Artsakh’s healthcare system was swamped during the recent war. Today, in the post-war period, four of the seventeen medical institutions in Artsakh are under Azerbaijani control. The remaining medical institutions were seriously damaged. Hospital windows remain shattered and there is no permanent electricity. Medical personnel are lacking as well, with some specialists completely absent.

Hetq discussed these issues with Artsakh Minister of Health Ararat Ohanjanyan.

How many medical institutions existed in Artsakh before the war? How many remain under Armenian control?

There were seventeen medical institutions, four of which are under occupation. They are regional hospitals in Hadrut, Shushi, Kashatagh and Shahumyan. Almost all were furnished and renovated. Only the Shahumyan one was not renovated. We were constructing a new building there. Hadrut and Shushi were fully furnished hospitals.

How many medical institutions have resumed normal operation?

All the other thirteen medical institutions work regularly. Although there is a lack of specialists, the main hospitals are already accepting patients. We have patients in the hospital, the dispensary is working, and medicines are provided.

How are public health services organized today? What are the main obstacles you face in this post-war phase?

The organization of health services is carried out in accordance with the post-war situation. Of course, there are difficulties related to the operation of this or that hospital, the availability of specialists, equipment, electricity, heating. All are problems that, of course, are being fixed. I can say that in besides the hospitals that remained in the occupied territories, the other thirteen medical institutions are currently operating.

Where are these thirteen medical institutions located?

Ten of the thirteen are in Stepanakert. The three regional hospitals are in Martuni, Martakert and Askeran.

What are the equipment and medical staff problems you mentioned? What essential equipment do you need?

Some of the medical staff did not return. They remained in Armenia. There was a lack of specialists even before the war. In terms of equipment, the Republican Clinic (Stepanakert-ed.) is mainly furnished with good equipment. Of course, this does not mean that the other clinics are in bad condition, but, of course, the Republican Clinic is our main, most important hospital.

We can say that we do not have an equipment problem. There is a lack of specialist equipment in the children's hospital, the maternity hospital. By the way, the new building of the maternity hospital was ready. A tender had been announced for the equipment, but that building was hit and today it is unusable. The government must now invest again to restore it.

The rest of the medical institutions, of course, suffered in terms of equipment and building conditions. There is not a single hospital that has not been damaged. None have windows. They were all shattered. 

One of the problems is the lack of electricity. To date, this problem continues in Martuni, Martakert, Askeran.

Has the issue of electricity been solved in Stepanakert?

There are still outages in Stepanakert, but, unlike other places, Stepanakert is in a slightly safer situation. In terms of capacity, for example, it does not maintain 220 volts. The regions get it 150-160 volts. Thus, more than half of our equipment does not work, which creates problems.

Can this result in equipment breakdowns?

Yes. Since our equipment is mainly European, the fluctuations lead to some breakdowns. Recently, for example, we were afraid to turn on the MRI device so that it would not be damaged by the power fluctuations. We must consult with specialists again to see if it’s possible.

Replacing windows is a huge expense. The cost of each hospital window is about 6-7 million AMD. Then, there’s the Republican Hospital, a separate building that that was shelled. A projectile fell in the hospital yard These costs can be very extensive. Restoration costs have yet to be calculated.

Are there estimates as to when the electricity supply issue will be resolved?

Well, in the regions, where we have installed generators, the situation has been normalized somewhat. But, as I said, we have fluctuation problem. For example, in our Republican Hospital, the electronic heating system automatically shuts down at night due to the fluctuations. We face the same problem every day.

Can the windows be replaced with state resources? 

Some money is provided by the state, some by other organizations. For example, the Russian peacekeepers allocated some glass for the windows.  The Red Cross will cover the cost for the Martuni Hospital. They also supplied windows for the Martakert Hospital. We have a preliminary agreement with the Aurora Fund to partially finance the work.

We’ve held meetings with the Armenian General Benevolent Union, Aurora Foundation, French Doctors Without Borders, the Red Cross and others.

You mentioned the lack of specialists. What specialists do you need?

There was a lack of some specialists. Some moved to Armenia because of the war situation and did not return. There’s a shortage at the Children’s and Maternity Hospital.

Today, there are no neonatologists, invasive cardiologists, vascular surgeons, otolaryngologists, pediatric endocrinologists, pediatric neurologists, pediatric cardiologists, pediatric traumatologists, pediatric ophthalmologists or pediatric sonographers in Artsakh.

Are there any programs to fill these positions if the specialists do not return?

Yes, there is. We are trying to negotiate with medical institutions of Armenia. Let's see if they’ll be able to recruit specialists to work for us. The second backup option is that we might apply to Russian peacekeeping department. They have already promised to solve the problem of the cardiologist. A specialist from St. Petersburg is scheduled to arrive this week.

Recently, a group of sixty doctors from Russia came to Artsakh. Can you talk about it?

Yes, They’re part of the Russian peacekeeping group. They have already set up a field hospital in the airport. I visited the site to see the state of the field hospital. It’s equipped with mid-level equipment that will provide medical services for their employees, soldiers. They also provide medical care for our civilian patients, mainly outpatient services.

Do you cooperate with the medical staff of the Russian peacekeeping unit?

Yes. We meet almost every day. They bring some of the tests of Covid-19 patients to us for analysis.