... However, young people were not only being killed in Sarajevo. They were being murdered in Serbia as well, only without television cameras to record death rattles. Babies were dying every month - because of lack of basic medical equipment, because of the non-availability of even the simplest drugs, because of the lack of incubators.

Dr. Mima Simic, a thirty-five-year-old psychiatrist in a state hospital, confirmed that the medical situation in the country was more than desperate, it was fatal.

"So many of my patients," she explained, "require drug merely to function. We have nothing in the hospitals any longer. Instead of ministering to patients, doctors can only comfort and solace them. Most of my colleagues are morally shattered by now. Patients are slipping away from us, dying or retrogressing for lack of the simplest, basic medicines. The weakest are going first - infants, young children, the elderly. But soon it will affect everybody."

A team composed of some of the top medical experts in Yugoslavia prepared a document about the effect of sanctions on the health of a country which had only recently boasted of superlative services. It was a long, sad bit of work. In this instance, the mortar shell was fired by the United Nations, the victims were still often children and the murders continued. "Is it possible that the world is really ready to coldly implement measures causing a slow death of millions of innocent people?" This is a horrible question asked by the population of a country condemned to isolation.

"According to provisions and principles of the international humanitarian law, the right to life and health is a fundamental human right. This right is also guaranteed by the United Nations charter and the World Health Organization constitution. The definition of health accepted by the world is that of the World Health Organization according to which, health means material, social, psychological and physical wellbeing of the man. It is then needless to ask whether UN Security Council Resolutions 757 and 820 condemned to a loss of life and health citizens of the Federal Republic of Yugoslavia, and together with them refugees and ail others receiving health protection in its territory, since they can receive it nowhere else in the former Yugoslavia. And to what are condemned sick people in Yugoslavia by the Security Council sanctions?

"It is a well known fact that Yugoslav health service almost entirely depends on import. About 90% of medicines are produced exclusively on the basis of foreign licences and imported raw materials or half-made products. Other medicines are imported as ready-made products. Over 95% of sanitary material and 90% of medical material are also imported Almost ail medical equipment is imported, as well as spare parts. In order to function, Yugoslav health service needs to import each month thousands of various medical products - drugs, needles, syringes, various surgical sutures, bandages, tubes, catheters, pacemakers, blood testing equipment, infusion systems. If one is familiar with medicine and health, one knows that for various types of surgeries alone, a number of articles such as tubes, catheters and similar equipment is needed.

"The sanctions, introduced in late May, 1992, imposed procedure according to which each individual foreign trade turnover of these articles requires approval of the United Nations Committee for the implementation of Sanctions. I order to obtain approval, it is necessary to find a partner who is willing to cooperate, and then obtain approval of his government. And this is not enough! There is the second round of the process with the same procedure for carrying out financial transactions for this purpose. And finally the third round, i.e. obtaining approvals for transport of purchased goods.

"Despite the World Health Organization memorandum according to which financial transactions for health products must be excluded from sanctions, 50% of requests for deblocking of financial resources in foreign banks has not been met since September, 1992. Member countries of the United Nations and the World Health Organization that voted at the assemblies of this organization for the two resolutions under which health cannot be subject to sanctions, either for political or for any other reasons, are competing in making purchase and transport of medical products for the needs of the Federal Republic of Yugoslavia as slow as possible or even impossible. Many vehicles transporting humanitarian assistance are even prevented and stopped, thus discouraging those who collect, send and bring this assistance. In the meantime, surgeries for Yugoslav patients are being postponed and some of them die as a result.

"This country, that until recently had first-class medicine and health protection, has abandoned almost all methods of sophisticated specialist treatment. Babies with heart diseases die since surgery is impossible, operating rooms for open-heart surgeries were not heated during the winter, 1993, and there are long lists of patients waiting for kidney transplantation. Some of them die and for others death is closer and closer. Even if they are lucky enough to be operated on, it is not certain that they are going to live, since their illness deteriorates due to the long delay. And even if they survive this stage, still there is no hope for them, because there are no immuno-suppressive medicines to prevent rejection of the transplanted organ. Neurosurgeons are carrying out the most complex surgeries, e.g. brain tumor surgeries and similar, without X-ray equipment that would better locate the tumor, thus improving the chance of survival. However, it is not only this highest level of health protection that is the problem. Namely for several months now it has not been possible to implement even routine health protection. Due to the lack of tranquilizers, patients with mental disorders are again tied up and treated with electric shocks, although these are not only abandoned, but also banned methods. Death rate of these patients is rising enormously, and increasingly often when having fits of aggression, they attack doctors and other medical staff, who have no means to calm them down.

"Clinics for contagious diseases are full of patients whose blood has been infected since it has not been tested to hepatitis, while shelves for drugs are empty. Patients suffering from allergy cannot be treated with penicillin, cannot receive any help at all at clinics, since other antibiotics are available only occasionally, when they arrive as part of humanitarian aid. Private pharmacies still have medicines, and patients are buying their own anesthetic for surgery, needles, sutures, cytostatics. For one medicine they give their entire monthly salary, and for longer treatment they sell all they have.

"The following are only some of the effects of the sanctions so far:

"The Institute of Oncology in Belgrade does not have even the most fundamental cytostatics. Although three months ago, $500,000 was paid to import these medicines, and although all necessary approvals have been obtained, the bank in London has not released these resources. Four months ago a payment was made to the Siemens' account for spare parts for X-ray equipment. No reply has been received from the Siemens yet.

