Serbian Anthropological Society and Belgrade City Library
(abstracts from the scientific conference held on April 26th)

COLLATERAL VICTIMS

Associate Professor Marija Djuric Srejic
President of Serbian Anthropological Society
E-mail: marijads@eunet.yu

After the Second World War, European and even American intellectual circles did not remain silent about the war; on the contrary, a large number of individuals raised a warning voice, the United Nations was founded and later, many anti-war organisations. Nevertheless, the fact that wars continued to be waged, as Umberto Eco says, shows that the words of intellectuals were not heeded. There were not enough of them, and they did not have a sufficiently large historical space. The bombardment of Yugoslavia by the NATO forces is at least the eighth in the series of wars that have been launched, incited or financed by the USA in the past 50 years, and is yet another indicator that in present-day society, the condemnation of every form of violence is only an illusory, declarative act, and that in practice, aggression is still the means for accomplishing military, political and economic supremacy. All that is required is to convince the public that the reasons for waging war are justified and, if possible, that the aims are humanitarian. It is particularly desirable that they should be in the domain of human rights.

The protests over the military aggression against Yugoslavia held in the Western countries, indicate that the Western media have not altogether succeeded in explaining the motives of this war, which have surpassed the logic of national forces. Also, pictures of the devastation which, despite ideological and factographical censorship, sometimes, do reach those media, are gradually eroding the belief of people in the moral and every other justification of this aggression.

The Western public describes the direct civilian victims as “collateral damage”, a term that already sounds disgusting. We ask ourselves what expression will be used to explain and encompass the complexity of the suffering that has been caused by these bombings.

As a scientific society that upholds an inter-disciplinary approach to the study of man in his physical and spiritual integrity, the Serbian Anthropological Society felt it was necessary to initiate a gathering at which experts would point to the complexity of the catastrophe that has befallen us from the aspect of different scientific disciplines, to a whole range of suffering which, besides direct, also has extremely long-term and diverse effects. This gathering is an appeal to the Western public, and its aim is to point to at least some of the indirect suffering our population is being subjected to, so carelessly described as “collateral damage” or “side effects”.

The number of civilian victims of this war is far greater than the “over five hundred dead and several thousand wounded,” as recently stated by the Federal Information Ministry. The figures do not apply for those people who are already suffering or will inevitably suffer from war effects that do not involve the direct action of bombing civilians and civilian facilities. Will our colleague, a doctor who fled from Croatia to Bosnia as a refugee, then again fled Bosnia and came to Serbia as a refugee, and ultimately, several days after the beginning of the bombardment of Yugoslavia, committed suicide, ever be counted as a war victim?

Since March 24th, the inhabitants of Yugoslavia have had to face the acute danger of losing their lives and, in this respect, health care has become secondary, both from the point of view of patients who are preoccupied with surviving in conditions of war, and from the aspect of the state, whose primary concern is to provide the needs of the most vulnerable segments of the community. In a small survey we conducted among patients with cardiological diseases, we noted that of the 40 respondees, 32 were suffering from intensified heart trouble, but that only three of them had visited a doctor, whereas the remaining patients had dealt with their worsening condition on their own, by increasing the doses of therapy prescribed to them earlier. The Director of the Oncological Clinic in Belgrade, Prof. Nikola Mitrovic, recently stated that since the bombing started, the number of out-patients had declined from 700-1,000 per day, to 200 patients per day and he sent out an appeal to patients to keep coming for diagnostic tests and not to interrupt their therapy because of the war, as this would drastically increase the death rate among patients with malignant diseases. There are about 150,000 cases of malignant tumours in Serbia today. The average number of cured patients so far, was about 50%. If the current practice continues, with only one fifth of all patients continuing regularly to come for treatment, 60,000 people will not be cured. Also, of the 30,000 newly diagnosed malignant cases registered in Serbia, the lives of 24,000 of them will be in danger.

According to the statement of Prof. Darko Plecas, Head of the Fertility Department in the Belgrade Clinic Centre’s Gynaecological Clinic, since the bombing started the numbers of miscarriages and premature births, perinatal morbity and morality have increased, while the number of hospitalised women patients has decreased by two thirds. Surgical operations are performed only in emergencies, puerperium has been reduced only to two days. The Department for Sterility and Endocrinology are not working, and the Obstetrics Department is currently located in an epidemiologically unsuitable place.

