All across Armenia’s health care landscape, one can spot oases of hope and healing that stand as monuments to the profound impact of the Diaspora in saving and improving lives over the last three decades.
Many of these showcases of advanced medicine and innovative therapies—now attracting patients and practitioners from across the region and around the globe—are the mark of enterprising physicians, educators and community leaders from the United States, deeply rooted in first world western style medicine.
Most were at the top of their careers with thriving medical practices, professorships and chairmanships competing for their time. But with the massive earthquake of 1988 in Armenia, these accomplished healers were among the first to answer what they are called to do by oath as well as by sentiment and history.
Sowing Seeds of Opportunity
Of their own volition, these trailblazers, with the backing of an existing organization or just as self-funded solo practitioners, planted an early stake in the modernization of Armenia’s healthcare system—through the dark years of independence and economic hardship that triggered the first wave of emigration by Armenia’s best and brightest, many in the medical sector.
Growing in Stature
Yet with each successive visit and more positive outcomes to their credit, these practical idealists persisted through changing times and the latest breakthroughs and best practice wisdom they would happily share—in person or via telemedicine sessions—with a new generation of physicians eager to contribute to the revival of their country.
Soon, they built up the infrastructure to enlist non-Armenian colleagues to join them on missions and projects, and thereby experience the psychic rewards of healing the sick, suffering and impoverished who had been subjected to untold upheavals.
As their individual footprints deepened, these self-starters also recognized the importance of collaboration and cooperation, forming alliances with other professional associations and networks across the Diaspora that would empower them through the collegial exchange of ideas, experiences and the latest science.
Securing a Legacy
Since the Earthquake, there has never been a disaster or emergency in the homeland that didn’t trigger a rousing response from the Diasporan medical community—initiating a short-term intervention, establishing an ongoing program, or founding a sustainable non-profit enterprise such as a hospital, polyclinic, diagnostic center, mobile-clinic or university department.
While some initiatives served their purpose for a season, others grew and expanded, generating support from a mix of funding streams from individual donors, foundations and global corporations to international philanthropies and foreign governments.
Through an Ophthamologist’s Lens
Lawrence V. Najarian, MD is a second-generation Armenian American and the founder and Medical Director of the Bedminster Eye and Laser Center of New Jersey. For over 30 years, he has served as voluntary faculty, teaching ophthalmology residents at New York University and New York Eye and Ear Infirmary. What’s more, since 2006, he has served as President of the Armenian-American Health Professionals Organiz-ation (AAHPO), a medical philanthropy that provides health education and care in the U.S. and Armenia and has led multiple medical missions to Armenia.
Not only did Dr. Najarian facilitate the donation of a $1 million microsurgical training laboratory in Armenia, but also he helped provide training to physicians in rural villages as well as raised funds for tele-health programming. For his leadership in the Armenian Eyecare Project (AECP), he earned a Silver Award.
As such, Dr. Najarian knows a thing or two about medical entrepreneurism and is a walking archive of the rich legacy of those who braved the unknown world of post-soviet Armenia to create what would become first world centers of excellence. In his leadership role at AAHPO, he considers it a matter of principle and point of pride to enlighten the world to the extraordinary contributions of his predecessors and colleagues in laying a foundation for future generations of healers in and out of Armenia.
What Defines a Center of Excellence
Dr. Najarian maintains that the primary attributes of a center of excellence must first be making a positive impact in patient’s lives, possessing the capacity to provide education, conduct original research, and to turn Armenia into a respected authority in a specific field or sub-specialty.
He also cites soft-skill qualities like patience, persistence and resilience, the ability to identify and empower local talent, a willingness to collaborate with other like-minded individuals and organizations, and a “inconspicuous benevolence,” which means a respect for the local mentality and a selflessness in pursuing goals.
“In my view, it takes a certain personality to build the necessary partnerships to keep growing. Back in the 1990’s, there were no rules or regulations, but the government of Armenia has made strides and now we must continue cementing mutual trust to achieve our goals. Every initiative must have a mission that is well defined and fulfills a need that local communities can buy into. And most of all, you need to identify the right local partners. They are the key.”
Recently, as a guest on a recent AAHPO virtual town hall meeting, President of the Carnegie Corporation of New York Vartan Gregorian shared his dream of a Cleveland Clinic in Armenia. “These things just don’t happen,” observed Dr. Najarian. “You have to put the building blocks in place. I believe this dream may become a reality with continued collaboration between the Diaspora and Armenia.”
