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Þ Þ Þ Þ Þ No8 No8 No8 No8 Ü Ü Ü Ü Ü
November 2010
THE AMIC NEWSLETTER
I- Armenia’s Third International Medical Conference
Armenia’s Third International Medical Conference will take place from July 7 to July 9, 2011. AMIC received a preliminary report giving the following information:
An Organizing Committee has been formed with Professor Derenik Doumanyan, Director of the National Institute of Health, as President.
The members of the O.C. are: Professor Ara Babloyan, Jury Thounyan, Vladimir Davidyan, Ara Ter-Grigorian, Mkrtich Avagyan, Armine Zarayelyan, Susan Thokmagyan, Gagik Avagyan, Geganush Stepanyan, Sergey Sargsyan, Hrach Arshakyan and Eva Movsesyan.
The list of the Scientific Committee members is not yet completed. AMIC will send the completed list upon reception.
The Registration fees are as follows (the fees might not be final, especially for young doctors):
|
Specialties |
Before May 1, 2011 |
After May 1, 2011 |
|
Doctors |
US $ 440 / 350 Euros |
US $ 500 / 400 Euros |
|
Nurses |
US $ 250 / 195 Euros |
US $ 275 / 215 Euros |
|
Students and Residents |
US $ 100 / 75 Euros |
US $ 130 / 100 Euros |
The website, hotel accommodations, and other pertinent information will be announced and sent to you as soon as AMIC gets the necessary data from the Organizing Committee.
II- AMIC’s Annual General Assembly
AMIC’s Annual General Assembly was held in Montreal from October 14 to October 16, 2010. Member associations’ presidents and representatives came from France (Dr. Serge Simonian), Toronto/Canada (Dr. Berge Artinian), New York (Dr. Lawrence Najarian), San Francisco (Drs. Jerry and Mariam Manoukian), Los Angeles (Mrs. Kohar Kesian and Dr. Varoosh Alaverdian). The Executive was represented by AMIC’s President, Dr. Avedis Bogosyan (Toronto), Dr. Antranik Benohanian (Montreal), Mr. Richard Elliott (Treasurer, Montreal), and Aida Boudjikanian (administrative director, Montreal). The presidents of the member associations of Washington D .C. and Great Britain were excused, being on mission in Armenia.
Besides the usual administrative reports, the International Medical Conference to be held in Armenia (July 7-9, 2011) and AMIC’s 11th Armenian Medical World Congress to be held in 2013 were on the agenda. The attendees all presented reports of their associations’ activities during 2010. Forthcoming issues of Info-Flash, as well as the minutes of the meeting, will present summaries of these reports.
III- The First Conference on Tobacco or Health in Armenia
During AMIC’s Tenth Armenian Medical World Congress held in New York in 2009, a group of physicians and public health professionals presented a petition to the Ministers of Health and Education and Science and to the Rector of the Yerevan State Medical University about the health hazards of tobacco addictions and the necessity to fight against its dangers. On May 31, 2010, the First Conference on Tobacco was organized in Armenia.
We present below reports and pictures of the event which united not only specialists but also students who organized public marches to explain directly to the public the dangers of tobacco use. The reports were sent to AMIC by Dr. Robert A. Bagramian. AMIC would like to thank him and Dr. Gevorg Yaghjyan, for their efforts.
First Conference on "Tobacco or Health" in Armenia
May 31, 2010
To celebrate the World "No Tobacco Day" the Yerevan State Medical University (YSMU) and the American University of Armenia (AUA) convened the first "Tobacco or Health" Conference in Armenia on May 31, 2010.
The Conference brought together medical and public health students, faculty, clinicians, public health professionals from Armenia and Diaspora as well as international experts to discuss the mounting evidence on health hazards of smoking and health professional’s responsibility in countering the smoking epidemic in Armenia. This event was organized within the framework of the Yerevan State Medical University 90th anniversary celebration.
The leaders of two universities Dr. Gohar Kyalyan and Dr. Haroutune Armenian made opening remarks, and the Chair of the Parliamentary Committee on Health Dr. Ara Babloyan and the Advisor to the Minister of Health Mr. Suren Krmoyan welcomed the participants of the Conference.
Dr. Kyalyan emphasized the vital role that health professionals play in delivering the truth about smoking addiction to the society as the number one preventable cause of death: "It is high time to start respecting ourselves and to be proud of being healthy…"
Dr. Armenian highlighted: "Twentieth century medicine had its major emphasis on prevention of diseases; 21st century medicine will be the century where we build health." He called the participants, medical students, physicians and other health professionals to quit smoking now: "You are our nation’s health leaders, therefore you cannot smoke."
