unicef armenia year book

ARMENIAFor every childHealth, Education, Equality, ProtectionADVANCE HUMANITY

Cover Photo: © UNICEF / Armenia / Onnik Krikorian 2005

1

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

2. Child Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Child Abuse and Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

De-institutionalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Community–based Care Centers . . . . . . . . . . . . . . . . . . . . . 16

Outreach Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Inclusive Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

3. Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Pre-school Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Life Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

4. Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Integrated Management of Childhood Illnesses . . . . . . . . . 34

5. Young People’s Health & Development . . . . . . . . . . . . . . . . . . . 37

Peer Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Freedom of Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

For every childHealth, Education, Equality, ProtectionADVANCE HUMANITY

ARMENIA INDEX

BOX 1 ARMENIA KEY STATISTICS

Source: The State of the World’s Children, UNICEF 2005

STATISTICS AND INDICATORS

Under-5 mortality rank 94

Under-5 mortality rate per 1,000 live births (2003) 33

Under-5 mortality rate average annual rate of reduction (%), 1990-2003 4.6

Under-5 mortality rate reduction since 1990 (%) 45

Infant mortality rate per 1,000 live births (under 1), 2003 30

Total population (thousands), 2003 3061

Annual no. of births (thousands), 2003 29

Annual no. of under-5 deaths (thousands), 2003 1

GNI per capita (US$), 2003 950

Net primary school enrollment / attendance (%) (1996-2003) 97

% of infants with low birthweight 1998-2003 7

% of children who are exclusively breastfed (<6 months 1995-2003) 30

% of children who are breastfed with complementary food (6-9 months 1995-2003) 51

% of children who are still breastfeeding (20-23 months 1995-2003) 13

% of under-fives suffering from underweight (moderate & severe 1995-2003) 3

% of under-fives suffering from stunting (moderate and severe) (1995-2003) 13

% of households consuming iodized salt (1997-2003) 84

% of one-year-olds fully immunized against tuberculosis (2003) 92

% of one-year-olds fully immunized against DPT3 (2003) 94

% of one-year-olds fully immunized against polio3 (2003) 96

% of one-year-olds fully immunized against measles (2003) 94

% of one-year-olds fully immunized against hepB3 (2003) 93

% of under-fives with ARI (1998-2003) 11

% under-fives with diarrhoea receiving oral rehydration (1994 – 2003) 48

Estimated number of people living with HIV, 2003 (in thousands) low estimate 1.2

Estimated number of people living with HIV, 2003 (in thousands) high estimate 4.3

5

Almost immediately after the collapse of the

Soviet Union, Armenia was plunged into a

period of deep economic and social crisis. From

1990 to 1993, the country's gross domestic

product (GDP) contracted by half, the largest

decline in the Commonwealth of Independent

States (CIS) and one of the sharpest recorded

by any country.

Ten years later, nearly a quarter of the country'spopulation had emigrated in search of workand a better life abroad.

The impact of this decline has been so deepthat until recently, approximately half of thecountry's population was living below thenational poverty line with one in seven unableto meet their basic needs for survival.

Women are much more likely to be living inpoverty than men, and children are the mostlikely to be exposed to its consequences thanany other social group. Many parents,particularly the poorest and most sociallydisadvantaged from rural areas, are unable toregister their children at birth, potentiallydepriving them of essential social services andincreasing their vulnerability to humantrafficking.

Thankfully, social indicators have graduallyimproved over the past decade and in manycases are better than those in other transitionalcountries. However, averages mask starkinequalities. While better off families in urbanareas have access to quality health careservices, the rural poor often do not. Householdsurveys indicate that the top 20 per cent of thepopulation consume 3 times more healthservices on average than the lowest 20 percent.

Public financing of primary health care remainsinadequate, and the low morale of health carestaff has also affected the quality of services.Rapid surveys also indicate that schoolabsenteeism and drop-out rates in refugee andminority-populated areas are twice the nationalaverage. Children are frequently absent fromschool in the winter months since heating isoften poor or non-existent.

While the incidence of HIV/AIDS remainsrelatively low, Armenia is part of a region withthe fastest growth of infection and surveillanceindicates that HIV is spreading rapidly in thecountry. Young people's awareness of HIV/AIDSand sexually transmitted infections (STIs) variesbut even so, surveys indicate that even amongthose who are aware of the dangers, high riskbehavior is prevalent.

INTRODUCTION

YEREVAN

Gyumri Vanadzor

Sisian

Kapan

TURKEY

IRAN

AZERBAIJAN

GEORGIA

NAKHICHEVAN

0

0

25

25

50 km

50 m

Lake Sevan

GEORGIA

Yet, despite the enormity of the challenges,there is reason for hope.

The Government of Armenia has adopted anambitious ten year National Plan of Action(NPA) to address the needs and protect therights of children. The NPA is linked to thecountry's Poverty Reduction Strategy Paper(PRSP) that lays the foundation for meeting theMillennium Development Goals (MDGs).

Working in cooperation with other members ofthe UN family as well as NGOs and donors,UNICEF's new country programme will focuson sustaining progress already made inaccordance with the UN DevelopmentAssistance Framework for Armenia.

Throughout this publication, you will meetsome of the Armenians that UNICEF is workingwith and for. With your continued support, we

will expand on these efforts in health,education, child protection and young people'shealth and development. Expectations are highfor a better future that is now being written.

Sheldon Yett

UNICEF Representative,Republic of Armenia

6

In the past decade, Armenia has made

significant progress and introduced

comprehensive reforms that positively affect

the lives of children. However, the impact of

economic decline in the early years of

transition was so severe that at the beginning

of 2005, approximately 44 per cent of the

population was living below the national

poverty line. In this environment, children are

more susceptible and vulnerable to the

consequences of poverty than any other age

group.

In many socially disadvantaged communities,parents are often unable to register theirchildren at birth and continue to rely on publiccare institutions as their primary social safetynet. Over 10,000 children are currently enrolledin 53 special/boarding schools and more than900 children have been placed in 8 state-runchildren's homes (orphanages) although themajority has at least 1 parent.

For those children that have been admitted intoan institution there is often little attempt to re-integrate them back into their families.Moreover, in later life, these children can findthemselves at greater risk of being trafficked,abused or in conflict with the law.

Because of this reliance on institutional care forchildren from socially vulnerable families, withdisabilities or those at risk, UNICEF has placedspecial emphasis on promoting a state policyon de-institutionalization and the prevention ofinstitutionalization. By reforming the admissionsystem for special schools, establishing fivecommunity-based alternative care centersthroughout Armenia and promoting inclusiveeducation as well as foster care, it is now lesslikely that children from vulnerable families willbe placed in institutions.

Nevertheless, most kindergartens and schoolsare still unable to provide services to over 8,000

children registered as disabled in Armenia, themajority of which remain excluded from specialand mainstream education. Thanks to UNICEF'ssupport for programmes that promote inclusiveeducation, however, over 250 children withdisabilities have already been mainstreamedinto pre-schools and basic educational facilities.

UNICEF was one of the first organizations toinitiate studies into the phenomenon oftrafficking in women and children fromArmenia. In 2003, UNICEF published a surveyinto child abuse and neglect.

