STEPANAKERT, NKR–As the world commemorates the 22nd anniversary of the independence of Nagorno Karabagh Republic (NKR), the population of Karabagh is still reeling from the ongoing social impact of the war two decades ago. The cumulative health burden of the conflict has implications that are far-reaching and pervasive.
In September 2013, Armenian-American surgeons Dr. Hratch Karamanoukian and Dr. Raffy Karamanoukian conducted a surgical mission to strengthen ties with the medical and surgical staff at the Central Republican Hospital in Stepanakert, the capital of Karabagh. Their trip coincided with the opening of the new Central Republican Hospital within the city.
“One of the most salient impressions we experienced was the ongoing impact of the war on daily life,” said plastic surgeon Raffy Karamanoukian. “Our meetings with surgeons and patients reminded us of the enormous physical and psychological burdens the conflict had on the population. In turn, we appreciated the enormous resiliency of the Karabagh population to return to normal life.”
During the surgical mission, both doctors met with Chief of Plastic Surgery Dr. Igor Zakharyan to discuss challenging case reports in the United States and Karabagh, as well as current techniques in microsurgical reconstruction, limb salvage procedures, and trauma surgery. Hratch Karamanoukian, a cardiovascular and vein surgeon, provided important dialogue on trauma protocol and cardiovascular surgery.
Of special significance was a discussion regarding ongoing efforts by the Halo Trust to clear landmines. According to a report by the Halo Trust, Karabagh has one of the world’s highest per capita rates of accidents caused by mines, cluster munitions, and other explosive remnants of war. A case report presented by Zakharyan, a skilled microsurgeon, demonstrated a successful limb salvage of an adult male who sustained traumatic upper extremity injury as a result of a landmine. The medical and trauma team at the Central Republican Hospital administered limb-saving resuscitation of the individual.
With the opening of the new Central Republican Hospital, the surgical trauma team will be better equipped to administer trauma care to patients in acute settings. Discussions with the anesthesia, nursing, and post-surgical teams demonstrated unparalleled professionalism and work ethic supported by highly trained staff. According to Deputy Minister of Health Dr. Karen Ghukasyan, the new hospital has been equipped with state-of-the-art diagnostic and surgical equipment from the U.S. and Europe.
The surgeons also participated in the care of patients with ongoing problems resulting from post-traumatic amputation. Many of the patients were highly functional war veterans who sustained limb amputation as a result of war. “The population of Karabagh made extreme sacrifices with a heavy loss of life,” said Hratch Karamanoukian. “They, however, have an indomitable spirit and resiliency that allows them to flourish and rebuild, despite hardship.”