Once considered one of the best health-care systems among all the Soviet republics, in the aftermath of independence Armenia suddenly found itself failing to meet the basic healthcare needs of the majority of its people. During the past decade, however, the introduction of several primary healthcare reforms, including basic healthcare coverage, modern medical equipment and more public health services, has meant that today, the state of healthcare in Armenia is steadily improving. The Armenian government is trying to address the problems with a recent focus on prevention and the better management of chronic diseases. Among the most pressing concerns, the nation still struggles to distribute its resources to rural villages, despite increased help from the Armenian diaspora.
Few people are able to afford healthcare insurance and the cost of a visit to a hospital or medical center can be a significant deterrent, especially for vulnerable elderly women, widows and mothers with many children. At the same time, a traditional cultural mentality meant that few women would openly discuss their care needs and simply perferred not to know the cause of what may have been ailing them.
Over the past decade, however, the extraordinary efforts of several visionary women and the organizations they lead are turning the tide, raising awareness and yielding remarkable results in the battle to improve healthcare outcomes for Armenian women.
Dr. Kristina Melikyan
Vitromed Reproductive Health Center
In a nation of less than three million people, reproductive healthcare has critical implications for the population of Armenia. One in six couples experience difficulty conceiving. Equally acute is secondary infertility, when a couple with a child or children struggle to have a second or third child. A well-documented decline in semen quality—linked to smoking, poor diet and a lack of vitamins—has furthermore compounded Armenia’s reproductive health burden.
The advent of several technological developments in the field of reproductive healthcare including Assisted Reproductive Technology (ART) and the ability to freeze and store eggs for later retrieval is helping more and more couples to experience the joy of children that they might otherwise have missed.
Such treatment, however, is difficult to access in Armenia due to the high cost, low level of public awareness and relatively low effectiveness. Fertility specialist Dr. Kristina Melikyan has devoted her career to changing that reality by working at the cutting edge of reproductive health technology while striving to make it more accessible and affordable for the public.
After three years as the Head of the Department of Reproductive Health at the Shengavit Medical Center in Yerevan, Melikyan left in 2011 to open her own clinic, Vitromed, in order to specialize in the treatment of infertility and human reproduction. “It was very hard at first, my husband and I both quit our jobs and we were not sure whether the project would work,” she says. “I now know without a doubt that it was the right decision and look forward to continuing to expand our vision to help couples conceive.”
Considered a leader in reproductive health in Armenia, Dr. Melikyan and her highly-trained medical staff provide a comprehensive range of services in the treatment of infertility and assisted reproductive technologies, including intrauterine insemination (IAI), in vitro fertilization (IVF), intracytoplasmatic sperm injection (ICSI) and cryopreservation, as well as egg donor programs. The clinic also provides treatment for gynecological, urological and andrological diseases.
As more and more women are choosing to start a family after first establishing themselves in their careers—increasingly at age 35 and older—Dr. Melikyan strives to raise awareness of the risks associated with conception at a more advanced age. To help offer couples the best chances to conceive a healthy child and prevent birth defects, she is planning to implement a high-quality genetic screening program currently lacking in the country. “This is a very important issue in Armenia,” she says. “Genetic screening is advanced in the United States and Europe and increases the chances for women to have healthy children.”
With greater public awareness of the risks of having children at an advanced age, women are also increasingly choosing to assert more control over their reproduction by freezing their healthy eggs and preserving their reproductive potential when they want to conceive later in life. Vitromed is one of the few clinics in the country that not only offers such elective fertility preservation services, but under the expert guidance of Dr. Melikyan and her medical staff, has helped raise the standard and quality of cryopreservation in Armenia.
Although she runs her own private clinic, educating the broader public is at the heart of Dr. Melikyan’s practice. She strives to change the traditional mentality that focused solely on women. The inability to conceive in as many as 30% of couples is the result of male infertility. “Previously when we were telling mothers-in-law that we would first test their sons, they were hostile to it. It was very hard to say that a man can be the source of the problem. I have had female patients who have been suffering for years and their partners have not been checked—a clinical analysis of sperm was not done.” Dr. Melikyan’s staff now always tests male partners first as it is easier to identify if they may be the source of potential fertility problems.
With each couple Dr. Melikyan has successfully helped to conceive, her reputation as a leading Armenian expert in the field grows, attracting more patients to her clinic.
