The social and economic upheavals that followed the earthquake of 1988 combined with the political collapse of the Soviet Union to create a catastrophic public health situation in Armenia. According to Soviet statistics published between 1989 and 1991, the incidence of tuberculosis, viral hepatitis, and cancer were among the lowest in the Soviet republics (see table 2, Appendix). In 1990 the rates of infant mortality and maternal mortality, 17.1 and 34.6 per 1,000 population, respectively, were also among the lowest rates in the Soviet Union.

The level of medical care declined rapidly in the late 1980s and the early 1990s, however, largely because of the Azerbaijani blockade and the additional stress caused by war casualties. Even in 1990, Armenia ranked lowest among the republics in hospital beds per 1,000 population and exactly the Soviet Union average for doctors per 1,000 population. Before 1991 Armenia had acquired stocks of medical supplies and equipment, thanks largely to the Western aid projects that followed the 1988 earthquake. By 1992, however, the trade blockade had made the supply of such basic items as surgical gloves, syringes, and chlorine for water purification unreliable. In the escalating medical crisis that resulted from this vulnerability, elderly people and newborns were particularly at risk in late 1992 and early 1993, healthy infants reportedly were dying in hospitals because of the cold and the lack of adequate equipment.

In December 1992, President Ter-Petrosian declared Armenia a disaster area and appealed to the UN Security Council to focus on the crisis in the republic. Government officials estimated that without emergency humanitarian aid some 30,000 people would die. Early in 1993, the United States launched Operation Winter Rescue to send needed assistance to Armenia. In June Project Hope sent US$3.9 million worth of medicine from the United States. From mid-1992 to mid-1993, United States medical assistance totaled US$20 million.

All hospitals in Armenia are under the jurisdiction of the Ministry of Health or the Erevan Health Department. In 1993 about 29,900 hospital beds were available. Hospitals generally had surgical, physical therapy, pediatric, obstetric/gynecological, and infectious disease wards. But according to reports, by 1993 more than half the hospitals in Armenia had ceased functioning because electricity, heat, or supplies were lacking.

Thirty-seven polyclinics serve the rural areas, which have no comprehensive health centers such clinics are each designated to provide basic medical services to about 10,000 people. Sixty-two outpatient centers specialize in child or adult medicine in urban areas. Immunizations against certain diseases are given to most infants before they are one year old: in 1991 some 95 percent of infants were immunized against poliomyelitis, 88 percent against diphtheria, and 86 percent against pertussis.

Between 1986 and 1994, two cases of acquired immune deficiency syndrome (AIDS) were reported in Armenia: one foreigner who was subsequently deported, an275 and one Armenian who contracted the disease in Tanzania and was treated in Armenia. Experts believe that the Azerbaijani blockade has acted to limit the incidence of AIDS. Although no AIDS clinics are operating, some research has been conducted. In 1992 Armenian scientists announced the discovery of a possible treatment compound.

Data as of March 1994