By Cynthia Bosnian

In eight months of operation, Yerevan’s Wellness Center has performed close to 500 screenings

Yerevan -- As part of its 9th Medical Mission to Armenia, the U.S.-based Armenian American Cultural Association (AACA) installed the first DEXA machine in Armenia at Yerevan’s Armenian American Wellness Center last October. After eight months of operation, the unit is on the verge of performing its 500th screening – and thereby helping advance a quiet revolution in healthcare for the city’s women. The DEXA apparatus (the acronym stands for dual-energy x-ray absorptiometry) is the established standard for measuring bone mineral density. Generously donated by Hologic, Inc., of Bedford, Mass., the $50,000 state-of-the-art unit represents a breakthrough for osteoporosis detection in the Republic of Armenia. The non-invasive, digital DEXA unit is the latest in a series of cutting-edge medical appliances that the Wellness Center has received and installed through the generosity of individuals and companies in the U.S. and Europe. Through its nine Medical Missions and 44 medical exchanges over the past 10 years, AACA has brought Western-style technology and training to the doctors, nurses, and staff at the Wellness Center. Rita Balian, president and founder of the Wellness Center (AAWC), led the 9th mission. The DEXA unit donation, installation, and subsequent training was led by Larry Mowat, R.T., Hologic’s Senior Applications Specialist, who is also a member of the AAWC U.S. Medical Advisory Board. Mowat has been instrumental in the Wellness Center’s history since its opening in April 1997. Participating in the first Medical Mission, he organized the donation of and training on two mammography units and other equipment, including an ultrasound machine. During several follow-up trips to Armenia, he established quality control (QC) standards through which all the center’s imaging equipment and film supplies would be evaluated daily. Once a month, the center sends all of its evaluation reports as well as its test films to Mowat for QC standard assessment.

* Help from an unexpected source

The challenges facing the DEXA project were significant – there were technical as well as educational barriers to be overcome. To train a Yerevan-based biomedical engineer for the installation would have cost upwards of $10,000 (including travel, lodging, and training in the U.S.), so Mowat e-mailed the European headquarters of Hologic (in Belgium) to see if a DEXA installation engineer was available. Receiving a reply from Hologic Europe’s Distribution Sales Director, Mowat was greatly surprised to learn that a technical support specialist from France would be provided at no charge, and further that all associated expenses (travel, lodging, etc.) would also be paid. In addition, the sales director -- who heads up Hologic’s operations in Europe, Africa, the CIS countries, and the Middle East -- offered to be present as well. As it turned out, he was actually an Armenian -- Okkis Arisian -- based in France and Belgium. According to Rita Balian, “Mr. Arisian not only paid for all of the expenses of the installation engineer, he also took hold of the opportunity to travel to Armenia -- his first time -- to ensure that everything proceeded according to plan, and to establish a connection with his homeland.” Born and raised in Damascus, Syria, Arisian emigrated to France in his youth, and eventually rose to a position of prominence with Hologic Europe. “During the three days that he spent in Armenia, he was overwhelmed with emotion, and expressed his wish to return more often, and bring his wife and children,” said Mrs. Balian. The night before the unit was to be installed at the Wellness Center, Mowat met Yves D’Aspe, the technical support specialist, at the airport. When D’Aspe emerged from customs, he had no luggage or tools. Apparently, the airline never put Daspe’s luggage on board because it wanted to make more room for paid cargo. Mowat explained: “So, we were thinking the local [Yerevan] engineer would have tools, but on the ride back from the airport we learned of another setback: Edvard Hasratyan, the local biomedical engineer, wouldn’t be able to work on the DEXA installation because his mother was scheduled for eye surgery.” Nonetheless, Mowat and D’Aspe arrived the next day and installed the unit. The only tools at their disposal were a set of metric wrenches (despite the fact that the parts used standard American measurements), a No. 2 Phillips screwdriver, a pair of scissors, and a kitchen knife. Despite the setback, the unit was up and running in less than a day. Mowat recalled: “Because of Yves’s vast experience and knowledge, we were able to install this machine with the basic tools at our disposal.” When D’Aspe’s luggage arrived the following day, the duo used the tools and calibration equipment to verify what they already knew: everything had been installed correctly.

