2023

Building a Foundation in Destructive Times


Through wars and a global pandemic, Dr. Alina Dorian has worked with government and academic leaders to develop public health capacity in Armenia and Artsakh.

 

Editor’s note: This article was published in September 2023, just before a full-scale military operation in which Azerbaijan seized control of Nagorno-Karabakh (also known as Artsakh), resulting in the forced displacement of the vast majority of the region’s ethnically Armenian population.

 

 

Alina Dorian
Dr. Alina Dorian
  • Physically in L.A.
  • Mentally in Artsakh
  • Emotionally Broken

THE DECLARATION WAS POSTED on social media by someone else, but it perfectly encapsulated how Dr. Alina Dorian felt as the Republic of Artsakh, the predominantly Armenian-populated region also known as the Nagorno-Karabakh Republic, suffered through the latest in an ongoing series of traumatic events. These events, including a war and a blockade, have challenged the efforts of leaders like Dorian who have sought to bolster the public health system of the disputed region — particularly following the onset of the COVID-19 pandemic.

Dorian, associate dean for public health practice and associate professor of community health sciences at the UCLA Fielding School of Public Health, is the daughter of Armenian immigrants and granddaughter of survivors of the Armenian genocide. She’s spent nearly three decades collaborating on public health training and programming with government and academic leaders in Armenia and in Artsakh, a conflict zone that declared its independence from Azerbaijan but has not been internationally recognized.

The relationship dates back to the mid-1990s. As a PhD student, Dorian authored Artsakh’s first national health plan. She led the first large-scale national survey to assess demographic and health needs in the region following a cease-fire in the six-year war that started in 1988. In the years that followed, Dorian was awarded back-to-back grants by the United States Agency for International Development to implement primary healthcare programs in Artsakh through the American Red Cross, International Committee of the Red Cross, and American University of Armenia.

IN 2021, COLLABORATORS FROM FSPH, THE AMERICAN UNIVERSITY OF ARMENIA, AND THE MINISTRIES OF HEALTH IN ARMENIA AND ARTSAKH USED THE ABOVE BILLBOARD TO PROMOTE COVID-19 VACCINES. TRANSLATED TO ENGLISH: MILLIONS OF INDIVIDUALS HAVE BEEN VACCINATED AGAINST COVID-19 AROUND THE WORLD. BE SAFE, GET VACCINATED. THE WORLD’S LEADING SCIENTISTS HAVE COMBINED THEIR EFFORTS TO CREATE SAFE AND EFFECTIVE VACCINES.
In 2021, collaborators form FSPH, the American University of Armenia, and the Ministries of Health in Armenia and Artsakh used the above billboard to promote COVID-19 vaccines. Translated to English: Millions of individuals have been vaccinated against COVID-19 around the world. Be safe, get vaccinated. The world's leading scientists have combined their efforts to create safe and effective vaccines.

In March 2020, Dorian and FSPH faculty colleagues Dr. Michael Prelip (MPH ’85) and Dr. Shira Shafir (PhD ’06) began providing technical assistance to the ministries of health in Armenia and Artsakh aiming to limit the spread of COVID-19, including working with the American University of Armenia to establish the National Case Investigation and Contact Tracing Program for Armenia. Those efforts were severely hampered by the eruption of a full-scale war in September 2020 in Artsakh — during which Azerbaijan used sophisticated weaponry and subsequently imposed a blockade of the only road in and out of Artsakh, beginning in December 2022 and continuing well into 2023. In April, with the blockade well into its fifth month, Dorian was preparing to meet, virtually, with the leadership of Artsakh’s Ministry of Health to discuss data her team had collected as part of the first and largest demographic and health survey conducted in Artsakh since the 2020 war. “It’s hard to plan when you don’t know what the political reality of the region will be in the near future,” Dorian says. “But I have no choice but to be hopeful. In my work I have been surrounded by mothers who have lost their children, and they say, ‘They died so we can live here — in this place — where we have lived for centuries....’ If they’re not going to give up, no one else can.”

