“Salvard” rural community development foundation and
“Partnership and Learning” NGO have conducted the research in outpatient health
care institutions of five communities in Sisian and Goris with the aim to
determine  the accessibility of first
medical assistance for pensioners. The choice of the monitoring focus is not
accidental, residents and NGOs of the community voiced the problem during the follow-up
meeting.

The
monitoring has been implemented within the frames of the “Grassroots voice for
human rights mobilization” programme
launched in 2011 implemented jointly by World vision Armenia, Helsinki
Committee of Armenia and Civil Society Institute NGOs.

The monitoring results

There
are five primary health care centers in the region and each of it provides
services for 5-6 communities.

“The
observed first-aid posts lacked utilities and adequate working conditions. Three
of the observed first-aid posts do not have a toilet facility. Only two posts
have heating. One post does not have electricity. Not a single first-aid post
has a land line phone”, stressed out Gayane Mesropyan, employee of the World
Vision Armenia Sisian Area Development Programme while presenting the results
of the monitoring during the discussion held in Sisian on September 27.

The
interviews with the pensioners who apply for health care services revealed that
the first and foremost problem of health sector is the expensiveness of
medication (30%), high cost of health care services, even though outpatient
clinics' services are provided free of charge (21%) and quite a long distance
between the community and the outpatient healthcare institution that provides
services to it (20%).

The
nurses highlighted that they disseminate information on getting free of charge healthcare
services and medication on the privileged basis through pamphlets, meetings, consultancies,
provision of publications, information billboards and home visits. While 35% of
the interviewed pensioners are unaware that the provided services are free of
charge. 53% of surveyed pensioners are unaware about free of charge or provided
at 30% discount medication. The rest of respondents are aware but only 16 % of
them use this privilege.

“One
of the reasons is that among pensioners the most common are impaired cardiac
function and hypertension and medication is not allocated free of charge for
these diseases”, highlights Gayane Mesropyan and suggests to include medication
for these diseases in the list of state-commissioned medication.

Free of charge medication: head ache for medical personnel

Directors
of primary health care centers unanimously complained that the function of
distribution of free of charge medication is a head ache for them.

“It
is a serious responsibility, big volume of job and zero profit”, stressed out
director of “Darbas” healthcare center Anush Nersisyan.

 “The science develops, I want to prescribe effective
medication but we are not entitled to order it as there is no approved list. The
patients are discontented of course”, says director of “Gorayq” healthcare
center Karine Harutyunyan.

Doctors
ask to “release them from the medication” and suggest to raise the pensions
instead, so that pensioners afford necessary medication.

There is a privilege but pensioners cannot use it

In
the rural communities of Sisian and Goris there is a serious problem concerning
the privilege of getting a medication at discount.

“For
unemployed old-age pensioners or pensioners who are not recognized disabled the
state provides 30 % discount for medication. However the right to get it
differs from the real possibility”, says Ashot Babayan, employee of World
Vision Armenia Sisian Area Development Programme and adds that the state should
create the conditions for implementation of this privilege.

Doctors
say that 30 % of discount does not work in practice and frequently they give
this medication free of charge. 

Nobody
knows whom and how unemployed pensioner should apply to buy this medication,
how he/she should prove that does not work and finally where to buy the
medication at discount.

Discussion
participants complain that in rural areas there are no pharmacies because they
do not have pharmaceutists with university degree. 

“In the past there was a mobile pharmacy, then it stopped
functioning and nothing has been offered instead”, says Anush Nersisyan and
suggests giving nurses the license for selling medication.

“We are not doctors but paper workers”

Director of “Gorayq” healthcare center Karine
Harutyunyan complains about lots of paper work.

“There is so much paper work we should do. During a
day we are able to provide service to only one patient. Filling out the
documents takes the whole day”, she says.

“We were forced to be paper workers not doctors.
Instead of doing our job, we are writing from the morning until the end of day”,
complains the Director of the healthcare facility.

Organizers
of the discussion assured that the end of the programme does not mean the end
of their activities. They will extend the raised issues to the public
authorities and continue the follow-up to find out solutions to the issues.