The conference covered public health and policy aspects of tobacco use, benefits of smoke-free hospitals, emphasized the evidence that tobacco is a major risk factor for many deadly diseases and the need for smoking cessation interventions in Armenia. World renowned experts in tobacco control Dr. Frances Stillman, Co-Director of the Johns Hopkins Global Tobacco Control, and Dr. Gregory Connolly, Chair of the Division of Public Health Practice at the Harvard School of Public Health (video address) shared their experience with the conference participants and suggested ways to make smoking history in Armenia.
The Organizing Committee of the 1st "Tobacco or Health" Conference [which included professionals from YSMU, AUA, and the RA Ministry of Health] developed a conference resolution on future strategies for smoking prevention and control by health professionals emphasizing smoke-free hospitals, integration of tobacco control education in the medical curriculum, and endorsement of smoking cessation guidelines.
Student Walk Dedicated to the World "No Tobacco Day"
May 31, 2010
The Student Council of the American University of Armenia (AUA) in collaboration with the students from other Universities and volunteers of the Armenian Red Cross Society organized a student walk dedicated to the World "No Tobacco Day" on May 31, 2010.
The aim of the walk was to bring the tobacco epidemic to the attention of the society and health specialists, to raise awareness about the health hazards of smoking and tobacco control legislation, and to integrate youth in efforts to curb the tobacco epidemic in Armenia.
The participants of the walk met near Cascade and walked toward the Yerevan State Medical University where participants of the first conference on "Tobacco or Health" joined the event. Then the participants walked along Abovyan Street to the Republic Square where posters exclaiming "No Smoking" and "Clean Air" made from empty cigarette boxes were used as petitions to the general public not to smoke.
Leaflets about tobacco control legislation, the health hazards of smoking and second hand smoke were passed out during the walk and various activities, such as "flash mob" and exchange of cigarette packs with small gifts were utilized to draw the public’s attention to this urgent problem in Armenia.
Dr. Rochelle Parks-Yancy, an associate professor of management at Jesse H. Jones School of Business at Texas Southern University and Fulbright Fellow at AUA, shared her impressions from the walk: "I participated in the walk and was amazed at the level of organization, participation, and effectiveness of the event. AUA students were very proactive in approaching smokers to give up their cigarette packs in return for chocolate and, surprisingly, most smokers willingly relinquished their cancer-causing agents (packs of cigarettes). The use of flash mobs was well organized and generated a lot of publicity. I am quite impressed with the quality and enthusiasm of AUA's students and, especially, acknowledge the efforts of the Student Council to make this event a rousing success."
Pictures from the Student Walk
And from the Conference
IV- The American Austrian Foundation
Dr. Gevorg Yaghjyan sent the following news to Info-Flash. In previous issues, articles were written about the conferences and training sessions for Armenian health care professionals held in this American Austrian Foundation. It is useful and good to know that it is back functioning again, thanks in part to funds from Armenia.
SCHLOSS ARRENBERG REOPENS
Schloss
Arenberg April 2010
Armenia
Lounge
The American Austrian Foundation is delighted to announce that Schoss Arenberg
is up and running, better than ever!
In April 2009, a fire and the ensuing water damage completely destroyed the building, but in less than one year the "Salzburg Building Society" (GSWB) and its partners were able to rebuild Schloss Arenberg from the ground up.
The newly renovated Schloss has wireless LAN throughout the building and air conditioning in all the lecture halls. There is a new lounge on the top floor for fellows to congregate, known as the "Armenia Lounge," thanks to the funds raised in Armenia at a benefit concert organized by Dr. Bella Grigorian after the fire last May.
Special thanks to Ing. Heinrich Moslechner who supervised the entire project, managing up to 300 workers per day on the construction site, and Frau Mag. Maria Perndorfer and her team, who worked in containers on-site for nine months, while the Schloss was rebuilt. The first seminar took place at the end of March 2010.
V- Health Status and its Dynamics in Armenia
Tamara Toronyan Ph.D., the author of the following article is a researcher at the National Institute of Health in Armenia. She is one of ANSEF (Armenian National Science and Education Fund) 2010 Scientific Award winners and accepted graciously to publish this article written in the framework of the ANSEF program in an issue of Info-Flash.
Health Status and its Dynamics in Armenia
Unlike many other transition countries, social-economic factors have prevented the implementation of medical insurance and generated a decrease in subsidized health services and visits for medical services. This has led to an increase in illness’ length and chronic pathology.
