Bringing Sight To Armenian Eyes

Jeffrey Paretchan

March/April 2012

Dr. Anna Simonyan conducts an eye screening at a school.

Dr. Roger Ohanesian examines a patient.

A patient thanks doctors from the Armenian EyeCare Project for a
successful surgery, which was performed free of charge. Left to right:
Dr. John Hovhannisian, Dr. Asatur Hovsepyan, Dr. Anthony Aldave.

The Mobile Eye Hospital

Surgery takes place inside the Mobile Eye Hospital.

Makruhi Raganyan’s son Hakob received laser eye surgery and was saved
from lifetime blindness.

Dr. Thomas Lee treats Armenian infant Hakob Raganyan.

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“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

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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