The 1988 earthquake in Armenia is all but forgotten here in the United States. The heroic relief efforts ended long ago; the Soviet Union, of which Armenia was a part, no longer exists; and Mikhail Gorbachev, who cut short his first American visit to return to that stricken country, is a private citizen now.

But the earthquake still looms large in the lives of the Armenian people, says Mr. Sarkis Boghjalian, senior program coordinator of Catholic Near East Welfare Association, who recently returned from a tour of that country.

Mr. Boghjalian traveled to Armenia with Dr. Sheila Rothman, director of the Externship Program in Human Rights and Health Care at Columbia University’s College of Physicians and Surgeons. Dr. Rothman’s purpose in making the trip was to explore the possibility of including Redemptoris Mater, an Armenian hospital supported by Catholic Near East Welfare Association, in the externship program.

Reconstruction began immediately after the earthquake, when Armenia was still part of the Soviet Union, and stopped abruptly when the Union dissolved, says Mr. Boghjalian. Armenia is independent now, and suffers the same economic problems that plague the other countries of the former Soviet Union. No funds are available from the financially strapped government to rebuild. As a result, whole towns consist of buildings without roofs or windows.

New hospitals, built by Western funds when relief efforts were at their peak, are deteriorating. One of the problems, Mr. Boghjalian notes, is that these hospitals were often equipped with modern, sophisticated technology requiring highly skilled personnel. In many cases the nations that provided relief made no provisions to continue services. As a result, when funding ended, standards could not be maintained. The Association’s representative, who visited Armenia last year, notes that in just one year he could see a decline in the environment and quality of care.

Many Armenian doctors are sent to the West for additional training, Mr. Boghjalian says, but they are not allowed enough time to learn both the new language and new medical techniques.

The earthquake and inadequate Western support have cast a shadow of despair over Armenia, he points out.

Take, for example, the reaction of one doctor to the death of his son. Prior to the earthquake, this physician, motivated by the Gospel, built a thousand-bed hospital in which he served. When the earthquake struck, his son was one of 200 children killed in the local school, while drunks loitering nearby went unharmed. As a result of this inexplicable injustice, he cannot believe in God.

However despair is not limited to the area affected by the earthquake. Mr. Boghjalian notes that extreme hardship exists throughout the country; shortages of gasoline, electricity, food, water and other basic necessities are acute. As a result, there is a great deal of theft. In hospitals, for example, a highly advanced X-ray device donated by a Western European government may be incapacitated because the plug has been severed.

The two Americans visited hospitals in the capital of Yerevan as well as in the earthquake area and found that although health care in Armenia is free, government support is minimal. Food and medicine are always in short supply. It is common for patients to arrive at a hospital for medical treatment and be told that the necessary medications are unavailable. A patient may be asked to obtain the medication himself (presumably from the flourishing black market) and return to the hospital, where physicians will administer the drug.

Mr. Boghjalian tells of an incident where a doctor gave him some bread intended for the patients. The American tried to break the bread into smaller pieces, but was not able to do so. “What,” he asked, “could have been added to the bread to supplement the flour?”

“Who knows?” the doctor replied.

“Of all the hospitals visited, Redemptoris Mater Hospital in the village of Ashotzk, a non-governmental hospital, offered the best environment and the best interaction between patients and staff,” Mr. Boghjalian reports.

Supported by Catholic Near East Welfare Association, Caritas Italiana, the U.S. Bishops’ Office to Aid the Catholic Church in Central and Eastern Europe, and with additional support from the Camillian Fathers, who also administer the hospital, Redemptoris Mater provides an outstanding example of the good that sustained assistance can achieve.

Armenia’s woes are exacerbated by the war with Azerbaijan over the enclave of Naghorno Karabakh (situated in neighboring Azerbaijan but populated by Armenians), by a blockade imposed by Azerbaijan and Turkey, and by the war in Georgia. According to Mr. Boghjalian, of the 350,000 Armenians who had been living in Azerbaijan (excluding the enclave), none are left – all have fled to Armenia or to other countries. Refugees from Georgia have also been arriving.

These circumstances have created a tremendous refugee problem. There are now 360,000 refugees in Armenia, comprising 10 percent of the total population, government officials told Mr. Boghjalian. Of these, 40 percent are children and 25 percent are elderly or handicapped.

In discussions about the war, the Association’s representative was told by an international group of medical volunteers that their colleagues traveling in the combat zone have been caught in the crossfire. Unconfirmed reports allege that 5,000 young people have died and 15,000 have been wounded. Delicate surgery is not possible on the front lines, so the wounded are patched up as best possible. Thus a whole generation is in danger of growing up with disabilities that could have been prevented.

Obviously, stopping the war is the nation’s first priority, but upgrading medical care runs a close second, Mr. Boghjalian says.

Increased funding of Armenian hospitals by both public and private agencies in the West is essential if basic medical services are to be maintained, he warns.

“People in Armenia are beginning to feel that maybe communism was not so bad,” he emphasizes. “At least under communism basic needs were addressed.”

Peg Maron is the copy editor of Catholic Near East.