Past
65 year-old Hamo Babayan is an epidemiologist. He also serves a deputy director of the Hadrut Hospital on a voluntary basis. He was appointed chief physician in 1984, the year the hospital was built, and he occupied that position until 1994. During the war he managed the military medical service as well.
“I’m from Hadrut. I went to medical school in Yerevan, graduated from Yerevan Medical Institute and then came to Hadrut. I’ve been here ever since, for 41 years,” Babayan said.
Students who went to Yerevan for their university education had serious problems in Soviet times, when Karabakh was an autonomous region within Azerbaijan. The Azerbaijani authorities were reluctant to accept young people who had been educated in the Armenian capital and had returned to Karabakh.
“They didn’t encourage us,” Dr. Babayan remembered. “I had a very hard time getting this job; I had to get references saying that my parents were ill and needed care. I worked for about a year without a formal contract before I finally succeeded.”
Hamo Babayan said that in past, conditions in the hospital were excellent-it had its own continuous water supply and sewer system, and a centralized heating system with a boiler that ran on oil. Today, only the water supply system remains.
The Hadrut Hospital, the only medical institution in the region, was often bombarded during the war. For safety, the hospital was moved to the basement of the regional administration, and facilities were set up for surgery, maternity care, and other medical activities.
“It was in April of 1992,” Babayan remembered. After we moved, we began to admit wounded people – both civilians and soldiers.
That continued until December 1993. Then the military department was dismantled, but they kept bringing the wounded to our hospital for a long time.” He believes this cooperation had a positive impact on the quality of health care.
“Getting supplies to the army was a top priority, but our civilian population also benefited from drugs and medical supplies.”
Present
The hospital was built in 1983 and has not undergone any major repair in the 23 years since then. The war left its marks as well. The roof was repeatedly torn up by bombings; the building bears the scars of rocket and shell explosions.
Chief Physician Ara Yeremyan said that the maternity ward and outpatient department had been renovated thanks to international charity funds. The fate of the surgery, therapeutic, children’s and infectious disease departments is unclear, as the funds provided by the Karabakh government don’t even cover operating costs.
Surgery is performed in what can hardly be called an operating room. Perhaps this can be understood in light of the fact that in the not-too-distant past operations were performed under field conditions. But for people who have lived in peace for twelve years now, having surgery here means endangering their own lives.
Yeremyan said that quality is maintained only thanks to excellent professional skills of the doctors, even though the hospital is not fully staffed. Currently there are only eleven physicians working in the hospital, though twenty are needed. “These are the top priority specialists,” Yeremyan said, “ a surgeon, a therapist, an epidemiologist, etc. We don’t have other specialists, like ophthalmologists, or ear, nose, and throat doctors, in Hadrut.”
“From time to time groups of doctors come from Stepanakert to see people from Hadrut and the surrounding villages. That’s how we try to solve the problem, but it is not a long-term, sustainable solution,” the chief doctor said.
The staff shortage is not acutely felt at the moment, since it is not possible to set up new departments, given the hospital building and obsolete medical equipment. However, once the hospital is renovated and reequipped, Hadrut will have to think about bringing in new doctors. The health ministries of Armenia and Karabakh deal with the issue of specialists, but prior to finding the required doctors sending them here, they should think about providing them with minimal living conditions. A surgeon who came to Hadrut from the Shirak Marz three years ago only recently got an apartment. The hospital administration say it would be a good idea to address this problem during the construction of the hospital and provide temporary accommodations with modern conveniences for newly arriving physicians.
The Hadrut Hospital has only one ambulance, which serves the town and the 37 villages of the region. Some villages are 30-50 kilometers away from the regional center. The roads that connect the settlements in the region are treacherous and untended. Unpaved roads are impassable during rainy months. If the ambulance goes to one remote village and then there is a medical emergency in another village, they have to call on the village mayor or someone else who has a car fro help. Sometimes the hospital itself borrows a car from the regional administration to send a doctor to the village.
Now imagine that the ambulance has reached a remote village with great difficulties and has brought a patient with an acute infectious disease to the hospital. The old person or the child brought to the hospital must be treated here. This is the infectious department of the Hadrut hospital – the only one in the region, and a child suffering from infectious disease has no other alternative. Experts say it would make no sense to repair the building, since it wasn’t built properly in the first place; there is no basement and groundwater seeps into the foundation walls. The only solution is to build a new hospital.
Future
The only bright spot in the Hadrut Hospital is the maternity department. It was renovated in 1999 with a grant from USAID.
The head of the department, Susanna Petrosova, came back to Hadrut from Baku in 1990. Remembering the hardships of the war and the years that followed, she smiled, “In any case, we were always optimistic.” About 200 babies are born in the Hadrut region each year. 150 of them are born here, and the first cry of each newborn baby inspires hope for the future. All.
The doctors can do is cherish this hope. “I’ve worked here since 1990 and no maternity death has occurred in that time, neither in Hadrut nor in the villages,” Petrosova said. But rather than feeling proud, she is sorry that her department stands alone.
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