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Gumri, ARMENIA Nursing House Pilot Project


      

Gumri Central Church, Armenian Orthodox

The purpose of the Gumi Nursing House Pilot Project in Armenia was threefold: to extend assistance to the residents of the Nursing house to meet their immediate short-term needs; to test the model of short-term assistance while considering longer-term interventions; and work with this particular facility in order to determine further potential activities.

There are several nursing houses and orphanages in Armenia that need assistance and support in different areas: social and health services, humanitarian aid, infrastructure, education, etc. Given the limited resources at hand it was decided to pilot a small-scale project in a way that would achieve some outcomes and yet generate conceptualizations and opportunities for further action.

The Pilot Project was undertaken to try a method of assistance of supplying needed items through a four-step process: 1) In-person site visit for a rapid needs assessment. 2) Acquiring resources to meet needs through collaboration, appeal, or direct action. 3) On- site personal delivery of materials or assistance. 4) Follow-up evaluation.

Background

The Gumri nursing house currently accommodates 110 residents (65 women, 45 men): elderly, disabled, mentally sick, etc. There are four nursing houses in the Republic of Armenia, with a total population of about 1000 people. All of them are under the Ministry of Social Welfare, which supports these facilities, while providing salary for the staff, resources for maintenance of the building, etc. The collapse of the Soviet regime in early 90s, coupled with energy crisis and economic hardships shrank the government resources drastically. The nursing houses, orphanages and similar facilities had extremely scarce resources to keep the facilities operating properly and they deteriorated rapidly. Many of these facilities survived through the economic crisis due to external assistance and the dedication and commitment of the staff.

Culturally and traditionally the young generation looks up to the elderly and it is very rare to have old parents reside in the nursing houses. Generally, children take care of their parents financially, physically and otherwise.

The building has six wings, including the administration, a health unit, residential area, a kitchen facility, a club, laundry and ironing room. Nice tree backyards are between the wings, which make a nice summer place for the residents. There is also a big green rest area where the residents spend their spare time.

In the Soviet times the building was heated by hot water radiators using a gas-powered boiler, which is not functional now. The cold water supply is sufficient, the pipes and the entire sanitation system is in desperate condition. The only way to heat the water for cooking and other purposes are submersible electrical heaters. Electric space heaters with bare wire heating coils are the only means to heat the rooms in wintertime. Hallways have some discoloration and cracking of plaster that is evidence of leaks in the roof. Fortunately, this is an arid region, receiving about 20 centimeters (9 inches) of precipitation per year, most of it as snow.

Having said this, it should be mentioned that the building is very well maintained with the limited resources due to the excellent job of the staff of 50 people, headed by Olga Mkrtchian, the director.

All sections of the building including the residential parts and the bathrooms and rooms are always clean and carefully taken care of. The residents are receiving three good meals a day.

Rationale

Usually the visits to such facilities as nursing houses or orphanages are not very pleasant given their overall bad condition, stinking bathrooms, etc. Many of them have water and other problems, the existing systems or sanitation or hygiene are deteriorated and/or not functional. Management varies from place to place. Nursing houses receive little external assistance compared to orphanages. In the last few years certain orphanages received humanitarian assistance from different donor organizations or individuals. For example, under the auspices of Mother Theresa a small orphanage was established in nearby Spitak, a small town in Shirak region, in early 90s. It is still operating and receiving support from Project HOPE, and other organizations.

Orphanages in Yerevan, the capital city, receive regular support from foreign and Diaspora organizations. The underlying reason for extending more assistance to orphanages than to nursing houses is that organizations and people tend to help more who are younger, who are the next generation.

Unfortunately, nursing houses donít get a lot of attention and the staff has an overwhelming burden of taking care of the residents with extremely poor governmental support. Gumri, the second biggest city in Armenia, has a special meaning for many people for its unique culture, traditions, hospitality and values. In 1988 a devastating earthquake took away about 25,000 lives, while leaving a lot more without a proper shelter. The economic crisis and related hardships following the earthquake made things even worse while adversely affecting lives of thousands of people. Gumri suffered tremendously and currently, after 12 years it is still facing the hardships of under or unemployment, poor economy and poverty. Half-standing or demolished buildings all over the city are commonplace.

