(english / italiano)
Serbia: il sistema sanitario allo sfascio
1. SERBIA: SANITA' ALLO SFASCIO, SPAZIO AGLI STREGONI (ANSA)
2. SERBIA: SICK HEALTH SERVICE NEEDS FIRST AID (IWPR)
=== 1 ===
SERBIA: SANITA' ALLO SFASCIO, SPAZIO AGLI STREGONI
(Di Beatrice Ottaviano e Dragan Petrovic)
(ANSA) - BELGRADO, 10 AGO - Due anni di attesa per una angiografia, un
anno per gli esami necessari a un intervento ortopedico, almeno dieci
mesi per una visita dall'oncologo: la crisi economica e la transizione
hanno messo in ginocchio la sanita' in Serbia, lasciando campo libero
agli stregoni.
La misura della crisi del sistema sanitario e' data dal tentativo del
governo di varare una legge che la stampa locale ha subito ribattezzato
come 'lapot', termine intraducibile che indica l'antica tradizione
montenegrina di uccidere, in periodi di carestia, i parenti anziani e
ammalati per garantire la sopravvivenza dei giovani. Il disegno
prevedeva infatti di sospendere farmaci salvavita gratuiti come i
citostatici (usati per tenere sotto controllo alcuni tipi di tumore)
alle persone con piu' di 60 anni di eta'. Il governo ha dovuto fare una
rapida marcia indietro, sia per le proteste delle organizzazioni
umanitarie, sia per non alienarsi il vasto serbatoio elettorale dei
pensionati: ma il ritmo attuale di spesa resta insostenibile per le
casse statali.
Ed ecco allora proliferare sui giornali, in televisione, alle radio,
miriadi di annunci di cosiddetti maghi bianchi che propongono a un
pubblico suggestionabile una serie di improbabili rimedi, dai talismani
alla medicina etnica alla piu' pericolosa erboristeria 'fai da te': con
risultati spesso tragici, a volte comici. Come nel caso della sedicente
'Sonia l'onnipotente', una maga che fino al recente arresto per truffa
'curava' i telespettatori di un canale locale ad Alibunar, nella Serbia
centrorientale: ''Signora, lei e' seriamente ammalata, ha problemi di
prostata'', ha detto a una attonita spettatrice che aveva telefonato
per lamentare sintomi dolorosi al bacino.
Spesso i moderni 'stregoni' mischiano elementi della medicina olistica,
delle tradizioni orientali e della locale superstizione: ''Affiancano
l'agopuntura alla radioestesia, le pozioni a base di sangue di
tartaruga, un animale peraltro protetto, alle tisane, addirittura al
gasolio'', accusano i responsabili del Centro nazionale per la lotta ai
tumori, che ha presentato una dettagliata denuncia alla polizia. ''La
responsabilita' non e' solo del truffatore o del truffato - aggiungono
- ma anche e soprattutto di quelle televisioni e quei giornali che
danno spazio ai sedicenti maghi bianchi. Senza dimenticare lo sfascio
della sanita' che alimenta l'ignoranza e crea terreno fertile per
questi 'guaritori' senza scrupoli''.
Sfruttava l'ignoranza Slobodan Velickovic, che a Pancevo (cittadina
industriale a ridosso di Belgrado) si faceva pagare migliaia di euro
per pomate reperibili farmacia per pochi spiccioli. Gli bastava
cambiare flaconi ed etichettare come 'bioelisir' normali unguenti
antinfiammatori, sciroppi per la tosse e medicine da banco per
convincere gli sprovveduti clienti che il rimedio funzionava. Con
questo sistema, un contadino della zona, Nedelko Zivkovic, ha pagato
1.670 euro per un po' di cera decorata con pentagrammi, che doveva
togliere un presunto malocchio, e una pomata antireumatica del costo di
due euro.
Succede raramente, ma a volte accade, che questi rimedi funzionino,
specialmente se a suggestione si aggiunge suggestione: e' il caso di un
giovane montenegrino caduto in depressione, Sasha Daniksic, cui un
locale mago ha diagnosticato una intossicazione da filtro amoroso.
Stando al Merlino di turno, una aspirante strega innamorata aveva fatto
bere al ragazzo un caffe' con due gocce di sangue mestruale, ricetta
tipica della stregoneria europea per le cosiddette pozioni d'amore. La
cura e' stata indossare l'orologio del padre finche questo non si e'
scaricato, e apparentemente ha funzionato.
