AECP - Eletronic Bulletin - 2009

Volume 4, issue 2 Fall 2009

electronic bulletin

Results of the AECP 2009 mission and prospects for 2010 From June 2003 to September 2009, the AECP has completed three tours in Armenia. More than 240,000 people have been screened and over 10,000 sight-saving surgeries and laser treatments have been performed in the Mobile Eye Hospital. Nearly 26,000 eyeglasses have been distributed to the Armenian population all over the country.

Thanks to the professionalism and the sincere dedication of AECP specialists working in the “Bringing Sight to Armenian Eyes” initiative, a large number of people in Armenia have recovered their eyesight. Within the scope of the project the AECP Medical teams and the state-of-the-art Mobile Eye Hospital travel throughout Armenia to provide eye care to the population free of charge.

In 2009, the Mobile Eye Hospital visited the regions of Kotayk, Tavush, Lori, and Shirak.

More than 19,000 people were examined

and over 1,500 surgeries and laser operations performed.

The AECP began its fourth tour in Armenia in the Aragatsotn region on October 6, 2009.

Starting from spring 2010, the AECP medical teams and the Mobile Eye Hospital will travel to the regions of Vayots Dzor, Syunik, Ararat, and Armavir.

As usual, the tour will be accompanied by medical trainings for regional family doctors, who stand at the front line of medical care in Armenian regions. Local physicians will receive up-to-date skills and knowledge to ensure quality services for the population across the country. The first training session as part of the AECP fourth initiative has taken place for 20 local physicians in Ashtarak (Aragartsotn).

With the Mobile Eye Hospital garaged for the winter following its travels throughout the regions, the AECP medical teams provide services in Yerevan. In order to reach out to children and other vulnerable groups the

sight

The Mobile Eye Hospital

medical teams visit schools, kindergartens, and charitable organizations functioning in Yerevan. Eye care trainings are provided for nurses working in schools and kindergartens to make sure that medical personnel detect eye diseases among children at an early stage.

This winter the AECP has already been providing services in the community of Davitashen, and in February and March of 2010 the AECP will be working in Erebuni in Yerevan.

bringing

to armenian eyes the armenian eyecare project p.o. box 5630 aygestan 5, house 7 newport beach, ca 92662 yerevan, armenia phone 949.675.5767 phone (374 10) 55 90 68 fax 949 673.2356 fax (374 10) 57 76 94 aecp@eyecareproject.com aecp@cornet.am www.eyecareproject.com

Founded in 1992, in the United States by an American-Armenian ophthalmologist Roger Ohanesian, M.D., the Armenian EyeCare Project (AECP) is a California based nonprofit corporation dedicated to the elimination of preventable blindness in Armenia. In 2003, the AECP established an office in Yerevan and launched its seven-year initiative, “Bringing Sight to Armenian Eyes.” The Initiative has five comprehensive, integrated components developed to eliminate preventable blindness.

They include direct patient care, medical education and training, public education, research and capacity building. The AECP has been a USAID partner since 2004.

In this issue - 2009 results and 2010 plans - Donating to AECP:

Adopt-A-Village/School - Highlights 2009:

- Celebrating World Sight Day in Armenia

- Data analysis and research: Gender disaggregation of AECP data on eye diseases

- The Gift of Sight: Opening the doors to hope

- AECP 32nd Medical Mission to Armenia

2 AECP Electronic Bulletin Volume 4, issue 2 Fall 2009

Donating to AECP: Adopt-A-Village/School

Making a difference in people’s lives

In this issue, we would like to highlight activities in the villages and orphanages that benefited from the Adopt-a-Village/School program in the fall of 2009. The program envisions targeted donations for screening and treatment in specific locations/institutions.

Jrarat Village, Shirak Region

Marie Izmirlyan Special Orphanage, Yerevan

September 4, 2009

Thanks to the generous sponsorship of Ms. Dianne Der Boghosian, 98 people in Jrarat village were screened. Of those people 57 were diagnosed with refraction problems (nearsighted, farsighted) and all received new eyeglasses.