“I feel very happy and proud that now people from Russia, Europe and even the United States have become our patients,” she says. “We have also raised Armenia’s reputation in the field of medicine.”
I feel very happy and proud that now people from Russia, Europe and even the United States have become our patients. We have helped raise Armenia’s reputation in the field of medicine.
Dr. Anna Yeghiazaryan
Armenian Red Cross Society
For nearly a century, the Armenian Red Cross Society (ARCS) has helped ease human suffering, responding to emergency situations with compassionate humanitarian aid and assistance. While its most active period involved administering disaster relief in the aftermath of the devastating 1988 earthquake, the organization’s focus has since shifted from providing strictly humanitarian aid to a broad array of development and social projects. The expanded scope of activities includes not just humanitarian aid, disaster management, first aid, population movement and search-and-rescue operations, but increasingly more social and healthcare services, efforts to address youth issues and the dissemination of humanitarian values.
As secretary general, Dr. Anna Yeghiazaryan has spent more than a decade overseeing the organization’s activities and leading a large staff in both theheadquarters in Yerevan and in branches throughout the country. Each year, the ARCS unites 3,000-3,500 volunteers around its mission. She works closely in a supportive capacity with almost every ministry, where her experience is widely respected. The organization, however, remains entirely independent and is led by The International Red Cross and Red Crescent Movement principles of humanity, impartiality, neutrality, universality, independence, unity and voluntary service.
With a Ph.D. in economics and private sector experience working in a financial institution—as well as having taught at a university—Yeghiazaryan brings both broad knowledge and expertise to the position. “I was attracted to this field because I know I can talk about problems and advance ideas that might be useful in upholding humanitarian values. And people are grateful for our work,” she says.
The Armenian Red Cross Society works in all strategic areas, striving to address numerous challenges faced by the state and society. “ARCS supports the Armenian government by providing additional services where state resources are lacking. We are involved in various working groups, governmental commissions and, due to our experience, our voice is heard,” she says.
ARCS manages a broad range of social and healthcare programs benefiting the most vulnerable social groups, including the elderly and children living in residential institutions. Over the past five years, the Armenian Red Cross Society has also been actively involved in coordinating several programs to assist Syrian Armenians who fled the Syrian War, providing not only humanitarian aid but also the resources for new arrivals to start businesses and integrate economically and socially.
Under Yeghiazaryan’s direction, the Armenian Red Cross Society is now beginning to address women’s rights issues, including the impact of violence against women, which for the longest time was rarely if ever acknowledged in Armenian society. Violence against women can have many devastating consequences on women’s short-term and long-term health and well-being. Studies have shown that along with the immediate physical and emotional impact, a woman’s overall quality of life can be adversely affected over an entire lifetime. The consequences to individual women can, in turn, have ripple effects on society as a whole.
Currently there are very few organizations in Armenia with the means and resources to dedicate themselves to the prevention of violence against women. Yeghiazaryan is hoping to change that, insisting that both governmental and non-governmental organizations have a responsibility to fulfill.
“We have a big role and we find the problem is very significant. We started working on violence only recently. It has never been part of our main activities, but this is a very acute problem. Without greater involvement from society and the support of non-governmental organizations this problem cannot be solved. And we, as an organization that plays a key role with regard to human rights and humanitarian values, have a responsibility to work in this field. We cannot stay on the sidelines,” she says.
Without greater involvement from society and the support of non-governmental organizations [violence against women] cannot be solved…We cannot stay on the sidelines.
The Armenian Red Cross now offers guidance to victims of violence against women on where they can access psychological, legal, social and healthcare support services. At the same time the organization is focused on prevention, and is examining other avenues to advocate for change and improve legislation.
As long as society tolerates violence against women, women in Armenia will be vulnerable. “We have not reached a level of consciousness so that women feel equal,” says Yeghiazaryan. Continually striving to improve and enhance the organization’s capacity, she knows the challenge to make all women feel useful and heard. Having their opinions respected will require a greater coordinated effort, but she is confident that Armenia is making strides in the right direction.
As Armenia continues to make gradual progress towards greater democratization, its people are proactively driving a grassroots revolution at the same time, tackling urgent social problems to help improve conditions and opportunities for vulnerable members of society.
