Azerbaijan International

Autumn 1996 (4.3)
Pages 4-5, 86

Aziza Captivates Czechs
I recently attended a concert of Aziza Mustafa Zadeh. To tell you the truth, I had no idea what to expect that evening at Prague's International Jazz Piano Festival as I'm not a great fan of jazz. I thought Aziza would be an older woman who looked more like a buxom opera singer.

Two other jazz piano players performed before she did. They weren't bad, but clearly Aziza stole the show. When she appeared on stage, so youthful and slim with her beautiful long dark hair, everyone was astonished.

She addressed the audience in a quiet voice, telling us how wonderful it was to be in Prague after ten years. Just before she sat down at the piano to play, she informed us, "I will begin now-with passion!" As soon as her long, slim fingers touched the keyboard, she became totally transformed into a different person. "Passion" is the only word I know that can describe her. Everyone was wondering how such a delicate-looking girl could play the piano in such a forceful, dynamic way. Beginning with the very first piece, she captured our hearts.

Then she started to accompany her playing by singing as well, and her voice with all its broad range of tremulous high and low notes made us shiver. Enthusiastic applause followed each piece. At about 11 p.m., she looked at her watch and apologized that it was time to go, but we didn't let her. We obliged her to play more and more. After the concert, my friends and I went backstage to thank her for her remarkable music. The concert was an enormous success. Aziza is putting Azerbaijan "on the map." People are beginning to know this incredible jazz performer even if they haven't heard anything about Azerbaijan itself.

Hana Jilovska
Czech Republic
May 1996

Don't Mix Politics with Medicine
I have read your magazine since its inception and have been impressed with the quality and general presentation of its format and contents. Congratulations for your excellent work in informing the U.S. readership about the Republic of Azerbaijan, its realities and vast potential opportunities.

Your Editorial regarding "Health and Medical Care" (AI 3:4, Winter 1995) was especially pertinent to a practicing orthopedic surgeon like myself, who has worked in Yerevan (Armenia) since 1989.

Having worked there for awhile now, I know that only a few of the vast number of physicians were well trained. Proper teaching as we know it here [in the U.S.] did not exist. This caused an erratic level of medical competence. The proof was evident in the quality of care that victims received from the December 1988 earthquake in Armenia and the 1986 Chernobyl nuclear disaster in the Ukraine. Both of those disasters happened under the Soviet Regime.

We also know that Soviet vaccines often caused the very diseases and complications they were supposed to prevent. Folk medicine has flourished, underlining the lack of faith people had in the Soviet health care system.

As for the point in your Editorial that the Karabakh war is the culprit for the health care woes of Azerbaijan today, it is not a serious statement and belittles our intelligence. I agree with you that the unfortunate war between neighbors in the ex-USSR has been draining human and financial resources, but it is simply naive to blame all the health care problems on the conflict itself.

One should look at the root causes of the problem, without injecting politics into the discourse. Absent the unfortunate present conflict, Azerbaijan and Armenia would still have the same problems. Reading the Editorial, if you substituted Armenia for Azerbaijan, the health care issues are identical and, in my opinion, should be addressed in parallel. Only then, once these "neighbors" are back dealing with one another normally, can they keep the infections and other diseases from crossing their borders.

Keep on with your good work and keep the issues informative, leaving the politics to future volumes, not in the issue that deals with "Health Care."

Francois S. Antounian, MD
San Francisco, CA
May 20, 1996

Editor's Response: Thanks for your observation and concern that the medical problems that we addressed in our issue about Azerbaijan's health care problems are similar to those in Armenia. No doubt, analogies can be found elsewhere in the former Soviet Union.

We agree that during the Soviet period medical care left much to be desired and that health care issues require cooperation across borders, not only between next-door neighbors, such as Azerbaijan and Armenia, but among members of the international community. And not primarily to keep infection and disease out of one's own backyard, but rather to get to the root of the problem and to eradicate it altogether by pooling medical knowledge and sharing advanced technology.

However, in regard to the Karabakh War, we beg to differ with your opinion. A more careful reading of our Health issue will reveal that we have never singled out the war as the primary cause of Azerbaijan's ills-neither in the Editorial, nor in the supporting articles.

Clearly, the war has been one of the major contributing factors, but not the single reason that Azerbaijan is experiencing a medical crisis. At the same time, establishing a permanent peace and bringing the war to a conclusion can be a significant part of the solution-once again, not the only necessary requirement.

It has never been our intention at the magazine to deliberately politicize the issue of health care. However, the facts cannot be denied: health and politics and war are inextricably linked because of the complex human and financial resources needed to untangle and resolve these problems. In fact, it's rather surprising to us that someone in the medical profession would not be among the first to admit this relationship.

Even without war, politics has always been an integral part of the formula of health care in every country in the world. In the case of the former republics, it was politics that brought about the collapse of the Soviet Union in the first place and which, today, has left each of the republics paralyzed economically so that they cannot offer their people adequate care.

