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14 The Armenian Reporter | December 13, 2008ArmeniaFrom Armenia, in briefArmenian intellectualssign an open letter toAbdullah GülOver three hundred Armenianwriters, journalists, composers,and academics from Armenia havesigned an open letter to Turkey’sPresident Abdullah Gül. The letterstates that while the normalizationof relations between Armenia andTurkey calls for brave and realisticsolutions, the Armenian Genocideremains a critical issue. The letterstates: “The Armenian Genocideis a crime against humanity andagainst the values of modern civilization,and no individual, organization,or even state authority hasthe power to question these events.We should all accept the fact thatOttoman Turkey is responsiblefor the genocidal crime againstArmenians, while today’s Turkishstate has inherited this responsibility.”The signatories of the letteracknowledge that Abdullah Gül’svisit to Armenia inspires hope thatthere is progress in Turkey. “Theseefforts, however may fail, if thestate does not take decisive stepstoward putting an end once and forall to its present policy of denyingthe Armenian Genocide,” the letterconcludes. The full text and listof signatories appears on www.reporter.am.fPresident pardonsthree people convictedfor March 1 eventsOn December 8, President SergeSargsian pardoned three peopleDecember 7, 198820 years onconvicted of participating in themass unrest in Yerevan on March 1.Edward Ashughyan, ArmanMargaryan, and SurenNazaryan, who were sentencedto three to three and a half yearsfor putting up resistance againstthe police and taking part in massdisturbances, were pardoned. Accordingto the president’s spokespersonSamvel Farmanyan,“While making the decision to signthe decree, the president took intoconsideration the applications ofamnesty by the mentioned convicts,the fact that they have notbeen convicted before, their criminalcase, and other family circumstances.The president of the republichas always been ready to studyamnesty applications. There areno changes in these approaches.”Thomas Hammarberg, theCouncil of Europe’s ParliamentaryAssembly’s human rights commissionerduring a visit to the countrylast month had said that the administrationshould free all those jailedLeft: Taxisprotesting inYerevan.Right:Conferenceon SuccessfulTechniques forthe Investigationand Prosecutionof Corruption.Photos:Photolure.on politically motivated charges orface the possibility of sanctions. fTaxi drivers take to thestreetsOn December 8, hundreds of taxidrivers staged a protest in downtownYerevan in front of the governmentbuilding on RepublicSquare. They were protesting newrequirements approved by thegovernment in March 2007, whichcalled for stricter licensing andtaxation rules. Another stipulation,which has frustrated primarily independenttaxi drivers, is that allcars operating as taxis cannot bemore than 10 years old. All taxis areto have electronic fee meters andpay an annual state duty of 200,000AMD (approximately $650) in additionto their regular revenue tax.Similar protests took place inJuly of last year, which forced thegovernment to delay enforcementof the new regulations until afterFebruary 2008.According to RFE/RL one of thedrivers said, “If our demands arenot met today, we are ready to goon a hunger strike. Or else, ourchildren will go hungry.”Government officials have saidthat they will not ensure enforcementof the law till after January15 and will continue negotiationswith the taxi drivers including simplifyingtaxation procedures for independentcab drivers. fU.S. Department ofJustice organizescorruption conferencein YerevanA conference titled SuccessfulTechniques for the Investigationand Prosecution of Corruptionkicked off in Yerevan on December8 with the participation ofArmenian and U.S. law enforcementbodies. The two day conferencewas organized by the UnitedStates Department of Justice.Speaking at the conference,U.S. ambassador to ArmeniaMarie Yovanovich emphasizedthe necessity to increase publicconfidence in law enforcementbodies. According to Mediamax,Ambassador Yovanovich alsonoted that the main danger isthe overriding perception in Armeniathat corruption in societyis a given.According to Armenpress, U.S.and Armenian law enforcementofficials spoke about their respectiveapproaches to fighting allforms of corruption, includingmisconduct by police, judges, andother high ranking officials. Techniques,including the use of confidentialinformants, undercoverpolice officers, drug screening,financial investigations, and electronicsurveillance were discussed.The ambassador also stated thatthe U.S. government will assistin every possible way to help Armenianauthorities fight corruption.fArmenia commemorates 20th anniversary of earthquaken Continued from page On Sunday morning, a specialchurch service in Gyumri attendedby Karekin II, Catholicos of All Armenians,and broadcast live acrossthe republic, was attended by PresidentSerge Sargsian and