At the helm of this burgeoning, organic movement is a growing number of fearless and formidable women guided by John F. Kennedy’s famous call to arms: “Ask not what your country can do for you; ask what you can do for your country.” Anahit Minassian, Maro Matosian and Marina Adulyan share a belief that lasting social change is a gradual process that starts from the ground up. Success is measured by convincing others to replace narrow-minded attitudes and cultural stereotypes with a willingness to embrace change. Every day, these women challenge gender inequality, prejudice and bigotry—the underlying causes of many social injustices—through their groundbreaking work relating to the protection of victims of domestic violence, helping disabled children and empowering youth.
Empowering youth via education
Anahit Minassian has never wavered in her belief in her own ability to create change for the better. “I witnessed several social problems in Armenia and it became important for me to do something about them,” says Minassian in explaining her avid interest in non-profit work. As Executive Director of KASA Swiss Humanitarian Foundation in Armenia since 2011, she devotes herself to promoting quality youth development and fostering youth engagement. Despite daunting challenges, underfunding, and a general lack of resources, Minassian takes pride in knowing that even by changing one person’s perspective through education, she is contributing to meaningful change. “We aim to awaken civic consciousness and make young people understand that they are also responsible for developments in our country,” she says.
With vast expertise in youth work and development, Minassian helped transform KASA’s philanthropic philosophy from providing humanitarian aid to empowering various vulnerable groups, including refugees from Syria and families in Armenia’s remote regions, to build their own vocational skills in order to make a living on their own. The organization’s cultural and social development centers in Yerevan and Gyumri provide a diverse array of educational programs for children and youth, including social and material assistance to families in need, after-school activities for children and teenagers, and scholarships for students. KASA is also well known for its innovative social integration programs for Syrian Armenians and other displaced people living in Armenia.
Minassian considers education the most powerful tool to nurture young people’s civic consciousness and a culture of democracy. “People who volunteer with us for a few years change drastically,” she says. “They start understanding the complexity of social change and their role in it.”
KASA focuses on e-learning and alternative education projects to enhance young people’s soft skills.
In addition to offering numerous training programs, KASA’s 12 youth clubs in Yerevan and Gyumri offer a platform for teenagers and young people to engage in direct conversations about social problems. They are encouraged to find possible solutions to particular issues. To date, more than 19,000 young people across the country have attended and benefited from KASA’s programs. “We should prompt change through young people and give them an opportunity to do so. They have the power and desire to create change and social transformation,” says Minassian.
As part of that transformation, Minassian believes that both men and women should be equally involved in determining the future of the country and need empowerment in different forms. “Women certainly need more avenues to participate in decision-making processes. To do so, some of the social norms have to be challenged. We live in a conservative society and as women, we have limited tools to work with men. I shouldn’t have to be a man to be taken seriously. At the same time, quality educational programs need to be designed to empower both young women and men and prepare them for a healthy dialogue both in private and social life.”
As a dynamic, influential female leader and role model, Minassian is helping to change that reality through education. She is confident that increasingly more women can overcome stereotypical attitudes through their professionalism, and contribute to the sustainable development of their nation.
Helping women resist abuse
The devastating impact of domestic violence is felt in every nation in the world. It transcends borders, culture, ethnicity, religion, and socio-economic status. According to a global study by the Women’s Health Organization, 35 percent of women worldwide have experienced some form of either physical and/or sexual intimate partner or non-partner violence.
In Armenia, the disturbing reality of domestic abuse is only now becoming accepted and openly talked about, having long been a cultural taboo to which the patriarchal society turned a blind eye. That taboo was broken when a number of non-profit organizations started helping abused women and began using the media to bring the issue to the fore of public consciousness. “It causes so much damage and can ruin a society from within,” says Maro Matosian, founder and executive director of the Women’s Support Center (WSC) in Yerevan. “Abused women are usually not capable of taking care of their children and need help themselves to walk out of an abusive relationship.”
Matosian founded the Women’s Support Center in 2010, one of the only organizations in Armenia dedicated to the prevention of domestic violence through the protection and empowerment of victims, rehabilitation of family members and education on gender equality and domestic violence and its consequences. The staff diligently works with each victim and their families to provide holistic healing and support, including shelter, healthcare, psychological counseling, and emotional and physical therapy in order to best position them for a brighter future.
“When women come to our center we empower them to take decisions they were banned from making,” Matosian says, referring to the behavior of offenders who put psychological pressure on their partners to limit their independence and break their confidence.