In the Gastroenterology Department of the Clinic Center of Serbia, since bombing started the number of out-patients had declined from 25 to 5 per day, the number of impatiens word from 40 to 15 and number of ultrasound examinations from 120-150 to 16 per day.

At this point in time, it is not possible to clearly estimate the consequences of this ongoing war on people’s health, and especially not those which will manifest themselves in the coming years. The number of civilian casualties in the NATO agression is more than the “over 500 killed and several thousand wounded,” as it said in the statement of the Yugoslav Ministry for Foreign Affairs. This refers only to the immediate victims, to the number of civilians directly killed by the bombs or killed under the debris of the destroyed buildings. The people who are suffering or who will die, due to the consequences of the NATO bombing, have not been taken into account. However, the data on the visible and dangerous effects of the economic sanctions which the UN Security Council imposed against our country in 1992, was presented at a conference on April 7th 1994, sponsored by the Federal Ministry for Labour Health and Welfare and some other organisations. I will cite some examples:

1. The total number of children who died in the Pediatric and Surgical Departments of the University Clinic Hospital for Children in Belgrade, in 1993, was 141, which is 61 more than in 1991.

2. The mortality rate in the Clinic Centre of Serbia increased in 1992/1993 from 1.8% to 2.5% (i.e. by 40%).

3. The number of deaths from communicable diseases, e.g. AIDS (enterocollitis, dysentry, TB, encephalitis, measles…) increased from 191 (in 1989) to 271 (in 1993). In Kosovo and Metohia, the number of epidemics of infectious diseases increased from 2 in 1991, to 41 in 1993 (20 times over).

4. The number of people who became ill due to hydric epidemics (caused by the inadequate bacteriological quality of water) in the entire territory of Yugoslavia, increased from 889 (in 1990) to 8,080 (in 1993).

5. In the obstetrics departments of hospitals in Central Serbia, case fatality rates due to hospital infections increased from 2.5% (in 1989) to 17.8 % (in 1992).

6. On the territory of Belgrade, by 1993 the availability of medical staff qualified in children’s health care decreased by 12.5%, and by 24.9% in adult health care. The number of undernourished school children dramatically increased from 4.7% in 1989, to 9.4% in 1993. Due to problems connected with the supply of medical materials, the number of laboratory diagnostic procedures dropped by 36.03% and the taking of X-rays by 63.15%. In the domain of physical medicine, the number of therapeutic and diagnostic procedures decreased by 45.11%.

7. In the Institute of Gynaecology and Obstetrics at the Belgrade Clinic Centre, the number of pregnant women with imminent miscarriages increased from 360 in 1989, to 549 in 1993. The number of women in a state of imminent premature delivery increased from 79 to 222, and the number of intrauterine growth retardation increased from 93 to 191. In the same department, the usage of disinfectants fell from 1,256 lit. (in 1989), to 432 lit. (in 1993).

8. The systematic medical examination of Belgrade University students indicated a significant increase of anemia (from 3.4% in 1989, to 36% in 1992). In 1993, the number of registered cases of scabies increased sevenfold, compared to 1989.

9. In Belgrade, the hospitalisation rate of people aged 60 years and over, fell by 32.4%, with a significant increase in the mortality rate in hospitals: from 74 to 96.6 per 1,000 hospitalised patients.

10. The Institute of Oncology and Radiology of Serbia announced that 2,600 more patients died in the period from May 1992 to June 1993, than in the corresponding periods prior to the imposition of the economic sanctions. Also, due to the lack of early detection of malignant diseases, 55,000 patients will not survive a period of 5 years.

11. In the Institute for Cardiovascular Diseases in the Belgrade Clinic Centre, the percentage of pacemaker implantations dropped by 36.2% in 1993, in comparison to 1992.

12. Referring to life threatening late diabetic complications, the Diabetic Centre of the Institute for Endocrinology in the Belgrade Clinic Centre announced that the incidence of amputation as the outcome of treatment of foot gangrene increased more than tenfold in the first six months of 1993, compared to 1992.