Case Histories of Medical Entrepreneurs in Armenia
FAR Fellows Program
Reinventing continuing medical education
Dr. Najarian insists that the story of Diasporan philanthropy in the health sphere begins with a key protagonist, the late Dr. Edgar Housepian, who “was a giant in his field.”
“Dr. Housepian created what, I believe is the foundation of sustainable health care in Armenia—the FAR (Fund for Armenian Relief) Fellows Program. Since early independence, it has provided over 100,000 hours of Continuing Medical Education (CME) to the doctors of Armenia and 33,000 hours of learning to physicians in Artsakh.”
Dr. Housepian also arranged for close to 100 young doctors in Armenia to visit the U.S. for clinical training. A majority returned to their homeland to become academic pillars and mentors to successive generations of physicians. This initiative came at a crucial time because after the earthquake and collapse of the soviet system, many physicians in Armenia had not been able to continue their medical education since graduating medical school. In fact, it was only two years ago that the Pashinyan administration started requiring all physicians in Armenia to do so. “Dr. Housepian’s gift to Armenia just keeps on giving,” quipped Dr. Najarian.
Osteoporosis Treatment Program (OTP)
Putting Armenia on the healthcare map
Another project for which Dr. Housepian planted the seed, is the Osteoporosis Treatment Program, the brainchild of Dr. John Bilezikian, Chairman of the Endocrinology at Columbia University who was a colleague of Dr. Housepian, then-Chairman of the Neurosurgery department. As Dr. Najarian recounts it, Edgar persuaded John to make a trip to Armenia, so sure was he that John would fall in love in the people and never look back, just as he had. He was right.
The OTP has become a longstanding center of excellence, not only treating patients but also providing research and physician training for the progressive disease of osteoporosis for which medication and behavior can help prevent. Today, patients from surrounding countries as well as foreign doctors look to Armenia for treatment and to learn about osteoporosis and its significance.
“In effect, Dr. Bilezikian put Armenia on the map for the osteoporosis world and that is pretty incredible, “Dr. Najarian remarked. “There is a whole cascade of generations of physicians in Armenia who have the world-class training in a specialty they otherwise couldn’t have without OTP.”
Armenian Eyecare Project (AECP)
Attracting talent, partners and patient trust
Another outstanding example with which Dr. Najarian is intimately familiar is the Armenian EyeCare Project, founded in the early 90s by Dr. Roger Ohanesian of California. “Again, it was using the same principle of bringing a select group of talented physicians here to the U.S., many of whom returned home to form the nucleus of a teaching program. In fact, Armenia’s Malayan Eye Hospital, which is considered a center of excellence in its own right, was started by participants of the AECP.”
Over the last 20 years, AECP has treated many thousands of patients in Armenia, having trained multiple generations of young local physicians in best-practice ophthalmology. It also fostered research that caught the attention of inter-national health companies, such as the global Glaukos Corporation, which chose Armenia to conduct original research on glaucoma and their medical devices. Not only that, but state-side associates of Dr. Ohanessian have been rotating trips to Armenia to administer care across the regions through the fully-equipped AECP mobile eye clinics, bringing the gift of sight back to patients without the means to travel to Yerevan or other capitals for life-changing corrective procedures.
“This is significant,” Dr. Najarian emphasizes. “It raises Armenia’s profile for its research capabilities, for its transfer of knowledge, and for, well, something that gives me a certain satisfaction when I attend conferences with my American colleagues. It could be a hall with as many as 5,000 ophthalmologists assembled and some thought leader, like the Chairman of Ophthalmology at the world-class Robert Wood Johnson, for example, would get up and say, “I went to Armenia to learn this procedure.”
He also notes the numerous patients who fly from Moscow for specialized eye care procedures not available in Russia or other neighboring states.
The Claudia Nazarian Radiology Center
Advancing diagnostic capacity with state-of-the art technology
In 1996, Philadelphia’s Jefferson Ultrasound Research and Educa-tion Institute partnered with AGBU, under the direction of prominent radiologist Dr. Levon Nazarian, to establish ultrasound departments at Armenia’s V. A. Fanarjyan National Center of Oncology and Erebuni Medical Center, serving thousands of patients.
Joining the AGBU Central Board of Directors in 2006, Dr. Nazarian—professor and Vice Chair for Education at the Department of Radiology at Thomas Jefferson University Hospital—facilitated the access to both ultrasound technology and education in the country, uniting doctors, researchers, and institutions across borders.
