Jaundice During Hard Times

The epidemic spread with the speed of a bush fire in late February and early March this year. The health authorities have registered 351 cases, but there are estimates that the number is three times higher. In the beginning many wondered how jaundice had appeared in Rozaje, and one of the most frequent explanations was that it had arrived from the sea, from a thirsty Ulcinj (town on the Montenegrin coast) where the dry water pipes were washed out from time to time with sickly, yellow-colored water. Once the illness took over, the question of the source of the disease was raised, but it proved impossible to determine. One thing is certain, it wasn't the water, even though its taste has changed, because of the chloride.

Rozaje is paying the price of its ambitions to change from a backward place somewhere between Novi Pazar and Berane into a town like any other. In its development, it has relied on what it has most - wood, so that the "Gornji Ibar" wood processing company became the fulcrum of its development. The municipality has 23,000 inhabitants living in an area covering 34,000 hectares, of which number 10,000 people live in the town. The figures are not big, but half the population is in the urban zone. Municipality President Nusret Kalac who gave us these facts, said that the area of Bandzovo Brdo, just above town, had been meadows until about fifteen years ago. Today the place is full of houses, built practically one on top of the other. Estimates put the number at 600-700, while it is difficult to find any statistical data, since most of them have been built without building permits. The people were drawn to the town by industry, the prospects of earning some money and amenities offered by the town such as electricity which was slow in reaching the villages. Narrow city lots now have to accommodate village habits. Cowsheds were built alongside houses, outdoor toilets are preferred to bathrooms and toilets in the house, hay-stacks, manure heaps and makeshift hen houses have been nailed together, right next to the main dwelling. Surrealist scenes are common. We watched as a black and white cow walked into the ground floor of a three-storey house, of which each storey was revetted with expensive stone and boasted a sat dish. The girl who followed the cow, stopped and said that after going down several steps the cow would enter the courtyard where the cowsheds were. The cow passes this way daily. Other scenes include a horse taxi station, cows on steep and muddy suburban streets, hens scratching the ground close to the old town center.

"It's the mentality", said the Montenegrin "Merhamet" branch vice-president Ejup Nurkovic who is also the Rozaje municipality finance department chief. Nurkovic said that only a small number of households were linked to the city water supply system, that the municipality didn't have enough money to buy a vehicle for cleaning the streets which cost around 200,000 dinars.

Health Center Director dr. Abdulah Kalac said that the mentality and traditions were to blame for the situation, and wondered out loud who could ban the keeping of cows etc., in a situation when the population was becoming impoverished very rapidly, and when one cow was worth at least six worker's salaries. Most of the workers are on forced leave and rarely get their salaries. Poverty has hit those who have always been poor and have tried to improve their situation. Rozaje is such a place. The industry faces a collapse, there are more unemployed than there are employed, including 5,000 persons who worked in the social sector.

Our collocutor, the calm and highly esteemed Dr. Kalac, a gynecologist and head doctor, became what he is today thanks to a burning desire to break away from the illiteracy and backwardness that surrounded him. With the arrival of jaundice he has gone back to educating the people. He organizes prevention and battles against panic. During the first cycle in November, when 70 persons came down with jaundice, there was panic among the people. The panic has abated, but the disease remains. The "Mustafa Pecanin" Primary School director Mehmet Ademagic said: "We're used to it". Ademagic said that 60 children were ill in November, and that he doesn't know the number of ill children right now. Parents said that the stench from the toilets could be smelled at the entrance before. The sharp smell of disinfectant permeated the room in which Ademagic talked to us. It is cold in the school. The boiler had broken down and after it was repaired it turned out that the chimney was out of order. "It's the end of the heating season", said the Ademagic. Everybody has become used to this too.

Apart from jaundice, doctors in the Rozaje Health Center are also plagued by quack doctors. The people believe in cooking tea from herbs. The herbs, however, get rid of the yellow color in the eye white, but don't do anything about the liver. The absence of a yellowish color in the eye white also hinders diagnosis.