Although there has been a sharp fall in timely referrals to physicians, this does not truly reflect the situation in which population morbidity has been increasing. (See Figure 1).
Figure 1. Morbidity of population and children at the age of 0 –14 years with the diagnosis set for the first time
Per 100 000 population and children.
Source: NSS, Statistical Yearbook of Armenia, 2008.
The overall birth rate from 1970 to 1990 was around 22 per 1000 population, but has since dropped to around 13 in 2008. Between 1990 and 2001, the birth rate sharply decreased while the overall death rate remained comparatively constant; however a certain increase can be noticed in the last few years. Thus, the overall rate of increase in the population has sharply fallen and as would be expected, the fertility rate has also declined.[1]
Table 1: Demographic change in population (per 1000 population)
|
Indicators |
1990 |
2000 |
2001 |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
|
Birth rate |
22,5 |
9,0 |
10,0 |
10,1 |
11,2 |
11,7 |
11,7 |
11,7 |
12,4 |
12,8 |
|
Death rate |
6,2 |
6,3 |
7,5 |
8,0 |
8,1 |
8.,0 |
8,2 |
8,5 |
8,3 |
8,5 |
|
Dem. Growth |
16,3 |
2,69 |
2,5 |
2,1 |
3,1 |
3,7 |
3,5 |
3,2 |
4,1 |
4,3 |
Source: National Statistical Service
Mortality indicators in Armenia should be treated with a degree of caution. There are significant differences between populations based surveys and official estimates. The official statistics recorded that the general mortality rate per 1000 increased and the natural growth rate of the population declined from 16,3 to 4,3 per 1000 in 2008.[2] The leading causes of premature death (under 65) in Armenia are, in order of magnitude, diseases of the circulatory system, cancer, external injuries and poisoning.[3]
Table 2. Trends in selected health status indicator
|
Indicators |
1990 |
2000 |
2004 |
2005 |
2006 |
2007 |
|
Life expectancy at birth, general population (years) |
70,7 |
72,5 |
73,4 |
73,5 |
73,3 |
73,4 |
|
Female life expectancy at birth (years) |
75,2 |
75,7 |
76,4 |
76,5 |
76,4 |
76,6 |
|
Male life expectancy at birth (years) |
68,4 |
70,9 |
70,3 |
70,3 |
70,0 |
70,2 |
|
MMR (per 100,000 live births) |
40,1 |
52,5 |
26,7 |
16,0 |
12,3 |
15,0 |
|
IMR(per 100,000 live births) |
23,8 |
15,6 |
11,6 |
12,3 |
13,8 |
12,3 |
Source: National Statistical Service
Although there is a discrepancy between the nationally-reported data, WHO estimated data, and data from various surveys, all sources testify to the declining trend in infant, child, and maternal mortality since 1990.[4] (See Table 2).
Official statistics recorded a decline in infant and maternal mortality. In 2007 433 deaths were recorded among children aged 0-1, and infant mortality rate was 10.9 compared to 18.5 per 1000 live births in 1990. Mortality rate among children under 5 was 12,3 per 1000 live births in 2007 as compared to 23,8 in 1990. These differences in child mortality might be explained by the impact of three major factors linked to poverty: access to affordable health care, mother’s education, and nutrition. The ratio of maternal mortality per 10000 live births was 15,0 compared to 40,1 in 1990.
Mortality has remained stable, except for maternal mortality. Early childhood mortality has declined over the past decade and compares well with other transition countries. The infant mortality rate (IMR) has increased slowly since 1995 while the maternal mortality rate (MMR) especially in 2000 has shot up to 52,5 per 100,000 live births compared with 34,7 in 1995 due to an increase in the number of unassisted home deliveries and abortions, however, since 2001 it has essentially decreased. Thus, the decreasing health status in case of the maternal health may therefore be the result of unhealthy behaviour and the inefficient health system could also play a significant role. The infant mortality factor was improving systematically and reached 11,6 cases per every 1,000 live births in 2004, to be compared with 23,8 cases per 1,000 live births in 1990.[5] (See Table 2). It was lower than the average for the CIS region (more than 13 cases per 1,000 live births), but much higher than the average for the EU Member States (5,25 cases per 1,000 live births).[6]
"Countries with comparable higher spending on health usually have higher or better life expectancy (LE) rates." This statement is often found in the literature. Higher health spending per capita is generally associated with higher life expectancy at birth while from time to time this relationship is less pronounced amongst countries with higher health spending per capita.