By supporting revision of the juvenile justicesystem, UNICEF has also promoted positivelegislative changes including the introductionof alternative systems such as probation. Over300 members of the police and judiciary, aswell as NGOs and care providers in residentialinstitutions have already gained a betterknowledge of children's rights and their ownresponsibilities in this regard. Minors findingthemselves in conflict with the law have neverbeen guaranteed as much legal protection asthey are today although more work is stillneeded.

Armenia acceded to the Convention on theRights of the Child in 1992. In 2005 the countryratified Optional protocols to the Convention onthe Rights of the Child on the sale of children,child prostitution and pornography as well ason the involvement of children in armedconflicts.

Through the development of legislation,policies and programmes, UNICEF assists thegovernment in establishing the mechanisms tocreate a "protective environment" for allchildren in Armenia without exception as partof the National Plan of Action (NPA) for theProtection of Children's Rights and the PovertyReduction Strategy Paper (PRSP).

9

CHILD PROTECTION

11

Abandoned by her husband, a single mother

appears close to another nervous breakdown.

Living in one of the many metal domiks that

define part of the urban landscape of

Armenia's second largest city, Gyumri, she

responds with violence when her two teenage

daughters plead with her to stop "walking the

streets."

Back in the Armenian capital, another motherholds back her tears as she clutches thephotograph of her youngest daughter. Isabella,captured on film at the age of eighteen months,will never get to celebrate her second birthday.Months earlier, while playing unsupervised ona dilapidated stairwell in one of Yerevan's sub-standard hostels, she was pushed by anotherchild and fell seven floors to her death.

Yet, although the problem exists everywhere,there are many who would rather not admitthat child abuse and neglect also occurs inArmenia, even though adverse socio-economicconditions can exasperate the situation.Children that fall victim to abuse and neglectincreasingly play truant from school or beg onthe streets and, in extreme cases, can end up injuvenile detention or residential care. Someeven become easy picking for traffickers.

As a result, in a UNICEF commissioned surveypublished in 2003, the wall of silence thatsometimes surrounds the problem of childabuse and neglect was finally broken down.The survey of over 2,000 respondents served asthe basis for raising awareness amonggovernment officials and inter-agencycommittees.

In particular, the survey concluded that poorliving conditions, unemployment and thepsychological stress of living below thenational poverty line had resulted in anincrease in the number of cases of abuse and

neglect, not only in the family but also inschools and children's institutions. Alcohol anddrug abuse was considered a major cause forthe behavior of some parents towards theirchildren.

Karen Harutyunyan, Coordinator of theArmenian National Task Force on thePrevention of Child Abuse and Neglect,however, stresses the need for caution whendiscussing such a sensitive issue and says thatthe problem also affects children from otherstrata in society. "We have to remember thattoday's parents are yesterday's children," hesays, adding that abuse and neglect, albeit indifferent forms, exists even among financiallysecure families.

"Studies in many countries have repeatedlyshown that victims of physical abuse duringchildhood have an increased risk of becomingviolent offenders themselves," explainsSheldon Yett, UNICEF's Representative inArmenia. "Some evidence indicates thatrepeated psychological and emotional abusecan have an even greater impact on childhoodvictims than physical violence."

The National Task Force on the Prevention ofChild Abuse and Neglect, a group that includesmembers from key ministries, NGOs andUNICEF, will therefore seek to address theproblem through the development of alegislative framework for the earlyidentification, registration, referral andtreatment of child abuse as well as through theprovision of training materials.

"Of course, parents still have the primaryresponsibility to safeguard their children fromviolence and neglect," says Yett. "However, totackle this issue, a holistic approach isnecessary. Community Outreach programmesneed to be in place and those found guilty of

Child Abuse and Neglect

Feature Child Protection

12

abuse should be held accountable. Community-based systems are essential and need to beexpanded."

Through the development of such approaches,technical support will be provided to the localauthorities and the programme presented tothe wider NGO community. Draft regulationson child abuse and neglect will be submitted toParliament and new ethical and professionalguidelines for police and health care providersintroduced. The proposed legislation also callsfor the protection of the rights of childwitnesses and victims of crime.

Until then, UNICEF has already supported thecreation and development of various initiativesthat will be crucial in any programme toaddress the problem. In 2002, UNICEF fundedthe establishment of a Community-based CareCenter for Children at Risk in Gyumri and lastyear, the development of Outreach Services at

the Fund for Armenian Relief's Children'sReception & Orientation Center in Yerevan.

UNICEF also supported the Douleurs SansFrontiers (DSF) International NGO in traininghealth professionals working in the primaryhealth care system in Yerevan and Gyumri toidentify cases of child abuse and neglect.

However, according to Harutyunyan, thesensitivity of the issue still remains a stumblingblock. As a psychologist formerly working forFAR, he says that at least 6-7 per cent ofapproximately 800 children working or livingon the streets and at risk that were placed inthe center were sexually abused. "There arechildren that have had very problematicexperiences in boarding schools, in theirneighborhoods and in their families," he says.

13

According to the Director, the majority of

children enrolled into his boarding school

situated somewhere in the Armenian capital

stay on full-board. Yet, after its annual New

Year Party, only two remained while others

returned home for the holidays.

In both cases, the children had seemingly beenforgotten only because their parents were lateto collect them. Moreover, out of 130 childrenattending a special school designated forchildren with learning difficulties, the majorityshowed no sign of any disability at all.

Instead, with 44 per cent of the populationliving below the national poverty line, manyfamilies still increasingly look to residentialinstitutions to provide what the First DeputyMinister of Social Security, Ashot Yesayan, callsthe "primary 'social safety-net' for theirchildren."

More than 10,000 children in Armenia arecurrently enrolled into special schools with asmany as 40 per cent staying on full board.Studies show that this reliance has led to theemergence of an "underclass of childrenmarked by poverty, stigmatization and a lack ofproper care and education who are likely tolack opportunity as adults."

In some of these schools, because childrenfrom vulnerable families receive an educationintended for children with disabilities, theirdevelopment is seriously hindered. At the sametime, many children with disabilities remainexcluded from educational facilities that wereonce originally intended to cater for theirneeds.

Yet, despite the common misconception thatmost children placed into residential care inArmenia are abandoned, few actually are.According to Naira Avetisyan, UNICEF's Child

Protection Officer, at least 70 per cent ofchildren enrolled have families they couldreturn to if socio-economic conditionsimproved. Many children instead come fromsingle-parent households where the mother isdivorced, widowed or separated from ahusband working abroad or in prison.

"There are many reasons why children withparents are deprived of parental care inArmenia," explains Avetisyan. "First of all thereis poverty, then centralization of specialeducation within the boarding school systemand finally, the absence of alternatives andcommunity-based support services forvulnerable families at risk."

In 2000, UNICEF invited an internationalconsultant to conduct a study on residentialcare institutions in Armenia.

Based on the recommendations of the report,alternatives to institutionalization werediscussed in round table discussions with theMinistries of Health, Education, Social Welfare,Justice and Police. A three year plan of actionwas developed and UNICEF, the ArmenianGovernment and NGOs collaborated togetheron the implementation of a work plan.