One patient required a surgical laser procedure on both eyes in the AECP Mobile Eye Hospital.

Yerevan Children’s Home, Yerevan

November 3, 2009

Rouzanna Malkhasyan, 8, asked to pass her song “Mayrik” to people, who helped check their eyes in the orphanage and made this action possible.

Thanks to a donation from Ms. Laura Berger, 44 children had eye examinations. The director said this was the first eye screening at the orphanage in many years and the most complete and professional eye examination for the children.

September 8, 2009 As a devoted member of the United Nations Women’s Guild, Ms. Annette A. Hayrapetian lives by the motto, “Working for the welfare of needy children throughout the world”.

Ms. Annette A. Hayrapetian’s donation helped the AECP visit the Yerevan Children’s Home. The medical group examined 71 children and identified 12 with eye problems.

Nerkin Sasunashen, Aragatsotn Region September 23, 2009 Children of Nerkin Sasunashen decided to thank the contributors to the eye screening in their school with drawings. They wanted to present their friends from the United States with treasures of the motherland such as Mount Ararat, Armenian khachqars, and Armenian tulips.

Eye screening in Nerkin Sasunashen was generously sponsored by the Western Diocese Armenian Church Summer Camp. Two AECP medical teams visited the village with one team examining 99 children at the local school and a second team examining 48 adults in the village’s medical center. The AECP doctors referred 14 patients to the Mobile Eye Hospital for further evaluation and seven of those required surgical procedures.

Your donation brings hope and changes lives.

“Gender and Eye Health” - World Sight Day 2009 October 8, 2009

45 million people worldwide are blind, and 269 million are visually impaired. Nearly two-thirds of those people are women or girls.

Along with events taking place in more than 50 countries worldwide, the Armenian EyeCare Project (AECP) participated in this year’s World Sight Day (WSD) theme “Gender & Eye Health.” It is a crucial topic because nearly two-thirds of blind people worldwide are women and girls. In several countries

women have considerable limitations accessing eye care compared to men.

Along these lines, a joint action of the AECP, the Republic of Armenia Ministries of Justice and Health, and USAID was taken to raise awareness and to provide medical assistance to women in detention.

On October 8, the AECP medical group visited Abovyan Penitentiary. They examined 103 women and 17 teenagers, and prescribed medical treatment.

“According to global research data, equal access to eye care could substantially reduce blindness in low income countries,” said AECP Country director Nune Yeghiazaryan. She noted that according to the Project’s 2003-2007 data, women constitute over 50 percent of AECP beneficiaries, which indicates that overall they have enjoyed equal access to the services provided by the AECP. Of the 130,000 examined by the AECP, 73,832 patients (56.8 percent) were women and of the 5,645 surgical cases in the AECP Mobile Eye Hospital, 2,935 (52 percent) were women.. “This year we decided to help the women

who have more limitations in their access to eye care and live in a stressful environment,” Yeghiazaryan said.

The chief ophthalmologist of Armenia, Professor Alexander Malayan, arrived in person at the penitentiary to check the quality of conducted examinations.

Brochures describing basic eye diseases, their symptoms and explaining eye care procedures that prevent blindness were also distributed. AECP specialist delivered a special presentation to strengthen the knowledge of imprisoned women on basic eye diseases and symptoms. Prisoners at the Abovian penitentiary are aged 20-72, but mainly there are middle-aged women who are in jail for committing different types of crimes including trafficking and theft.

In 2008, the AECP collaborated with the Department of Criminal-Executive Institutions of the RA Ministry of Justice.

Medical teams visited several prisons, screened more than 1,000 inmates and provided 782 pairs of new eyeglasses.

The event was covered by Armenian media which helped to raise awareness of the themes of World Sight Day 2009.

