This is where you can find out about some of the exciting ways in which PHCR helped improve lives of real people throughout Armenia.
PHCR Leverages Outside FundsIt is very gratifying to realize that one’s support for improving peoples’ lives is, in fact, doing that. It is even more gratifying to witness how one’s support serves as a catalyst for further improvements.
With funds provided by the American People through the United States Agency for International Development (USAID), the Primary Healthcare Reform Project (PHCR) helps improve quality and accessibility of primary care in Armenia. To increase effectiveness and efficiency in the use of funds, the Project not only coordinates activities with other donor organizations, but, where possible, also endeavors to leverage and mobilize outside resources.
In the fall of 2007, PHCR teamed up with Jinishian Memorial Foundation (JMF) to strengthen primary healthcare in rural Armenia. The JMF was established by the bequest of Vartan H. Jinishian, an American Armenian, and registered as a local charity organization in 1999 with the purpose of supporting durable solutions to Armenia’s social and economic problems. As part of its activities, JMF supports improvements in primary care in rural Armenia and recognized that by collaborating with PHCR could produce synergistic results. Learning that PHCR trains rural nurses countrywide, JMF agreed to support this process by training nurse clinical preceptors, contributing to the nurse training budget, publishing some of the training materials, and providing glucometers with strips for medical kits distributed to rural primary care providers. In 2007 and 2008, JMF contributed US$ 62,000, and will continue the support until PHCR completes rural nurse training in all regions of Armenia.
PHCR also raised other Diaspora funds to further enhance rural health infrastructure upgrades. As the Project announced that it would renovate the interior of the health post in Zovashen community (Kotayk region), Ms. Sonya Artinyan, an Armenian living in Toronto, Canada, volunteered to donate US$ 2,250 for the reconstruction of the health post’s roof. Thanks to Ms. Artinyan’s contribution, the renovated interior of the health post is now safe from roof leaks and will last much longer.
No less importantly, communities themselves, too, became motivated by PHCR work. While renovating primary healthcare facilities in Lori, Shirak, Tavush, Gegharkunik, and Kotayk regions, the Project succeeded in obtaining input from all 78 target communities. Even despite the severely limited funds and personnel, in particular, in rural areas, community contributions, direct and indirect, totaled nearly AMD 85 Million (approximately US$ 280,000). Interestingly enough, health post related improvements often serve as an incentive for the communities to initiate renovations of other community infrastructure. The involvement of communities not only helped boost the effect of PHCR-supported improvements, but it also helped place the owner-ship of the upgrades in the hands of the community, thus enhancing greater sustainability.
As the Project moves to other regions, it will keep seeking yet other sources of funding, for even greater results and lasting impact.
Photo caption: Through collaboration between PHCR and JMF, a greater number of nurses from rural Armenia receive up-to-date training in a number of critical nursing topics.
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PHCR Training Saves a Newborn's LifeVarditer Iskandaryan, 35, is a family physician and a clinical preceptor at the medical ambulatory of Gandzakar community of Tavush region. Earlier in May 2007, Varditer participated in a series of trainings organized by the Primary Healthcare Reform Project (PHCR) for family physicians and clinical preceptors. Training on cardiovascular diseases was the latest one in the series.
This lifesaving story began on October 5, when Varditer went on a routine afterbirth home visit to Anna Yaribekyan who had just returned from the maternity hospital with her newly born baby, Tatoul. The routine examination of the young mother showed that she was recovering successfully. However, the infant’s breathing pattern and tachycardia made Varditer grow fearfully anxious. “I immediately recalled everything I learned as part of the “When and why to suspect cardiovascular problems in neonates and infants” module of the recent PHCR training,” she said later. Even despite the 130-kilometer distance to Yerevan, the doctor strongly advised that the parents should as soon as possible take the baby to cardiologists at the Children’s Department of the Yerevan Nork Marash Medical Center. Fortunately, they did not hesitate a moment and followed Varditer’s advice immediately.
After examining little Tatoul, doctors at Nork Marash Medical Center diagnosed a combined heart defect with patent ductus arteriosus and critical coarctation of aorta. The latter would lead to the baby’s death within the first two months of life. The doctors stated that this was an insidious disorder, hard to detect, and for this reason rarely identified in Armenia. In the mean-time, though one of the leading causes of infant mortality from heart problems, this defect can be fully eliminated if addressed timely. The doctors at the Center admired Varditer’s professional attitude and knowledge. Tatoul was hospitalized and on November 6, underwent a heart surgery.
Soon enough, the baby recovered - to the utter joy of his happy parents and all the physicians. The final examination showed Tatoul’s heart and circulatory system had no more abnormalities, and he can live a healthy life.
Varditer will always remember this case as a truly unbelievable lifesaving experience. “I am so incredibly glad that the knowl-edge I obtained during PHCR trainings helped save a baby’s life,” said Varditer when the story came to its happy end. “You know, this is when it really pays to be a doctor.”
Photo caption: Doctor Varditer Iskandaryan with her now safe and healthy little patient Tatoul.
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Improving Rural Healthcare ServicesCommunity nurses are the first point of medical care for a large percentage of Armenia’s population, working from Health Posts that dot the country’s rural landscape. Health Posts service communities with limited access to the larger health centers and polyclinics that are staffed by primary care physicians and specialists.
Despite the crucial role that community nurses play in Armenia’s health care system, there has been little investment to ensure these healthcare providers are trained in up-to-date skills and techniques. The Primary Healthcare Reform project (PHCR) is implementing a community nurse training program in order to fill this quality of care gap for rural residents.
Karine Bekjanyan has been a community nurse in Neghots since 1992. With the nearest health center six kilometers away, and over 15 kilometers to the closest polyclinic, Neghots needs a health care provider who can act quickly and effectively. Karine participated in PHCR’s six-month training course, covering 35 healthcare topics from the Unified Family Nursing Curriculum, the official nationwide nursing education curriculum.
The training came in handy for her one recent evening when Rita Dallakyan, aged 13, was brought to the health post with a severely fractured arm. When examining her patient, Karine relied on the skills learned in the emergency care module of the PHCR training and was sure what to do: she immediately immobilized the girl’s arm and two adjacent joints so the fracture didn’t worsen or harm surrounding tissues. Thanks to her actions and the pain reliever she administered, the young patient slept com-fortably that evening.
The next morning at the health center, Rita’s doctor put the arm in a cast, acknowledging the quality of Karine’s work. The X-ray showed that the fracture was properly set without complications.
Karine says the new skills she mastered in the PHCR training will spare Neghots residents the delays and expense of traveling to get quality medical care. “In our workaday routine it is not al-ways possible to keep track of the latest developments in nursing practice. Personally I and, I’m sure, most of my peer trainees, learn something entirely new every training session. I feel so much more confident dealing with various health problems now.”
Training of 130 nurses from Lori and Shirak, the Northern regions of Armenia, will be completed in mid-November 2007. By the end of 2010, PHCR will have delivered training to more than 550 rural nurses across Armenia.
Photo caption: Neghots health post nurse Karine Bekjanyan (right) is happy for her young patient’s quick recovery.
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