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Hope on the Balkans
The miracle-cure campaign

by Petar Lukovic

It was about two weeks ago that the regime of Yugoslav President Slobodan Milosevic kicked off its Health Ministry-sponsored election campaign, promising the citizens of Serbia that overnight they would have all that has been lacking for over a decade. There will be plenty of vital medicines, queues in hospitals will diminish, and doctors will cure like they've never cured before. Pregnant women will no longer be obligated to bring their own beds to the maternity ward, and patients will no longer need to provide their own linens, pillows, needles, and medicines. Everything will be available, if only the regime can get through the elections quietly and calmly. But skeptics and there are many opine that much-needed and long-overdue health reforms are more likely to be the result of a divine miracle than the actions of the ruling elite. State media have helped to make the health campaign the election's number-one issue especially since senior citizens are Milosevic's largest group of supporters. Local newspapers loyal to the regime have offered their readers encouraging and sensational reports on the great leaps forward the incumbent president has taken in regards to his citizens' health. Over the past two weeks, headlines have announced "More Order in Health," "Public Tender for Drugs and Medical Supplies," "Doctor Arrested for Bribery," "Smoking Forbidden in Health Institutions," "Exceptional Importance of Serbian Government's Health Measures," "Treatment Made Easier for Patients," and so on.

But as far as most doctors and patients are concerned, the reality of health in Yugoslavia is somewhere between disaster and horror. The shelves of state pharmacies are empty, key antibiotics are depleted, quality insulin has vanished, and a trip to the hospital has become a conscientious step toward death. "We tell patients to drop by a private pharmacy before being admitted to the ward and buy the necessary drugs," a local doctor, who asked that his name not be used, says. While that method may sometimes work for a few patients, for emergency situations it is not an option. "More often than not, the pharmacies don't have the life-saving medicines, either," the doctor adds. Faced with the knowledge that many of their patients will die without proper drugs, some doctors even buy their own medical supplies on the way to work. However, prices are disproportionately high and most doctors can't afford to supply many patients.


The regime's media has attempted to explain away the country's dire health situation by blaming it all on what they call the policies of the new world order: Namely, that the United States and its allies are determined to destroy the Serbian nation. The regime points to economic sanctions imposed on Yugoslavia to drive its point hit home. Without sanctions, there would be medicine, say government officials.

Sanctions and embargoes imposed on any country negatively affect the citizenry where it concerns health care restrictions can result in access to quality equipment and medicinal imports. Still, there is at least one serious flaw in the government's argument. According to the 1999 federal budget, the Yugoslav army was to receive 16.4 billion dinars ($1.4 billion), in contrast with the health sector, which was allotted only 12.3 billion ($1.1 billion). Adding salt to the wound, a recent decision passed by parliament gave 75 percent of the entire federal budget to the army for 2001. (For comparison, the average percentage of the budget going to the armed forces in other countries of transition varies between 10 and 15 percent). Ironically, the elderly who are caught zigzagging back and forth between pharmacies, desperately searching for the medicines they need and never questioning the price when they do find them are Milosevic's greatest supporters.

In a recent interview with the daily newspaper Mladina, Dr. Zeljka Ilic, a radiology specialist and the president of the opposition Democratic Party Health Board, explained that 11 years ago Serbia was only two to three years behind the rest of the world in regard to health care standards. Technology studies conducted last year by local medical experts, however, showed that the Yugoslav republic is now lagging 27 years behind. "It's hard for someone not living in Serbia to understand the dimensions of this horror," Ilic says. "A patient enters a hospital without linen, towels, pajamas, or soap, and restrooms are an epidemic epicenter: You don't have to ask where the toilet is, you'll smell it."

During a highly dramatic and emotional press conference that recently took place in the Serbian city of Gornji Milanovac, anesthesiologist Nevena Petkovic told reporters: "I induce the patients into anesthesia and prepare them for surgery on the table without any opportunity to see x-rays beforehand. Simply, there's no film for this, and I am aware of the risk I am taking. ... Once we didn't take patients' temperatures for three days because we had no thermometers. ... I am presently working by God's will alone because we don't have even the most basic means," Petkovic said. "Though it's a public secret," she added, "many hospitals administer medications whose validity has long ago expired. In confirmation of Petkovic's testimony, Mladina quoted one unnamed doctor as saying, "We have no fresh medicines, so we administer old ones. What happens, happens."


The story of humanitarian aid ended before it ever really began. Medical supplies destined for the Red Cross of Yugoslavia have been detained at the borders and then redirected to the few elite clinics owned and operated by the members of the governing parties, the Socialist Party of Serbia and the Yugoslav United Left. It is those clinics where shortages do not exist to which the regime points as examples of health improvements in the country.

Having misused or misappropriated what international aid that has arrived, and suffering from international sanctions and its own voluntary isolation from much of the world, Yugoslavia has aggressively turned toward support from Burma, North Korea, Libya, Iraq, and China not only for political reasons, but also out of medical necessity.

Late last year, Serbia imported 80 deficient types of medicines from China. The questionable deal was cut by Dr. Milovan Bojic, the vice president of Serbia in charge of health affairs. Doctors immediately warned against using the medicines. The insulin, they said, was not the standard type, and hospitals lacked the necessary equipment to detect the impurities, which turned out to be many. Nonetheless, the insulin was delivered to hospitals and clinics and has continued to be used on patients. The result has been anything from blindness, dialysis, and organ transplants to leg amputations. Even today, that insulin has not been thoroughly analyzed.

A shipment of antibiotics was also imported from China at cut-rate prices. The antibiotics came in sacks, and labels did not coincide with contents. Serbia, says Dr. Ilic, has become a "chemical dump" for deficient and dated medicines that China no longer wants.

According to a recent report on health care in Serbia released by UNICEF, over the past year there has been an increase of pulmonary diseases, asthma, and anemia in children. The report also pointed to an alarming rise in tuberculosis cases, and lamented the general lack of medical supplies and properly functioning equipment. The State Health Insurance Fund, UNICEF reported, is so poor that medical needs can hardly be met. In the Serbian municipality of Brajevo, for example, a mere $1.30 is allocated annually per capita for health care.

The fear of falling ill in Yugoslavia is a very real one. Faith in miracles has become the traditional outlet, but it's rarely enough. Patients can hardly expect doctors, who survive on a meager salary of about $50 per month, to cure them on enthusiasm alone. It is common knowledge, if not tradition, that a visit to a doctor involves a bribe, either in the form of foreign currency, a bottle of whiskey, or some other favor. Despite the forced optimism of the regime's newspapers, hospitals are doubtfully going to turn into humanitarian corridors overnight. Still, it is on this platform, perhaps more than any other, that Milosevic is planning his continuance of authoritarian rule. And, much like those who have been taken in by contemporary quacks and faith healers, in a last attempt at desperate hope many will buy those promises.

Petar Lukovic is the Belgrade correspondent for the Croatian weekly Feral Tribune

Source: Transitions Online ©2000

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