Surgeon and doctor of medical sciences Norair Davidyan has been the Health Minister of Armenia since June 2003. Although N. Davidyan has always received excellent marks in school, however there were many reforms during his years of study at the Medical Institute and there are still huge reforms made by the ministry and for several years now, the health sector of Armenia has received satisfactory ratings during the annual report of the Health Ministry. It’s not clear as to whether or not the minister is in favor of the activities’ evaluation mechanism.
– If the “Dashnaktsutyun” isn’t able to form a political majority after the parliamentary elections in May, whom would you like to see in this post, or if the ARF forms part of the political coalition, will they trust you to be the Health Minister again?
– During the ministerial works completed as suggested by the coalitional government and my party (it’s no secret that this is a partisan plan), I have tried to do my job based on the position of my governmental party. As for the elections, I am certain that the “Dashnaktsutyun” will have its own spot in the parliament. If the political party forms part of the coalition and the health sector once again belongs to the ARF, then the political party will decide to hand it over to Davidyan or not. I don’t see anything terrible. I am a doctor; I have always worked by profession and have never been dependent on my position. There are many meritorious doctors in Armenia who can be trusted as the Minister of Health.
– In your opinion, when is health care efficient-in the case of a paid or free system?
– Both state-run institutions and sole proprietorships must function in the health care system. The private hospitals and clinics function based on our boards. I am in favor of both.
– The private medical institutions are for the higher level of society.
– I don’t think so. All of the clinics of Armenia have state orders for the needy. We have to do everything we can so that the level of medical service stays the same both in state-run and private medical institutions.
– We can’t circumvent state orders, although they have been talked about over and over by mass media. There are many complaints about this. Isn’t it possible to direct the extra annual funds for health care (20-25% yearly) and the means for improving the quality of state orders to one sector, let’s say, birth assistance?
– Why maternity wards and not infection clinics or the surgical sector? That’s not a correct approach; you can’t choose one field and develop only that field. Medicine is an intercommunicative structure. Funds must be distributed proportionally, especially since Armenia is developing in the fields of heart/artery, urology and rehabilitation. We mustn’t focus on only one field; we are working with patients.
– What’s the ministry’s number one issue?
– Health care is the field where financing is just never enough. Although I must say that the Health Ministry’s budget has grown 3-4 times since 2002 and funds have come in on time. The health care funds keep growing and just last year, we provided 1 billion drams for the reconstruction of facilities, mainly in the regions of Armenia. We have been buying updated medical equipment for three years now and 80-90% of that equipment is transferred to the regions.
– What is the ministry going to do about the vacant spots for doctors in the regions?
– To tell you the truth, I am in favor of the system that was working during the years of the Soviet Union. The doctors that visit the regions become more professional. Perhaps that goes against human rights, but the student who has studied by state order must still visit to work in the regions. In any case, the ministry is creating the imperative conditions. First of all, we foresee raises. The ministry has already made agreements with the regional heads of the regions to provide homes to the visiting doctors and there are doctors wishing to go and work in the regions. The Ministry of Health receives not only demands, but also proposals and not only from doctors, but also patients and average citizens. I must mention that last year, there were more than 4,000 receptions. The questions raised through the means of the ministry’s “hotline” are mainly medical. Whereas before people used to complain that there is no medicine at all, now there is no such problem.
– They say that Armenian citizens have become very demanding when it comes to drugs and the medical aid provided by the state.
– That’s a very good thing. I am not against that. We are doing everything for them, but we explain to them that there are drugs that, unfortunately, we don’t have.
– There were delays in the distribution of insulin last year. Why?
-Yes, there was a small delay, but in the end no patient suffered from that. That’s a clearly formulated system. We haven’t had any issues with insulin during the past three years and I don’t think we will have any in the years to come. For two years, patients are only injected with human insulin. True, that’s more expensive, but people’s health is worth more. We have been able to suffice the insulin demand by 100% for the past three years. I must add that people are more informed now. In 2006, for the first time, 25 million drams of the budget was provided for the works on providing information about the system. I think that people must be informed, including the fact that the state is doing everything it can to ensure the health of everyone. So, last year, polyclinic medical aid became free of charge. It doesn’t matter whether they call that populism or whatever. We economize and diagnose the illnesses in the preliminary stage by doing that.
