Question remains urgent

Azat Artsakh, Republic of Nagorno Karabakh (NKR)
June 24, 2003


Along with positive tendencies the transition to market economy
brought a number of problems. Some of them are especially urgent in
the sphere of health care connected with introduction of paid medical
service and low purchasing capacity of the population. And although
the government has undertaken the free of charge medical care of the
socially insecure and separate groups of patients the problem remains
urgent. The system of medical care is especially vulnerable in the
regions, especially in those areas which even temporarily appeared in
the hands of the enemy who destroyed and plundered the hospitals and
schools with special ardour. In 1992-1993 the regional hospital of
Martakert was ruined and plundered by the Azerbaijanis. In the
post-war period certain reconstruction works were carried out here on
both budget and humanitarian means. The department of maternity and
gynecology and policlinic, partly the surgical department were
reconstructed, and the local hospitals, which have been placed in
other buildings, minimum conditions have been provided, mainly for
maternity care and out-patient treatment. By the means of the
Stepanakert office of the Red Cross and the communities certain
reconstruction work was carried out in the maternity wards of the
region. Nevertheless, the situation is far from being satisfactory
especially in the villages where the maternity wards are placed in
houses, do not have necessary equipment. Recently at the meeting of
the regional council the director of the Martakert Medical Union
after Sergey Ohanian presented a report on the work done in 2003. The
NKR Minister of Health Zoya Lazarian was also present. The Medical
Union includes the regional hospital with surgical, therapeutic,
pediatric, maternity, infectious, policlinic departments, three local
(villages Haterk, Vank, Getavan) hospitals with 10 wards, two
out-patient treatment and 39 maternity wards, provides free medical
care and service within the framework of state medical programs, as
well as paid services. Free medical care is provided to invalids of
the 1st, 2nd and 3rd groups, veterans of the World War II and people
with an equal status, families of the servicemen who were killed or
died during the defence of NKR and military service, participants of
the disposal of the damage of Chernobil, life pensioners and sole
mothers, parents of the families having 4 and more children under 18.
In 2003 within the framework of the state medical care the regional
hospital provided care of 53 million 314 thousand drams instead of
the provided 52 million 211 thousand and received additional 53
patients. In 2003 for medical care and aid 79 946 patients against
the provided 69 855 visited the hospital of which 34 598 the
maternity wards, 6848 the local hospitals and 37 300 the regional
hospital. 1441 patients received in-patient treatment. It was
mentioned that the positive tendencies in the improvement of medical
care in 2003 are stable. The number of visits of patients grew, cases
of hospital death, as well as the rate of child death (under 12
months) and stillbirth dropped, the number of home calls and doctor
visits increased. Nevertheless, medical service in the region needs
serious improvements. Among these the director of the medical union
mentioned the problem of cadres: of the 17 doctors involved in the
union 12 work in the regional center. Compared to the volume of work,
the number of registered and potential patients this is a small
number. For example, in the therapeutic department of the regional
hospital 1 doctor works instead of 3. In the policlinic department
not all the surgeries have necessary specialists. The same is with
the pediatric and gynecology, and venereal and dermatological
departments. It was mentioned that all the three local hospitals have
ambulance cars. There is one doctor in Vank and in Getavan and 3
doctors in Haterk hospital. In 2003 the local hospitals together
received 17 117 patients, 124 births were registered. There were also
8 cases of delivery at home. Continuing on problems, S. Ohanian
mentioned the necessity of new equipment, repairs of the therapeutic,
infection and surgical departments, construction of new maternity
wards in all the village communities. It was mentioned that the
supply of medicine to villages is carried out on the means provided
by village municipalities which is trifling compared to the demand.
The gap is filled with the humanitarian aid provided by the
international organizations. The minister of health promised to study
the problems raised and start their settlement as soon as possible.