After having spent about 5 months in Armenia last year, I returned in June to continue interning for World Vision NGO. This time my placement was in Talin, a small town about an hour NW of Yerevan. Despite having been in Armenia before, I was really anxious prior to coming. I guess I was mostly concerned about what my homestay family would be like, and how I would manage to exercise in Talin. Armed with my travel friendly resistance bands and jump rope, I was greeted in Talin by a great family with 2 girls around my age. I was off to a good start.
My work with World Vision consists largely of preparing, conducting and assessing public health trainings with mother support groups in the various villages around Talin (and occasionally with kids at summer camps). We cover topics ranging from diabetes to proper breastfeeding practices. The way I see it, the active mothers in the group serve as the internet for their community; they have those answers that you would have asked Google. We have one village that truly deserves a gold medal, as it has gone above and beyond and we have seen real changes in health indicators. Much of this can be accredited to a very passionate mother with a commanding presence. However, the success of this program has varied from village to village and has at times caused me much frustration.
Upon investigating why we aren’t seeing that level of success across the board, it becomes clear that the situation is a complex one. However, that being said, the biggest barrier has been the Armenian tendency to only deal with something once it is no longer unavoidable, aka inadequate, if not the entire absence of prevention. My guesstimate is that 80% of health issues here are completely preventable; and that is painful to see. In a country where the financial situation for the majority greatly inhibits access to “new” information and tends to promote putting off a visit to the doctor until it is a matter of life or death, one would think that the majority would be eager to take advantage of our program. Discouragingly, we find that without using gifts as bait, we often have trouble getting the desired participation rates.
Although there are many mini-success stories, it is the challenges that have had the largest impact on me; they have led me to think more “big-picture”. It has been the impetus to my decision to add a law degree to my plans to pursue a degree in public health. It has helped me realize that sustainable change requires changes in policy and changes in what the government considers a priority. I am not anti-small scale work by any means, and as I said we have had some great successes, but it isn’t enough; necessary but not sufficient.