DRAMATIC SITUATION AS A RESULT OF THE
COVERING UP OF FACTS
Summary:
The closing down of health care facilities, in the name of "economy" has adverse effects on the health status and life quality of Kosovo's citizens. - The practice of not registering patients with infectious diseases is continued, rendering impossible the evaluation of the actual proportions of the problem .- Salmonellosis identified in a large number of maternity hospitals in Kosovo. In the last ten years 1769 infants have died only from diarrhoea, while only in the first ten months of this year 25 persons died from intenstinal diseases and a total of 62 from infectious diseases.
Although the humanitarian organization "Mother Theresa" through its out-patient clinics, as well as the organizations "Docteurs sans frontiers", "Doctors of the World", and UNICEF are doing everything they can to alleviate the grave epidemiological situation in Kosovo, it evidently is not enough. Especially if it is possible, according to facts from a UNICEF publication published in 1988, for only one dollar to provde a considerable quantity of medicines, vaccines and injections. In any case, the state of health care and health status among tahe population in Kosovo is alarming. When last summer there were outbreaks of various infectious diseases, including cholera in the neighbouring countries, the most frequent comment among the population was that "it was a real miracle that an epidemic of the plague had not broken out."
The reason behind such reactions, in addition to being an expression of supressed fear, is primarily the result of the inefficiency and indifference of the current municipal authorities, which instead of dealing with such problems prefer to devote their energy to politics. This is in brief the topic of the text which attempts, by giving numerous data on the number of patients affected with diseases which hardly exist any more in the world and through data reflecting the increased mortality rate, to present a true picture of the health situation in Kosovo. the
DRAMATIC SITUATION AS A RESULT OF THE COVERING UP OF FACTS
" The epidemiological situation in Kosovo is more than critical, so there is no room for the creation of sensations", are the words of one of the leading health officials in Kosovo.
Kosovo is still a epidemiological zone in which there are outbreaks of infectious diseases that have been uprooted long ago in the world and which are rare even in the territory of former Yugoslavia. The best indicators for the health status of the population of a specific territory and its general level of development are facts pertaining to mortality and birth rates. According to 1989 data, with a mortality rate of 52.1 per mil. and a birth-rate of 28 per mil. Kosovo holds the first place in Europe, and by these indicatos it can be classified among the Third World countries. In the last five years, owing to the health care situation, the mortality rate has been on the rise. This fact has been confirmed by the very leading doctors of the Pristina hospitals, who have come at the head of these institutions after the introduction of provisional measures in almost all the health institutions of this region.
For the sake of comparison, in 1989 2,855 deaths, mostly children, caused by contagious diseases have been registered in Kosovo, while in the same period in Vojvodina 261 children died from these causes, which is nearly 11 times less than in Kosovo, and the fact than in the last ten years as many of 1,769 children lost their lives due to diarrhoea is more than alarming...
According to the data of the Kosovo Health Institute, last year 21,629 persons were affected with contagious diseases, of which 221 died. Intestinal contagious diseases were registered in 5,636 cases, to the main part children, of which 112 children died, from infants to two-year olds. Only in the course of this year, the same diseases were registered in 1.198 cases, of which 25 have already been fatal. In spite of these data, the actual number of those affected with intestinal diseases is much greater, primarily because a considerable number of doctors, regaradless of whether they work in state health institutions or have their own private practice do not register the patients thata have contracted the mentioned diseases.
Last year as many as 33 epidemics of contagious diseases broke out in Kosovo, which is 15 more than in the previous year.
Salmonellosis which has been registered in a large number of maternity hospitals in Kosovo, as well as intra-hospital infections are primarily the result of the extremely low level of health care and hygiene, particularly in Pristina, Prizren, Djakovica. Salmonella infections were the cause of death in 18 cases, while 13 children died from complications caused by measles. This number of affected children is the best indicator of the level of prevention in Kosovo, namely of the low vaccination coverage, which had it been more widespread could have prevented such fatal consequences for children.
In the first six months of this year, contagious diseases registered a slight decrease as compared to the same period last year. This six-month period was characterized by an outbreak of typhoid affecting 98 persons, with seven sporadic cases. The number of those that came down with jaundice reached 51, of which one person died, while l6 were affected with hemorrhagic fever, of which four did not survive.
In the first half of the year a considerable growth of viral meningoencephalitis was registered, namely 30 persons contracted this disease of which three died. In the same period 43 persons contracted pyretic meningoencephalitis of which 11 died. Out of 439 cases of tuberculosis in the past period, with an increased number of terminal cases, in the course of this year 372 persons contracted tuberculosis, of which three died.
Therefore, in the first six months of this year, 6,855 persons contracted contagious diseases and 62 died.
