Journal Highlights: Roads I Have Traveled ... Excerpt # 6 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August 19,1998: This morning our delegation traveled north and east out of Stepanakert to the city of Martakert. It is near the Karabakh-Azerbaijan border where incidents of sniper fire and land-mine explosions are still occurring. The hospital there serves fifty-seven smaller villages in the region. Immediately upon arriving at the hospital I met a young soldier and photographed the wounds he had just received. 

The thought flashed through my mind that I could have easily been the one in the cross hairs of the sniper’s sights. The sniper’s bullet had entered his upper-left chest cavity, collapsed his left lung, and exited out his back. The shot had somehow missed his heart, and the doctors assured us that the young man will survive and heal successfully.

 All the hospitals we had visited in Stepanakert needed everything. In Martakert, they simply needed more than everything.

It kept blaring inside my head, These are the brave doctors on the front lines of this ongoing conflict, and they have nothing to work with. Just the donation of a little would go so far

Dinner, again, was very late, and by the time I headed for my room, the wind had begun to blow and it was trying to rain. The last thing Baroness Cox told me was that Zori had informed her there will probably be no possibility of taking the helicopter back to Yerevan, Armenia tomorrow. The storm that has moved in has brought with it very dense clouds that are totally blocking the mountains. I asked Lady Cox what the difference in travel time will be if we have to drive back over the mountains. 

“They have repaired some of the bombed-out places in the roadway,” she said, “so now even in good weather, we are probably looking at fourteen hours as opposed to an hour and a quarter or an hour and a half by helicopter. 

I went to sleep thinking about the probability of returning over the mountains to Armenia tomorrow in a caravan of vehicles, bouncing over rutty roads and sitting on metal seats for at least fourteen hours. I awoke in the middle of the night and listened to it rain. Then I fell back to sleep singing a little ditty I had composed in the dark: “No caravan to Yerevan, Lord. Let me fly by chopper.” 

Thursday, August 20

In the morning the clouds had lifted a bit, but it was still raining. At breakfast Dr. Tony Peel and I discussed our presentation to the prime minister. Even around the table, it was the consensus of opinion that the pilots will probably not chance flying the chopper across the rugged mountain peaks in the storm. We all moaned at the thought of a fourteen-hour ride back to Armenia. I kept humming, “No caravan to Yerevan, Lord. Let me fly by chopper.” 

Our meeting with the prime minister could not have gone better. He guaranteed personally that the medical goods from Project CURE will be received under his watchful eye, free of any tax or duty requirements. Dr. Peel and I laid out our recommendations that they not put any more expense or effort into trying to salvage four of the hospital buildings in the city of Stepanakert. Rather, contrary to the old Soviet model, we recommended they choose a new location for a unified hospital that would include separate departments for each specialty. That way each department could take advantage of a centralized laboratory, a modern radiology department, and common surgery facilities. We pointed out that they would be able to cut down on the number of beds in the combined hospital and would have better cost control over the supplies and staff. 

The prime minister just beamed. He had been thinking about the same things but was certain he would encounter opposition from the heads of the separate hospitals because they would be losing “turf.” We pointed out that he and the minister of health could reassure those directors that they would still have control over their individual budgets for their departments, even in the unified hospital. 

One of the members of our medical team had talked to me a couple of days ago about making an anonymous gift of $1.5 million toward the construction of the new hospital if I could get the minister of health and the prime minister to go along with the idea and agree to certain guidelines. I presented the prime minister with that possibility, and Zori, Baroness Cox, and the prime minister all just about took off into orbit. 

The prime minister and Zori repeatedly thanked us for having done such a thorough job in our research and recommendations. Now they can start planning how to totally change their health care delivery system and dump the old inefficient Soviet nightmare. It was about noon when we left the prime minister’s office. The rain had stopped, but the clouds were dense and low over the mountain peaks. Zori just shook his head and announced at lunch that there would be no helicopter. “No caravan to Yerevan,” I hummed as I enjoyed my lunch of greasy, fried eggplant and beans. 

About 1:00 p.m., a strange thing happened. As we were ready to load up the vans for our caravan trip, the sun broke out, and the clouds began to lift. I actually watched the dense cloud line move up the mountain peaks. As we finished loading the luggage, word came to Zori from the helicopter pilots. They now felt it would be safe to fly! The caravan of luggage and passengers headed to the airport instead of the mountain pass. “No caravan to Yerevan,” I continued to hum. 

As we flew back to Armenia, I once in a while caught a glimpse of the winding road traversing its way up and over the mountain range. I smiled and told God, Thank you. 

Friday, August 21

Today was a whirlwind day. At 10:30 a.m., I had the privilege of meeting with Viken Aykazian, bishop of the Armenian Orthodox Christian Church. At 11:30 a.m., the foreign affairs minister of Armenia met with us. 

Between 1:30 p.m. and 3:00 p.m., a news conference was held at the main government building in Yerevan. About twenty-five newspaper reporters and TV journalists assembled in the official press-conference room. Baroness Cox was really the star of the press conference. Nearly everyone in Armenia knows her and her tireless work around the world on behalf of Armenia and Nagorno-Karabakh. She introduced me, and I was able to talk about Project C.U.R.E. and its impact around the world, as well as our findings in Nagorno-Karabakh and our plans for the future regarding its health-care system and the medical institutions we had visited. 

