The healt in ex Jugoslavia before and after the war
Sommary
di Vera Litricin
The health care system in Serbia and Monte Negro is in very bad conditions. In former Yugoslavia we had completely free health care that covered wide range of services, for almost the whole population. Health care of women included regular checks up on pregnant women, free and safe labor, one tear sickleave for new mothers, wide range of pre- schools and nurseries, the whole system of medical institutions for curing sterility and contraception, etc. At the same time there were regular checks up of babies including vaccinations, special care for risk-groups of children, free holidays for mothers and children who needed, for their health, the change of climate. Of course, hospital treatment and operations were free too. A few years before the war started quite enough attention had been paid on promotion of mental health for children. All medical drugs, from aspirin to citostatics, were free; radiological investigation and treatments were free, as well as laboratory. For last 40 years abortion has been available, for last 20 years it was free; between 1974 and 1992, the right of free parenthood was in the Constitution. The causes of Yugoslavia economic crisis that had its climax in 1993, are deep and they go for at least 20 years in the past. Economical breakdown caused partly by investments in war program and economic sanctions of UN resulted in inflation of 300.000.000% per year, 60% per day. The national income pro capite fell from 3000 dollars in 1989 to 800 in 1994. In such a circumstances the economic power of population fell drastically and, of course, the abilities of people to invest in their health decreased too. Even on such a small geopolitical space different groups of women and children are in very different position, now. Women and children who live in regions directly exposed to military actions are, of course, in the most horrible positions; the next group are refugees and they have their specific problems, with health, too. The third group are women and children who haven't been directly jeopardized by the war but economic and other factors caused dicrease in their health. As on each war zone in the world, the physical and mental health of women and children on the war zones on territory of former Yugoslavia has been jeopardized to the level of surviving. Relation between mother and child is harmed from the very beginning by stresses, malnutrition and lack of medical checks up during pregnancy. Labors are taking place in unbelievable circumstances, without hygienic supplies, medical drugs and food. That causes a high ratio of neonatal morbidity. Babies, infants and school-children do not have regular vaccinations, proper nutrition and they are more prone to all diseases; well known diseases of poverty - tubercolosis, skin-diseases and helmintiasis - reappeared in epidemiologically significant ranges. Psycological development of children is extremely harmed. They are born and they grow up in the frightening reality of cruelty and constant persistence of death. The fear for their own life and the lives of their loving ones are the part of their childhood and youth; the feeling of sadness and helplessness is deeply set in their hearts. The protective role of family and school is weak because these institutions are also in danger and weak. "I am nothing, my mum is Croatian, my daddy is Serbian and I am nothing", these are words of a refugee-boy who came with his father to Serbia while his mother stayed in Croatia. There are 500.000 of refugees in Serbia and 95% of them are settled down in families. In the beginning it was suitable for them, because of family atmosphere and feeling of closeness and acceptness. By the time host families were worn out. They have not got any support from the state or from social services. Women in these families have to provide meals for the members of their own families and for the refugee family with a very small amount of money. Misunderstanding caused by lack of money, space, emotional support, started to appear. On the other hand, refugee women started to feel that they are not accepted anymore, and felt need to make a better life for their children what was impossible in those circumstances. So, host women and refugee women get into depression. 5% of refugees are settled in refugee-camps, mainly they are women and children. Refugee-camps are usually faraway from towns; in camps refugees have not got a chance to take care of themselves and their families, to go to cities or to earn some money. They usually have fear for the members of family who stayed in the war zones - brothers, husbands - and/or grief for members of family that got killed in the war. All this jeopardizes their mental and physical health. The elderly people feel sorrow and uncertainty for lost of material values that they have been making all their lives. Refugee children are mainly with their mothers in host families. Some of them are in camps. Teenagers from families who stayed in war zones are settled down mostly in student homes. There are several psycological teams which have been working with these children. They are reporting that children feel refugee status as a stress. Often they express it by "crying, sadness, introvert behaviuor, acting out a different degree of fear and alertness, high level of tension, a lack of concentration, deterioration in school, hyperactivity, sleep-, feeding- and speak- disorders, different kinds of emotional dependence of mothers and other adults, aggression, etc.". Children and adolescents of all age expressed, as the most important for themselves, wish to go back to their home-towns; the next concern was worries for absent members of family, then problems that they have in the new surrounding and fear from the future. "My name is Dejan, in October I will be 11. I live in Belgrade but I am a refugee from Bania. In Belgrade I live with my aunty Seka in New Belgrade. My aunty is 68 and my uncle is 78. I am alone with them, my sister is with my other aunt. Daddy and mummy have stayed in Bania. I've not seen my daddy for 9 months and my mum came to see me in February...Before the war I strongly believed in God. But later, then, I taught of something: if there is one God...all this will not happen. Now I believe in God, but a little bit. If I were a wizard I would end this war and I would make possible for all refugees who want so to go back home. If I were wizard..." (Dejan, Banija, August 92) "I would be a good wizard. I would not do any evil as it happens in this war. I would turn the world into the freedom, I would turn world into freedom, I would make that thewar never happen again." (Nikolina, Lipik, 9 August 92). "If I were lioness...I would build a nice house, to stay in peace and never let hunters come to us." (Radojka, 11,V.Kladusa, August 92) Population who have not been directly exposed to the war suffered from a lot of frustration, too. Forced mobilitation put women into painful dilemma between care for their loved ones - brothers, sons, husbands - and respect of patriarchal values. It was harder in small comunities where patriarchal values are better inforced. There is estimation that 200.000 of young men avoided forced mobilization by leaving the country. As for a health, we have a quick, huge and painful change from completely free health care system to a lack of basic medical supplies. Women, children and old people are groups that are at the highest risk in those conditions. The ratio of morbidity and mortality increased; the ratio of suicide increased drastically among old people. Hyperinflation caused both economic and mental problems. Living in complete uncertenty made us feel deeply unsafe and helpless. We women - activists from womens' groups - "SOS Hotline", "Womens' center against sexual violence", "Women in black", etc., made a lot of effort to work on project in refugee camps, to work on political level and to do humanitarian work. That makes us less helpless. We had a strong support from womens' and anti-war groups from all over the world and that was very, very important to us.