''Non mi stupisce che in qualche caso si ottenga quello che la medicina
chiama 'effetto placebo' - dice Voja Antovic, autore di un libro sul
fenomeno - i malati hanno una straordinaria capacita' autocurativa se
debitamente suggestionati''. Comunque, ''Quella che i sedicenti
stregoni chiamano bioenergia, dicendosi in grado di maneggiarla, non
esiste - afferma perentorio il fisico nucleare Vladimir Ajdacic - siamo
in grado di registrare energie subatomiche, infinitesimali. Se ci fosse
qualcosa come la bioenergia, i nostri strumenti dovrebbero essere in
grado di riscontrarla''. (ANSA). OT
10/08/2004 17:59
http://www.ansa.it/balcani/fattidelgiorno/200408101759161057/
200408101759161057.html
=== 2 ===
http://www.iwpr.net/index.pl?archive/bcr3/bcr3_200403_484_2_eng.txt
IWPR'S BALKAN CRISIS REPORT, No. 484, March 10, 2004
SERBIA: SICK HEALTH SERVICE NEEDS FIRST AID
Years of underinvestment have left a system that was a showcase for
socialism in ruins.
By Zelimir Bojovic in Belgrade
At the Belgrade Institute of Urology, head nurse Liljana Nikolic takes
unusual measures to compensate for years of underinvestment in the
nation's hospitals.
Touring the luxurious foreign-owned hotels in the new part of the city,
she asks them to donate their spare linen, which they no longer need
because it is torn or blemished. The building where she works is
crumbling and crowded. "It's all falling apart," she said, pointing to
a ward where 30 patients - most with cancer - share one bathroom and
two toilets.
With its ravaged 80-year-old façade, warehouse-style entrance, grey
corridors and crowded lavatories, the urology institute is a symbol of
Serbia's failing health service. Virtually ignored under Slobodan
Milosevic's 12-year regime, when money was channelled into nationalist
military projects [Note: THIS A BLATANT LIE. THE WEST FORCED YUGOSLAVIA
INTO WAR; ON THE OTHER HAND, DISINVESTIMENT AND DESTRUCTION OF THE
STATE-OWNED SANITARY SYSTEM ONLY STARTED AFTER MILOSEVIC WAS OUSTED BY
PRO-WESTERN POLITICIANS -- THOSE WHO ARE GOING ON KILLING THE COUNTRY,
RIGHT NOW. I.Slavo], the health service is on its last legs.
Money is short. Whereas Britain annually spends 1,500 US dollars per
person on health, Serbia and Montenegro spends 50. The monthly salaries
of the country's 26,000 doctors average 20,000 dinars, or around 300
euro - a fraction of what counterparts earn in the West.
The 130,000 workers in the state health system are a demoralised army.
From October 2 until late December last year about half were on strike,
demanding pay increases. The government could not even consider their
demands, as the budget for 2004 had not been adopted owing to early
parliamentary elections in December 2003. The health service unions
have warned they will resume their strike the moment a new government
is formed.
Although health workers' salaries are low, they consume 60 per cent of
the 1 billion euro total health budget. Many officials are demanding
staff cuts. "The system we have now is excessive," said the health
minister, Dragomir Marisavljevic. "It is too bulky and inert. It must
be reshaped."
In the meantime, underpaid hospital staff work part-time in private
clinics to make ends meet - to the detriment of their jobs in the state
sector.
Milan Spuran has worked for 13 years at the state-run Serbian Clinical
Centre in Belgrade. "Even including night shifts, my salary is only
24,000 dinars (350 euro)," he complained. In spite of holding down a
key job, he cannot buy an apartment, which is why he works part-time
elsewhere. "I do private medical examinations at times and also provide
consulting services," he said. "Hopefully, our salaries will soon be
higher and our equipment repaired and replaced."
But Spuran's hopes are unlikely to be realised soon. Though some new
equipment has been purchased, including X-ray machines, ambulances and
new operating theatres, real structural improvement depends on
continued foreign aid.
According to the health ministry, foreign aid for health has so far
amounted to about 100 million euro. Another 50 million euro is in the
pipeline in the form of a loan from the European Investment Bank. But
this money has been held up in parliament after some opposition
deputies complained it was adding to the country's massive foreign
debt.
