Thursday, May 25, 2006

Next week

So I'm running low on time in the states and trying my very best to visit with each and every one of you before June 2nd. The question of the month is: "So are you ready?"

No, not really. Please understand that although I've wanted to do service work abroad since my sophomore year at Capital I didn't think about the Peace Corps until September and I didn't seriously consider it until February. I received this placement last month and I don't think I've done anything to get ready until last week when I purchased some wool socks from I'm not frightened, simply excited about what lies ahead. I've spoken with a few people from Armenia in the past two weeks who have all agreed that it is a beautiful (but poor) country. I can't anticipate what is to come but I am just trying to trust that this is what I should be doing right now.

In my heart this week I've been considering my skills and gifts and wondering if this work is the correct decision. I don't know if I should be leaving America knowing that there is also a desperate need for service in our southern states. I expect that this is something that will become very clear by June 6 or so.

Please stay in touch.

Monday, May 15, 2006

Project Background

Here is a short summary of the country's current situation:
Armenia is in the transition to the democratic and market oriented society. The major implications of modern health challenges for health care reform are: a shift from curative to preventive care with an emphasis on well-being of the population; a shift of the funds from secondary and tertiary care to primary care; as well as emphasis on motivation of individuals, families and communities to adopt healthy lifestyles and accept responsibility for health.

Until recently, Armenia's healthcare system, which developed as part of the Soviet-planned system, could be seen as a planned public service provided by the state, with all health personnel being state employees. The system was highly centralized and standardized. Services were free to patients, provided in state-owned facilities, and financed mostly by the state budget. The Soviet health care system was successful in providing access to comprehensive health services for most of the country's population, including those who resided in rural and remote areas. However, maintaining such a system required substantial and continuous budgetary support and enormous manpower resources and managerial skills. The system deteriorated of late, largely due to the political and economic turmoil that accompanied the collapse of the Soviet Union.

After the collapse, the GDP fell by as much as 50 percent and funding to the health sector decreased to about 1 to 3 percent of the GDP. This led to declines in life expectancy, increased morbidity, mortality, poor conditions in hospitals and other facilities and decreased quality of care. This situation, as well as the guarantee of free basic health care in the 1995 Constitution, prompted the country to search for other ways to fund health services. In 1997, the government-run health care institutions began a process of privatization, resulting in the re-registration of the state institutions into closed joint-stock companies, run as for-profit business organizations but managed by the government.

The major causes of death in Armenia are similar to those of industrialized countries: cardiovascular disease, cancer and accidents. The insufficiency of the health industry mirrors the decline in the country's socioeconomic condition as people are increasingly unable to pay medical costs. The search for alternative health care systems as well as a means to finance the health care system has become a difficult political issue; health care reform has become a priority for many.

Enter the Peace Corps.

In 2000, PC/Armenia joined the efforts of a number of other international organizations in the country to assist health care reforms and the development of primary health care, in particular, by launching the Community Health Education (CHE) project. This is what I hope to do during the next few years.

The CHE Project's purpose:
By the end of 2010, 50,000 people in the communities throughout Armenia will have increased awareness of why public health is important to them, and will practice preventive health measures achieving improved health due to social organization, skill development and behavior change.

The project's goals include: community assessment, community education, and capacity and sustainability.