"At cardiosurgical wards for children in Serbia 41 babies have died since doctors have not been able to carry out necessary surgeries." Dr. Jadran Magic, a doctor at the Institute of the Mother and the Child in Belgrade, who provided this information, explained how tragic it was to decide which baby was to be operated first, and which one to be sent to death. These babies had heavy heart diseases. Who will take the responsibility for babies that are yet to be born, whose diseases, considered 'most ordinary' by the rest of the world, will be impossible to treat, since there will be no means for that?

"As a response to all appeals of Yugoslav doctors and officials and to the WHO resolutions, the UN Security Council Committee for Sanctions banned the import of raw materials for the production of medicines in Yugoslavia in November, 1992, since it allegedly had information that Yugoslav factories exported medicines to Slovenia. After five months of correspondence, the committee informed competent people in the country that only one small private company from Belgrade carried out export transactions for medicines with some similar Slovenian company from Maribor. Needless to say, not even after this has the ban been lifted. This is despite WHO resolutions 41.31 and 42.24, stating that health industry is not subject to sanctions. Yugoslav doctors, therefore, tried to raise their voice and tell the world that sanctions are seriously endangering the most innocent, children and the sick. Appeals were sent to the world public. In the context of April 7, World Health Day, our country required the World Health Organization to demand lifting of sanctions in the health sector in the United Nations. Doctors have organized peaceful protests in front of the American, Russian, French and German embassies in Belgrade.

"As a response, it happened that a new Security Council resolution on a complete isolation of Yugoslavia was adopted. The resolution contains a provision that humanitarian aid and medicines are exempted from the ban on import. One can but wonder how 'exempted' health sector will be under Resolution 820, when under the more lenient Resolution 757 it was 'exempted' in such a manner.

"The people of Yugoslavia has become a hostage of the international process of solving the war crisis in Bosnia. Isolation put an embargo on humanity, violated the fundamental human rights, and people in one European country are facing death - out of anyone's sight, without a single offered hand. Doctors of Yugoslavia have the following message: 'We shall find a way to sooner or later charge and condemn those who took the lives of our patients or deteriorated their health.'

"For months now there has been a permanent shortage in this country of a whole range of medicines for basic health care. In the hospitals and pharmacies, there are no drugs for cardiac patients, no drugs for malignant diseases, no antibiotics, no tranquilizers and anti-depressants, no drugs to treat hypertension, no drugs to prevent the rejection of transplanted organs; surgical hospitals have no medical supplies, no anesthetics, no anti-shock therapy drugs, no medicaments for intensive care. The semi-illicit private market, the wares of which are of doubtful origin and quality, is the only source of supply for ill people from which they can buy, for instance, everything that they need for an operation, for doctors to be able indeed to perform one. Not only do chronic patients spend all of their earnings or pensions to buy medicines on this market, but they are frequently forced to sell what little they have, acquired painstakingly, to be able to get treatment.

"Yugoslav doctors have already publicized preliminary surveys which demonstrate a very significant deterioration of the health condition of the population.

"Due to the lack of anti-tetanus vaccines in a hospital in Loznica (on the border between Serbia and Bosnia and Herzegovina) a patient contracted this grave and fatal disease. Another patient had an epilepsy seizure for two days, due to the lack of intravenous anti-epileptics. She survived, but with severe irreversible damage to her cerebral functions.

"In one of the dialysis centers, of the 15 kidney patients whole dialysis was reduced from the needed three treatments to two weekly, four died immediately.

"Over only a year the number of tuberculosis patients in I Belgrade has increased by 68 cases. At the Emergency Center in Belgrade, over less than a year, the mortality of injured patients went up by as much as 20% because of the lack of medicines and medical supplies for their timely treatment.

"At the Cardio-Vascular Surgery Center in Belgrade, in 1991 502 open-heart surgeries were performed, and only 203 ~ in 1992. The number of kidney transplants has been reduced ! by as much as 50% and in medicine, percentages of even 1 and 2% are significant.

"Epidemics of hepatitis, measles, intestinal and other infections are on the rise. Under the impact of Resolution 820 of the UN Security Council, it is expected that the present situation, difficult as it is, will only deteriorate further."

The tragedy of drug shortages throughout Yugoslavia cannot be fully understood or appreciated by reading a medical report, no matter how factual. The dilemma produced by the shortages grows more poignant and real when observed through patients' eyes particularly little patients.

Dr. Slavko Simeunovic, fifty-three, MD, PhD, vice dean of pediatrics and cardiology at Belgrade's University Children's Hospital, could not estimate how many of his tiny patients had worsened or even died because of the lack of medicines or proper medical equipment.

"There is a terrible antibiotic shortage. Every day there are less cardiotonics available to us. We don't have dieting and nutritional drugs that are essential for the treatment of certain disorders. I have been postponing operating on children with congenital heart diseases because we don't have vital oxygen equipment. And even if the parents locate the $2,000 needed to buy the equipment, where will they find it? How will they import it?

"Once, this hospital, and medicine generally in Yugoslavia. was ranked with the best facilities of Western Europe. Now it is not only that I cannot perform the operations here by myself I cannot even recommend sending the children overseas because there is simply not enough money."

No one will venture to guess how many sick people have already died because of the sanctions and the consequent lack of medical drugs and equipment. "We are only certain.' the cardiologist continued. "that the very young and the very old are the first to succumb.'

The ward was full of everything from infants to toddlers to young children. Parents were worried and frightened, incredulous that their children might be permitted to slip away from them. in this day and age of advanced science - because of a lack of medicine.

"I don t want to suggest that we don't have any medicine at all, continued the doctor, but our supplies are dwindling every day. We cannot schedule anything anymore. As the medicines drop, so do the expectations of our young patients. The longer the sanctions continue the worse it will be and the greater the suffering.

About Mr. Arnold Sherman's book
"PERFIDY IN THE BALKANS - THE RAPE OF YUGOSLAVIA".