BAKU, Azerbaijan — Dr. Solmaz Yusifova never expected a 35-year-old woman from a rural village in the mountains of Azerbaijan to change her life.

A "Mountain Jew" herself, Yusifova was working nine years ago as a doctor of infectious diseases in the Azeri capital of Baku when she found herself in Kuba, a sleepy, traditionalist Jewish town a three-hour drive north of the capital.

Yusifova had begun helping Azeri Jews who otherwise could not afford medical treatment in the wake of the Communist system's collapse.

She met Sara in Kuba. Scarce job opportunities had compelled Sara's husband to go to Moscow in search of work three years earlier, and Sara and her three young children had been left to live with her husband's parents.

Social custom dictated a home-bound life consumed by cooking, cleaning and washing for her in-laws. She raised her children alone and had no chance of venturing outdoors to meet peers even for tea and gossip. Her husband visited a few times every year.

Then Sara contracted hepatitis, likely the result of her husband's infidelity. It's not uncommon for lonely men in Moscow to visit prostitutes or other women, and then bring home sexual diseases.

"These sexually transmitted diseases are sometimes the only 'joy' that their husbands give to them," Yusifova says. "And she can't complain to her husband because he's out there trying to feed the family. She has to be patient and supportive."

Sara became depressed and nearly suicidal.

"She wasn't in a good state of mind," Yusifova says. "I had a responsibility to help."

She soon discovered that Sara was not alone. Subservient by tradition and taught to keep their emotions in check, scores of other women were in similar situations.

"They are cut off from the outside world," says Yusifova, 52, alternating between English and Russian.

As a respected doctor, Yusifova thought she was uniquely qualified to do something about the situation. In 1996, she created the Havva charity center, an organization devoted to the psychological, physical and spiritual needs of women in Azerbaijan.

The organization offers services such as social welfare, health education, food programs and Shabbat prayer services. But Havva's reach — about 200 clients between the ages of 30 and 60 — barely has made a dent in the ancient, patriarchal way of life here, says Yusifova, who serves as Havva's executive director.

Even women in Baku, which is more liberal and cosmopolitan, suffer from similar problems.

Ironically, Azerbaijan's newly won freedoms of the past decade help to compound the situation. Freedom also means the choice to return to tradition, a choice that has rolled back social progress for some young Jewish women in Azerbaijan.

Before, the Soviet regime required all boys and girls to finish high school, and many young women from Kuba went on to university in Baku or Moscow.

Today, parents in Kuba once again are free to pull their daughters from school at age 14, get them engaged by 15 and have them married and producing children by 16 or 17.

Yusifova says she would have wound up like Sara had her grandfather, a textile manufacturer in the Georgian capital of Tbilisi, not been exposed to cosmopolitan life and ideas through his business.

Her grandfather's work took him from Tbilisi to Moscow and points in between, giving him a more enlightened view of women. His daughter, Yusifova's mother, became the first woman in the family to graduate high school. She earned diplomas in kindergarten teaching and accounting, and helped her father in his business.

Still, Yusifova's mother married at 16. She bore nine children, seven of whom survived childhood.

Yusifova says her mother seemed to regret that she had not gone to Moscow to continue her education. She compensated for it by stressing the value of education to her three daughters.

"When I opened my eyes," Yusifova says with a smile, "the first thing I heard was, 'You have to study, you have to study.'"

Encouraged by her brothers, Yusifova went to medical school and eventually took a post at Baku's top hospital for infectious diseases.

She had little to do with the Jewish community until 1993. That year, in the midst of Azerbaijan's economic crisis and war with Armenia, a Jewish acquaintance approached Yusifova and asked her to help arrange free medical aid for elderly Jews.

Yusifova agreed and enlisted the help of Jewish colleagues. A few Azeri colleagues also joined in, and some of them now work with Havva.

"I'm a secular Muslim who believes in learning from the experiences of other religions," says Elchin Sardarov, who runs an Azeri welfare group of his own. "Here they have a warm, hospitable atmosphere where we learn to build a tradition of volunteerism."