The main focus was to do everything possibleto prevent the institutionalization of childrenand to create alternative models for children atrisk from vulnerable families and those withdisabilities. Several activities directed towardsall of these objectives were implemented inArmenia from 2001-2004.

"In 2000, the majority of children in boardingschools were staying on full board" saysAvetisyan. "Later the institutions started tosupport the reintegration of children back intotheir families although they were still not

De-institutionalization


14

attending mainstream schools. However, theywere returning to their families in the evening."

According to Avetisyan, this was a majorachievement because linkages with the familywere not only maintained but alsostrengthened. "Parents understood that theyhad certain responsibilities towards theirchildren," she says. "Even so, becausemainstream schools were unable to provideservices for children from vulnerable families,they were still stigmatized by being placed inan institution."

Of as much concern is that out of 10,000children attending special schools in Armeniaonly less than 4,000 have disabilities. Manychildren with disabilities are instead left out ofthe education system and have not beenintegrated into society. UNICEF thereforesupported government attempts to integratethem into mainstream education starting withinclusive pre-schools and later, with inclusiveschools.

In particular, UNICEF supported the Ministry ofEducation and NGOs such as Mission East,World Vision and Bridge of Hope inestablishing inclusive education models thathave now been expanded throughout Armenia.Nevertheless, Avetisyan says that there are stillmany obstacles to overcome.

"There is still not enough awareness in societyregarding the needs and capacities of childrenwith special needs or of families at risk," shesays. "Therefore, during these years, a majorcomponent has been education. In all ourprojects, booklets and leaflets have beenproduced for parents as well as serviceproviders in community centers."

Mentalities are changing, however, andespecially among decision-makers. This was agreat success, says Avetisyan, because in the

past the general consensus was that aninstitution was the best place for children withdisabilities or from vulnerable families.

Now, the Armenian Government is interested inde-institutionalization through familyreintegration, foster care and the prevention ofinstitutionalization through community-basedsupport centers. It has also developed a lawthat obligates the state to provide support to"graduates" from Children's Homes once theyreach the age of 18.

"Even if you create excellent conditions in theinstitution, when the children leave thisartificial environment they have no life skills orthe capacity to deal with daily problems,"Avetisyan says. "For example, studies showthat as a result, many of these children end upin conflict with the law and some girls becomeprostitutes and are more prone to trafficking."

Avetisyan is also quick to point out that there isan additional need to limit the large andinfluential Armenian Diaspora's seeminglyendless ability to financially support institutionsit mistakenly supposes accommodatesorphans. "The importance of strengtheningvulnerable families by providing them with jobopportunities has to be emphasised rather thansupporting the institution," she says.

"The problem of children in institutions isprobably one of the most important issues toaddress as it violates the most basic rights ofthe child – to grow up in a family environment,"Avetisyan concludes. "The majority of childrenin boarding schools and children's homes arenot orphans.

They have parents and the right to live withtheir families. Nothing can replace theimportance of that environment – not even thebest institution."


16

Sixteen years after the 1988 earthquake

devastated Armenia's second largest city,

Vartouhi Petrosyan lives in one of the several

hundred domiks (temporary metal containers)

that make up the urban landscape of modern-

day Gyumri.

Unemployment is 2 to 3 times higher than thenational average and 60 per cent of thepopulation lives below the poverty line. Likemany others living in Gyumri, Vartouhi's familyhas no electricity or water and lives on a staplediet of potatoes, pasta and bread. She has beenparticularly hit by the desperate socio-economic situation because she is a singlemother.

Fourteen years earlier, however, after survivingthe earthquake that killed her parents andeldest brother, Vartouhi had a promising future.In 1990, she enrolled at Yerevan StateUniversity and was in her third year studyinglinguistics when her future husband“kidnapped” her, a tradition that is stillsometimes practiced in Armenia.

After they married, the newlyweds moved toRussia but when their relationship failed sevenyears later, Vartouhi Petrosyan returned toGyumri. Unemployed and penniless, shearrived with her two children, Svetlana, nowaged 13, and Emma, aged 11.

"When we came back, my daughters couldspeak only in a mixture of Russian andArmenian," she says. "They couldn't attendschool because we didn't have any money tobuy books or even clothes. When my childrenwere hungry and there was no food, I beatthem out of desperation. I wanted to commitsuicide. We couldn't even heat our home."

However, when it was discovered that Svetlanaand Emma weren't attending school,

Geghanush Gyunashyan, Director of the ShirakInternational Association's Community-basedCare Center for Children at Risk, actedimmediately to assist the family.

The Center was established in 2002 with theassistance of UNICEF to support families withchildren found unaccompanied and working onthe streets or that are unable to attend schoolsimply because they are poor. Fifty childrenaged between 6 and 15 are registered at thecenter although more attend on an irregularbasis. Like Svetlana and Emma, twenty of thechildren come from single parent families.

At the Center, a staff of 2 social workers, 2teachers, a nurse, doctor, psychologist and 10volunteers cater for the children's needs. Theylearn handicrafts and receive assistance withtheir school work.

"The Center is the only reason why we survive,"says Vartouhi Petrosyan. "In order to receivefood my children attend a boarding school butthey don't like it there. After classes finish at2pm, they go to the Center and stay until 6pm.They like spending their time at the Center.Geghanush is like a second mother to them."

When Svetlana and Emma first visited thecenter they couldn't even read. Now, thanks toaccess to equipment at the center, Svetlanasays she wants to become a computerprogrammer. However, although Svetlana andEmma now receive an education, that is not tosay that the family's situation has otherwiseimproved.

In April, Vartouhi Petrosyan was admitted intohospital after the psychological pressure ofliving below the national poverty line took itstoll. "She was beating her children and walkingaround with a knife," says Gyunashyan. "Wetook her to the psychological center and they

Community-based Care Centers


17

said that she was dangerous and had to betaken to hospital."

One month later, after Vartouhi receivedtreatment, Svetlana and Emma were reunitedwith their mother. Without support from theShirak International Association, the experiencemight have torn the family apart. Like manyother children in the same situation, 13-year-oldSvetlana has already aged beyond her years.

"I am ready to work to look after my mother,"she says. "My dream is to have a strong family.I don't want to be a burden to my motherbecause I know how difficult it is to find food."

Gyunashyan says that none of the children inher care have otherwise been separated fromtheir families. As a result of poverty there hasbeen a significant increase in the number ofchildren from vulnerable families enrolled intospecialized boarding schools and children's

homes originally intended for children withdisabilities or those without parents.

"This initiative is essential for the developmentof a state strategy on alternative care toprevent the institutionalization of children atrisk," adds Naira Avetisyan, UNICEF's ChildProtection Officer.

"The role of the local authorities andcommunity must be encouraged to ensure thesustainability of such initiatives as part of astate policy on children and families at risk."

18

Like many other pensioners, Vahe’s

grandfather struggles to survive on a pension

that does not even cover the price of bread. To

one side, with a newborn child still swaddled

in her arms, his daughter stands motionless,

devoid of any emotion as a social worker and

psychologist from the Fund for Armenian

Relief's Outpatient Service assess whether

seven-year-old Vahe should be removed from

his family.