We used our last dinner together to honor the helicopter pilots who had been so kind to us during our stay in Armenia and Nagorno-Karabakh, and all the other helicopter pilots who had given their lives to keep the corridor open between Armenia and Karabakh during the recent war years.

My research of the Armenians and the Nagorno-Karabakh situation had somewhat prepared me for a cursory understanding of the history of the Karabakh region, but I was in no way prepared for the emotional wrenching I experienced during my stay. I know I can’t keep up forever the pace of what I am doing now. My exposure is high, and the risks I am taking are, according to common sense, quite stupid. But while God gives me good health and high energy, I want to make my life count for kindness, justice, and righteousness. I truly believe those are the high objectives that will delight the heart of God.

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House

Journal Highlights: Roads I Have Traveled ... Excerpt # 5 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August, 1998: The archbishop is a strong man whom I judged to be in his late fifties. His slightly graying beard somewhat hid a classic squared jaw and chiseled features. He stood with strength and dignity, but his soft eyes revealed his kindness and gentleness of spirit. He knew some English, but he spoke to us through an interpreter. 

Our meeting with the archbishop was so meaningful to me that I asked if I could have my photo taken with the archbishop and Baroness Cox. Along with Zori, they had fought an impossible war and were not defeated. “The war showed many miracles. As with the miracles in the Old Testament, victory was not just because of the people of Karabakh; it was because of the Lord.” To illustrate his point, he told me the account of a battle during the war that took place close by in a village referred to as “Under the Rock.” 

A small group of thirty Karabakhi soldiers were dispatched to guard the village from a sneak attack. A battalion of at least three hundred Turkish and Azerbaijani soldiers surrounded the village and prepared for their offensive to completely destroy the village and all the men, women and children there. The day was completely clear and sunny. The group of Karabakhi soldiers realized they needed thirty minutes at least to get all the women and children out of the village before the deadly attack of the enemy. They prayed that God would somehow grant them the thirty minutes necessary. Out of nowhere in the sky came a bright-white vapor cloud. The fog was so dense that they couldn’t see in front of them. The cloud of fog passed between the villagers and the enemy and stopped for thirty minutes. When the women and children were safely out and away, the cloud passed on and evaporated. 

In the ensuing battle, which lasted the rest of the day, only thirteen Karabakhi soldiers were killed. The Karabakhi soldiers had won. Over half of the Azerbaijani forces lay dead, and many more were wounded. “That was a miracle,” insisted the archbishop. 

Tuesday, August 18

Our next stop was Stepanakert’s general hospital. The schedule was tight enough that we didn’t even have time for a lunch break. The thing I observed that both the children’s hospital and the general hospital need most is a total replacement of the buildings. Both hospitals had taken fifteen to twenty direct missile hits and a lot of mortar hits. The ceilings and walls still have not been repaired, and it isn’t unusual to find holes and bomb fragments in the wooden hallways. 

Next, we rushed to assess the maternity hospital where Dr. Arthur Marutian and his administration staff welcomed us. The maternity hospital received quite a number of direct and indirect missile and mortar hits during the fighting. Quite frankly, the building isn’t worth trying to salvage. The outside walls are collapsing, and the inside of the building sustained structural damage. On our tour of the facilities, I discovered that the hospital has been completely without water for the past four days. I kept asking myself how they can run a hospital without regular access to fresh water and electricity. 

Dr. Marutian responded very positively when I suggested that they think about altering the old Soviet style and philosophy of health care. As we walked down the dark corridors of the hospital, I told him about the many hundreds of hospitals I had visited throughout the old Soviet Union. 

“I am very aware,” I told the doctor, “of the idea of total central control of the health-care system by the Soviet government. Their idea was to place each specialty in a separate hospital location. Then they could more easily control the movements and procedures of everyone, because no one had an opportunity to communicate with anyone else.” He nodded his head in agreement. “The hospitals I have visited so far in Stepanakert have all needed everything. I am guessing that the other ones we will be visiting also need everything. But Project C.U.R.E. can’t fully equip five or six separate hospitals here in the city. It would be my suggestion that you abandon separate hospitals and combine all the medical specialties in one new hospital building with separate departments for the specialties. By so doing, you here at the maternity hospital would have access to a fully equipped, modern operating room, radiology department, and diagnostics laboratory.” 

To my surprise, Dr. Marutian really jumped at the idea and said there were others in Stepanakert who were in agreement about needing to dump the old Soviet system of medical care. To underscore the maternity hospital’s dire need for new equipment, the doctor took me into the main delivery room. There he walked to the metal delivery table and lifted up the pad that covered the tabletop. The entire end of the table where the delivery procedures took place was completely rusted out.

 “This is not just unsanitary with all this rust,” he said, “but if the end of the table drops off during one of my deliveries, we will all be in great trouble.” 

I told Dr. Marutian that before we leave Karabakh, Dr. Anthony Peel, the surgeon from England, and I will be meeting with the prime minister and making recommendations for Stepanakert’s health-care system. I told Dr. Marutian that since he is one of the doctors who would be willing to break away from the old Soviet health system concepts, I would like to be able to call on him or at least use his name to support our recommendations. He smiled broadly and gave me a “thumbs up.” I knew that somehow we were going to hit a homerun!

Next Week: No Caravan to Yerevan, Lord let me fly by chopper. 

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House