3 AECP Electronic Bulletin Volume 4, issue 2 Fall 2009

Data Analysis & Research Gender disaggregation of AECP data on eye diseases In line with the focus of the World Sight Day 2009, the AECP presents research findings on gender specifics of eye diseases among AECP beneficiaries.

Research and Analysis is an important component of the Project’s Five-Point Initiative to eliminate preventable blindness and to provide access to eyecare for all Armenians. As part of the research component the AECP has developed a database of 130,000 individuals (adults and children) screened from 2003 through 2007. Analysis of the data reveals that 56.8 percent of individuals screened during this time period were female.

The data on about 71, 000 screened adults (over 16 years old) shows that men are more likely than women to have eye and vision problems.

Out of 71,000 screened adults nearly 44 percent (31,236 people) were revealed having at least one serious eye disease or disorder (including glaucoma, cataract, corneal and fundus disorders and diseases). In the group of the screened women this figure was lower: 41 percent, while among men it comprised 49 percent.

Comparison of prevalence of mentioned serious eye diseases among the screened male and female adult population (see the diagram) shows that screened female beneficiaries had better eye health characteristics.

AECP male and female adult beneficiaries having eye diseases, %

0

Glaucoma

10

20

40

50

Opening the Doors to Hope

“I have 2 children: Narek, 13, and Maria, who advised patching and then apparatus 6. I am the only breadwinner in this family. treatment, which did not improve the situaMy husband left us when Maria was a tion. According to doctors the only solution baby. Currently I do not have a permanent for Maria was the surgery.

Anahit realized the urgency of the situemployment. I do odd jobs to be able to feed my children and to at least ensure their ation but could do nothing. She is bringing survival,” Anahit Mktchyan said, telling us up her children alone, has no job and could about her family.

Maria Hovsepian lives with her mother and brother in the Southwestern community of Yerevan (it is commonly called Bangladesh, maybe for its remoteness from the center). She likes to read, write, draw, and knows many poems.

Maria draws equally well with her right and left hand and is a very bright child. She is going to school and is determined to study with straight As. Maria had strabismus. She was referred to AECP through a Maria loves her mom very much. donor and was operated on both eyes; now all her symptoms of strabismus are gone. not afford any “additional” expenses. She When Maria was 3 and-a-half years old her had been postponing the surgery, hoping mother noticed that both of her daughter’s that there will be a miracle and that someeyes periodically changed their angle of thing would help her child. Anahit permavision. She took the child to eye doctors nently felt the burden of her incapability of

helping her daughter and could do nothing but hope for better times and a miracle.

Time passed, and Anahit realized that there was not much time left - surgery was needed, otherwise she could be too late to take steps to correct Maria’s vision.

Maria was the best at reciting poems at the Farewell ball at her kindergarten, but she was shy and hardly ever raised her eyes.

The donor of the kindergarten saw her and decided to help. He contacted the AECP, explained the situation and Maria received a referral for a free diagnosis and surgery at the Malayan Eye Center.

Anahit was unable to explain how she felt when she saw that Maria’s eyes were getting better. “You should feel this.

You should feel when hope comes true,” she said.

Looking at Maria now it is difficult to imagine how unhappy she was and how often she asked her mother not to take her to kindergarten because the other children laughed at her crossed eyes. She did not like to play with other children at that time. But now she says she has many friends and is full of plans for her future.

