Breakdown in Maternity Hospital

Late last year 21 babies and one mother were infected by the salmonella bacteria, the result was that one baby died. The Maternity Hospital "Dr Dragisa Misovic" in Belgrade did not take in new patients from 21.12.1994 and this situation lasted for a month. After the hot water boiler and the heating were repaired and the premises disinfected, the Serbian Sanitary Inspectorate allowed the hospital to continue normal work, and the maternity ward started working on 16.1.1995, when this year's first baby was born. The epidemic casts a shadow on the hospital's work so far, which was envisioned and organized according to world standards, said hospital director Dr. Zoran Sretenovic.

VREME: Why are the conditions for work in the hospital unfavorable, what is the current situation and who finances you?

SRETENOVIC: The Hospital "Dr. Dragisa Misovic" is in the competency of the City of Belgrade, and we are paid by the Serbian Fund for Health Protection through the Belgrade Administration for Health Protection, but a large part of the material and equipment come from humanitarian organizations and a large number of sponsors. We are grateful to the Serbian Orthodox Church, the Red Cross organizations of Serbia and Yugoslavia, UNICEF, the Association of Serbian Sisters, and many state and private firms and individuals for small and large contributions. However, a complex institution such as a maternity hospital cannot meet all its need in this way, considering that many well-meaning but uninformed donors sent inappropriate presents and materials. There were cases when we received medicine whose date of expiry had passed or disinfectants which didn't disinfect, so that such presents can do more harm than good.

VREME: There has recently been a lot of talk about a drop in the birthrate. What are your conclusions concerning the number of newly born babies, compared to the Seventies and the Eighties?

SRETENOVIC: The number of births is dropping in the whole territory of Yugoslavia and in Kosovo in comparison to the Seventies and the Eighties. We had 2,011 births in 1993 and 2,378 in 1994. This number would certainly have been higher if the hospital hadn't closed in December, and it is a rise of about 20% in comparison to the previous year. The fact that the number of births here is higher does not mean a rise in the birthrate, but that many of the women wished to have their babies in our hospital and that they were attracted by the different treatment we offered.

VREME: Did this increased number of women and greater number of births help spread the epidemic?

SRETENOVIC: It can be said that the salmonella epidemic is the result of over-booking. Also, the breakdown of the boilers resulted in a lack of hot water, so that hygiene wasn't up to mark. Perhaps we didn't react adequately, and should have stopped taking in patients. Over-crowdedness and close contact helped spread the infection. Nowhere in the world is it possible to stop the entry of individual cases of infection into the maternity ward, but it is vital to discover and isolate such patients quickly. After undergoing several analyses, none of the staff showed a positive result, so that the infection must have come from outside.

VREME: Is the prevention or limiting of abortions through legal measures a way of increasing the birthrate, or is it the right of every woman to decide freely if she will bear a child or not?

SRETENOVIC: To demand of health workers to prevent abortions today, at the end of twentieth century, and to force women to bear unwanted children in order to increase the birthrate, is absurd. There is no law under the sun which will stop a woman from aborting if she has decided to do so. She will find a way even if it endangers her life. If we introduce bans now, then criminal abortions will appear, even laymen will carry them out, so that we will just endanger the women's lives.

VREME: What are you short of right now?

SRETENOVIC: We need a continuous supply of all the materials used in the maternity ward. Above all nappies for the babies and nighties for mothers, compresses, staff uniforms, sewing material, analgetics, antibiotics, detergents, etc. Most of the equipment is old and worn and can't be mended anymore. We need two new incubators, because the six we have are insufficient for the number of babies, and some are outdated. We have four new cardiographs, but we don't have paper for registering the heart beats of the embryo or the contractions of the uterus. We need new delivery tables, because the ones we have are seven years old and run down; plastic sheeting, equipment for measuring pressure and many other things. It often happens that our patients or visitors take away things or break the inventory. A little more love and care should be shown to equipment that was acquired with difficulty, as well as discipline, both by the patients and staff.