Thursday, July 07, 2005

More Diasporan Myopia?

The Christian Youth Mission to Armenia have posted a blog by Diasporan Armenians volunteering in the Republic. Lovely idea. Unfortunately, however, incredibly naieve. I can forgive them that, of course, straight off the plane and blinded by the sight of Ararat on a clear day. What I can't forgive, however, is that my comments on one blog do not appear and I am now on "moderation." Again, fine if I had been offensive but instead I pointed out how they were wrong. The reason was a blog by Anahid Ovanessoff, a member of the CYMA Executive Committee, on the health sector in Armenia.
The nurses with whom I work, only make $55 a month…A MONTH!!… and they work longer hours and more days than the nurses in America… some of their shifts being from 9 am one day till 5 pm the next day…most of them working 5 or more days a week. Regardless, I really feel like the people here try not to dwell on the fact that they have such hardships and instead appreciate life, taking into account the wonderful things that they do have.
Sorry to burst your bubble, Anahid, but in fact, no nurse in Armenia makes only $55 a month. There is a system of “informal payments” in the medical sector that means that treatment that should be free by law isn’t. As an example, although treatment for children under the age of 7 are entitle to free treatment, it never happens. In one morning alone at a Yerevan hospital I saw 20 families pay a doctor $250 each for a 15 minute hernia operation on their children aged less than 3 years old that should be free. In half a day, over $5,000 entered the shadow economy and was distributed among the doctors and nurses as well as going higher on up in the chain.

As a result, according to official statistics, ony 1 in 3 Armenians seeks medical treatment. Of course, it’s a Catch-22 situation. If salaries are low, corruption flourishes and because it does, and as the economy is weak, the state budget can’t increase salaries in the public sector sufficiently to stamp out corruption. Incidentally, even payments that should be made end up in the shadow. Instead of going through a system of official paperwork they are paid into the hands of doctors and nurses and as a result, hospitals can not be kept in sufficient shape.

It’s a huge issue in Armenia. I recently heard of one case from an international worker here that when a local friend of his was recruited by a hospital, salary $50-100, she was then expected to pay her department head $1,000 on her first day of work. I think that gives you an indication of how much money is unofficially going through the system. Anyway, there’s an interesting document on this subject by the Armenian International Policy Research Group available for anyone to read.

In fact, the situation is well known and even made a story on RFE/RL in February.

Public healthcare, which is only partly subsidized by the state, remains effectively off limits to the majority of Armenia’s population hamstrung by poverty and especially rampant corruption among medical personnel.

Government research, backed up by anecdotal evidence, indicates that most Armenians suffering from various illnesses continue to turn to doctors as a last resort, when hospitalization becomes their only chance of survival.

The thriving practice of informal payments at virtually every government-funded hospital or policlinic means they remain reluctant to seek even those medical services that are officially free of charge. According to the most recent household survey conducted by the National Statistical Service in 2003, only one in three people with health problems visit a medical facility.
However, Anahid goes on to say how most Armenians live humble lives and it is only Americans who extravagantly flaunt their wealth. True, but she obviously has yet to see the motorcades of the oligarchs made up of Hummers, or the mansions and cafes built by government officials. Go out towards Abovian, Anahid, and take a look at Gagik Tsarukian's (AKA Dodi Gago) “palace” on the hill? Yet, every year, his businesses which include Kotayk beer, post losses. Armenia is also one of the most socially polarized countries in the world.

Up until an hour ago, I had been telling locals and the more astute Diasporans around about this blog entry I encountered this morning. I said that I don't begrudge these guys for not being able to see past their rose-tinted glasses. However, as my comments posted at 9.30am today have been effectively censored it now has to be said that this sort of approach does nobody any favors in Armenia.

If anything, at a time when international organizations and local NGOs are attempting to tackle corruption in the medical sector and tax avoidance elsewhere, it only exasperates the problem.

Hardly Christian now, is it guys?

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