Bearing in mind the fact that 90% of the population in Kosovo consists of Albanians, and that a considerable number of them do not have orderly health insurance documents, in the majority of cases they seek medical care in out-patient clinics of the humanitarian organization "Mother Theresa" in Kosovo and in other private practitioners' offices which, as a rule, do not register cases of contagious diseases. Only the severest cases are compelled to seek aid in "Serbian hospitals". In view of all this, it is not difficult to conclude that the actual number of cases of contagious diseases, especially those which are transmitted by dirty hands, is at least five times greater.
Such partial data on the causes and consequences of contagious diseases are quite alarming, although the local health workers are quite aware that greater efforts on their part could considerably improve this dramatic situation. However, in the last four years the health care system has been systematically destroyed, partly due to unprofessional personnel which has been appointed to leading posts and given consirable discretionary powers virtually directly from the schoolroom, and partly due to the evident lack of interest on the part of the current Serbian authorities to improve the health status in Kosovo.
A number of cases when extremely expensive medical equipment from local hospitals and clinics has been moved to some health institutions in Serbia only confirms the above mentioned. Given the closing down of a considerable number of health facilities, from out-patient clinics in villages, tuberculosis centres to maternity hospitals, and the suspension of the right to health care for a large number of Albanians after they have been layed off from work, irregular vaccination of children (among other things due to the inefficiency of the communal services dominated by Serbs), as well as the decreased standard of living, it would be logical to expect that the numbers were even more alarming.
The prevention of the tragic consequences caused by contagious diseases rests mainly with the Albanian heath personnel employed in the humanitarian "Mother Theresa" health centres, where in additional to being examined by doctors, patients receive free-of-charge treatment. Doctors employed in state institutions, as well as international humanitarian health organizations,also gave a significant contribution in this respect, especially at the time of the outbreak of the measles epidemic last year and typhoid this year. Their contribution was particularly marked in preventing the consequences of possible contagious disease epidemics in the flooded regions of Kosovo: Suva Reka i Orahovac.
In addition, members of the team "Docteurs sans frontiers" (the team which completed its mandate in Kosovo a month ago) in cooperation with the personnel of the humanitarian "Mother Theresa" health centres and out-patient clinics, initiated an action in elementary school for the identification of scabies and pediculosis cases, at what time they distributed medicines and hygienic means free of charge provided by this organization.
The organization "Doctors of the World" from New York is undertaking an action for the identification and treatment of tuberculosis patients in Urosevc and Strpci. UNICEF is undertaking a project for the prevention of enterocolitis which is the cause of death of a large number of children.
However, all this is not sufficient. It appears as if the current authorities in Serbia are not interested in improving the level of health care and health status of the population in Kosovo. The introduction of the system of participating in the costs of medical treatment, and of charging fees for emergency treatment in state clinics, the cutting down of the health care network and explaining that action by reasons of economy, namely by claiming that "the state can no longer cover the costs", can hardly be taken as a valid justification for closing down these medical facilities, especially as the citizens themselves were prepared, if allowed, to maintain the facilities and compensate the medical personnel, especially in rural areas. After all, if the lack of funds is the real cause of the alarming situation in athe field of health care in Kosovo, the Albanians from Kosovo are curious to know the real reasons behind the frequent obstacles faced by international humanitarian or health organizations when coming to Kosovo.
If we add to this the fact that 40% of the population in Kosovo is using inadequate drinking water and foodstuffs, which as such are the cause of various infections and food poisoning, as well as the problem of the so called "black waters" which is a special problem since waste waters flood over the pavements of the streets, in the first place because the newly appointed Serbian officials in the communes have no desire to do something about such problems, and that garbage dumps are mushrooming everywhere without any control, and that at times garbage cans are not emptied for months on end, then outbreaks of new epidemics which "we have not had for ages" would not come as a surprise.
In one of UNICEF's publications from 1988, it is stated that for one dollar it is possible to by a foetoscope for controlling the heartbeats of an infant before birth, or a sufficient number of vitamin A pills to protect 30 children from blindness caused by food, a sufficient quantity of vaccines to vaccinate nine children against measles or 13 against polio which the main cause of child disability, as well as sufficient vaccines to protect 30 children against tuberculosis, or a sufficient number of vaccines to protect 50 children against a triple threat: diphtheria, whooping cough and tetanus, including many other preparations and medicines for the treatment of children. Bearing in mind how little money it takes to prevent various diseases and fatal consequences, the causes of death in Kosovo would seem banal for the developed world. And really can there be anything more banal that to die in this time and age of diarrhoea, measles, whooping cough, jaundice...
Hamide Latifi AIM Pristina