One week earlier, the Armenian Commission ofMinors contacted FAR with concerns that thechild was deprived of appropriate parental care.An assessment team from the OutpatientService was immediately dispatched. "Whenwe visited the family we could see that theshelter, if we can call it that, where Vahe wasliving was dangerous for his health," saysLusine Khachatryan, the social worker assignedto his case. "Because of this, an earlyintervention had to be made."

Lacking even a birth certificate, the police latercomplete all the necessary documentationbefore transporting him to the Fund forArmenian Relief's Children's Reception andOrientation Center – effectively a "clearinghouse" for vulnerable children at risk in theZeytun district of the capital. Since the centerwas opened in February 2000, more than 700children have passed through its doors.

In May 2004, UNICEF funded the Center'sOutpatient Service.

Two hours later, when Vahe arrives at the FARCenter, he undergoes a medical checkup beforebeing quarantined. Although otherwise healthy,scars on his back show that he has recentlysuffered from scabies. As a matter ofprecaution his hair is also sprayed with achemical that will kill any lice beforeshowering, perhaps for the first time in his life.

Vahe then changes into a clean set of clothesand settles down in the recently-constructedand purpose-built isolation wing that willaccommodate him for the next few days.

Karine Hayrapetyan, the center's pediatrician,says that she has noticed a significantdeterioration in the health of children broughtto her in the past year. "There were cases oftuberculosis before," she gives as an example,"but they were passive. This year, however, notonly have cases been active but they haveincreased. The fact that we've had cases ofsyphilis in children as young as twelve alsosays something about the situation inArmenia."

"There has been an increase in the number ofcases of parental negligence where children areabused within the family," says ArmenPashinyan, the Outpatient Service'spsychologist. "Now we will try to address thefamily's psychological situation to see if it ispossible for them to take him back but ofcourse, it's going to be impossible to build a"paradise" for him at home."

UNICEF's Child Protection Project Assistant,Arman Darbinyan, knows this reality only toowell. Less than a month ago, he visited anotherfamily with the FAR Outpatient Service.

"The situation was very, very bad," heremembers. "You couldn't say that theconditions were fit for anyone to live in. Thefamily was living in something like a derelicttrain wagon that was about four square metersin size. There was only one bed toaccommodate 3 people – a 3-year-old boy, his21-year-old disabled brother and their motherwho was an alcoholic. There was nothing else."

It was also suspected that in order to makeends meet, the mother was working as a

Outreach Services


19

prostitute but the main concern was that heryoungest child was neglected. Every night, herfriends would gather in this tiny living space tosmoke and drink vodka. Although admittedlyhappy by nature, the boy was under-developedand could hardly speak. He also hadtuberculosis.

"It was a pity," says Darbinyan, even though heis glad to notice a marked improvement in thechild who still remains temporarily in the FARCenter. "Despite the situation, the mother andchild were very attached to each other and shecried when he was taken away. On the otherhand, the conditions were very bad and he wasdefinitely in danger."

In the past, and in lieu of fostering options,children at risk would eventually end up in aChildren's Home or Boarding School, but SarkisMovsisyan, Head of the Social Department atthe FAR Center, says that the service will

instead try to facilitate and support thereintegration of children back into theirfamilies.

According to Movsisyan, approximately 65 percent of children have been successfullyreintegrated since 2000 and the new OutpatientService should increase that percentage in thefuture.

"The Case Management, Harm Reduction andMonitoring Outpatient Service for Children atRisk and their Families service is reallybeneficial to the work of this Center," he says."We are trying to help children remain withtheir families and in this respect, themonitoring aspect of the service is important toreduce the risk of them falling into neglectagain. This service will definitely help usprevent that in the future."

20

According to official statistics, there are over

8,000 children with disabilities living in the

Republic of Armenia, many of which have been

isolated from society and are excluded from

mainstream education.

But thanks to an initiative supported byUNICEF, the stigma attached to disabilities inArmenia is slowly disappearing. Hundreds ofchildren who would otherwise have beendenied a proper education can now studyalongside those without any disability at all.

"We are creating equal opportunities andaccess to education for children withdisabilities," says Susanna Tadevosyan,President of the Bridge of Hope NGO.Established in 1996, the organization continuesto expand based on its experience to date. Inaddition to supporting inclusive education forchildren with disabilities in five regular schoolsin the Armenian capital, for example, Bridge ofHope also provides community-based servicesthrough Child Development Centers in Dilijan,Ijevan, Berd and Noyemberian.

The four centers that cater for over 400 childrenare located in Armenia's north eastern regionof Tavoush which was chosen because it alsosuffered the most from cross-border shellingduring the conflict with neighboring Azerbaijanover the disputed territory of NagornoKarabakh. It is also one of the poorest in theRepublic.

Unlike other regions in Armenia, there werealso no soviet-era specialized boarding schoolssituated in the region to cater for children withdisabilities. As a result, not only were disabledchildren denied access to mainstreameducation but they were also prevented fromreceiving any kind of education at all. Manyweren't even taught at home.

"We started to identify the families of childrenwith disabilities and then set about mobilizingthe parents," says Tadevosyan. "We identifiedthe children through the local social servicesbut even so, some families continued to hidetheir disabled children from the community,especially those living in villages."

While the centers cater for children aged from 3years of age to 18, some children aged 14 or 15had never even attended school before. "It isvery difficult to educate these children," saysTadevosyan, "but it is certainly not too late."

"My daughter was born with Cerebral Palsy,"says one mother whose child has benefitedfrom the work of the organization. "Relativestried to convince me that my daughter,Ashkhen, wasn't normal and would destroy mylife and that of my family. My husbandabandoned me and I was left alone."

Ashkhen grew up in isolation and was deprivedof the opportunity to interact with otherchildren until she was later enrolled into aspecialized boarding school that offered only awatered-down curriculum for children withlearning disabilities. Ashkhen returned homeon weekends. In 1996, however, when hermother heard about Bridge of Hope, she waseager to find out more.

"When I entered the center, the first thing Inoticed was that there were non-disabledchildren there," she says. "I never thought thatdisabled and non-disabled children could relateto each other." Sixty per cent of the childrenthat attend are not disabled and of those thatare, nearly half are diagnosed with cerebralpalsy and a third with Down's Syndrome.

Over the years, while still attending thespecialized school, Tatevik says that Ashkhendeveloped quickly, becoming more

Inclusive Education


communicable and confident. In 1999, at theage of 15, Bridge of Hope helped Ashkhenmake the move to a regular school close towhere she lives. She is now one of the mostactive and high-achieving children in her class.

UNICEF started collaborating with Bridge ofHope in 1998 and continues to support theNGO with technical support for its community-based centers. "UNICEF is like a resource centerfor us," says Tadevosyan, "especially when itcomes to advocacy and lobbying work. In fact,it is very important for us to have this supportbecause we feel empowered."

However, sustainability is the key andTadevosyan also says that it is the goal of theNGO to partner with local authorities andcommunities. The model they are creating forinclusive education in Armenia has alsoattracted the attention of NGOs hoping toachieve similar results in neighboring republics.