Health care representatives are demanding ratification of the loan,
pointing out that there is no time limit on the repayment. They warn
that without the money, they might soon be unable to provide even a
minimum service.
Surgery and basic hospital care remain free of charge in Serbia and
Montenegro, but patients already have to pay for an increasing
percentage of their medical bills. For people on low salaries, these
sums are frightening.
Milinko, 52, is not only concerned about whether he will survive
complex surgery but about the cost of post-operative medications. A
doctor has sent his family a long list of drugs and therapies that he
will need to purchase for himself.
"I have already spent about 10,000 dinars (150 euro) on medication and
other materials before surgery," said Milinko, who earns 17,000 dinars
monthly. After, he says he will have to spend several thousand more, "I
will have to pay for it all, so my family is economising on other
things."
Milinko appears confused by his plight. His small hospital room is
decrepit with dirty walls on which paint has peeled away. On a beside
table lies the remains of a meagre hospital meal, which Milinko has not
eaten.
Even when the sums required of patients amount only to a few hundred
dinars, it is a heavy burden, especially to people on pensions or
refugees. Vojo, 55, a refugee from Drvar, in north-west Bosnia, was
trying to beg for 200 dinars from passers-by in front of a clinic where
his wife is undergoing treated for cancer. "So far I've paid more than
150 euro for examinations and now the doctors have told me to buy
medication which costs 200 dinars," he said. "It embarrasses me to beg
but I have no one here in Belgrade to borrow from."
The grinding poverty afflicting patients and health workers alike
creates a fertile breeding ground for bribery. In January, a police
anti-corruption unit detained Laslo Svirtlih, head of the Miroslav
Zotovic clinic, on suspicion of demanding unauthorised payments from
his patients.
Svirtlih was accused of insisting on a down payment of 300 euro to
admit a patient to his hospital and then another 100 euro to extend his
treatment few days later. The police caught him receiving money, having
been informed beforehand. The family of the patient had marked the
banknotes that they handed over. He is currently awaiting trial.
Zoran Ilic, leader of a union with many health worker members, says
combating crime within the system should be a priority, but that "small
progress has been made in this respect". In reality, petty corruption
has been part of the health system for years. Patients often expect to
routinely hand doctors "gifts" in cash or objects to secure proper
treatment.
Tomica Milosavljevic, a former health minister, insists Serbia still
possesses a relatively well developed network of health institutions
and that the problem comes down to poor maintainance. "Many of our
problems are simply banal ones," he said, "like burst pipes, windows
that won't shut, inadequate heating and poor food for patients."
Milosavljevic blames a relatively low level of health insurance, which
is mandatory but only 11 per cent of incomes, as opposed to a European
average of at least 13 per cent. He also wants to see higher percentage
of public spending going towards health care.
While he and his successor, Dragomir Marisavljevic, predict an upturn
in the Serbian health service over the next decade, the patients of
today will have to make do with run-down facilities and overstretched
staff. As one 58-year-old woman waiting for treatment in a Belgrade
clinic remarked, ruefully, "People with no money can't afford to get
ill."
Zelimir Bojovic is a Deutsche Welle correspondent in Belgrade.
(...) Balkan Crisis Report is supported by the Department for
International Development, the European Commission, the Swedish
International Development and Cooperation Agency, The Netherlands
Ministry for Foreign Affairs, and other funders. IWPR also acknowledges
general support from the Ford Foundation.
For further details on this project, other information services and
media programmes, visit IWPR's website: www.iwpr.net (...) The
Institute for War & Peace Reporting is a London-based independent
non-profit organisation supporting regional media and democratic
change. [sic]
Lancaster House, 33 Islington High Street, London N1 9LH, United
Kingdom. Tel: +44 (0)20 7713 7130, Fax: +44 (0)20 7713 7140 E-mail:
info@... Web: www.iwpr.net
The opinions expressed in Balkan Crisis Report are those of the authors
and do not necessarily represent those of the publication or of IWPR.