* New concept, new challenges

The DEXA unit has introduced a new concept -- osteoporosis screening, and its associated educational challenges -- to Armenia. Women in the country generally have had little knowledge about the problem of bone density loss, and know even less about preventing or lessening its impact. So the Wellness Center has embarked on an outreach awareness campaign which emphasizes the importance of a good diet, exercise, and regular bone density screenings. To further instill trust in the public, the Wellness Center performed the first trial screenings on the center’s co-founders, Rita Balian and Hranush Hakobyan; its director Khachanush Hakobyan; and the center staff -- as well as on personnel from other medical establishments, the U.S. Embassy, and members of the international community. With that kind of endorsement of the procedure’s safety, it’s small wonder that close to 500 people have already received osteoporosis screenings since the October 2006 installation. As part of the program to train technicians in the use of the machine, Larry Mowat was proud to confer certificates on two doctors, radiologist Dr. Ani Hakobyan, and family medicine internist Dr. Zara Sahradyan. Mowat was eager to say that “of all the doctors and technicians I have trained in the U.S. and Canada over the past several years, the Armenian doctors have been the smartest, and the fastest learners.” He emphasized that this DEXA installation experience was one of the most rewarding he had ever had. Though he has no ancestral ties to Armenia, Mowat explains his motivation in this way: “It’s to give back, because I feel I have been very blessed in my life. I’m not a rich man to give money; but I can donate my time and talents.” Indeed, Larry Mowat timed his last visit to Armenia to coincide with the Annual Health Walk, the Wellness Center’s celebration of women’s health and its observance of Breast Cancer Awareness Month. Donning a kilt he’d recently purchased in Scotland for the occasion, Mowat addressed the crowd in the courtyard of the Matenadaran, thanking the Wellness Center and the Armenian people for motivating him to explore his own Scottish ancestry. Explaining that he feels a familial bond between the two countries, Mowat has taken to visiting Scotland each time he goes to Armenia.

* Helping make miracles happen

The other participants of the 9th Medical Mission were Dr. Emma Zargarian, MD, PA, of Greater Baltimore Medical Center (affiliated with Johns Hopkins University), on her fifth training trip; and Michelle Parsons, RT, RN, a mammography technologist from Columbus, on her third training trip. Dr. Zargarian had previously provided training to physicians from Armenia at her clinic in the U.S. and later at the Johns Hopkins University Hospital. In 2001 she traveled to Armenia to help establish the Center’s GYN department for basic gynecological services, and introduced the concept of Western style annual Pap smears for early detection of cervical cancer -- the second most frequent cause of cancer deaths among women in Armenia. During her subsequent trips to Armenia, Dr. Zargarian has expanded gynecological services, including the treatment of sexually transmitted infections, and infertility problems. As a result of her work, the Wellness Center has witnessed the birth of 38 “miracle babies” to couples previously unable to conceive. Michelle Parsons’ input has also been critical since the center’s establishment in 1997. She has trained all of the radiologists in mammography screening techniques, development of films, and best quality imaging. During her most recent trip, Parsons evaluated the knowledge and skills of the Mammography Department staff and monitored their screening techniques and quality control imaging to meet American standards. Like Larry Mowat, both Zargarian and Parsons are members of the Wellness Center’s U.S. Medical Advisory Board.

For information about the Wellness Center, visit the AACA’s website at www.aacainc.org, or e-mail info@aacainc.org. The center accepts contributions, which can be made payable to the Armenian American Cultural Association, 1300 Crystal Drive, Suite 1504, Arlington, VA 22202.