Partnering with Yerevan State Medical University (YSMU) in 2002, AGBU and Jefferson opened a new ultrasound training and research center. Hundreds of medical personnel from both Armenia and abroad have completed courses at the Ultrasound Center, leveraging their medical education with instruction and hands-on training in all aspects of ultrasound, including interventional, abdominal, obstetric and gynecological.
Since its founding, the Center has trained over 140 doctors in the certificate program and more than 235 students in the medical internship program. In 2005, with the sponsorship of Dr. Nazarian, the Center obtained a CT Scan machine; two years later, 12 new ultrasound machines were donated to various state health institutions. AGBU supporters periodically donate ultrasound machines to hospitals in Armenia, Artsakh and the predominantly Armenian-inhabited region of Javakh in neighboring Georgia.
In 2010, through the donation by AGBU Council of Trustees member Nazar Nazarian, YSMU honored Dr. Nazarian’s commitment by officially opening the “AGBU-YSMU Levon and Claudia Nazarian Radiology Center. From March through August 2020, the Center performed 3,322 CT exams, 1285 of the chest, 526 of which were confirmed COVID-19 patients. Currently, the Center is one of the few national coordinating bodies for the stroke and cardiovascular endovascular treatment project developed by Armenia’s Ministry of Health.”
Armenian-American Wellness Center (AAWC)
Preventing premature deaths through early detection
What is now a full-service wellness center involved in the diagnosis and treatment of multiple diseases, the AAWC’s journey dates back to the early 1990’s, when Rita Balian, an Armenian community leader from the states, decided it was time for Armenia to address its high rates of breast cancer—the leading cause of death among Armenia’s women—and, oddly, with a higher than normal incidence skewing younger. With the initial backing of the Armenian Cultural Association, Balian convinced the Armenian government to donate the first floor of a government building to initiate the groundbreaking project of bringing mammogram screening to the country.
By the time the medical specialists from the states arrived to select and train the local medical and technical team, the government was ready to donate the entire building. The next step was renovating the structure from floor to ceiling to meet the world-class standards of public safety and best practice management that Balian and her architect husband Vartkes envisioned.
This new chapter of expansionary growth drew the support of the United States Agency for International Development (USAID) which offered to partner with the AAWC, giving it the momentum to transform the facility into a state-of-the-art mecca in breast cancer detection and treatment. Today, the center includes three Hologic Selenia 3Dimension Mammography Systems which can magnify formations up to 1000 times for millimeter-precision accuracy.
Visitors from Georgia, Russia, Ukraine and other nearby countries as well as expats working in embassies and international organizations in Armenia also trust the center for their annual check ups.
To extend modern screening services to Armenians in rural areas the Center organizes monthly medical outreach missions using portable ultrasound equipment for free-of-charge screenings.
Master’s Program in Public Health
Cultivating new generations of public health professionals
Kim Hekimian, PhD, an Assistant Professor of Nutrition in Pediat-rics at the Institute of Human Nutrition at Columbia University as well as Associate Director of Education for the VP&S Program in Education in Global and Population Health was the driving force behind the establishment of the American University of Armenia (AUA) Gerald and Patricia Turpanjian School of Public Health in 1995. At the time, she served as the Associate Director of the MPH Program and Director of the Center for Health Services Research. She continues to be a link between Columbia University and AUA in nutritional initiatives in Armenia and educates the public on the health needs in the country.
The two-year graduate program leading to a Master’s in Public Health (MPH), engages experienced professionals from health care and other related fields in transformational education and training in population-based approaches to health and health services research, delivery, and evaluation. Graduates are then prepared to lead in improving health and health services in Armenia, the Caucasus, Europe, and the world.
A new initiative of the Turpanjian School of Public Health is developing ways to encourage younger doctors to open private practices in Armenia’s regions, where there is a dearth of qualified local specialists.
Hand in Hand
Upgrading dental hygiene and health in war-torn Artsakh
By the mid-1990s, the rural population of Artsakh was hit hard by the severe post-Soviet economic collapse and the devastating aftermath of a six-year war of independence. As a founding member and former president of the Armenian International Dental Association, Dr. Berdj Kiladjian of Boston realized the urgency of helping the population of Artsakh and helped found Hand in Hand, a non-profit charitable organization dedicated to the improvement of health and social welfare, focusing on dental care and preventative education in Armenia and Nagorno-Karabakh. The first free clinic opened in 1998 in the historic city of Shushi, which had been largely destroyed during the war. With so many other priorities, the local population could not afford to look after their teeth and what medical facilities and equipment they did have were outworn and outdated.