Several visits to the Gumri nursing house indicated that tremendous effort, continuous care and commitment has been keeping the facility operational through the difficult years of transition. Under these circumstances the nursing house in Gumri stood out by its demonstration of high level of responsibility: the staff were proud and did their job with dignity regardless of extremely low incentives ($10-20/month salary).

Unlike other nursing houses this nursing house is not only hosting elderly, but also disabled, handicapped, bed-ridden and people with mental problems. These patients or residents need somewhat special care, adjusted facilities and special help-devices. Without the appropriate means itís awfully hard on the staff to make sure that people are healthy and in a good shape.

Hasmik lived in Iran as a small child. She had medical problem as a child poor medical treatment resulted in having her legs amputated when she was 13 years old. The nursing house provides her with a place to live and opportunity for a much more normal life than she could otherwise have. She is even able to get some knitting supplies so she makes things like the knitted swans and doily she is holding on her lap.

The listed factors and our own observations reinforced our decision to select the Gumri nursing house as a pilot site for our assistance. Through our meetings with the management and staff we came to believe that this would be an appropriate site for our modest assistance in light of unmet needs and resilient and dedicated staff.

Accomplishments

Rapid needs assessment

On May 12, 2001 a team consisting of David Watt and Nara Ghazarian did a rapid needs assessment in Gumri nursing house. Olga Mkrtchyan, the Director, was happy to see the team and share information about the overall situation. The interview with her, the staff and the residents, coupled with the walk through in the facility indicated that the facility has two sets of needs.

The first set is facility related, such as repair of the heating system, including a gas powered boiler and hot water radiators, replacement of the plumbing (water lines and sewer lines), some roof repair, re-plastering some areas, painting, and furniture replacement. Water supply is not a problem, all the first floor rooms have 24-hour water supply. The second floor however, gets water only when they operate a water pump. The pipes, fixtures, and sewer lines are old, worn out and therefore, needs frequent fixing. The rooms usually accommodate 2-4 people. They are small, but clean and neat, with limited furniture: table, a couple of chairs, small bed-stands or shelves. Two adjacent rooms share one bathroom. The overall conditions and well being of the facility will significantly improve in many ways provided these needs are somehow addressed and brought to acceptable standards. These issues need more long-term investments.

The second set of needs is more immediate, smaller in nature and easier to address in short-term: clothing (especially underclothing), shoes, house slippers, bedding, hygiene items, sanitary items (towels, soap, napkins, pampers), etc.

Procurement of goods

After the need assessment was conducted, the team then developed a tentative list of goods for procurement. Many of the residents in the nursing house were bed-ridden and therefore, needed some specific items. The next step was to locate reasonable stores for the actual purchase.

The director indicated that the most reasonable prices were in Yerevan, not in Gumri. Please note that even in Yerevan you buy what the stores have at the time, so the team had to make several trips to different stores in order to buy all the necessary items.

The purchase of goods was a unique experience in that once the sales people would hear about the Gumri nursing house, they would immediately express their gratitude and appreciation. They would then suggest lower prices. The owners of one clothing store, for example, were originally from Gumri and were quite touched with our efforts and care. They suggested a lot of clothing with very reasonable prices and said that itís their contribution. In another store, where we were buying clothing, we noticed a sewing machine behind the sales counter, the owner expressed his appreciation for our Gumri efforts and agreed to a very good price for a brand new electrical sewing machine.

