Tuesday, 25 September

Illusions and Reality: Kashatagh hospital services are no longer free of charge

A child was born at the hospital in Berdzor on June 18. When we returned to Berdzor on June 22, after touring the villages of the Kashatagh region, there was another birth in progress. “We have an average of two births a week,” said the nurse on duty.

The hospital is being renovated with the help of the charity Aznavour for Armenia. The government lacks the financial means to fund hospitals or to rebuild houses for relocated residents. But the same government managed to allocate 18 million drams to widen the Kashatagh regional administrative building by two meters.

On June 22, the hospital at Berdzor, the regional center, celebrated its tenth anniversary. This institution, which had provided free services from the day it was founded, started working on a paid basis on July 1. Chief Doctor Artsakh Bunyatyan was upset by the change, and felt at the time as if those were his last days on the job.

Bunyatyan has no idea whose decision led to this change of policy. The doctor, who performed hundreds of operations at the military hospital during the Karabakh war, was one of the founders of the Berdzor hospital. Now he will probably resign or may be relieved of his duties by the authorities. He cannot imagine refusing to admit a patient who cannot afford to pay. Even today, he does not accept payment from patients, thus consciously breaking the law.

“Our hospital provided free care for ten years, and we were been proud to say that there was no other medical institution like it in Armenia or Karabakh. The government now says that it should not be free. If a patient is admitted to the hospital and has no referral papers, then he has to pay 8,000 drams a day. The Karabakh government has taken this decision. It's as if there is a specific aim to close down this hospital. Isn't it obvious that they want to empty the region of Kashatagh? If they didn't want that to happen, wouldn't they talk to the emigrants and say, ‘You've lived here 10-13 years, why leave now?'” Bunyatyan said. “But who is going to do that? If that isn't being done, then it means that this is state policy. When such things are being done by the government, you can't find anyone specific to blame. The villages now stand deserted – we used to have 103 villages, but they're emptying out now, schools are either closing down or being forced to merge. And there's so much land; people have gone to such pains to establish villages, but they are now being deserted, everyone's leaving.”

Two years ago there were 94 medical professionals in the region. Now, many have left the area, creating a shortage. As of this writing, the hospital at Berdzor had no attending physician. Artsakh Bunyatyan has not been able to perform surgery for two months now– an eye operation left him with weakened vision. In the past, the hospital regularly had 20-25 patients; when we were there, it was almost empty. People simply don't have the money to pay for care. Treatment for pneumonia costs 50,000 drams, bandages cost 5,000 drams and so on.

“Pensioners receive 12,000-14,000 drams a month – how can they support themselves, let alone think about going to a doctor? They are trying to damage our relationship with the people. This is akin to betraying the patients. There's nothing you can do against it, it's a mafia – this is business, not medicine. It's impossible that the president does not know; everyone knows. There was a birth here this morning. If the mother and child need to stay here longer than three days, they will have to pay 8,000 drams per day. But it is possible for some sort of complication to occur that would require them stay, right? And if I don't take the money, the authorities can come and check, and if there is no money to show for their stay, then they can say that I put it into my own pocket,” said Bunyatyan angrily.

The hospital has neither proper medical equipment nor beds. Here in Berdzor, I recalled a donation of hospital beds from a US charity that had been made to the Erebuni Medical Center in Yerevan. It is well known that Erebuni is a private medical center, and its owner is considered one of Armenia's richest people. In the winter of 2006, some journalists and I had taken a homeless man to that hospital, only to find him back on the street the next day. It is nearly impossible to get care in that medical center free of charge. Yet that is the kind of hospital that receives free drugs and equipment from state and international organizations, and the government exempts them from customs duty as an act of charity.

Armenians lack the victor mentality

As Artsakh Bunyatyan sees it, the government should have relocated around 200,000-300,000 residents to this region, given them certain privileges, and built homes. “Why isn't that happening?” I asked.

“I think we lack a clear policy. The authorities seem to be afraid when it comes to the Turks. We have shed blood here. Now they're waiting to see what the Turks will do, and then they'll tremble and give some sort of reply. Armenians don't have the mentality of victors. That's horrible – to have won but to be unable to express that victory; to continue shivering wretchedly looking for patrons and sponsors to make your decisions for you, seeking nannies to sing you lullabies and tell you what to do. And there are plenty of those nannies,” said the doctor.

“What it like for someone living in Kashatagh? He's cut off from everything - no news, no radio, no television, no decent socio-economic conditions, living in shacks in the kingdom of ruins. These people came to rebuild the wrecks, but the government reduced their mentality to ruin. And they feel swindled – the promises that were made have not been kept. They feel that there is no plan, there is no future. When high-ranking officials – popular men ­who determine the fate of our nation – make announcements about the intention to return land, then these people start to think that their days here are numbered and that something is about to happen here. And they get up and leave – nobody can blame them,” Bunyatyan said worriedly.

There comes a time when the boys say “Enough!”

But Artsakh Bunyatyan suggests that not everyone can be forced to leave, no matter how bad things get, even as he believes that this wave of emigration was planned.

“Maybe the planners didn't see the war. I suspect that, because who owns everything now - all the wealth, the good life, the casinos? Those who ran away, hid or escaped to foreign countries and made their wealth there. But our brothers, whose blood flowed for this victory, have come here to live, and now they are on the brink of starvation and can't support their families. They've been subjected to control and are being given instructions by the rich. Isn't it obvious that Kashatagh means nothing to them? Whether we lose or not doesn't matter to them; there has never been an ounce of patriotism in them, and they're proud of that. But we shouldn't let them rule over us. After all, there comes a time when the boys say, ‘Enough! There is a limit to how long you can keep us reined in.' If I say it, and then you do, and then someone else, then we're three or four people already, and that is enough. We can tour the villages, and talk to at least one man in each village who fought in the war. We all know each other and are well aware of how badly off we are in these economic conditions. We are being neglected – I am a chief doctor, but the authorities ignore me. The ex-soldiers are very badly off, they can't manage… they are in a very poor state psychologically. They have no rights, they cannot better their situation. The government's distribution of medals does not mean anything in itself.”

This doctor, who has lived in Karabakh for more than ten years, does not believe the rumors about returning territory. “This land is already glued to our lungs. Now that we can breathe, should we cut out our lungs and give them to the enemy?” he said. “We are managing to live, what else can we do? If anyone signed an agreement of this sort, then he won't stay alive in Armenia, or anywhere else in the world. Nobody would risk signing a document like that.”


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