The program Dorian helped establish in Armenia in response to COVID-19 included trainings and workforce development in contact tracing and case investigation, not unlike work led in California by Dorian, Prelip, and colleagues at UCLA Extension, UC San Francisco, and the California Department of Public Health through the Virtual Training Academy. In addition to creating a cadre of trained public health professionals, the effort involved building an emergency call center for the National Center for Disease Control. Dorian’s group also helped to develop messaging on the importance of wearing masks and vaccinations.

When Artsakh was attacked by Azerbaijan a few months later, the effort became “less about COVID-19 and more about getting critical things done under extreme conditions,” Dorian says. Initially, COVID testing was administered in bunkers, often devoid of electricity. Ultimately, the vast majority of the Artsakh population fled into Armenia. Hospital beds were overrun not just by COVID cases but by victims of trauma from the war. In response, UCLA’s Operation Armenia — under the leadership of Dorian, Dr. Eric Esrailian (MPH ’05), and Dr. Shant Shekherdimian (MPH ’09), two additional UCLA faculty leaders who have long assisted in the region — mobilized an effort to provide medical disaster relief and supplies, and to start a home healthcare program to free up hospital bed space.

DR. ALINA DORIAN (FAR RIGHT IN THE PHOTO) SERVED AS PROJECT MANAGER FOR THE PLANNING AND CONSTRUCTION OF THE ARMINE PAGOUMIAN POLYCLINIC AND ANNA AND HIRAIR HOVNANIAN DIAGNOSTIC CENTER IN 2001, THE FIRST AND ONLY FULL-CARE OUTPATIENT MEDICAL CENTER IN THE REPUBLIC OF ARTSAKH.

Dr. Alina Dorian (far right) served as project manager for the planning & construction of the Armine Pagoumian Polyclinic & Anna & Hirair Hovnanian Diagnostic Center in 2001, the first & only full-care outpatient medical center in Artsakh.

MEMBERS OF VARIOUS MINISTRIES IN THE REPUBLIC OF ARMENIA COMPLETING A TRAINING DORIAN LED ON EMERGENCY PREPAREDNESS IN 2022.

Members of various ministries in the Republic of Armenia completing a training Dorian led on emergency preparedness in 2022.

The attack was one of many developments that posed substantial challenges to COVID-19 public health messaging efforts. “During a time of war and loss, masking and social distancing were not the priorities,” Dorian says. “People were out in the streets in large groups protesting — trying to garner international attention for the war. Meanwhile, funerals and church services were happening all over the country in massive waves. There was a lot of grieving, hugging, and consoling. And with underlying generational trauma, as survivors of genocide, there was more worry around the war and ethnic cleansing — and community — than COVID-19.”

Since then, the Dorian-led work has expanded to encompass a multitude of programs aimed at advancing public health in the republics of Armenia and Artsakh. The Artsakh Public Health Academy, a virtual platform that includes courses taught by UCLA Fielding and American University of Armenia faculty, aims to strengthen the public health workforce and build a more resilient system. In collaboration with the World Health Organization, Dorian continues to design and implement programming to improve Armenia’s disaster response infrastructure, policies, protocols, and training. Among the other initiatives under development are a workforce and pathways program to proactively identify, place, and train individuals in both ministries of health.

Anyone who has been there knows this is a magical place with tenacious and bold people. These are horrendous times, but I’m going to use all of my energy to continue to move programming forward.


Dr. Alina Dorian

In recent years, much of Dorian’s work in Armenia and Artsakh has been supported by Esrailian, chief of UCLA’s Vatche and Tamar Manoukian Division of Digestive Diseases as well as a major philanthropist whose Promise Armenian Institute was established at UCLA in 2019. “Eric has been critical in mobilizing resources, funds, and people at UCLA, for which I’m extremely grateful,” Dorian says.

“I am honored to help Dr. Dorian, her incredible colleagues at the school, and the entire UCLA community with this important work,” Esrailian says. “Armenia and Artsakh now have a stronger connection to a global public health network — with prolific expertise — thanks to this connection to UCLA.”

