Pediatric Cancer Treatment in Armenia Continues to Need Support

Financially, fundraising has become difficult. Demirtshyan said that doing a few online concerts or events does not produce the same result as in-person events, while costs remain the same. The majority of people in Armenia would not be able to afford these costs but children cannot be allowed not to get treatment, she said, due to funding problems.

Housing for visiting parents is on hold because it was not possible to do the fundraising planned for 2020. Instead, funding available is being used for treatment costs. It will become the first priority of the foundation when the latter are fully assured.

However, one bit of good news is that a palliative care center, the first ever in Armenia, is 90 percent finished. It will have five rooms and be completed in 2-3 months so that it will become operational in the beginning of 2021. This is for children who cannot be saved through treatment, and fortunately donations had already been received for it, though there are still a few rooms with naming opportunities left.

Special training of doctors and nurses occurred to a certain degree in 2019 but were put on hold in 2020. The doctors and residents are encouraged to present at conferences. Demirtshyan said that it is important to motivate the younger ones so they feel appreciated and stay in their own country despite incomparably low salaries. They need to do research and learn about new developments around the world. They work with platforms like the Union for International Cancer Control, headquartered in Switzerland.

Demirtshyan pointed out that providing funding for research by Armenian doctors, aside from serving as motivation to do new work, also is important as a way to increase their monthly income a bit. Dedication and passion is important, but people also need the means to support themselves and their families, she said.

The Center for Pediatric Oncology and Hematology is part of the Dr. R. H. Yolyan Hematology Center. All the hematology work in Armenia is conducted here, and some adult oncology is treated too. The Armenian government’s Ministry of Health supports these centers so that the hospital in which they are located is maintained through government funding, and certain medication is provided for the children being treated, but the resources provided are limited. The City of Smile Foundation is physically located at the hospital center although it is not connected with the ministry or government.

Organizational Structure

The City of Smile Foundation was established in 2014 by Drs. Gevorg Tamamyan and Lilit Sargsyan. It only has three fulltime staff members, including Demirtshyan, so everyone multitasks, according to the latter. It has managed to keep overhead less than 10 percent, including the cost of marketing, salaries and taxes.

While in 2019, Anna Hakobyan, wife of Prime Minister Nikol Pashinyan, was honorary chair of the board of trustees of the City of Smile Foundation, she resigned in mid-September this year due to personal reasons, while remaining a board member. As a private foundation, the City of Smile is independent of the Armenian government and all political parties.

In addition to the City of Smile board in Armenia, a City of Smile nonprofit board was created in 2020 for the United States. Cynthia Kazanjian, who spearheaded this process, said that the main purpose was to enable American donors to enjoy tax deductions in exchange for their philanthropy. It took a year and two months to finalize the process, but in the spring of 2020 501(c)3 status was achieved. In the meantime, the Armenian Missionary Association of America supported the City of Smile Foundation with office and clerical help, and tax receipts.

The successful fundraising events in various parts of the US in 2019 led to enrolling nine board members from Boston, Washington D.C., Los Angeles, New York/New Jersey, and Texas. There will be two more spots filled, to make a total of 11. Current members include Cynthia Kazanjian, Acting President (MA), Yelena Bisharyan, Fund Raising (MA), Fr. Martiros Hakobyan, Fund Raising (Houston, TX), Mariya Nagapetyan, Treasurer (CA), Shant Shekherdimian, Board Member and Medical Advisor (CA), Ester Demirtshyan, Secretary / Executive Director of City of Smile (Yerevan), and board members Leon Ariyan (NJ), Naz Atikian (CA), Avo Avetisyan (CA), Jim Kalustian (MA) and Ramella Markarian (CA).

Tracking Donations and Expenditures

When the City of Smile Foundation gives money for a particular purchase or treatment, it asks for a report from the doctor involved, and a separate report from the nurse who would give the item to the patient. Then the two report lists are reconciled. Demirtshyan said that parents nowadays are knowledgeable so it would not be easy for staff to be attempting to get bribes from them. The parents feel entitled to the aid so they would complain if something was demanded illegally, she explained.

On the macro level, Demirtshyan said that the City of Smile Foundation hires a company, usually an experienced 15-20-year-old one, for its annual audits of donations and spending. Those who donate to the foundation directly receive a report of how the money given was spent. Furthermore, quarterly reports are posted on the foundation’s website with every single child or youth’s name and the amount given for treatment for those three months.

Armenia’s tax authorities audit the foundation annually. It submits a report to the government which the tax authorities can check. The City of Smile Foundation does not have to pay taxes on donations it receives but it must pay taxes on purchases, like all charities in Armenia. Incidentally, donations are not tax-deductible in Armenia for donors. Companies can receive a very small percentage of tax-deductions.

When money was raised from the US and elsewhere in 2019, the foundation wanted to create an endowment fund which would provide a stable annual income. However, as donations had fallen so greatly in 2020, it was necessary to use some of the money intended for the endowment to cover expenses. Only a small fund could be established, but, Demirtshyan said, if there is no other way to cover the expenses of treatments, it will have to be spent too.

Meanwhile Kazanjian, acting president of the US board, said that the latter will carefully monitor how the money donated from the US is being spent.

Call for New Donations

Demirtshyan said that usually funding from the diaspora is based on events, though a small number of people have agreed to make direct monthly payments online. In normal times, more money comes from abroad than from Armenia. Though the absolute number of donors from Armenia is greater, Demirtshyan said that the sums given are larger by donors abroad.

Though it is not possible to have the large banquets and events that were so successful in 2019, and Armenians throughout the world are fixated on the aftermath of the Artsakh war, Demitrtshyan said that new support is critical. “Given the situation, with Armenia exhausted financially, but cancer continuing to spread, we cannot wait till better times. We are reaching out to people saying that literally every single donation matters. Even ten dollars can buy something. It is very hard to see things that can be treated in kids that we have to leave untreated. We can save lives,” Demitshyan exclaimed.

If you wish to support the work of the City of Smile Foundation, please use this link to donate through GoFundMe: https://gf.me/u/zaa5qi.  For tax-free donations in the US, you can go to https://us-donate.cityofsmile.org/.