The WSC’s success has been nothing short of remarkable. In 2016, it received 1,064 calls to its hotline—up 50 percent from the year before, along with more than 327 walk-ins. More than 80 percent of victims helped by the center reported living free from abuse in a one year follow up, while 63 percent reported they are employed and have since gained financial independence.
The WSC not only actively assists and empowers victims of domestic violence but also serves as an advocate for the defense of women’s rights in Armenia. In a speech delivered to the Armenian International Women’s Association in 2016, Matosian remarked that “Today with the majority of the population in Armenia being women we cannot afford to not use women’s potential to advance our country. For this we have to raise our voices and demand that women are treated with respect and break away from stereotypes that demean and belittle women to reinforce sexism and male dominance.”
Armenia, however, still lacks any comprehensive legislation that criminalizes domestic violence or includes provisions to protect victims. The critical gap reinforces the culture of impunity that prevents women from speaking out against abuse. Matosian is convinced that the adoption of a law targeting domestic violence would have an immediate impact on reducing abuse, enabling institutions to respond more effectively to the needs of battered women and their children, and making women feel more protected at the institutional level. “Currently police do not have many tools to act,” says Matosian, wthough she adds that police and other law enforcement bodies now acknowledge the problem and are more willing to cooperate with the center.
Helping to transform victims of abuse into empowered women in charge of their lives motivates and inspires Matosian to continue working despite the emotional and psychological difficulty of dealing with cases of abuse every day. “Societies that value women, their skills and mental abilities thrive.”
Returning abandoned children to families
In 2014, a heartbreaking social media post changed Marina Adulyan’s life forever. Reading the story about a baby boy named Raphael, born without limbs and subsequently abandoned by his family because of his disability, Adulyan knew she had to help. Together with a group of Armenian mothers, they compassionately decided to care for Raphael themselves and return him to his family.
The desire to help one child evolved into Bari Mama (Kind Mother), a grassroots movement of mothers whose mission is to ensure that every child is raised in a family. A year later, Bari Mama developed into a non-profit organization with 15 volunteers and approximately 7,500 supporters worldwide. The organization’s first priority is to make sure that no child is ever abandoned and therefore it strives to identify mothers who fall into the high-risk group for known or potential birth defects in children and to subsequently work with them to ensure they are ready for the possible challenges and understand what to expect.
Until recently, abandonment due to in-birth disability was a common occurrence. In 2016, 35 newborn babies were abandoned because of their birth defects. The babies were sent to one of three state-run specialized orphanages, home to 460 children with special needs that make up 5.6 percent of disabled children across the country.
When the joy of the birth vanishes with the news of disability some parents face the what-to-do question, intimidated by a lack of knowledge, prevailing stigma and pressure from in-laws. This is when Bari Mama’s volunteers step in. “Within the past three years fewer women have abandoned their children with disabilities,” notes Adulyan. “We had a huge role in this.” To date Bari Mama has successfully made sure approximately 85 children have either not been abandoned in the first place or have been returned to and accepted by their families.
When Bari Mama’s volunteers and supporters learn that a baby with special needs has been born, they rush to hospitals or orphanages with the goal of simply talking to parents, explaining that it is possible to raise a child with special needs in the family. A recent survey by Human Rights Watch entitled “When Will I Get to Go Home? Abuses and Discrimination against Children in Institutions and Lack of Access to Quality Inclusive Education in Armenia,” found that a lack of availability and access to rehabilitation and education services within communities—together with economic hardship—impacts a family’s decision to abandon their children. Although orphanages in Armenia are fully equipped to care for disabled children, Adulyan is convinced that these children above all need the love and warmth of their parents to thrive.
To help fulfill its mission, Bari Mama holds public awareness campaigns, charity events and other activities informing potential parents about the importance of having children in need of their love and affection remain in the family. For orphaned children under Bari Mama’s care, until they are placed into families, volunteers organize fun activities and ensure that the children have everything they need for their well-being, including food and clothing. The organization also aims to encourage child adoption in general and particularly the adoption of children abandoned due to health problems or innate disabilities.
A busy lecturer at Yerevan State University and a mother of two, Adulyan admits that overseeing Bari Mama is both emotionally draining and incredibly rewarding. “I consider myself a mother with many children as I know the problems and dreams of all the disabled children in orphanages,” Adulyan says, admitting she becomes attached to every child. She is encouraged to continue expanding Bari Mama knowing it has a real impact on helping to make sure children grow up in their families.
Banner photo by Eric Grigorian