For all of the hurdles to progress in Armenia and Artsakh, Dorian remains unrelenting in her commitment. “Anyone who has been there knows this is a magical place with tenacious and bold people,” she says. “These are horrendous times, but I’m going to use all of my energy to continue to move programming forward — and honestly, I get a lot more out of this work than I give. I am inspired every day and I know how blessed and privileged I am to be able to do this work alongside such dedicated, positive, and strong people.”

Faculty Referenced in this Article

Dr. Alina Dorian
Alina Dorian
Community Health Sciences
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Dr. Michael Prelip
Michael Prelip
Community Health Sciences
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Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
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Wendelin Slusser
Community Health Sciences
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Philip Massey headshot
Philip Massey
Community Health Sciences
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Natalie Muth
Community Health Sciences
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Bo-Kyung Elizabeth Kim headshot.png
Bo-Kyung Elizabeth Kim
Community Health Sciences
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Dr. Dana Rose Garfin
Dana Rose Garfin
Community Health Sciences
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Dawn Upchurch
Community Health Sciences
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Jennifer A. Wagman
Jennifer A. Wagman
Community Health Sciences
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Dr. Anne Pebley
Anne Pebley
Community Health Sciences
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Dana Hunnes
Dana Hunnes
Community Health Sciences
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Kimberley Shoaf
Community Health Sciences
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Sarah Blenner
Sarah Blenner

Director of Field Studies and Applied Professional Training

Community Health Sciences
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May Wang headshot
May C. Wang
Community Health Sciences
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Dr. Judith M. Siegel
Judith M. Siegel
Community Health Sciences
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glik, deborah
Deborah Glik
Community Health Sciences
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Kimberly Gregory
Kimberly Gregory
Community Health Sciences
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Charlotte Neumann
Charlotte G. Neumann
Community Health Sciences
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Dr. Jessica Gipson
Jessica Gipson
Community Health Sciences
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Dr. Michael Rodriguez
Michael Rodriguez
Community Health Sciences
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Sean Darling-Hammond
Sean Darling-Hammond
Biostatistics Community Health Sciences
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Dr. Samuel Stratton
Samuel Stratton
Community Health Sciences
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Dr. Gilbert Gee
Gilbert C. Gee
Community Health Sciences
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Virginia C. Li
Virginia C. Li
Community Health Sciences
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Dr. Elizabeth Yzquierdo
Elizabeth Yzquierdo
Community Health Sciences
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Valentine M. Villa
Community Health Sciences
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Dr. Donald Morisky
Donald E. Morisky
Community Health Sciences
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Dr. May Sudhinaraset
May Sudhinaraset
Community Health Sciences
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James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
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Dr. Randall Kuhn
Randall Kuhn
Community Health Sciences
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halbert, ronald
Ronald Halbert
Community Health Sciences
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Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
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Cathy Lang
Cathy Lang

Assistant Dean for Research & Adjunct Associate Professor of Community Health Sciences

Community Health Sciences
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Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
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Dr. Hiram Beltrán-Sánchez
Hiram Beltrán-Sánchez
Community Health Sciences
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Dr. Michael Goldstein
Michael Goldstein
Community Health Sciences
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David Eisenman
David Eisenman
Community Health Sciences
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Dr. Elizabeth D'Amico
Elizabeth D’Amico
Community Health Sciences
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Courtney Thomas Tobin headshot.png
Courtney S. Thomas Tobin
Community Health Sciences
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Marjorie Kagawa-Singer
Marjorie Kagawa-Singer
Community Health Sciences
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Ilan H. Meyer
Ilan H. Meyer
Community Health Sciences
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Paula Tavrow
Paula Tavrow
Community Health Sciences
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Dr. Chandra Ford
Chandra Ford
Community Health Sciences
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Sheba George
Community Health Sciences
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Diana Bonta
Diana Bonta
Community Health Sciences
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Dena Herman
Dena Herman
Community Health Sciences
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Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
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