NikolayRyzhkov. Mr. Ryzhkov, thepremier of the Soviet Union at thetime of the earthquake, had personallyoverseen initial rescue andrelief efforts. During the service amoment of silence was observedat the exact time the earthquakestruck, 11:41 a.m.After the service, the presidentand the Catholicos led a processionto the nearby site of a newmemorial in honor of the victimsof the earthquake. Joining themat this time was former PresidentRobert Kocharian. Mr. Sargsianmade a speech in which hethanked all those who came tothe aid of Armenia during thosedifficult days. He also promisedthat by 2013, every last person lefthomeless by the earthquake wouldreceive a home.Mr. Ryzhkov read a messagefrom Russian President DimitriMedvedev: “We bow our heads beforethe memory of the thousandsof victims of this natural disaster.We remember with deep respectand gratitude today the courage ofSquare in Spitak named after Ukrainian politicianVictor Yanukovich. Photo: Photolure.Victor Yanukovich, formerprime minister of Ukraine andcurrent leader of Ukraine’s mainopposition party, was in Armeniato commemorate the 20thanniversary of the 1988 Spitakearthquake. Mr. Yanukovich hadtaken an active role in the reconstructionefforts in the earthquakezone from 1988 to 1989,when he was sent there by theSoviet government. At the timehe was the head of a constructioncompany.A square in the town of Spitakwas named after Victor Yanukovich.Armenian officials and manyothers took part in the official ceremonies.“ I have come to bow to this longsufferingland and the Armenianpeople,” Yanukovich told RFE/RL.“I haven’t forgotten anything. Iremember how people cried forhelp in clearing the rubble andrescuing people trapped there. Iremember seeing a crane operatordying of a heart attack after noticinga woman who shielded her twochildren with her body,” he said.While in the earthquake zone,Mr. Yanukovich also went to Gyumriwhere he laid flowers at thememorial to the earthquake victimsand said a prayer in a localchurch. Later that day, he had aprivate meeting with PresidentSerge Sargsian.fSpecial churchservices forthe 20thanniversary ofthe earthquakepresided overby Karekin II,Catholicos of AllArmenians inGyumri. Photo:Photolure.the rescuers who answered the callfor help. In this hour of difficultyRussia quickly extended a helpinghand to Armenia, made its contributionto the rescue operationArmenian PM pledges changesWhile taking part in commemorationceremonies for the20th anniversary of the Spitakearthquake, Armenia’s PrimeMinister Tigran Sarkisiansaid that the government islooking into plans to turn Gyumriand Spitak into free economiczones. He said that thiswill create extra stimulus forthe development of the shatteredeconomies in the earthquakezone. The prime ministeralso promised that housingissues for the homeless wouldbe resolved in the next fewyears.According to Arminfo, Mr.Sarkisian said that 4,883 newand recovery work. It is cause forgratitude that the memory of thisis carefully preserved by the Armenianpeople.”Earlier in the week, Mr. Ryzhkov,who is a member of Russia’sFederation Council and co-chair ofthe Armenia-Russian committeeon interparliamentary cooperation,was named a National Hero of Armenia.On the occasion of the 20th anniversary,messages and lettersof sympathy were received fromworld leaders, including U.S. PresidentGeorge W. Bush.Similar commemoration ceremoniestook place in Vanadzor,another city damaged by the earthquake.Taking part in the commemorationwas former Georgianleader Jumber Patiashvili, aswell as builders and rescuers fromRussia and Ukraine who had takenpart in the reconstruction effortsin the years immediately followingthe earthquake.fapartments and houses will bebuilt by 2013. It is foreseen that2,300 apartments in Gyumri, inthe Ani and Mush districts; 182apartments in Akhuryan villageof Shirak; 354 apartments in Spitak;and 1,821 houses in the Loriregion will be built. The budgetalso include 49 apartments inStepanavan.Between 1998 and 2006 over20,000 families either receivednew apartments or had theirexisting homes improved; 5,914received apartments throughthe program of issues housingcertificates. Many schools,health and cultural centers wererestored.f
The Armenian Reporter | December 13, 2008 15ArmeniaIncurable forms of TB are a global challengeby Maria TitizianYEREVAN – In a jarring articledatelined Yerevan, December 7,New York Times columnist NicholasD. Kristof sounded the alarmabout a potential worldwide publichealthdisaster, the quick spread ofextensively drug-resistant tuberculosis(XDR TB).The article, “A Killer without Borders,”focuses on a young man withthe disease, and notes that by ridingcrowded public transportation,he exposes dozens of people to XDRTB every day. The man happens tolive in Armenia. Mr. Kristof’s pointis that he could be anywhere.Only a fraction of people exposedto TB actually develop the disease.People with weak immune systemsare especially vulnerable.How the healthcare system andpublic-health