And the impact is certainly felt in Armenia. Fiveyears ago, Bridge of Hope established amonthly magazine which is distributed to 50regular schools in Yerevan and Tavoush. Bothchildren with and without disabilities providethe content for the magazine and are involvedin every aspect of its production.

"The magazine aims to raise awareness andchange the attitude towards disabilities," saysTadevosyan. "Through it, we can involve allchildren in advocating the rights of the child aswell as change society’s perception of thosewith disabilities."

21

24

Education has always been traditionally

prioritized by the state and local communities

in Armenia although socio-economic

conditions and over-staffing have contributed

to the emergence of significant problems since

independence was declared in 1991. With

public expenditure on education falling from

2.2 per cent of GDP in 1999 to 1.9 per cent in

2002, absenteeism and drop out rates remain

high for children from vulnerable families and

25 per cent of children do not continue studies

after grade 8.

Children from vulnerable communities,including those from ethnic minority groups,often enter school with a poor grasp of theArmenian language and face additionalproblems such as the lack of basic schoolsupplies and textbooks in their mother tongue.Attendance rates for children from refugee andminority communities are half the nationalaverage and UNICEF's first priority hastherefore been to respond to the mostimmediate needs of schools and kindergartensin the five most disadvantaged regions ofArmenia such as the supply of educationalmaterials and teacher training.

In 1996, ownership of pre-school institutionswas transferred to local government andcommunities that often lacked the necessaryfinancial resources, knowledge and ability tomaintain them. Although attendance was notmandatory during the Soviet era with only 47per cent of eligible children enrolled, the figurehas since dropped to 25 per cent, the lowest inthe CEE/CIS.

Studies show that preschool education has adecisive impact upon the emotional andphysical development of children. Because ofthis, UNICEF will support the government withthe implementation of a comprehensive

programme for preschool childcare, educationand development during 2005.

By supporting the development andintroduction of new policies and strategies,decrees and regulations, UNICEF will alsosupport the government in improving thequality of existing services as well asintroducing low-cost alternative services forvulnerable communities in Armenia. It is alsosupporting the development of parentaleducation to improve the level of home-basededucation for those currently not attending pre-school.

More than 2,000 caregivers have already beentrained in child-centered pre-school teachingand care practices. Alternative services havebeen successfully piloted in 5 preschools in theArarat region and resulted in the enrolment ofover 180 children who did not previouslyattend. There are also five parental resourcecenters in the Gegharkunik region of therepublic.

Although there is generally no gender disparitybetween the sexes, in national minoritycommunities, girls are more likely not tocontinue studies after grade 8. Moreover,because educational institutions receivefunding on a per capita basis, lower attendancefigures are often not reported. As part of itsnew country strategy, UNICEF is assessing theability and capacity to monitor school drop outrates on both the national and local level.

The Life Skills project is one of severaleducational reform initiatives that have beenundertaken in Armenia since the adoption ofthe 1995 Constitution, which affirmed the rightof all citizens to free education, and the 1999Law on Education that proposed thehumanization of education with a focus on the

EDUCATION

25

development of the individual as well ashuman rights and civic consciousness.

UNICEF-supported Life Skills is a shift from ateacher-centered, knowledge-driven process ofschooling to one where knowledge, skills andvalues are seen as interrelated and wherepupils are considered a vital part of learningprocess. Acceptance of the significance of LifeSkills at the national level has been confirmedby its inclusion in the recently revised nationalcurriculum that will guide reforms in the areaof education in Armenia for the foreseeablefuture.

UNICEF-supported Life Skills contributes to thegradual development of a fully functioningdemocracy in Armenia and related to this goal,UNICEF also supports the training of schooldirectors and school boards in the country. Thenew system in place since reforms of thefinancial administration and management of

schools were introduced in 1998 requires thatschool management be conducted throughboards comprising of teachers, parents and thelocal community.

Now, with support from UNICEF, the Ministry ofEducation and Science has officially endorsedguidelines to allow student councils toparticipate in the management of schools. In2004, UNICEF also devised the conceptualstandards for child-friendly schools and, in2005, will finalize criteria to ensure a safe andenabling school environment for all children.This will contribute to the improvement of theeducational system as well as school facilitiesin Armenia.

26

It might seem a little early for Heghine

Suvaryan to make use of the parental resource

center established at her local kindergarten but

that is precisely what the expectant mother is

doing. Although she won’t give birth until

November, by browsing through reference

material in a room furnished, equipped and

supplied by UNICEF, she is already thinking

ahead.

Opposite sits Keghetzig Kocharyan, a mother oftwo. Her eldest child didn’t attend kindergartenbut her six-year-old daughter, Sona, is now inher final pre-school year. "I can see thedifference," she says. "Because my son neverattended kindergarten he wasn’t prepared forschool. Even his hand wasn’t prepared [forwriting]. It was difficult for him at first."

Marine Soukhudyan, UNICEF’s EducationProject Officer, knows this only too well.

"When children aren’t in possession of thebasics for entering school, it is more difficultfor them to adjust to this new environment andthey are less communicative with their teachersand peers," she says. "They have already beendeprived of the opportunity to open their mindsto explore, compare and learn. That is onereason why there are only two to five goodpupils on average in every class at schools inArmenia and why many children are unable tofully grasp the curriculum presented."

In order to address this problem, the ArmenianGovernment now intends to make enrollmentin pre-school classes mandatory for children atthe age of five. Because most kindergartens arerigid and inflexible, the plan is to make themmore child and parent-friendly with hours andservices designed to cater to the needs ofparents and their children. This shouldencourage higher figures for enrollment andattendance.

UNICEF will also support efforts to specificallytarget parents and improve the level of home-based education in communities without anykindergarten or pre-school facility at all.

In Vanadzor, the two mothers certainly appearrelaxed in this setting and totally at ease. Atfirst glance this might be considered as normala kindergarten as any to be found in the Westbut appearances can be deceptive. Althoughthe kindergarten in Armenia’s third largest citycan accommodate 120 children, only 75 of 107currently enrolled attend on a regular basis.Winter is the most difficult time when the costof heating taxes an already overstretchedbudget.

Nevertheless, attendance is higher than at mostkindergartens in Armenia. In this residentialdistrict of Vanadzor, for example, only 30 percent of eligible children attend kindergarten orpre-school classes. Receiving just $4,000 peryear from the community budget to cover thecost of salaries and utilities in addition to the $5per month fee that most parents have to pay,it’s amazing that this kindergarten is operatingat all.

Yet, despite adverse economic conditions, thekindergarten can be considered a success in acountry where only 2 out of 10 children areenrolled in any form of pre-school educationalfacility. What makes it different, however, is theapproach taken by the staff. Rather thancomplain about a lack of resources, newmethodologies introduced by UNICEF arequickly taken on board by a staff that is eagerto learn and adapt.

Outside the Director’s office, traditionalArmenian dolls made by the staff withmaterials supplied by parents decorate thewalls. Downstairs, a class of six-year-olds playscheckers with the tops collected from dozens of

Pre-School Education

Feature Education

27

soft drink bottles. As sad as it might sound, thetops are actually quite colorful and appealing.To one side of the room sit cardboard trafficlights that will later be used to teach thechildren about road-safety.

