EPIDEMICS STILL RAGING THROUGHOUT KOSOVO

AIM Pristina, 17 October 1996

It is often established, and not just in this space but also in international health symposia, that Kosovo is the region which ranks the first in Europe according to many things in this segment of life. Unfortunately in the negative sense. The region which has the highest density of the population per square kilometre, along with inadequate conditions for living, without appropriately regulated waterworks and sewage system, bad habit of avoiding regular check-ups and vaccination of children against various children's diseases, open the door to many agents the highly developed world has defeated a long time ago.

The situation started further to deteriorate in 1990, after the tumultous political developments in this space. Introduction of emergency measures by the Serbian regime at the Medical School in Pristina which incorporates all the clinical hospitals and almost all health institutions in Kosovo, created a new situation which directly reflected on the health status of the local population. Drop of the standard of living is also one of the main causes which affected spreading of various diseases. This is confirmed by the assistant-dean of the parallel Medical School, Dr Jusuf Dedushaj: "Due to poor diet, children in Kosovo at the age of 13 to 14 are developed like children between the age of seven and eight in the countries of Europe". He claims that for example: "only 40 per cent of the population in Kosovo use water fit to drink, and only 30 per cent of the population are covered by waterworks and the sewage system". Speaking about the health status, especially of the Albanian population in Kosovo, Prof. Dr. Alush Gashi, advisor for health of the leader of Kosovo Albanians, Dr Ibrahim Rugova, stresses that in the course of the past several years, ever since experts of Albanian nationality have not been working in hospitals, there were more than a hundred epidemics. "Death rate in Pristina hospitals is five times higher than, say, in Nis hospital. The number of pediatricians who are working with preschool children is 24 times smaller than the total number of pediatricians in the so-called Yugoslavia. A single specialist gynaecologist is in charge of 11,443 women, while only 27.18 per cent of babies are born in Kosovo with professional assistance of a physician", says Dr Alush Gashi.

What the actual health status of the citizens of Kosovo is like is probably best reflected by the fact that the highest death rate caused by tuberculosis in Europe is registered right here. The number of patients infected by this disease has been increasing as Director of the Health Institute in Pristina, Komnen Tmusic, says and adds that according to registered cases in health institutions which deal with this disease in Kosovo, in the period between 1991 and 1995 there were about 4,500 cases, out of which 57 were fatal, and that in just eight months of this year, more than 850 cases were registered, out of which six died. "According to parametres, the number of cases in this year in comparison with 1991 has doubled", stresses Dr Tmusic.

Lisa Adams from the American humanitarian organization "Physicians without Frontiers" which is active in a few Kosovo regions believed to be centres of tuberculosis, says: "After two years of work we are still getting new patients the number of whom reaches the figure of 25 persons a month. The number of cases varies depending on the time of year, so for example during the summer months we register 15 new cases a month, and in winter months this figure reaches 35. It is very bad that this disease strikes a large number of young people." According to Ms. Adams, reasons for this should be sought in "difficult living conditions in the regions, where these cases most frequently appear".

Dr Tmusic, however, sees reasons primarily in the political situation in Kosovo, but, he believes also "in the region in general". His colleagues, Nebojsa Janevski, from Belgrade hospital centre, states the opinion that "major responsibility for spreading of this disease lies with, as he stated, Albanian petty politicians "who have sacrificed a part of the population by creating the parallel system of health, by withdrawing from the state system and refusing vaccination".

There are other diseases in Kosovo which are claimed to be "diseases of social nature", as renowned Albanian pediatrician, prof. Dr. Izedin Osmani declared. In this group, apart from tuberculosis, are abdominal typhoid, hemorrhalgic fever, enteritis, white cough, chicken-pox, but other, one would tend to say, banal diseases, such as scabies. According to statistical data, only last year, 14 persons in Kosovo died of hemorrhalgic fever.

All things considered, the fact should not be neglected that there is a very small number of physicians in Kosovo in relation to the enormous Kosovo population. According to data of the Health Institute in Pristina, that is, according to registered situation in December last year, the situation is as follows: 1,134 inhabitants per one doctor of medical science, 6,442 inhabitants per one stomatologist, 37,964 inhabitants per one pharmacist, 940 per one health worker with university education, 343 per one worker with university or secondary medical school education, in other words 251 inhabitants per one medical worker in general. Circumstances are such that the number of physicians in 1995 increased in relation to 1990 by only four, that is, instead of 1,871 in 1990, there were 1,875 in 1995. It is especially unfavourable that the number of physicians in 1993 dropped to 1,596, in other words, by 275 in reference to 1990, while the total number of health workers in 1995 was smaller by 85 than the total number in 1990. According to data, the situation in other aspects of health protection is by no means better. The number of inhabitants per one physician in the emergency units reaches the figure of 24,721, and differs according to municipalities. In Podujevo there are 49,390 inhabitants per one physician in this specialized health service. "According to all empirical knowledge, 2.8 hospital beds per thousand inhabitants cannot by far satisfy needs of a population of over two million", it is stressed in the report of the Health Institute in Pristina headed by health workers of Albanian nationality.

Special problem in Kosovo during these troubled times has been immunization of the population by means of vaccination. After 1990, the rate of vaccination of children suddenly dropped, primarily due to political reasons. This led to reappearance of certain diseases which were belived to be eradicated. After several years, poliomyelitis reappeared again, and along with it other diseases raged Kosovo. Only 50 per cent of the total number of newly born children were, for instance, vaccinated against tuberculosis, but even if vaccination took place, the campaigns were occasional and never included all children. Assistant director of the Health Institute, Milan Parlic, believes that reasons are heterogeneous. Along with the political reason, he lists "high birthrate, birth outside health institutions, unregistered children, migration of the population from the villages to the cities, but also emigration from the country...". In this connection, Dr. Sami Rexhepi, pediatrician in one of the poorest parts of Pristina claims that "during vaccination of children against poliomyelitis, it was established that 24.6 per cent of children do not exist in any register, which means that they are not considered to be living at all", Dr. Rexhepi concluded. This campaign of vaccination against poliomyelitis backed by UNICEF, but carried out thanks to the contribution of physicians of both Albanian and the Serb nationality, but also to precious assistance of humanitarian organization Mother Theresa, was much more successful than anyone dared to expect. Teams of physicians in points on the entire territory of Kosovo, managed to vaccinate almost 90 per cent of boys and girls. In this way, by excellent response, Kosovo itself gave its contribution to the action of the World Health Organization in eradication of poliomyelitis by the year of 2000.

Besim ABAZI