SPH Publications on Impact of Artsakh War and COVID-19 Pandemic
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In 2020, the COVID-19 pandemic dealt a heavy blow to countries worldwide presenting unprecedented challenges to public health, food systems, work, and life. For Armenia, however, those hardships were exacerbated by the 44-day Artsakh War that Azerbaijan initiated on September 27, 2020. The combined impact of the war and pandemic on Armenian society, particularly on the mental health of the population, has been devastating. The Turpanjian School of Public Health (SPH) of the American University of Armenia (AUA) initiated scientific research to study the extent and facets of the impact of the pandemic and war, subsequently releasing several publications on the topic.
One of the publications, “Frozen conflict in the midst of a global pandemic: potential impact on mental health in Armenian border communities,” highlights the combined impact of war and pandemic in the northeastern Armenian border region of Tavush. The article provides the background portraying the years that followed the first Artsakh War in 1988-1994 and regular ceasefire violations that have disrupted life in Armenian border communities. More than a decade later, Armenia experienced the Four-Day War in 2016, but the subsequent July 2020 armed skirmishes were the most severe military escalation between Armenia and Azerbaijan since the 1990s, despite the United Nations Secretary-General’s call for a global ceasefire worldwide under conditions of the COVID-19 pandemic. Unfortunately, the July 2020 border clashes were a forewarning of the full-scale war that followed. In the study, SPH explores the combined effect of the armed conflict in the challenging times of the pandemic, largely focusing on the mental health of the residents of the border communities of Tavush.
In addition to the unprecedented challenges imposed by the pandemic and the more recent Artsakh War, the difficulties arising from the unequal distribution of vaccines worldwide has further affected the population of the Republic of Artsakh, as well as Armenia. The publication “War in Nagorno-Karabakh highlights the vulnerability of displaced populations to COVID-19” specifically focuses on the challenges of the people displaced as a result of the war. This article advocates increasing international attention to the vulnerable populations of Armenia and Artsakh, urging for focused attention to the more vulnerable segments of the population when prioritizing the allocation of medical resources and the distribution of vaccines. It is argued that the risks of infection are heightened among displaced Armenians, who are driven out of their homes and live in shared, crowded spaces. The increased risk of infection is found not only among the displaced families, but also among the receiving communities where they have found refuge, and the volunteers and social workers who work with them.
Another publication “War in the COVID-19 era: Mental health concerns in Armenia and Nagorno-Karabakh” further explores the health and social complications ensuing those two issues. An excerpt from the article underscores that “the destructive confluence of a deadly war, humanitarian crisis, domestic instability, and exorbitant rates of viral transmission will likely lead to a mental health crisis requiring timely attention… The risk applies especially to the displaced population that has lost its homeland, all material assets, and work and been forced to settle in new locations.”
When there are more immediate threats, such as war, individual and state priorities shift and trauma distracts the population from taking appropriate precautions to prevent infection and/or get vaccinated. This is one of the war’s impacts on Armenian society relative to the pandemic. Physical distancing, wearing masks, thinking about getting vaccinated when available, and complying with state regulations are often pushed to second place in the face of other very real issues. Thus, the article underlines the importance of accurately communicating the advantages of the vaccine along with other preventive measures.
Trust and understanding have been a global issue throughout the pandemic. Some countries have been more affected than others, and some countries have been more successful than others in terms of risk communication. In an interview with CivilNet in the early months of the pandemic, Dr. Vahe Khachadourian spoke about the RA government’s appropriate measures to contain COVID-19 while emphasizing the importance of taking individual responsibility.
The SPH studies point to the priority importance of mitigating the gap between Yerevan and the rural regions regarding access to information and mental health services. Border communities, such as those of Syunik, Tavush, and other regions, are facing higher levels of stress, anxiety, and trauma having been most severely affected by war. The border rural communities also have less access to mental health services and there are fewer mental health specialists in those regions. As one article concludes, “health professionals and practitioners, including health policy advocates and international organizations, should transition to more proactive roles aimed at de-escalation of conflicts and prevention of similar public health catastrophes from occurring.”
An earlier longitudinal study by SPH had tracked survivors of the 1988 Spitak earthquake over a period of over 20 years. These more recent studies related to the pandemic and war build new knowledge and collect rich data useful for reforming the health system in Armenia. In that regard, AUA plays an important role and SPH faculty are very active in producing scientific papers sharing their findings and building expertise on issues related to public health and system reform. Early in the pandemic, SPH faculty have also shared evidence and pertinent advice on national media networks.
The AUA School of Public Health works actively to improve population health and health services in Armenia and the region through interdisciplinary education and development of public health professionals to be leaders in public health, health services research and evaluation, and health care delivery and management.