The Director is also keen to point out the treesand shrubs outside that were planted andnurtured by the children. Although there hasbeen no instruction to raise environmentalawareness among these pre-school children, itis of vital importance that they do. Vanadzorwas devastated by the 1988 earthquake anddeforestation has occurred on a massive scale.

However, Robert Stepanyan, the Head of theDepartment of Information Analysis andDevelopment at the Ministry of Education andScience, resigns himself to the fact that thiskindergarten is representative of only 20 percent of those in the republic. Even in the Sovietera, enrollment stood at just 45 per cent ofeligible children with most parents viewing

kindergartens as more of a “repository” than assomewhere necessary for child development.

"There are a number of other reasons for thecurrent situation," explains Stepanyan. "Themain reason, of course, is that communities donot have the financial resources to maintaintheir local kindergartens. In addition, someparents cannot even afford the small monthlyfee charged for their children to attend. Othersare unhappy with the level and quality ofservices offered."

But Stepanyan is confident that the situationwill change. UNICEF and the World Bank arealready establishing a working group to resolvethe many problems facing kindergartens andpre-schools in Armenia. By introducing arevised curriculum and a new set of standards,Stepanyan also believes that kindergartenssuch as the one in Vanadzor will no longer bethe exception rather than the rule - even iffinancial resources are lacking.

28

A teenager is infected with HIV during a

contaminated blood transfusion yet, despite

contracting the virus that causes AIDS through

no fault of his own, is ostracized by his friends,

classmates and teachers.

What would you do if that teenager was yourfriend? Would you be willing to offer yourmoral support? And what if that teenagerwasn't your friend but in actual fact, were you?How would you expect to be treated?

This is just one of many scenarios presented tochildren attending Life Skills classes that arenow taught in most schools as part of thenational curriculum in the Republic of Armenia.The classes are part of a UNICEF-developedframework to develop a rights-based,interactive and participatory educationalsystem.

Characterized as "inclusive, healthy andprotective for all children,” lessons indeveloping skills that are relevant to the "realworld" also allow schoolchildren theopportunity to formulate and express their ownopinions on issues that might otherwise beignored or inadequately covered by other, moremainstream classes.

In School No. 120 in the Erebuni District of theArmenian capital, for example, as skills-basededucation has been shown to be more effectivein promoting healthier lifestyles, the classesoffer children the only opportunity they have tolearn about the risk of infection from HIV/AIDS.

Moreover, interactive teaching methods alsoimprove individual assertiveness andcommunication skills that can be utilized inlater life. Indeed, an independent reportcommissioned by UNICEF in 2001 assessed theproject positively, supporting UNICEF's opinionthat "possessing life skills is critical to young

people's ability to positively adapt to and dealwith the demands and challenges of life."

As a result, Life Skills classes will be extendedto every school in the Republic during 2005.

Yet, despite the benefits, not everyone washappy when Life Skills classes were firstintroduced in Armenia. Six years ago at SchoolNo. 120, for example, many parents wereinstead shocked to discover what their childrenwere learning.

In fact, teacher Karine Harutiunyan says thatthere was even resistance to teaching Life Skillsfrom other teachers, including the school'sDirector. Despite her training, by touching uponsensitive subjects such as trafficking, alcoholand drug abuse as well as the environment,she says that she was instead accused of beinga 'provocateur.'

"There was a lot of resistance at first but nowthere is none at all,” she says. “When parentsfirst heard about these classes they made manycomplaints but now, some even say that theywould like to participate."

Turning back to her class, Karine Harutiunyaninstructs the children to form separate groupsof four to discuss the given scenario that hasalready been read out aloud from a teacher'smanual produced and supplied by UNICEF.

After discussing the scenario, the children thenpass a pomegranate to each other, taking turnsto express their own opinion. There are noright and wrong answers, the children laterexplain. Instead, they are simply being giventhe opportunity to formulate ideas and toexpress themselves.

And it is this point that Harutiunyan wants tostress the most.

Life Skills

Feature Education

29

Not only is the pomegranate considered asymbol of national significance in Armenia, shesays, but it also represents democracy."Beneath a tough outer shell, the seeds are allequal," she explains, adding that children notonly talk about their own rights but also thoseof others.

And such an approach in a country which stillfaces a long and difficult transformation awayfrom a totalitarian past is of vital importance.

Even today, more than a decade afterindependence was declared from the formerSoviet Union, many citizens still lack theconfidence or ability to demand that theirvoices be heard. Indeed, some even lack theinclination to do so.

Such attitudes, however, may now bechanging.

"In this class we are allowed the freedom tothink," says 14-year-old Samuel. "Because we'renot given marks, we don't have to worry thatby expressing our own ideas and opinions we'llbe later told that we're wrong."

"It's very offensive if someone ignores youropinion," adds Anoush, another 14-year-old inthe same class. "Nobody has the right to ignoreme."

32

In the years following the devastating

earthquake that hit northern Armenia in 1988,

infant formula was imported into the republic

as humanitarian assistance and distributed free

of charge through polyclinics. As a result,

levels of breastfeeding were substantially

reduced.

This drastic decline was blamed on theshortage of food, economic hardship and thecontinuous stress that had endured since thecollapse of the Soviet Union. Mothers withyoung infants were reporting insufficient breastmilk and turned to infant formula because theylacked confidence in their breastfeedingcapabilities while living under such adverseconditions.

Studies show that exclusive breastfeeding upuntil the age of six months provides the bestnutrition and protection from illnesses forinfants. As a result, UNICEF began to supportthe implementation of a programme topromote breastfeeding in Armenia through thetraining of health providers in maternity unitsand parental education. The rate of exclusivebreastfeeding for 6 months increased from 0.7in 1993 to 30 per cent in 2000.

In addition, there are now 15 baby-friendlyhospitals out of 55, a UNICEF and World HealthOrganization (WHO) initiative that encouragesmaternity wings in Armenia to become centersfor the support of breastfeeding. UNICEF hasextended the programme to include polyclinicsso that the continuity of breastfeeding practicesthat mothers acquire at the maternity level canbe ensured.

Although the Armenian Government hasadopted some clauses of the International Codeof Marketing Breast Milk Substitutes, there isno comprehensive law although UNICEF isworking with the Ministry of Health and

National Assembly to introduce legislationgoverning the marketing of breast milksubstitutes.

The decrease in the rate of infant mortality inArmenia can be directly attributed to theimplementation of the breastfeeding,immunization programs and IntegratedManagement of Childhood Illnesses (IMCI).IMCI is an approach to child health that focuseson the well-being of the whole child. IMCI aimsto reduce death, illness and disability, and topromote improved growth and developmentamong children under five years of age. IMCIincludes both preventive and curative elementsthat are implemented by families andcommunities as well as by health facilities. Themajor components of these programmesinclude UNICEF's procurement of vaccines,essential drugs and supplies, training of healthproviders and parental education.

UNICEF is now assisting Armenia in thedevelopment of a strategy to eliminate measlesand provides vaccines against measles, mumpsand rubella (MMR) as well as other preventablediseases for the national immunizationschedule. Access to immunization services inArmenia is high and national coverage exceeds90 per cent.