A letter to the AECP from Anahit Mkrtchyan

8.2 5.5

Fundus disorders and diseases

18.3 16.6

Dear Friends, 32.6

Cataract

Corneal disorders and diseases

30

The Gift of Sight

26.6

One rarely meets this type of charity. Sometimes you encounter yourself in a hopeless situation, and doors to hope open

10.4

when you don’t expect anything at all. And you become happy when everything is changing, changing for the better. I

7.9

Men

Women

People over 50 are more vulnerable regarding their eye health. Based on the produced prevalence of main eye diseases, AECP developed the methodology for calculating an “Eye health Vulnerability Index” (EVI) for 50+ years old screened population. People of that age having at least one of the mentioned diseases and disorders were considered as having vulnerable eye health. According to AECP estimations, every second beneficiary (50%) in this age group had vulnerable eye health. Nevertheless, among AECP female beneficiaries over 50 the EVI is slightly lower: 48.8%, while for male beneficiaries it comprises 54.4%. Thus, the eye health characteristics of AECP 50+ female beneficiaries are better.

would like to thank heartily the Armenian EyeCare Project, all of those people who contributed and made this surgery possible. I would love to mention all their names, but I know only a few of them. We are very pleased and delighted with the attitude presented by the AECP, which was transferred similarly to the doctors at the Malayan Eye Center.

Many thanks indeed.

Yours sincerely,

Anahit Mkrtchyan

Women and the AECP “I am telling you. I am reborn!”

Lusik Yeritsyan (Tavush region) proclaims there are few things that can change an individual’s life as radically as restoring sight.

For 6 years Lusik Yeritsyan suffered from preventable blindness because of cataract in both eyes that was removed by the AECP doctors through sight-restoring surgery .

“I need eyes to help others”, almost blinded 64-year-old Flora Vardanyan (Yerevan) confessed to the AECP doctors before her cataract surgery.

Blindness was another challenge for Flora: she was the only breadwinner for her and her bedridden husband.

After the operation Flora Vardanyan was feeling well and was happy to share emotions about her garden.

“When I opened my eyes I saw how abandoned my garden was. But soon my garden blossomed again. Just like me after surgery!”

November 25, 2009, Yereven, Armenia

After the screening 78 year-old Jasmine Stepanyan (Yerevan) received eye glasses from the Armenian EyeCare Project. “I learnt about the upcoming eye screening from the Soup Kitchen staff and was very excited about the opportunity to check my vision,” – she said.

Jasmine does not have a family and survives on a pension of less than $30 per month making it extremely difficult to pay for the daily basics, let alone a doctor’s visit.

For many needy people this is the only chance to receive eye care.

4 AECP Electronic Bulletin Volume 4, issue 2 Fall 2009

Looking Forward to New Challenges

AECP 32nd Medical Mission to Armenia — November, 2009

Thanks to the on-going initiative of the Armenian EyeCare Project (AECP), American physicians visit Armenia on a semi-annual basis to transfer the know-how and skills in ophthalmology to their Armenian colleagues. Since 1992, more than 50 U.S. ophthalmologists have traveled to Armenia to train Armenian doctors and treat patients.

Dr. Geroge Bohigian

Dr. John Griffin

Dr. Richard Hill

A Major Project Combating retinopathy of prematurity (ROP) is one of the emerging priorities for the AECP program. Being entrusted by the Ministry of Health with a very interesting and challenging task of establishing a nationwide ROP program in Armenia, the AECP management invited interested parties to a seminar/ discussion dedicated to ROP problems in Armenia.

The meeting took place at the Educational Center of the Malayan Eye Center, established by the AECP, with representatives of pediatric ophthalmologists and neonatal rehabilitation specialists from different hospitals of Yerevan.

Though it is difficult to present exact statistics on the number of premature babies who have ROP in Armenia, the need for such a nationwide program is evident. Moreover, there is a definite growth tendency of this

Dr. Baruch Kuppermann Dr. Anthony Aldave, Dr. Sarkis Soukiasian and Dr. Larry Najarian This was the 32nd medical mission to Armenia organized by the AECP. Dr. John Hovanesian, Dr. Anthony Aldave and AECP president Dr. Roger Ohanesian examined a large number of patients, consulted cases and delivered lectures on the advances in ophthalmology. In addition, this trip was aimed at monitoring the ongoing activities of the AECP and strategizing their new directions.