Looking at a fish is another "treatment", but those who opt for this method do not wish to talk about it. It consists of catching a fish and putting it into a pot full of water. The patient then watches the fish while it goes round and round, and the yellow color then passes from the patient to the fish, the fish dies, and is buried 50cm deep in the ground, so that the illness won't return.

As in all the previous jaundice epidemics in the area around Rozaje and Berane, everybody here knows Stanija Vujosevic, an old woman from the village of Ljesnica near Ivangrad. She makes teas from recipes she keeps secret, and claims that some doctors have visited her in search of a cure. Stanija gives her teas freely, or accepts as much money as she is given. She claims to cure jaundice, some kidney illnesses and eczema. Stanija agrees to cure patients together with doctors - "And we'll see whose medicine will cure them first". She claims to have cured 16 infected pregnant women who later gave birth to healthy babies.

Dr. Kalac listens to these stories calmly. Many of the patients who visit regular doctors also visit Stanija Vujosevic. Barber Jusuf Fazlic asked: "What does the doctor think of Stanija's teas? I don't know, but these little ones have really developed an appetite since they've been drinking those teas." His two boys are refugees from Foca and parentless. They too have been infected. Of the 400 refugees in the buildings in Bandzovo Brdo only the two boys are ill, while none of the refugees in the Hotel Sloga have been affected. "There isn't much that can scare us," said Nazif Durakovic, a refugee from Trebinje. Montenegrin Government Commissioner for displaced persons in Rozaje, Fahrudin Topalovic, believes that the places where the cooking is done are ideal for spreading the disease.

Even though the opposition (SDP-LSCG coalition) is in power, the epidemic hasn't taken on political implications. "It's our fault and that of the Republic, because we weren't efficient, and didn't react on time", said the Rozaje municipality president. Even though the municipality has a majority Muslim population (about 92%), the illness hasn't provoked ethnic intolerence. President of the Orthodox religious community Milija Aleksic, said that in proportion to their number, the Muslims gave voluntary contributions for the building of the Orthodox church in Rozaje in 1990. "I was at the opening", said Milija. According to what the president of the local opposition DPS branch said, interparty relations aren't bad. This was confirmed by the fact that our collocutor Ejup Nurkovic, who, even though he is a member of the SDA Main Committee, is not a member of a municipality body. The fact that the population is practically of one nationality, greatly simplifies matters. But even after the arrest of a group of Muslims accused of arming in Sandzak (along with the process in Serbia), the Montenegrin authorities weren't very agile in carrying out their duties. The state of Montenegro has very loyal citizens in the Muslims of Rozaje, so that this is the reason for the tolerance shown to the authorities' tardiness in sending out a government inspection to the scene of the infection. The municipality officials underscored that the police were "absolutely correct" towards all nationalities. Rozaje, they said, was a quiet town.

Jaundice in Tutin

Jaundice has appeared in Tutin. Dr. Vesna Pavlovic who is also director of the hospital in Novi Pazar said that 225 cases have been recorded. But compared to the jaundice in Rozaje, the illness has polluted the political atmosphere in Tutin. The illness has spread along with the launching of the SDA petition calling for the amnesty of their leader Sulejman Ugljanin of responsibility in the arms campaign, and the "permanent arms investigation" which the Serbian authorities are conducting in Sandzak. A symptom of the political disease is a letter written by the Tutin president of "Merhamet" Albin Gegic, who claims that the authorities are not taking any steps towards dealing with jaundice and the response of journalists who have started a polemic with him, recommending that the inhabitants of Sandzak wash their hands more often, because jaundice is a "disease of dirty hands".

Dr. Pavlovic is more concerned with how to stop the disease and believes that a doctor from Novi Pazar should go to Tutin, considering that they don't have a specialist for infectious diseases there, and that contact with the ill would be limited then. The problem lies in quack doctors who give the patients various herbs which, as in Rozaje, remove the yellow color, but increase the necrosis of the liver.

As a rule, jaundice is an illness which usually affects the backward and the poor.