In 2002, the World Health Organization certifiedEurope as a polio free region. This alsoincluded Armenia where the last case of poliowas registered in 1994. In acknowledgement forthe role it played in eliminating the diseasefrom the country, the Armenian Governmentmade special mention of UNICEF.

Armenia is considered an endemic zone forIodine Deficiency Disorders (IDD) whichjeopardizes the mental and physical health ofchildren and affects the reproductive health ofwomen. Another less visible consequence of

HEALTH

33

IDD is a level of mental impairment that lowersintellectual prowess at home, at school and atwork.

During the Soviet era, salt in Armenia wasiodized but the quality of equipment and thestandard of iodization was so low thatbeginning in 1995, UNICEF supported theprocurement of new equipment as well aspotassium iodate which is used for saltiodization. As a result, the consumption ofiodized salt has risen to over 80 per cent.

UNICEF has also assisted in the development ofguidelines and protocols to prevent thetransmission of HIV from parent to child.UNICEF supported the training of a team of 26national trainers in 2004 and organized atraining session on the Prevention of Parent to

Child Transmission of HIV/AIDS (PPTCT) for 82heads of regional ante-natal care services andchief gynecologists.

Through cooperation with the Government andother national and international counterparts,UNICEF will continue to ensure that theprogress achieved is sustained and expandedto meet the Millennium Development Goal ofreducing child mortality by two thirds by 2015.

34

Eighteen days after his birth, rapid breathing

concerned a young infant's mother so much

that she immediately sought medical

attention. With a temperature of 38.5°

centigrade, the doctor diagnosed Hovik, now

aged 5 months, with pneumonia. Thanks to

early intervention, a life was probably saved.

Years earlier, however, the story might have

been different.

When Armenia declared its independence in1991, few realized that expenditure on socialservices, and health in particular, would bedrastically reduced. Still suffering from thedevastating effects of earthquake and war,infant mortality rose alarmingly in the post-soviet Republic.

In 1998, official statistics reported that one thirdof children that died from pneumonia inArmenia had not received any treatment in the24 hours preceding their deaths. In 2001,according to the Armenian Ministry of Health,over 20 per cent of infant deaths occurred athome or on the way to hospital.

In response to this situation, UNICEF decided toimplement a strategy known as the IntegratedManagement of Childhood Illnesses (IMCI) inArmenia. Since 1996, the strategy has beensuccessfully implemented in over 80 countries.After orientation meetings held in October1999, training for IMCI began in May 2001. Thefollowing year, additional training was carriedout in Martuni, a district situated in Armenia 'snorth-eastern Gegharkunik region which, untilrecently, had one of the highest rates of infantmortality in the Republic.

"This is a highland region," says Dr. LenaHovannisyan, Senior Pediatrician and DeputyDirector of the Polyclinic in Martuni. "Thewinters are very harsh and last seven or eight

months. There is no industry and livingconditions are very poor."

By consulting a chart that conforms tointernational standards adapted for use inArmenia, nurses can identify the most commonsymptoms of illnesses that children under theage of five might suffer from and can respondto their immediate needs.

"First the nurse checks if any symptoms arelisted in the red section of the chart becausethese are the serious problems," explainsHovannisyan. "Then they check the yellowsection which lists conditions that can betreated without hospitalization if the propermedicines are prescribed. Finally, symptomsthat can be treated at home without medicationare listed in green."

Another important component has been toraise awareness among parents themselves –especially in a region where conservativetraditions still play an important role in familylife. In the past, some mothers would seektreatment only upon the advice of other familymembers rather than the recommendation oftrained medical professionals. Now, mothersfeel empowered enough to make decisionsbased on what they have learned from IMCI.

"Before the program, mothers would take upour time with questions and concerns but nowthey know how to treat their children if theydisplay minor or less serious symptoms, " saysKarine Grigoryan, a District Pediatrician andTrainer for IMCI,

"Medical personnel are now very self-confidentand competent," adds Dr. Hovannisyan, "Thenumber of unnecessary hospitalizations haseven decreased because nurses can identify ifand when it's possible to treat a child at home."There have been other improvements as well.

Integrated Management of Childhood Illnesses

Feature Health

35

For example, the number of children sufferingfrom acute dehydration has been significantlyreduced.

According to Hovannisyan, the reduction in thenumber of cases of acute dehydration is almostentirely down to the introduction of Rehydronand other drugs provided free of charge byUNICEF for IMCI in the first year. Immunizationwith vaccines incorporated into the NationalImmunization Schedule provided with UNICEFsupport has also played an important role.

"If you went to the hospital a few years ago,you would see about ten children sufferingfrom dehydration. Now, thanks to IMCI andRehydron, it's unlikely that you'll see any. Theintroduction of Rehydron was really arevolution."

"Before the programme there were manyserious cases here," agrees Karine Manoukyan,

a nurse in the village of Zorakar on the outskirtsof Martuni. "So serious was one case ofdehydration in a three-year-old girl that herparents thought that she would die. By chance,we ran into the parents and thanks to IMCI,could administer the correct treatment in time."

But IMCI has also resulted in other less visibleachievements. "Another change has been thatfor many years we were unable to expand ourknowledge and acquire new skills," saysManoukyan. "IMCI has helped us upgrade bothour knowledge and skills as well as encourageour own professional growth. Now we feel likereal pediatricians."

37

As of April 2005, there were 304 officially

registered cases of human immunodeficiency

virus (HIV), including 57 under the age of 24,

among citizens of the Republic of Armenia.

However, the real number is believed to be 10

times higher. Professionals in the fields of

health, education, social welfare and other

sectors to whom young people could turn for

help are rarely trained in matters of sexuality,

sexual and reproductive health or in the

counseling of young people.

In this environment, sexually active youngpeople are at a greater risk of unwantedpregnancy, induced abortion, sexuallytransmitted infections (STIs), HIV, and theassociated social and health consequences ofthese risks. The lack of education and servicesis even more risky for disadvantaged groups ofadolescents such as those who areinstitutionalized or deprived of a familyenvironment.

Until recently, the importance of sexualeducation for young people in Armenia waslargely ignored. It has not been incorporatedinto the secondary school curriculum and norelated teacher-training syllabus exists. As aresult, parents and other family members, aswell as the larger community, are unable toeffectively support young people in this rapidlychanging environment.

Although attitudes in society towards thosediagnosed with HIV are changing, there is stilldiscrimination. UNICEF is working inpartnership with other local and internationalorganizations to change this situation. UNICEFseeks to strengthen the capacities of youngpeople aged 10-18 in preventing infection fromHIV/STIs through peer education, youth friendlyhealth services, and life skills based education.

UNICEF is also supporting programmes andactivities that seek to increase young people'saccess to information so that they can betterprotect themselves from HIV and STIs. TheYoung People's Health and Developmentproject aims to achieve this goal as well as helpyoung people identify situations that placethem at risk.

In 2005, UNICEF will provide technical supportfor collecting and analyzing behavioral data tobetter understand the context of vulnerabilityand the types of risky behavior that youngpeople aged 10-18 engage in. This will providethe basis for developing and implementingappropriate interventions to improve the healthof young people by minimizing the risk of HIVinfection and contribute to the prevention of itsspread in Armenia.