– No matter how long diagnoses are free of charge, it’s assumed that the main treatment is outside of the polyclinic.
– First aid is now free of charge and people attend polyclinics more calmly and easily. Based on preliminary data, in 2006, visits to polyclinics have gone up by 30-40%. Of course, there are problems, complaints, there are some antipathies towards some doctors; after all, there are many doctors. For the love of God, I don’t think that all doctors are ideal. However, those are just the minor things compared to the works and achievements of the Health Ministry-the death rate has reduced, birth rates have gone up, which not only implicates the development of he health care sector, but also Armenia’s socio-economic development.
– But Mr. Davidyan, based on the data of the National Statistics Service, in January-September 2006, the death coefficient has gone up by 0.3 pro-mil.
– Death rates have gone down in 2006 and Armenia is the only country in the CIS that has passed the international standards of children’s death rates. For example, before, the death of a 1-6 day old child wasn’t considered child death and that has been reflected in the general death coefficient. Judging from the WHO requirements, the maternal death coefficient is calculated on a three-year basis, in other words, by calculating 100,000 born. Countries where the population is less than 5 million, statistics are decided based on a three-year report.
– Last year, you had mentioned that there are 100-150 tons of expired drugs in Armenia which was accumulated by the humanitarian aid. We know that according to the government’s decision made in 1996, the Ministries of Environmental Protection and Health were assigned to take care of that problem. There are methods, which can be applied without spending any money. Why is that process in delay?
– That issue is subject to being solved with the Ministry of Environmental Protection. It is a serious ecological problem. During the Soviet era, people used to burn the drugs, but now we don’t have the right to do that. Expired drugs started being accumulated after the earthquake of 1988. There have been no imports of old drugs to Armenia for the past couple of years. Yes, we do face that problem and we will solve it this year jointly with the Ministry of Environmental Protection. Those drugs must be burnt in special heaters under high temperature.
– There was a proposal to burn the drugs in the heaters of cement/plaster factories.
– Yes, but we can’t force those factories. Those drugs contain chemicals; the glass vials and polyethylene packets may damage the heaters. There are no crematories in Armenia; if we had them, this problem would be solved much more quickly. Yerevan is full of cemeteries. Sooner or later there will be crematories; Armenia will follow the example set by European countries. No matter how much the national mentality stands in the way, crematories are the right choice both from the ecological and moral/psychological aspects. Of course, I can’t go against Christ’s Commandments-for me, the most important one is “Don’t judge so you won’t be judged.”
– Last September, there were rumors heard on news programs that Mormon and American businessman John Huntsman had proposed creating a modern oncology center in Yerevan. Is that true? After all, Armenia already has a national Oncology center.
– Yes, we did get a proposal on their part and perhaps we will sign a contract soon and create the oncology center on a separate base. The Americans were surprised to see how there can be hospitals in front of cemeteries. That’s the inheritance of the Soviet Union and it’s practically impossible to move those hospitals and cemeteries. It doesn’t help the patients both psychologically and esthetically.
-You mentioned that you are in favor of creating crematories, which is acceptable in the civilized world, but not in Armenia. Some countries apply euthanasia-the quickening of death upon the request of extremely ill patients. That is prohibited in Armenia and it is also going to be prohibited by the “Health Care” bill.
– As a Christian, I am against euthanasia because you can’t take away the life given by God. No matter how extremely bad the patients’ conditions are, I am strictly against having doctors kill patients. Perhaps many think that that is humanitarian, however unfortunately, we are dealing with human lives.
– Mr. Davidyan, I know that you have a collection of statuettes. Will you tell us about that hobby of yours?
– I have always loved collections. When I was a child, I used to love collecting matches and then stamps. Stamps and books were my weaknesses. In my house, I have a corner where I “add” military soldier statuettes, mainly statuettes of 16-17th century knights. As for art and literature, it’s probably a lifestyle or weakness. Each person has a weakness.