Even your own explanation of why Soviet medicine was so lax and weak boils down to a question of priorities-or lack, thereof, by none other than former Soviet politicians who were in power at the time.
But the immense negative impact that the Karabakh war has had on health care in Azerbaijan cannot be ignored. To do so would be as irresponsible as to blame the war for everything that has gone wrong in medicine. Nor can the critical need to find a resolution to this conflict be ignored as an essential factor for getting Azerbaijan (and Armenia) on the road to economic recovery which, in turn, could contribute to better health care for each of their populations. Although a cease-fire has been in place for nearly 2.5 years, the deeper issues related to the resolution of the war itself have not been worked out.

You ask that politics be kept for future volumes, not those which deal with "Health Care." Consider Azerbaijan's perspective. Armenian aggression in Karabakh and the neighboring regions has left thousands dead (on both sides). In addition, Azerbaijan is suffering under the burden of supporting an enormously large, displaced population. Armenians, too, have suffered from displacement, but not by any stretch of the imagination, to the same extent.

At present, Armenians are militarily occupying 20% of Azerbaijan's territory, which has resulted in one million Azerbaijanis having had to flee for their lives-sometimes with only a few moments' notice and sometimes wearing only the clothes on their backs. Such a catastrophe would put immense pressure on any health system, much less one struggling to re-establish itself.

Today, one out of every seven Azerbaijanis living in the Republic is a refugee. That means an estimated 5% of the world's entire refugee population is trying to stay alive on the limited human and financial resources available in a relatively small country the size of Austria or the state of Maine.

It cannot be denied that this, in turn, impacts the ability of the system to provide adequate medical care to the rest of the population. Add to this the confusion of a newly independent country trying to make the economic transition from a centralized economy to one which must compete in a tough world market.

Nor should it be forgotten that because of Armenian lobbyists, the U.S. Congress has made the egregious mistake of denying direct assistance to the Azerbaijani government to help cope with this phenomenal displacement (Freedom Support Act of 1992, Section 907). Azerbaijan is the only single former Soviet republic (out of 15) which is not receiving direct U.S. government assistance. In the meantime, Armenia, one of the least populated republics, enjoys more U.S. aid per capita than any other single republic in the former Soviet Union, including Russia.

Tens of thousands of Azerbaijanis are still living in massive camps, sleeping on the ground under thread-worn tents through extreme climactic conditions-the blistering heat of summer and the driving winds and rains of winter. (See AI 2:1, Winter 1994, "The Winter of Disbelief," an issue entirely devoted to the refugee problem-available on our Web Page: ( Nor have these conditions changed very much in the past 3.5 years. For many refugees, their tragic sagas began even earlier.

Zbigniew Brzezinski, who headed President Carter's National Security Council, not so long ago visited the Sabirabad refugee camps in the central plains region of Azerbaijan, and described the living conditions as inhuman, and worse than any he had seen in his lifetime either in Palestine or Afghanistan.

How can health not be classified as a political question when one's natural resistance to infection and disease is weakened because of being forced to live in subhuman circumstances, weakened by malnutrition, lack of hygienic conditions, inaccessibility to minimal medical supplies, and lack of adequate clothing and shelter?

How can politics be denied when outbreaks of influenza, diarrhea, hepatitis, typhoid, diphtheria and malaria threaten the refugee population, targeting the most susceptible of all-children and the elderly?

Aren't politics part of the formula when refugees are unable to deal with their psychological anger and succumb to heart attacks or literally die of broken hearts because of the traumatic experience of being totally stripped from the ancestral homes of their grandparents and great-grandparents? Many stories are told of those who looked back while fleeing and saw their houses being looted, ransacked or burned to the ground. Others live with the knowledge that the aggressors have settled down, squatting on their own land and currently reside in the very homes they were forced to abandon.

And is it not a political question when fathers, the traditional economic providers of the family, are helpless against protecting their own loved ones against malnutrition, hunger and cold? Sources of revenue have been wiped out and lifetime careers destroyed. Where can fathers and family providers (many of which are single women these days) get money to fend off these evils?

Is it not a political question when children lose the chance to receive a formal education during the prime years of their lives-especially in a country where not so long ago, the literacy was estimated at 99 percent? It's not uncommon these days to hear refugee mothers complain bitterly that their 12-year-olds have attended school for only three months of their entire lives.

Political decisions both facilitate, as well as obstruct, our lives on a daily basis-every place in the world. In regard to the Karabakh Conflict, what is needed is the political will from politicians and professionals-both Azerbaijanis and Armenians-to bring this war to an end and to begin to resolve the health crises that exist in both countries. Though ending the war, in and of itself, is not a "magic bullet" in resolving all medical care problems, it is unrealistic to suppose that radical fundamental changes will, or even can, take place, at least in Azerbaijan, until the war comes to an end. Whether we like it or not, it's clearly a question of politics on every level and impossible to deny.

Azerbaijan International (4.3) Autumn 1996.
© Azerbaijan International 1996. All rights reserved.

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