officials of any countryhandle tuberculosis effects the situationin the country and beyond.Armenian public-health authoritieshave been grappling with TBfor a long time. Indeed, childrenhave been given a mandatory vaccineagainst TB, the BCG vaccine,since Soviet times. There are signsthat the authorities are now steppingup their efforts, with the supportof Médecins Sans FrontièresFrance (MSF), the Global Fund, theInternational Committee of theRed Cross, and others.Infection, treatmentThe World Health Organizationestimates that one-third of theworld’s population is infected withlatent TB bacteria. TB is spreadthrough the air when a personwith active TB disease of the lungsor throat coughs or sneezes. Thesun quickly kills the bacteria, butin confined spaces, people nearbymay breathe in live bacteria and becomeinfected.According to the U.S. Centers forDisease Control, in most peoplewho breathe in TB bacteria and becomeinfected, the body is able tofight the bacteria to stop them fromgrowing. The bacteria become inactive.The person has no symptomsand cannot spread TB to others.But the bacteria remain alive inthe body and can become activelater – if the body’s immune systemcannot stop them. People withHIV, the virus that causes AIDS, andothers with weak immune systemsare at particular risk of developingtuberculosis.If active TB disease is detectedearly and fully treated with a courseof four standard, or first-line, anti-TB drugs, most people with the diseasequickly become noninfectiousand are eventually cured.But if they are infected with amultiple-drug-resistant strain ofTB (MDR TB), treatment becomesmuch more difficult. If they areinfected with XDR TB, which is resistantto first-line and second-linedrugs, they are left with treatmentoptions that are much less effective.Patients with active TB diseasewhose treatment is mismanagedcan develop MDR TB.Public-health challengeThe public-health challenge is tocontain MDR TB and XDR TB, and tomake sure that regular TB cases aremanaged properly.Gayane Ghougasyan, programcoordinator for communicable diseasesat the World Health Organization’soffice in Armenia, told theArmenian Reporter that several governmentinitiatives seek to tacklethis public-health challenge.Primary healthcare providersare familiar with the symptoms oftuberculosis and are able to referpatients to free treatment centers.A national TB dispensary has beenestablished in the city of Abovian,not far from the capital. Anotherdispensary has been established inYerevan. Regional hospitals haveTB units.Patients receive in-patient treatmentuntil they test negative foractive TB infection, which usuallytakes two months. They must thencontinue to take anti-TB drugs foranother four months.Because a failure to complete thecourse of treatment can lead to drugresistance, physicians are responsiblefor administering the drugsto outpatients every day, which canbe a formidable challenge.But Christian Ferrier, head ofmission of Médecins Sans FrontièresFrance (MSF), the medicalcharity, told the Armenian Reporterin an interview that primaryhealthcare providers do not alwaysknow what steps to take whenfaced with a TB case. Patients mayget incomplete treatment, or maybe treated with second-line drugs,increasing the danger that they willdevelop a drug-resistant infection.He said the Ministry of Health hasto tackle this problem with greaterenergy.Drug-resistant casesMDR TB cases are referred to MSF,which is implementing a pilotproject in two districts of Yerevan,Malatia-Sebastia and Shengavit.Mr. Ferrier said MSF has a contractwith the government to expand theproject, but implementation awaitsthe resolution of practical issueslike who is going to pay for hospitalfurniture.Mr. Ferrier said MSF has beentreating 170 MDR TB patients. Accordingto Ms. Ghougasyan, thepatients under MSF’s care accountfor about 15 percent of people withactive MDR TB in Armenia.Varduhi Petrosyan, associatedean of the College of Health Sciencesand director of the Centerfor Health Services Research andDevelopment at the American Universityof Armenia (AUA) told theArmenian Reporter in an interviewthat prisoners account for a significantportion of the populationwith active TB disease. With the assistanceof several international organizations,a program was implementedto control the spread of thedisease among the prison population.