|Gumri, ARMENIA Nursing House Pilot Project
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.
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.
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.
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
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.
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.
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.