Recommendations on reducing risk andpreventing HIV infection in infants and youngchildren were also developed for the Ministryof Health.

Young People’s Health & Development

38

Any visitor to School No. 43 in the Armenian

capital might easily mistake Veronica Seropyan

for a teacher. Yet, standing in front of 13 pupils

aged between 14 and 16, there is something

different about her class. The ubiquitous red

ribbons adorning the children’s t-shirts perhaps

provide a clue.

Seropyan isn’t a teacher but a member of theAIDS Prevention, Education and Care (APEC)NGO charged with the task of training 1,400schoolchildren as peer educators by May 2005.Through interactive teaching methods,discussion and games, the children learn aboutthe danger of infection from HIV/AIDS.

Peer education has been found to be aneffective method in reaching a specific targetgroup that might otherwise not listen tosomeone older or from a different socialbackground. In the summer, 120 of the mostpromising educators will attend a summercamp to expand their knowledge still further.

"We talk about the history of the disease," saysSeropyan, "and how it is spread, what effect ithas on the immune system as well as thebiological and psychological development ofteenagers. Later, they will pass that knowledgeon by talking with friends and classmates."

And there is a reason why APEC has chosen totarget this particular age group. AlthoughArmenia is considered a country with a lowprevalence of HIV/AIDS, the number of thoseinfected is growing. Last December, the UnitedNations warned that the republic faces a"potential disaster" if nothing is done to stop itsspread.

Moreover, while only 57 of 304 officiallyregistered cases of HIV/AIDS among Armeniancitizens were aged less than 24, surveys ofyouth and especially students indicate that

even though there is a high level of awarenessregarding the importance of practicing safersex, behaviour can be just the opposite.

Therefore, in 2001, UNICEF supported a pilotproject implemented by APEC in Armenia’ssouthern-most Siunik region to alert youngpeople to the danger of HIV/AIDS. Round-tablediscussions were held with school principalsand representatives of the local authorities. Itwas also decided to conduct a survey of youthin the region. The results were alarming.

While respondents knew of the dangers ofHIV/AIDS, very few knew about preventativemeasures. Instead, most teenagers receivedtheir information from unreliable sources suchas films or from friends who lacked acomprehensive understanding of the disease.The survey was repeated in 2003 and APECdecided to start training peer educators.

Although the initial reason for engaging inAIDS education was to prevent new infectionsfrom occurring, the need to reduce the stigmaand discrimination often attached to thedisease was also identified. In many countries,talk of HIV is often accompanied by ignorance,resentment and hatred by those who considerthemselves to be least at risk.

"The reality is that HIV/AIDS affects everyone,"says Emil Sahakyan, UNICEF’s Information andCommunication Officer. "However, becausemany people think that it will not affect them,they don’t take precautions. At the same time,informing people in the wrong way createsfear, stigma and discrimination."

As a result, on World AIDS day in 2003, UNICEFalso funded APEC’s campaign to raiseawareness of HIV/AIDS through the massmedia. The campaign sought to promotetolerance in society towards those living with

Peer Education

Feature Young People’s Health & Development

39

the disease and resulted in the distribution of80,000 leaflets, 2,500 calendars and 4,500 redribbons. A 1-minute video clip was also shownon 16 television stations in the republic.

In 2004, UNICEF also funded a summer schoolorganized by APEC to increase the capacity andknowledge of existing peer educators. In total,96 students were involved. Participantsreceived up-to-date information, booklets andleaflets and were awarded with certificates atthe end of six training sessions.

In 2005, UNICEF will also support theestablishment of youth friendly health servicesthroughout Armenia.

Meanwhile, because APEC’s work has been sosuccessful and is constantly being expanded,the NGO has now decided to concentrate solelyon education and preventative activities. Anoffshoot of the NGO, Real World – Real People,

will concern itself with people living withHIV/AIDS.

"I can’t say that Armenia is very open indiscussing such issues," says ArtakMushegyan, President of the NGO, "but thesituation is changing. We need time tounderstand how important it is to speak aboutthis problem which is why we also stress theimportance of educating parents and teachersas well."

40

At the age of 14, Gor Baghdasaryan, a young

filmmaker working with the Manana Youth-

Cultural non-governmental organization in

Yerevan, won the first-ever 1-Minute Video

Junior Award organized by UNICEF's Young

People's Media Network, the Sandberg

Institute and the European Cultural

Foundation.

His film, "Children must live without War," wasselected by the Oscar-nominated film director,Karim Traidia, as the best one-minute film inthe junior category. "Gor's film had a verystraightforward message, a great script and aninteresting style of filming that captures the eyefrom beginning to end," said Traidia during theawards ceremony held in Amsterdam on 10November 2002.

Three years later, now with many more filmsunder his belt, the young filmmaker has theunmistakable air of a serious artist about him.

"I tend to focus a lot on war because Armeniahas had many problems with conflict,"responds Baghdasaryan when asked why hechose to make a film with an anti-war message."When I grew up," he explains, "the war withAzerbaijan was continuing and, from my ownexperience, I can understand why it isn't goodfor children to live during times of conflict. I'mnot sure if my films will change anything butit's very important that they have an effect."

However, things might have been differentwithout encouragement from Manana, a youth-educational cultural center founded in 1995 inthe Armenian capital. Although theorganization began by encouraging children towrite articles and poems about their lives andsurroundings, it later expanded to incorporatephotojournalism, filmmaking, web design,publishing and painting. Numbers vary fromyear to year but on average, approximately 50

children aged between 6 and 18 participate inthe organization's activities.

"At first, there was only one club for journalismbut when the other clubs opened, filmmakingbecame my favorite," remembersBaghdasaryan. "That's why I decided tobecome a Director. While I liked the idea oftelling a story in writing, it is more effective totell it through images. I like to realize the ideasthat I have in my head through film."

Emil Sahakyan, UNICEF's Information &Communications Officer in Armenia, says thatthe international organization first started towork with Manana in order to promote theinvolvement of children and young people inthe media. "In 2003, within the framework ofthe International Children's Broadcasting Day(ICDB), students from Manana developedscenarios and produced a series of 1-minutevideos entitled 'My Hero'," he says.

However, the films that were made forArmenian television also found a larger, moreinternational audience. In March 2004 at theVideotivoli Film Festival in Finland, out of 80films selected for screening from 400 workssubmitted, 10 were from the "My Hero" series.The same month, "End of the Line," a filmproduced as part of UNICEF's "Leave no childout" campaign, was shown at the Palma deMallorca film festival for professionals whereBaghdasaryan was also invited to attend as aguest.

But, despite this success in the form ofrecognition from the international filmcommunity, perhaps Manana has alsomanaged to succeed on a more personallevel."I have learned many things here," saysBaghdasaryan, "and I am not sure what thefuture would hold in store for me if I wasn'tinvolved with Manana."

Freedom of Expression

Feature Young People’s Health & Development

UNICEF Armenia14 Adamyan Street,Yerevan, Republic of Armenia

(374-10) 523-546580-174543-809

[email protected]

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