Frontier Medicine: Nurses are the link of life for distant villages

Frontier Medicine: Nurses are the link of life for distant villages
April 02, 2004

By Vahan Ishkhanyan
ArmeniaNow reporter In the Ltchashen village of the Gegharkunik Region,
some 100 kilometers eastof Yerevan, 65 year old Paytsar Grigoryan runs from
house to house administering vaccinations to children before the medicine
can spoil.
The “clinic” at Ltchashen.

She has no way of keeping it fresh, and there is not even a window in what
used to be the village medical outpost.

Paytsar has been a nurse for 50 years, and remembers when the Soviet system
managed an efficient clinic in Ltchashen. But while those days have gone,
Paytsar has stayed, as her village’s link to medical care.

“Since 8 o’clock in the morning, I’m working,” Paytsar says. “I beg the head
of the village to at least put in a window that I could give injections to
patients here.”

But without so much as the light by which to aim a needle, the senior nurse
instead goes from house to house.

“Now I open a medicine and begin visiting people’s houses as I must manage
to vaccinate everyone within two hours,” Paytsar says. “If (authorities)
wanted, they could reconstruct the clinic. But they know that I run and
manage to visit all houses alone and that’s why they don’t rebuild it.”

In small villages like Ltchashen, lone nurses administer vaccinations and
injections prescribed by doctors, deliver babies, and are on call for

As the village health-care provider, 65-year old Paytsar Grigoryan with 50
years nursing experience is paid 5000 drams (about $9) per month.

The Belgian division of “Medecins Sans Frontieres” (Doctors Without Borders)
has begun a five-year program aimed at improving the state of ambulatories
and medical treatment. It also includes providing hospitals and polyclinics
with medicines and medical equipment.

But, waiting for those improvements, Paytsar’s situation is not unique.

Nurse Nune’s apartment has become an ambulatory.
ArmeniaNow visited four villages in the Vardenis district and found, at
best, dilapidated clinics. In two villages, Aghbiuradzor and Kakhakn, nurses
use their homes as medical stations.

The list of vaccinations is attached to the wall of the house of Kakhakn
nurse from Nune Vatyan.

“I give injections to little newborn babies at their homes but injections to
one-two year old children I give here,” says Nune.

Refugees from Azerbaijan live in Kakhakn, which has a total of about 530

“When a patient visits my home and I must give injection to him I tell my
husband to go out of the house. My home turns into a hospital ward,” says
Nune. “Many patients cannot come here and I visit them myself. I walk a lot.
I have a hard time. It’s ok if I have difficulties with my work I just want
them to send medicines to me so that I could render first aid, so that if
someone visits me I could give a tablet to a patient and tell him to put
that pill under his tongue. I have to buy medicines myself with my money as
I don’t want to tell patients, ‘go, I have no pills’.”

Nune also delivers babies. This year she has delivered three babies out of
five that were born in the village. The two she didn’t deliver were
first-borns. She believes the mother’s first child should have a proper
delivery, so she insists that her patients go to the nearest hospital, 10
kilometers away in Vardenis.