Introduction

The Republic of Armenia declared its independence from Soviet rule in 1991. However, the healthcare system continued to operate based on Soviet system, with no effective preventive healthcare for oncological diseases. Breast cancer had grown to endemic proportions, often detected at advanced stages when treatment was not possible. According to Armenia’s Ministry of Health statistics, breast cancer was and still remains the #1 cause of cancer deaths among women in Armenia, followed by cervical cancer, because early detection methods and mechanisms did not exist. On the other hand, the radical mastectomies were often performed for non-malignant tumors.  

In April 1997, in response to this crisis, Rita Balian, President of the   Armenian American Cultural Association (AACA Inc., USA), organized the First Medical Mission to Armenia, and together with Hranush Hakobian, then the Minister of Social Welfare and presently, the Minister of Diaspora Relations, established the Armenian American Wellness Center (AAWC or Wellness Center), and registered it as the first Non-Profit Organization (“Foundation”) in the country. Its Mission was “To Save, Prolong and Improve the Lives of Women/Mothers through the early and accurate detection of the diseases and to provide recommendations for appropriate treatment”.

U.S. Assistance Program

started in 2000, at the recommendation of the U.S. Ambassador in Armenia then, Amb. Peter Tomsen, for the Humanitarian Assistance Program within the State Department, to allocate a three year assistance program to AAWC, through its U.S. founding organization, the AACA.

In 2002, in recognition and appreciation of the impact that the Wellness Center had already made on women’s health care in the country, the Armenian Government, through a Special Presidential decree, donated to the Armenian American Wellness Center “Foundation” the entire Soviet era old building.

In 2004, USAID-ASHA (American Schools and Hospitals Abroad) joined the efforts of AACA and its Donors throughout the USA to reconstruct, renovate, expand and seismically reinforce, the old building into its present day 6-story modern medical facility, using Armenian architectural designs and American engineering expertise. Since then USAID-ASHA has become a partner in the investment of the center to procure western technology to provide quality healthcare and expertise based on American practices and standards.

The architectural plans were conceived and coordinated by Armenian American architect engineer, Vartkess Balian, one of very successful builders in the Metropolitan Washington DC area. His tremendous efforts on sight and follow through from the USA, made every set of AAWC related architectural-constructional plans a well thought out and functional.

Ecologically Clean and Renewable Energy

In 2006, the Armenian American Wellness Center was the first of the 16 NIS countries to have integrated 10 kiloWatt PV (Photo Voltaic) roof grid-connected solar power plant station.

In 2008, another energy producing system called Combined Heat and Power (CHP) was installed at the center to provide additional 120kW to help the center’s electrical needs for lighting as well as running the most western advanced medical equipment.

AAWC uses western technology and expertise based on American practices and standards. AAWC now has a state-of-the-art medical facility and has grown to include Nine (10) Departments:

1) Breast Screening & Diagnosis (Est. April 1997)

2) Gynecology (Est. June 2001)

3) Pathology Lab for Cytology & Histology (Est. June 2001)

4) Family Medicine, Endocrinology, & Dermatology (Est. July 2003)

5) Pharmacy and Hematology Lab (Est. July 2010)

6) Urology & Prostate Cancer Screening, diagnoses & treatment (Est. Sept. 2011)

7) Dental Clinic: Two Dental Clinics & a Lab (Est. May 2013)

8) Ambulatory Outpatient Surgery (Est. May 2013)

9) Diagnostic Imaging: CT-Scanner & Digital X-Ray (Est. Dec. 2015)

Also, Osteoporosis Screening (DEXA Unit) (Est. Dec. 2006)

10) Orthopedic Department ()Est. Jan. 2016)

The AAWC staff has 106 medical and administrative staff members of which 72 are women. Of the 106 staff members, 34 are medical professionals and 24 are women as AAWC and AACA believe in the empowerment of women.

Daily, 160 to 200 patients visit the Wellness Center to receive the highest quality healthcare services.

