It Was Better During the Sanctions

In the present situation of a "classic tragic existence", as Rade Konstantinovic puts it, when things get worse every day, when many people have lost everything, from loved ones to the very roof over their heads, their health and life’s earnings, one official publicly stated and published statistic has caused some doctors who are concerned about the health of this people to issue warnings over the media that our health is getting worse all the time, and that our children are less healthy from the very beginning.

"The bodily weight of newborns in 1994 has dropped with male children by 139 grams, and with female children, by 294 grams; with girls the skull circumference has dropped by nearly half a centimeter", stated Miladin Mirilov from the Health Institute in Novi Sad, and Ljiljana Hotic from the Medical Faculty in Novi Sad in their opening remarks at the IX Yugoslav Congress on Nutrition (Kotor, October 1996), where they also stated that "this problem requires further research".

Other studies were cited which point to the growing percentage of malnourished children, to the fact that army recruits are getting shorter and weaker, and that only ten years ago our boys were taller than their American counterparts! Systematic checkups throughout public schools confirm the fact that 7-year-olds are shorter by several centimeters than they were before "the years of hardship".

VREME has followed the trail of the most dramatic news of the oppressed "living substance" of a people — of babies whose "vital statistics" are radically dropping: we went through medical publications, we talked to specialists from the Institute for Mother and Child and from the Gynecology and Obstetrics Clinic in Narodnog Fronta Street in Belgrade. We also asked for commentaries from experts in the Belgrade office of Unicef who have analyzed the state of health in the nation and the main problems of health care.

Those we spoke to claim that their institutions are not in possession of exact indicators which would confirm the thesis put forth at the Congress on Nutrition. Experts at Unicef state that such dramatic changes in newborns would only be observed after many years of malnutrition of a population, which despite everything was not the case here at that time.

It is indicative that the thesis of dramatic changes in newborns originated in the Federal Ministry for Employment and Health 1993-1994, in publications entitled "The Effects of Sanctions on the Health of a Nation". It appears that the policies of the fattened and super rich political heads who warned of approaching hunger, and of the fact that "we can do without bread, but not without a state", began manipulating health statistics in their daily misinformation campaigns. Those are the policies that resulted in war and the socio-economic crisis and in hyper inflation to which healthcare ultimately succumbed.

AID WITHOUT BORDERS: At the Serbian Institute for Mother and Child in New Belgrade, the most serious children’s ailments, among other things, are being treated: leukemia, tumors, heart conditions, and complex and specific pathologies which require modern technologies for diagnosis and treatment. Surgery and Pediatrics have around 400 beds. Carefully conducted statistics over the years show a rise in the deaths of hospitalized children in the period from 1991-1994 in surgery and pediatrics sections.

These parameters are an indication of all-around poor conditions: the dropping standard of life in the population, poor nutrition, poor hygiene, family stress... All these inevitably have affected health, explains Dr. Prof. Radovan Bogdanovic, Director of the Children’s Clinic at the Institute, in his interview with VREME.

How did healthcare manage to keep operating in the difficult financial position it has been in for some time now?

"It was mainly through the exceptional self-sacrifice of the staff. There was a lot of humanitarian aid from various international organizations: we received the most significant aid from Unicef, but we also got aid from the International Red Cross, from Medicines sans Frontiers, from Pharmaceutics Without Borders... Humanitarian help was also sent by hospitals from France, Germany, from Yugoslav expatriates living abroad... We cooperated extremely well with colleagues in Italy, and we continue to cooperate in the treatment of leukemia."

Prof. Bogdanovic thinks that now is the most critical situation for medications, stating that during the sanctions things were better not only because of significant international aid, but also because they were being supplied by the national pharmaceutical industry which is now asking for money that the Institute simply does not have. Medications from abroad are lacking as 60-65% of the medications used here came from other parts of Yugoslavia.

"One third of the Fund for Healthcare goes to medications: the list of medications is too long and is in need of rationalization in accordance with our conditions and international standards. At present, our medications, especially vaccines, are too expensive. With such a measure a large part of the population could be accommodated", states the Professor.

HEART AND OTHER CONDITIONS: Our interviewee states that there is still much waste: for instance, we do not need three cardiovascular centers in an 80 km area. VREME thinks that it does not make economic sense for the Children’s Hospital in Tirsovo to be getting a section for heart surgery. Prof. Bogdanovic states equivocally that the Institute demonstrated with its work up to now that there is no need for such investment: with the four highly experienced heart surgeons on staff who specialized abroad, the Institute for Mother and Child has performed around 300 open heart surgeries since 1982. Despite that, last year there were no operations for over six months because there were no materials for surgery. Admittedly, now there is a promise from the Fund that materials for surgery will be provided as well as specialized diagnostics machines.

Prof. Bogdanovic states that children fare worse in specialized programs: specifically, the Professor wishes that younger heart patients be accorded the same attention as older ones. Cynics could say that children are not in the government, they hold no finances, and they do not vote.

The Institute for Mother and Child of Serbia, as a referral institution, wishes that children’s healthcare be maintained in times of transition, and the care that existed in the previous system not be lost, stresses Prof. Bogdanovic.

POTS AND POVERTY: The Mother and Child Clinic in Narodnog Fronta Street also does not have any statistics which would confirm the thesis of the change in vital statistics of newborns as the result of sanctions. Admittedly, there are more newborns and more premature births, but these are all the result of a dramatic drop in the standard of life for a large part of the population, according to specialists. Those interviewed by VREME state that war can not bring anything good, because living conditions drastically worsen. That is worth talking about: about fear and stress which both mother and father have to deal with, and about the fact that the majority lives on the brink of poverty.

In this hospital it is said that they are in a worse situation now than during the sanctions, as is the case with healthcare in general. At that time there was humanitarian aid, but now patients have to purchase medications for operations, and there is even rationing of hospital food.

The intensive care unit, thanks to international humanitarian aid, is equipped with the latest technology, but there is no money for maintenance so that many machines are on the brink. Surgery has been reduced to the most urgent cases.

Hospitals visited by VREME are not on strike: the children are the most important, state those interviewed, adding that conditions of work are exceptionally difficult, and pay is insultingly low. At the hospital in Narodnog Fronta Street where 6500 children are born annually, only 8 pediatricians are employed. If the sections equipped by donors are excluded, or luxury apartments which housed famous people (Dusanka Djogo-Antonovic, Mrs. Perucic or the daughter of the "Serbian Mother" Dafina) everything else paints a grim picture of a "hospital in Valjevo". This certainly must affect mothers and children more than the "hellish cacophony" of whistles and pots which Mirjana Markovic lamented in her diary in January of this year.