Dr. John Griffin and Dr. Basilio Kalpakian

Meeting Colleagues Meeting Patients AECP physicians were looking forward to seeing their patients first. These were people desperately seeking hope and advice or looking forward to hearing about recent news in ophthalmology.

During this mission Dr. Anthony Aldave and Dr. John Hovanesian examined about 80 patients at the Malayan Eye Center. The medical personnel of the Center highly appreciated their help in performing about 10 surgeries. Due to the continuous involvement of the AECP physicians from the U.S., the Armenian ophthalmologists practice innovative surgical techniques now: for example, the endothelial keratoplasty was used in two cases this time.

Both adults and children were examined during this mission.

A talented Armenian singer, Gohar Nersisyan is among AECP’s regular patients. At age 3, Goharik was diagnosed with uveitis, an eye disease that causes glaucoma. Her life is filled with surgeries, treatment, and check-ups. Despite the frequent operations and the possibility that she can go blind, she remains optimistic.

Goharik has to undergo yet another surgery to remove a cataract on her right eye which will probably be in May, 2010.

Dr. Anthony J. Aldave and AECP fellow Dr. Anna Hovakimyan

About 20 patients with very complex cases were referred by the AECP and many more by the Malayan Eye Center to Dr. Roger Ohanesian for examination. According to him, “The diseases that I see in Armenia, I never see in the United States. And one of the reasons is that many times the patient has waited for a long time to get treatment. There just seems to be a large amount of pathology that we see here in Armenia, which I don’t see in my private practice in the U.S.”

Vardan, 4, lost his vision because of a home injury. He and his siblings were playing with a knife and their game ended in tragedy. The child had a surgery performed on his right eye.

After the examination little Vardan seemed not to have any serious problems.

One of the main objectives of the AECP is to systematically bring to Armenia all available new methods and technologies in modern ophthalmology. AECP physicians gave presentations to the Malayan Eye Center personnel about available research on crystal lenses and recent breakthroughs in surgical techniques practiced in the United States.

Dr. John A. Hovanesian delivering a presentation about modern advances in use of crystal lenses.

Practical exercises followed the theoretical session of the conference at the Wet Lab established by the AECP at the Malayan Eye Center. AECP president shared his skills with young Armenian doctors.

“The bad carpenter always blames his tools,” Dr. Ohanesian said while explaining to younger specialists the realities of being a high-class professional by perennially developing his or her skills.

disease. No concrete actions have presently been taken due to a lack of officially adopted protocols and procedures. A nationwide program, involving both prevention and treatment phases will secure timely monitoring of ROP and treatment, if necessary.

Among the planned actions is the launch of a telemedicine program, which would secure consultations of the U.S. top professionals in ROP to assist the Armenian doctors fighting productively against ROP. In order for the ROP nationwide program to function at its full potential, a very expensive diagnostics camera must be brought to Armenia, which will help establish direct electronic data exchange with one of the world’s leading specialists working in the United States, Dr. Thomas Lee. The AECP emphasizes the importance of uniform regulations for all relevant institutions as well as the establishment of a unique center comprising all necessary equipment for the diagnoses and treatment of ROP. These are very important factors, because large amounts of funds will be invested in the program. As a result, a working group comprised of Armenian specialists was set up to provide necessary data and recommendations to start a nationwide program in Armenia.

Looking Forward The next medical mission is planned for May of 2010, with an international conference on ROP as its highlight. The AECP has impressive accomplishments and ambitious plans.

As AECP president said, “This project has been around for nearly 20 years and I expect that it will continue, even knowing that doctors are becoming self-reliant with much better abilities here in Armenia. We expect that we will continue working and coming to Armenia with the best American specialists to assist the doctors here. It becomes expensive to continue the Mobile Eye Hospital and to continue our programs and I just hope that the Diaspora recognizes the benefit that we are providing and continues to support the program so that we can continue our work in preventing blindness in this little country.”