Public Education and Annual Health Walks

AACA has trained AAWC to organize lectures at public gatherings and yearly health walks every October in observance of Breast Cancer Awareness Month. Through these public events, AAWC revolutionized the old mentality of Armenian mothers who traditionally prioritized the health of their families before their own, by conveying the message of taking care of their own healthcare first, and enabling the mothers to keep their families strong and healthy. Health walks are led by the US Ambassador of Armenia, AAWC co-founders, the Minister of Health, as well as 3000 health walk participants.

Results: Today, AAWC is a regional medical facility with the state-of-the-art technology and trained professionals during 96 medical exchanges to receive training on site in Armenia, USA and Europe that provides effective preventive and precise medical care to the needed population Armenia through its 9 departments AAWC provides quality healthcare to women and their families.        

Established in 1997, Breast Screening and Diagnosis Department is equipped with:

• Two 3D digital Mammography systems were installed in March, 2012, representing the latest technology called Selenia Dimensions (3D) Tomosynthesis System
• APLIO 500 and Xario 200 Ultrasound Units/Machines were installed in 2015 and 2016 for breast, thyroid,  and abdominal screening and diagnosis

Through early screening, public education on the importance of early and accurate detection, the Wellness Center aims to detect cancers at earlier stages and reduce the number of breast cancer deaths. The Breast Screening & Diagnosis Program currently screens 80-100 patients per day and up to 130 patients per day during Breast Cancer Awareness Month in October.

The establishment of the Gynecology Department in 2001 opened a new chapter not only at the Wellness Center, but also in Armenia – addressing the importance of annual Pap smears for early detection of cervical cancer and precancerous lesions, as well as diagnosis and treatment of sexually transmitted diseases, infertility caused by chronic infections, family planning through education and counseling, and addressing menopausal issues. Routine cervical cancer screening wasn’t widely available in Armenia prior to 2001.  The Center is also taking a great pride in the birth of 176 “Miracle Babies” born to couples who had struggled with infertility for 4-12 years. 

A Pathology laboratory was established in June 2001 for the study of cytology and histology tests and diagnosis. Cytology lab was needed to study the cells of Pap smears wither cancerous or benign and histology was needed for breast cancer tissue analysis. In December 2016, Pathology laboratory has been totally enriched by new equipment. histology laboratory was  modernized and restarted-up. The laboratory was then furnished with the latest equipment and procedural systems.

Family Medicine and Endocrinology and Dermatology were introduced by three American doctors of Armenian origin who kept on flying from California and metropolitan Washington DC area to train the doctors until today.

At the entrance of the building in-house Pharmacy and Hematology Laboratory are conveniently located.  The Pharmacy is operated by a full-time pharmacist and ensures accessibility not only to the Center’s patients, but also to the entire neighborhood as well as the Hematology lab for the testing of blood.

Urology and Prostate Cancer screening and treatment department was founded in September 2011 by American doctors of Armenian origin. The Wellness Center is the first medical facility to start a Prostate Cancer Screening Program in Armenia. Based on the statistical data, in recent years the incidence of prostatic gland and urinary bladder carcinomas have increased among Armenian men.

Dental Health with two dental clinics and a lab was established in May 2013 with the most modern dental equipment from Germany. It was established under the recommendation and assistance of George Washington University’s emeritus professor of immunology, Dr. Julia Albright. She emphasized that recent research has shown the direct correlation of dental health with heart health, breast cancer, pancreatic cancer, and arthritic diseases.

Ambulatory Outpatient Surgery was also established in May 2013 for Lumpectomy, Mastectomy, Mastectomy with Breast Reconstruction and Nipple Sparing techniques as well for Gynecologic, Urologic, Orthopedic and Plastic surgeries and procedures. Daily between 5 to 9 surgeries are taking place and patients are sent home maximum within 24 hours with very few exceptions to keep them another day.

The Diagnostic Imaging 9th Department was established in December 2015 with the installation of two very advanced digital units.

The first one was a Ct-Scanner (Toshiba Aquilion Lightning) which reduces radiation exposure to the patient up to 75%- 80%. The second unit was a Digital X-Ray unit (Toshiba Raffine) with a rotating arm that provides patients with complex, precise and comprehensive examinations without inconveniencing the patient to move in different positions.

