Wednesday, 26 September

Old Equipment and Moldy Walls: Treating Thousands, Ashtarak’s Medical Center Needs Intensive Care

While the Ashtarak Medical Center, located in the eponymous town of some 18,000 about a half hour’s drive north of Yerevan, treats thousands of patients every year, it too needs immediate care. 

The center is housed in four buildings, built during 1955-1979. Despite some partial cosmetic repairs, the center has never been totally renovated. 

Director Artur Hovhannisyan told Hetq that the building needs major renovations to comply with present requirements.

Artur Hovhannisyan

"Our requirements grow, and everything is relative. There are some medical facilities in Yerevan, which are newly renovated, equipped with modern facilities. Naturally, people want better conditions and to be examined with modern equipment. We are quite limited in this respect. This doesn’t allow us to be competitive, but we have a quite knowledgeable medical staff. Some want to be treated only by us," says Artur Hovhannisyan.

The director says they have received some equipment, beds and sideboards, from foreign and local charitable organizations during the past few years. The equipment is second-hand, but the director claims it’s in in "pretty good shape." 

Hovhannisyan says 47 modern beds, mattresses, operating equipment, and other items have been donated tothe medical center. Maternity and delivery rooms have been renovated with the help of donor organizations. A few wards and the reception center have also been renovated.

Delivery rooms renovated with donor funding

"Is that enough? Of course not. We try to implement new projects via state resources and charitable organizations," added the director. 

We should note that the furniture has not been updated in most of the wards. It would be a stretch to call some wards renovated, or equipped with modern beds and side cabinets. 

In most of the so-called renovated wards, the rooms are damp and covered with mold. Patients do not want to stay in some other wards because of the humid stench. The walls are wet, and the smell given off by the damp plaster makes breathing a chore.

Sink areas are in terrible condition. Plaster has fallen because of the moisture. There are holes in the walls.

Doctors told Hetq that the medical center’s water supply isn’t on a 24-hour basis. They have water twice a day - one hour in the morning, one hour in the evening. They must store water to use when the taps are dry.

Some of the center’s medical equipment is quite old. The staff can operate some of the equipment, somehow. The rest is unusable and must be repaired. The center has a very limited amount of new equipment.

The narcosis equipment at the maternity ward dates to the 1980s. At the time of our visit, the operating room door of the ward was locked. There’s almost never a need to open it. Doctors say the anesthetist refuses to operate with the equipment on hand. Therefore, it’s been a long time since this room has served its purpose. Surgeries on pregnant women are performed in the general operating room of the hospital.

According to Hovhannisyan, the X-ray and fluorography equipment are also ancient. The ones for physiotherapy are about thirty years old. 

The doctor in charge of X-rays says that it’s been 2-3 years that the fluoroscopy machine hasn’t work. The machine is necessary for examining the gastrointestinal tract.

The equipment doesn’t work

To resolve these issues, the center’s director says that economies of scale need to be implemented. Hovhannisyan points out that the center can operate more efficiently by using less than its 6,700-square meter space. 

"By restructuring, we can group different units in one area and free some other space, thus cutting some additional costs. This applies to electricity and gas, heating and sanitation expenses, human resource issues, etc.," the director says, adding that they have calculated a 4,000-square meter area to be enough for providing medical services.

Hovhannisyan says they are looking for ways to optimize the center and implement new projects together with the ministries of territorial administration and health. 

In the meantime, the number of patients at the center has decreased. The number of births is less than before. Having less space, according to the director, is efficient not only for the reasons mentioned above, but also due to the change of discharge terms. In the past, surgery patients were sometimes kept in the hospital for 15-20 days. According to the new protocol, they are to be discharged within several days and then be transferred to outpatient care.

According to the information Hovhannisyan provided, around 50,000 cases of outpatient service, 5,000 emergency calls, and 2,000 in-patient services are provided annually. 

The ambulance service needs modernization, too. The ambulance used today is a Soviet relic.

In 2016, the Ashtarak Medical Center delivered 300 babies. The number was 330 in 2015. Maternity hospital rooms haven’t been sufficiently renovated.

Some rooms even have holes in the floor corners. Peeking through, one can seethe floor below. The holes are plugged with pieces of cloth or with whatever’s handy. 

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