In-kind contribution from UMCOR

The United Methodist Committee on Relief (UMCOR) is a US private volunteer organization (PVO) has been operating in Armenia since 1994. Currently, they are implementing about 16 projects countrywide in the areas of health, economic opportunities, humanitarian assistance, and social programs. During the planning period the team was contacting different organizations, to verify if they are assisting orphanages or nursing houses. In addition, the team wanted to inform other organizations about their ideas and considerations, so there is coordination, networking and maybe interest for contributions. As a result, UMCOR representative expressed an interest to contribute 7 full boxes of hygiene kits to the nursing house. Each box contained almost 20 kits each.

Delivery of goods

On May 18, 2001 the team and UMCOR representative Kara Harutyunyan went to Gumri to deliver the goods to the Gumri nursing house. The staff arranged for the able-bodied residents to gather at the club, which is designed for social-cultural events. The director and the staff know best what the needs of each individual were, whether it was shoes, clothing or something else. Given the sufficient amount of hygiene kits, all residents plus the staff received one kit. The director and the staff helped determine the distribution of at least one item to each resident. As we were delivering the clothing and other items, one nurse was carefully writing down the name and gift received by each resident. After the ambulatory was served, the nursing staff prepared packages for those who were bed-ridden or could not come.

       

They would fill a bag with items, write the patients' names on them and the nurse working on that bag would lead one of the team members from room to room to give them to the bed-ridden. By the time he got back, another bag would be full and a different nurse, familiar with the items to be distributed and those residents would lead off to another section of the house. Finally every person got a package.

Given the surplus amount of hygiene kits and some leftover stockings, Kara indicated it would be appropriate to give one to each staff member. The staff was amazed: they said that of all the humanitarian assistance received during the past few years they had never been able to receive anything. Some were close to tears, not because of the gift, but because Kara thought of them and showed care for them.


Then we went into the sewing machine room to deliver the newly acquired electric machine. All they had was an old style manually operated treadle sewing machine, which showed signs of heavy use for many years. The staff was very happy for the gift. Since it is a brand and model that is widely used the sewing staff will be able to operate it efficiently and they will be able to get much-needed repairs of bedding and clothing accomplished.

       

We then returned to the director's office and gave her the list of her employee's that had received items and a box with what was left over, she was very grateful. It was obvious that she was very happy, overwhelmed and overjoyed by the much needed items. But she needed to maintain herself. Directors of the Soviet Union must be strong, hard, and disciplined. And she was.

Observations

The distribution went very smoothly, with everybody understanding that the goods were limited, but it was designed to help them for a while and each of them received something. The Director and the staff were extremely helpful and professional, making sure that everything was documented properly. Their knowledge and assistance in terms of delivering certain items to specific people was helpful too, so the goods served their purpose.

It was amazing to see the gratitude of the people and staff. Also incredible to see their hindrances. The horrible earthquake of 1988 had injured many of them. Most had lost families in the earthquake, so had no one to take care of them in their old age. But as the people came forward, missing arms, legs, damaged bodies, one man coming forward on a piece of plywood with wheels, pushing it with his hands, tucking the gifts into his suit jacket, said respectfully: "Tank you very much" (probably most of his English coming in one sentence).

It was good to have a camera to hide behind so the emotions would not show. They were all touched with care and attention and almost every one said, "God's blessing on you for your kindness". Many of them have not seen any family members for many years. For them, the attention was more important than the clothing or kits.

Summary

Even limited resources can make a big difference as clearly demonstrated in this small pilot project. It also demonstrated that regardless of the daily hardships the staff was facing, they had amazing patience and love for people, this is what kept them going during the harsh years of transition.

In the end, this is a small effort and it is about care, love and giving. It is about peopleís needs, wants and hardships, but it is also about pride, dignity and self-respect. When we gave a pair of stockings to the barber, he looked at us and said: "If you could get me electric cutters, my job would be so much better and quick. All I have is old pair of scissors". They didnít want anything for themselves, they wanted to take a good care of the residents but were limited with their resources.

It is very fulfilling to realize at the end of the day that your efforts made vulnerable and needy people happy, since there is no substitute for personal attention and it is in giving that we all gain.


 

 

 

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