“We had amazingly positiveCause for concernA recent WHO report, Anti-TuberculosisDrug Resistance in theWorld, which is based on informationcollected between 2002and 2006 on 90,000 TB patientsin 81 countries found that XDRTB has been recorded in 45 countries.Based on this survey, WHOestimates that there are nearlyhalf a million new cases of MDRTB, or about 5 percent of all newglobal TB cases (approximately 9million). The highest rate was recordedin Baku, Azerbaijan, wherenearly a quarter of all new TB cases(22.3 percent) were reported asMDR TB. The highest incidences ofMDR TB among new TB cases: 19.4percent in Moldova; 16 percent inDonetsk in Ukraine; 15 percent inTomsk Oblast in the Russian Federation;and 14.8 percent in Tashkentin Uzbekistan. These ratessurpass the highest levels of drugresistance published in the lastWHO report in 2004. The situationis also widespread in China. fresults,” Dr. Petrosyan said. “Thisshows that we can make changes.”Treatment of MDR TB involves anextended period of inpatient care– often six months – followed by twoyears of continued daily drug treatment.Ms. Petrosyan said the treatmentcosts over $50,000 per person.Based on the MSF pilot project,Mr. Ferrier said it is important toindividualize treatment, based onthe patient’s response to variousdrugs, side effects, other ailments,and similar considerations. He saidthe Ministry of Health needs todevelop firm yet flexible guidelines.“The attitude of healthcare providersin Armenia is that they can onlydo what is explicitly allowed,” hesaid. “Our attitude is that we cando whatever is not forbidden. Wecome across new challenges everyday, and physicians need to be creativein their solutions.”The National TB Program, underthe auspices of the Ministry ofHealth, declined repeated requestsfor an interview. However, the programis hosting a two-day conferencefor journalists on December13–14 as part of an effort to get theword out about TB.Indeed, Dr. Petrosyan said fearand stigma attached to TB areamong the factors that contributeto inadequate treatment. “TB inArmenian society carries a hugeMédecins Sans Frontières FranceMSF France has been working inArmenia since the earthquake 20years ago. Since 2004, it has focusedexclusively on tuberculosis.“We started our program in 2004with a pilot project,” head of missionChristian Ferrier said in aninterview. “This project had twocomponents – an institutionalcomponent to organize a goodsystem, a decentralized system toimprove the quality of the diagnosisand the detection of TB patients,all the TB patients, but wewere focusing on the treatment ofthe MDR TB patients.“The Ministry of Health and theauthorities were not able to treatTB patients at the beginning ofthe program. Therefore we treatedregular TB patients. From 2005,the Ministry of Health receivedstigma. Even health providers areafraid of patients with TB,” shesaid.An intensive effortAn important contribution mightbe a public awareness campaignto help people and health providersbetter understand the disease.“We need to understand that TB iscurable if managed properly,” Dr.Petrosyan added.In October, a conference broughttogether all the major stakeholdersin the fight against tuberculosis inArmenia. They included Armenia’sMinistry of Health, its NationalTB Program, the Global Fund, MSFFrance, the International Committeeof the Red Cross (ICRC), andothers.The conference considered astudy carried out by the AmericanUniversity of Armenia on behalf ofthe ICRC. The study will be releasedin January, Dr. Petrosyan said.A five-year grant from the GlobalFund supports TB treatment in Armenia.A second grant, under consideration,would build on that supportstarting in 2009. Mr. Ferrier saidthat the fund’s Green Light Committeehas set forth certain criteria; ifArmenia’s healthcare system meetsthose criteria, anti-TB drugs will becomeavailable to Armenia at about aquarter of the market cost. fsupport from the Global Fundand they also received supportfrom the ICRC and German bilateralcooperation. From 2005, theauthorities have had the means totreat regular TB patients. So fromthis point on we focused only onMDR TB patients,” he said.Today, MSF France is treating170 MDR TB patients in Armenia.Mr. Ferrier said 7.7 percentof their patients have been diagnosedwith XDR TB.MSF relies on volunteers, whotypically go on missions lastingan average of six months. Mr. Ferriersaid the organization does nottake money from governments; itwelcomes private contributions,however.fhttp://www.msf.org/Vic Darchinian visits Gyumri on 20thanniversary of earthquakeWBC, WBA, and IBF world boxingchampion Vic Darchinian tookpart in the 20th anniversary commemorationsof the 1988 SpitakEarthquake. While in Gyumri, Mr.Darchinian visited the Hope Children’sHouse where he passed outgifts he had brought for the children.According to Armenpress,the world famous boxer said, “AlthoughI have a big fight comingup, I felt I had to be here to honorthe memory of the victims of theearthquake. I am happy that I’mhere at the children’s house andcan communicate with the childrenmore closely.”The Hope Children’s Houseopened its doors in 2000 forhomeless orphans, beggars andabandoned children. The centernamed after Frederich Nansen ishome to 69 children. While thehouse struggles to keep operating,the director Rubik Markosian saidthat all these can be resolved.Vic Darchinian Photo: Photolure.“If you are not alone and thereare people by you, the difficultiesare possible to overcome.The only unsolved issue is theemployment of children of thehouse in future,” the directersaid.f
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