Together with a team of volunteer dentists, Dr. Kiladjian brought modern supplies and helped implement a screening program focused on prevention and proper dental hygiene. Hand in Hand now operates six fully staffed clinics in the region, including a mobile unit and a women’s health center, located in the capital of Stepanakert. The organization has also partnered with the Artsakh Ministry of Health to regularly host day, week, and month-long Brush-a-Mania events in schools and kindergartens to introduce proper oral hygiene habits to young children, helping to foster a healthier lifestyle and eventually a higher quality of life.
In the fall of 2014, Artsakh President Bako Sahakyan personally recognized Kiladjian’s efforts, presenting him the Medal of Gratitude for his services to the Republic of Artsakh.
Psychiatric Outreach Program (POP)
Treating traumatized children and de-stigmatizing mental illness
Immediately after the 1988 Earthquake, with the backing of the Armenian Relief Society of Glendale, CA, three prominent psychiatrists established the Psychiatric Outreach Program (POP). Armen Goenjian, MD, Adjunct Professor of Psychiatry at UCLA School of Medicine, was Medical Director and Louis M. Najarian, MD, Clinical Professor Psychiatry at the Zucker School of Medicine at Hofstra Northwell in New York, was Clinical Director. The late Dr. Haikaz Grigorian, an eminent practicing psychiatrist and professor in New Jersey played a major role in the early stages by making frequent visits to Armenia to support the permanent POP staff. Their goal was to provide crisis intervention to children and their families in the devastated cities of Gyumri and Spitak.
In the ensuing 25 years, teams of mental health specialists from the states rotated for one to two weeks to train local psychiatrists and psychologists in western psychotherapeutic techniques. The presence of American-Armenian professionals, fluent in the Armenian language, provided a vehicle for communication and trust so that novel methods such as psychotherapy (Talk Therapy) could be introduced into treatment, rather than default to soviet-style hospitalization and medication alone.
With the support of the local leaders in Gyumri and Spitak, POP was entrusted to hold meetings with teachers, children and families to discuss such disorders as Post Traumatic Stress Disorder (PTSD). A brief treatment for PTSD led to seminal clinical research, which POP staff published in respected peer reviewed journals and presented at major psychiatric conferences in and out of Armenia. Soon, experts began to use the knowledge from the “Armenian Earthquake” as an opening talking point about trauma and natural disasters.
POP eventually expanded to Yerevan and supported the establishment of the Association for Child Psychology and Psychiatry (ACPP), which provides continuing medical education for its members, as well as conducts and presents clinical research at international conferences.
Thanks to the work of these early trailblazers, there is greater recognition that most adult mental conditions begin in adolescence. In addition, bright children with developmental disabilities have received much attention through educational intervention rather than isolation at home.
Nork-Marash Medical Center
Establishing a regional hub for full-service cardiac care
In August 2020, Dr. Hrayr Hovagimian, an Aleppo native trained in cardiothoracic surgery in the United States, became the first doctor to be named National Hero of Armenia and awarded the Order of the Motherland medal, the highest honorific conferred by decree of the president of Armenia.
Dr. Hovagimian moved to Armenia shortly after its independence where he performed surgical procedures at Yerevan’s Mikayelyan Institute of Surgery from 1992 to 1993. A year later, he founded the Department of Pediatric Cardiac Surgery at Yerevan’s Nork-Marash Medical Center, soon followed by the Department of Adult Cardiac Surgery. As its chief cardiac surgeon, he has trained numerous Armenian doctors in the field
of cardiology and post-graduate cardiac surgery developing a staff of highly skilled cardiac surgeons and heart health specialists.
With the support of both the Armenian and United States governments, the Center was able to expand to a full service cardiac facility offering complete diagnosis and surgical capabilities to treat a variety of heart diseases, both congenital and acquired. It also offers minimal invasive access with no age/weight restrictions and children from newborns to age seven can be operated on free of charge.
A dynamic medical center equipped with advanced technology and knowledge base to expand both the quality and quantity of cardiac interventions, the Center has won the recognition of peers from Europe, resulting in ever larger numbers of patients from the CIS countries as well as foreign citizens seeking world-class cardiac care.
Banner Photo by Davit Hakobyan