by USAID.

    Building Local Capacity

    In addition to improving eye health and training medical professionals,
    the project has helped increase the capacity of Armenia's Ministry
    of Health. It also led to the creation of a database and analysis
    of ophthalmological-disease information in Armenia, which had not
    previously existed.

    Additionally, the partnership exemplified the significance of
    Armenian diaspora engagement, said AECP founder Dr. Ohanesian. "Why
    do we continue to go back to a country where there is a lot of work,
    a lot of effort, a lot of bureaucracy?" he asked, and then answered.

    "I remember one child was brought in. He had penetrating injuries
    into both eyes. Both eyes became infected. Both eyes had to be
    removed. It had happened six months before. I looked at him and
    I said, 'What can I do? He has already had both eyes removed. But
    he is crying-is he still in pain?' And his parents are crying too,
    and the interpreter talked to them and he turned to me and said,
    'No, they thought you brought new eyes from America.'"

    "That level of trust in what America can do-and what the diaspora
    can do-is what keeps us all going," Dr. Ohanesian said.

    The ending was happier for infant Hakob Raganyan. The ad-hoc laser
    treatment lasted until 3 a.m., when the AECP doctors and their
    Armenian colleagues completed their job. The surgery was a success
    and his mother is full of confidence that everything will be alright
    for her only child.

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