As a young medical student from the US I did not know exactly what to expect when I first walked into Yerevan’s Clinical Hospital No. 1. I had taken an observational position in the department of Plastic, Reconstructive and Microsurgery for three months and had the pleasure to work with some of the best physicians in all of Armenia. The surgeons I worked with are graduates of Yerevan State University’s Medical University during the Soviet era, had further training in the West, are fluent in English (among other languages) and in the 1990’s, served as surgeons during the Karabagh War where they saw some of the most complex plastic, reconstructive and microsurgical patients. Needless-to-say these physicians are well-educated, well-trained and well-seasoned surgeons. While these specific individuals are by no means the norm—there are many very skilled physicians in Armenia.

Another positive attribute of Armenian medicine that struck me immediately was how strong many of the caregiver-patient relationships are. How often would a physician in the US accept a bag of apples for the payment of surgery, have dinner brought to them at the hospital by a grateful patient or be given an endearing and respectful patronym. Perhaps the most amazing attribute of Armenian medicine is the ability for healthcare workers to operate productively under the conditions and the problems that they do have. These problems come in many forms; however it is the lack of resources, lack of regulation and enormous presence of corruption that are undoubtedly the central problems.

So what is to be done with Armenian medicine, which suffers chronically from such deficiencies? First of all, it must be said that the general attitudes that both foreigners and those in Armenia have about Armenian medicine needs to change. For example, one cannot say that Armenian medicine is totally flawed, there good doctors who do good things in Armenia. Also, one must realize that the problems are not unsolvable and also that they cannot be solved over-night.

As far as easy solutions go for those abroad, sending money or equipment blindly into the system is not acceptable. I have already cracked the door on corruption and need not discuss the consequences of blind donation. However this is not to say that money and equipment from abroad are not needed. If these resources are carefully sent to trustworthy recipients who can then properly distribute them, then by all means sending equipment and supplies can be very helpful. Another way of solving the problems of the Armenian healthcare system is by supporting organizations or institutions within Armenia that effectively help instill good medicine. Clearly medical workers coming to Armenia to volunteer in public health sectors, working as healthcare workers, training or speaking on their fields is immensely helpful.

Armenian medicine is not French or American and it needs to grow on its own-but at the same time it also needs help from the outside. Like the physicians I work with, the Armenian medical system needs to take what it can from the Western systems, like the technique and knowledge and bring it to the front lines of Armenian medicine where it can be adapted for their own scenarios where certain aspects, like caregiver-patient relationships, can be preserved.

Shant Korkigian (USA),
AMA volunteer and BR/DH participant