Life expectancy varies considerably across OECD countries and generally in 2006, in developed countries providing higher spending it was high: Switzerland (81,7), Iceland (81,2), France (80,9), Sweden (80,8), Norway (80,6), Canada (80,4), the Netherlands (79,8), and Germany (79,8).
All these countries had the highest per capita health spending and stayed above the OECD average. However, it shall be noted that the higher spending on health care does not necessarily prolong lives. There are some OECD countries devoting higher health spending: the United States spent more on health care than any other country in the world ($ US 6714 per person). Given their levels of health spending, Japan stands out as having relatively high life expectancy and the United States has relatively low life expectancy. Yet, average US life expectancy ranks 24th in the world (77,8 years). The highest life expectancy (82,4 years) is in Japan which spent $ US 2474 per capita or 36,8% of the US spending in 2006. High life expectancy in comparison to low health spending also had Australia (81,1), Spain (81,1) and Italy (80,9). A group of four countries - Turkey (71,6), Hungary (73,2), the Slovak Republic (74,3), and Poland (75,3) are at the other end of the line.
With considerably low public funding Armenia managed to ensure good health care indicators (in accordance with the European standards) compared to many countries in Europe and Central Asia (ECA). Life expectancy at birth has remained high, which was estimated at 70,2 for men and 76,6 for women during 2007. Both indicators were higher than those of 1990. While male life expectancy compares favourably with the European and Central Asia (ECA) countries’ average of 66,7 years, female life expectancy is similar to the regional average of 75,3 years.[7]
It is difficult to adequately explain the data, because from 1990 to 2006 the value of this indicator increased. During the Soviet era, Armenia had one of the best developed health care systems in the Soviet Union (SU).[8] Life expectancy, which in the early 1980s was the highest in the Soviet republics (73 years), fell in the early years after independence (71 years in 1991). Since the mid 1990s, this factor has been climbing steadily and reached 72,5 in 2000 and 73,4 in 2004. This was much higher than in Russia (65 years) or the average for the CIS region (67 years) and comparable to the average for the "new" EU Member States (74 years).[9] However, there was a period of economic collapse in the 1990s and economic crisis when the health status of the population logically should have decreased. This may relate to the lag associated with many outcome indicators. The economic collapse impacted health system outputs, but the outcomes from this may be distributed over longer periods of time, and may be felt to some extent in the future.
The top 30 OECD countries in the world plus Armenia ranked by life expectancy: comparing the health expenditure, many countries do better in terms of life expectancy than the US, with less than the half of the USA spending, the highest in the world.[10] With 73,4 years of life expectancy at birth, Armenia is ahead of Hungary (73,2 years of LE vs. $1504 PPP health spending) and Turkey (71,6 years of LE vs. $591 PPP health spending) with spending in total (both public and private) ($ US 253 PPP) per capita on health in 2005.[11] Life expectancy at birth has remained high in Armenia, which was estimated at 70,4 for men and 76,9 for women during 2008. In addition, it’s worth saying, that health status indicators reflect significant differences between rural and urban areas.
VI- What is AMIC?
The Armenian Medical International Committee (AMIC) was created 20 years ago. It is an umbrella organization that unites and promotes Armenian medical associations throughout the Diaspora, creating thus a large network through which information and data are exchanged.
AMIC organizes Armenian Medical Congresses. So far ten have been held in different cities of the Diaspora, the latest being the one held in New York from July 1 to July 4, 2009. In 2007, the "Second International Medical Congress of Armenia" organized by Armenia, was held in Yerevan (June 28 to June 30). The third one is to be held from July 7 to July 9, 2011.
Since 1998 AMIC has published an online newsletter which is sent free of charge to all Armenian Health Care Professionals. If you are a health care professional and are interested in receiving Info-Flash, please send us your email address (aida@amic.ca, or amic@amic.ca). To all those who already receive the Info, please do not forget to send us your new e-mail address when you change it. Info-Flash is posted on GROONG, but with a different format, and often with less data and graphics, due to GROONG’s rules. To receive it individually in full size and content, please contact AMIC’s office (aida@amic.ca, amic@amic.ca). For further information, visit our website: www.amic.ca
As of 2005, AMIC in collaboration with Regimedia, publishes a scientific journal, the "Armenian Medical Review". The fourth issue is out. To subscribe please visit www.amic-review.com
Useful information to remember: You can send medical equipment/medicine, free of charge from wherever you are located, through the services of the United Armenian Fund: Contact: U.A.F. President Mr. Harout Sassounian (sassoun@pacbell.net)