BMJ  2004;329:562-565 (4 September), doi:10.1136/bmj.329.7465.562

Education and debate

Understanding health care in the south Caucasus: examples from Armenia

Tido von Schoen-Angerer, head of mission1

1 Médecins Sans Frontières, Manushyan St 48, 375012 Yerevan, Armenia

Correspondence to: T von Schoen-Angerer, Médecins Sans Frontières, Am Köllnischen Park 1, 10179 Berlin, Germany tavschoen@yahoo.com

Along with sociopolitical and economic problems, the medical poverty trap in the south Caucasus region exacerbates its health problems

The first 150 words of the full text of this article appear below.

Introduction

Health care in the south Caucasus has suffered as a result of the socioeconomic decline that followed the collapse of the Soviet Union and the ensuing—still unresolved—conflicts between Armenia and Azerbaijan over Nagorno-Kharabakh and between Georgia and its breakaway republics Abkhazia and South Ossetia. As in most parts of the former Soviet Union, these places have increasing cardiovascular mortality, a high burden of mental illness, and spreading infectious diseases such as tuberculosis, sexually transmitted infections, and HIV.1 2 However, the widespread underreporting in dysfunctional and collapsing health systems leaves considerable uncertainty about actual figures.3

Collapse of healthcare services

Access to health care and the role of the state as healthcare provider are open questions in the south Caucasus. Instead of questioning and contributing funding to the extremely low government health budget of about US$10 (£5.4; {euro}8.1) per capita—as low as in many sub-Saharan countries in Africa2—the World Bank has explicitly encouraged health reform that . . . [Full text of this article]

Approach to medicine and public health

Sexually transmitted infections

Slow steps forward in psychiatry

Conclusions


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