However, the first Diagnostic Imaging unit for Osteoporosis Screening (DEXA Unit from Hologic Corp) was installed in December 2006 with the efforts of Rita Balian being the first to introduce it in Armenia.

Additionally, Discovery Upgrade System was added on the DEXA unit to enable the screening of the entire vertebra from neck bone all the way to coccyx bone. In the same year, FRAX program was also added to the system to help to prevent bone fractures in terms of identifying and assessing a 10-year risk of major osteoporosis-related fractures.

The Wellness Center was the first Medical Center to educate Armenian population about the importance of undergoing Bone Density examination in order to avoid potential bone fractures and pain.

Multipurpose Conference Hall with 250 seat capacity located on the 5th floor is suitable for scientific and medical conferences, meetings, seminars and live surgery presentations. Rental income is invested in providing free of charge examinations to the women from low income families.

Doctor's Cafe, constructed according to Western and European standards, completed at the end of 2015 and opened in January 2016. It has become one of the most popular locations for healthy lunch for AAWC staff, Medical University students and doctors from nearby Medical Clinics.

In Summary, the Wellness Center is equipped with the latest and most advanced Western medical technological systems, including:

• Two Selenia Dimensions 3D Tomosynthesis systems (3D Digital Mammography system) from Hologic Corporation
• DEXA Unit for Osteoporosis Screening with Discovery System and FRAX Upgrade (from England)
• APLIO 500 and Xario 200 Ultrasound Machines each with necessary three probes for breast, thyroid,  and abdominal screening and diagnosis
• BK Medical Ultrasound Unit with necessary probes for Urologic examination
• Newly installed CT-scanner (Toshiba Aquilion Lightning) with significantly reduced radiation exposure to the patient
• Newly installed Digital X-ray Machine (Toshiba Raffine) which has  a rotating arm                                      

Since 1998, the Wellness Center has been involved in organizing Outreach Medical Missions in 88 remote towns and villages, including 333 Missions in Armenia and 5 Medical Missions in Artsakh (Karabakh) to provide free-of-charge medical services, as well as ultrasound screenings using the latest portable systems for breast, abdominal, and osteoporosis screenings. 

For the past 20 years, from April 1997 through December 2017, the AAWC achieved tremendous success and accomplishments, resulting in:

160 to 200 - Patients visit the Center Daily

7,779 - Patients lives saved

417,498 - Patients served

530,254 - Medical services provided

272,647 - Breast Cancer Screenings & Diagnosis provided

150,907 - Gynecological services provided

176 - Miracle Babies born since 2004

30,447 - Family Medicine services provided

2,559 - Male patients received Urology services

22,036 - Patients served during Medical Outreach Missions

4,298 - Patients received surgeries

5,087 - CT-Scan & X-Ray Imaging and Diagnosis provided

51,285 - Cytological and histological services provided

3,125 - Dental services provided

The role of AAWC, as a Unique Medical Center in Armenia, is vital for accurate diagnostication of the diseases, their timely treatment, and utilization of successful preventive healthcare to the Armenian population. Advanced and new technologies will allow AAWC to further provide patients with the highest and most efficient level of medical services.

The secret of the Success of the Wellness Center is due to its 92 dedicated, well-trained and honest medical and administrative staff members who perform their duties with high integrity and strong work ethics, and due to a well-defined instruction and coordination of all departments, aimed to provide high quality healthcare services to their patients.

Conclusion

Today, the AAWC is a Primary Healthcare Medical Facility that has introduced Preventive Healthcare in Armenia for early and accurate detection of diseases. The introduction and implementation of preventive healthcare has made a profound difference in the lives of many thousands of women and men, and their families in Armenia. Through its advanced technology and well trained medical personnel, the AAWC will continue to provide patients with the highest level of medical and preventive care. The Wellness Center is truly A SUCCESS STORY, and its role as a unique medical center in Armenia is vital in creating a Healthier Nation in Armenia.

“Each time we save a mother, we save her entire family, her community, and thus, her Nation” – Rita Balian, President & Founder, AACA-AAWC.