Dr. Rox Anderson, Dr. Lilit Garibyan, Dr. Christine Avakoff and Dr. Hovik Stepanyan at the Wellman Center for Photomedicine in MGH. Dr. Stepanyan traveled from Yerevan to Boston to attend the Harvard Medical School CME Laser Training Course in November 2017.

Lasers Provide Ray of Light for Children and Adults Suffering in Armenia

417
0

BOSTON — A parent will do anything to help his or her child live a normal life. But, what if your child were born with life altering birthmark on their face? There is technology to treat your child, but you have no access to it. And even it there is access to it overseas, that costs a lot of money which the parents very probably do not have. This was the case, before we came to Yerevan, Armenia to change the lives of these children.

Dr. Ray Jalian, Dr. Hovik Stepanyan, Dr. Lilit Garibyan, Dr. Christine Avakoff and Dr. John Poochigian at the Armenian American Wellness center which is the other medical laser center they have established in Armenia.

Children in Armenia, born with red and purple birthmarks on their face or body, live with a life altering conditions that leaves them isolated and ostracized, ridiculed by other children in school, and deprived of a normal childhood. Although not life threating, these skin conditions have a huge psychological impact on a child’s life. In the United States and in most developed countries, these birthmarks, known as vascular anomalies, are treated shortly after birth with simple medical laser procedures. Such procedures for treating vascular birthmarks and scars, developed by Harvard Professor Dr. Rox Anderson, were made specifically to remove the birthmarks, without the need for conventional surgery. Millions of children worldwide, born with vascular anomalies, have benefited from these laser treatments, which have changed the trajectory of their entire lives.

In Armenia, these children were left untreated, because this technology did not exist. Untreated, these birthmarks become darker in color, increase in size and cause facial deformities. Unfortunately, as these children become adults, they become more isolated from their communities, and from the world. The shame associated with these lesions keeps most of them at home, as going out in public leads to uncomfortable interactions. When red birthmarks are located around the eyes, it can lead to increased pressure inside the eye, which if not diagnosed and treated, leads to blindness. This type of blindness is completely preventable, if the screening and treatment are started early.

There is nothing more deeply satisfying for doctors, than to help a child in need, and give them the opportunity to live a normal life. Successful treatment of a child enhances the quality of life of the tight knit, extended family. This is the reason Dr. Lilit Garibyan’s team decided to go Yerevan, and make history, by bringing medical laser technology, treatments, education and training for the children with vascular anomalies and scars.

Led by Garibyan, a Yerevan native, currently assistant professor of dermatology at Harvard Medical School, a team comprising dermatologists and laser experts was assembled to travel from the US to Yerevan to establish a medical laser clinic. Garibyan initiated these efforts as a resident in Dermatology at Massachusetts General Hospital/ Harvard Medical School, and was doing her postdoctoral fellowship with Anderson. This facilitated the task of obtaining lasers directly from companies that manufacture them, such as Candela-Syneron and Quanta.

Anderson is world-renowned for his contributions to laser medicine. In addition, he has conducted similar missions in Vietnam with Dr. Thanh Nga Tran, who was a classmate and co-resident with Garibyan at Harvard. At the time, Garibyan was also actively involved with Armenian-American Medical Association in Boston and served as their secretary for number of years, which helped make connections with Armenian doctors. Serendipitously, at the same time, another Armenian-American dermatologist, Dr. Christine Avakoff, was looking for a team of laser experts to travel to Armenia, with her to train a local doctor there, to perform laser treatment for vascular anomalies. Avakoff was about to retire and wanted to donate one of her own lasers to the Armenian American Wellness Center in Yerevan.

Get the Mirror in your inbox:

Garibyan also enlisted the help of her colleague and friend, Dr. Ray Jalian, who is also a laser fellowship trained Armenian dermatologist working in Los Angeles. This core team consisting of Garibyan, Anderson, Jalian and Avakoff, have worked closely together and made several trips to Yerevan to accomplish their goal of bringing much needed medical laser technology to the children of Armenia.

Their team also received much needed help from Dr. Nishan Goudsouzian, an anesthesiologist at Massachusetts General Hospital, who had close ties with Arabkir Medical Center in Yerevan. Goudsouzian traveled with the team to Yerevan and performed the general anesthesia for the children who were treated there.

Since 2013, when the team first traveled to Yerevan for this mission, they have now established two main centers in Yerevan, where medical laser treatments are done to treat children and adults. The two centers are the Armenian American Wellness Center and Arabkir Medical Center where for the first time, patients can receive laser treatments for vascular anomalies and scars.

Garibyan’s team has not only given lectures on the role of laser treatment of vascular anomalies, but has also educated the physicians on the medical management of these conditions and the associated side effects, such as blindness. Every patient with vascular anomaly known as port-wine stain around the eye, is now being screened for increased eye pressure, to start treatment before blindness occurs. Sadly, this association was not known to the doctors in Armenia, and multiple children and adults with port-wine-stain around the eye already had blindness in that eye. Thanks to this mission work, this unnecessary cause of blindness will no long happen.

Young children with another type of vascular anomaly known as hemangioma, are now being managed with oral medications, such as propranolol, instead of undergoing unnecessary and invasive surgical procedures, which may leave scars.

Hundreds of children and adults have now been treated with vascular medical lasers to remove red birthmarks from their face, giving them another chance for a normal life. This medical laser mission has now taken four different lasers, worth over $400,000, to Armenia capable of treating multiple vascular anomalies and scars. The hope for the donations is to make medical laser treatments accessible and affordable to everyone. Last month, this team even sponsored the travel and educational training, of one of the physicians from Armenia, Dr. Hovik Stepanyan, to Boston, for the Harvard Medical School Laser Training course. Stepanyan, who knew nothing about medical lasers before the training started, has now become an expert in laser treatments of vascular anomalies. He has completed several hundred medical laser treatments for patients in Armenia at the Armenian American Wellness Center. He has given two lectures in Spain and in Russian on the laser treatment outcome of his patients from Armenia. He has patient referrals from as far as Ukraine who travel to Armenia for consultation and treatment with him.

“There is no better way for me to give back to Armenia than use the education and training I have been fortunate to obtain in the US, to help children in Armenia,” Garibyan stated. “I have truly been blessed to live in the United States, to graduate from Harvard Medical School with an MD and PhD degrees, to complete residency training in dermatology at Harvard, and to meet Dr. Rox Anderson, who has become my mentor. But I can’t forget where I came from, and the people and children of Armenia who suffer from treatable skin conditions. The impact of these treatments was clearly apparent to me on our last trip to Armenia in 2016. A mother of a young girl with a facial birthmark, who had already received 4 laser treatments at the AAWC, and had obtained great results, hugged all of us with tearful eyes. Even though she could not speak English, her warm and grateful embrace told all of us how appreciative she was of this work.”

Garibyan said she encourages everyone in the community to help. If interested in getting involved and helping, contact Dr. Lilit Garibyan at lgaribyan@mgh.harvard.edu