ISSN: 1477-7932 Copyright (c) 2004 The Institute for War & Peace
Reporting
BALKAN CRISIS REPORT No. 484
Serbia: il sistema sanitario allo sfascio
1. SERBIA: SANITA' ALLO SFASCIO, SPAZIO AGLI STREGONI (ANSA)
2. SERBIA: SICK HEALTH SERVICE NEEDS FIRST AID (IWPR)
=== 1 ===
SERBIA: SANITA' ALLO SFASCIO, SPAZIO AGLI STREGONI
(Di Beatrice Ottaviano e Dragan Petrovic)
(ANSA) - BELGRADO, 10 AGO - Due anni di attesa per una angiografia, un
anno per gli esami necessari a un intervento ortopedico, almeno dieci
mesi per una visita dall'oncologo: la crisi economica e la transizione
hanno messo in ginocchio la sanita' in Serbia, lasciando campo libero
agli stregoni.
La misura della crisi del sistema sanitario e' data dal tentativo del
governo di varare una legge che la stampa locale ha subito ribattezzato
come 'lapot', termine intraducibile che indica l'antica tradizione
montenegrina di uccidere, in periodi di carestia, i parenti anziani e
ammalati per garantire la sopravvivenza dei giovani. Il disegno
prevedeva infatti di sospendere farmaci salvavita gratuiti come i
citostatici (usati per tenere sotto controllo alcuni tipi di tumore)
alle persone con piu' di 60 anni di eta'. Il governo ha dovuto fare una
rapida marcia indietro, sia per le proteste delle organizzazioni
umanitarie, sia per non alienarsi il vasto serbatoio elettorale dei
pensionati: ma il ritmo attuale di spesa resta insostenibile per le
casse statali.
Ed ecco allora proliferare sui giornali, in televisione, alle radio,
miriadi di annunci di cosiddetti maghi bianchi che propongono a un
pubblico suggestionabile una serie di improbabili rimedi, dai talismani
alla medicina etnica alla piu' pericolosa erboristeria 'fai da te': con
risultati spesso tragici, a volte comici. Come nel caso della sedicente
'Sonia l'onnipotente', una maga che fino al recente arresto per truffa
'curava' i telespettatori di un canale locale ad Alibunar, nella Serbia
centrorientale: ''Signora, lei e' seriamente ammalata, ha problemi di
prostata'', ha detto a una attonita spettatrice che aveva telefonato
per lamentare sintomi dolorosi al bacino.
Spesso i moderni 'stregoni' mischiano elementi della medicina olistica,
delle tradizioni orientali e della locale superstizione: ''Affiancano
l'agopuntura alla radioestesia, le pozioni a base di sangue di
tartaruga, un animale peraltro protetto, alle tisane, addirittura al
gasolio'', accusano i responsabili del Centro nazionale per la lotta ai
tumori, che ha presentato una dettagliata denuncia alla polizia. ''La
responsabilita' non e' solo del truffatore o del truffato - aggiungono
- ma anche e soprattutto di quelle televisioni e quei giornali che
danno spazio ai sedicenti maghi bianchi. Senza dimenticare lo sfascio
della sanita' che alimenta l'ignoranza e crea terreno fertile per
questi 'guaritori' senza scrupoli''.
Sfruttava l'ignoranza Slobodan Velickovic, che a Pancevo (cittadina
industriale a ridosso di Belgrado) si faceva pagare migliaia di euro
per pomate reperibili farmacia per pochi spiccioli. Gli bastava
cambiare flaconi ed etichettare come 'bioelisir' normali unguenti
antinfiammatori, sciroppi per la tosse e medicine da banco per
convincere gli sprovveduti clienti che il rimedio funzionava. Con
questo sistema, un contadino della zona, Nedelko Zivkovic, ha pagato
1.670 euro per un po' di cera decorata con pentagrammi, che doveva
togliere un presunto malocchio, e una pomata antireumatica del costo di
due euro.
Succede raramente, ma a volte accade, che questi rimedi funzionino,
specialmente se a suggestione si aggiunge suggestione: e' il caso di un
giovane montenegrino caduto in depressione, Sasha Daniksic, cui un
locale mago ha diagnosticato una intossicazione da filtro amoroso.
Stando al Merlino di turno, una aspirante strega innamorata aveva fatto
bere al ragazzo un caffe' con due gocce di sangue mestruale, ricetta
tipica della stregoneria europea per le cosiddette pozioni d'amore. La
cura e' stata indossare l'orologio del padre finche questo non si e'
scaricato, e apparentemente ha funzionato.
''Non mi stupisce che in qualche caso si ottenga quello che la medicina
chiama 'effetto placebo' - dice Voja Antovic, autore di un libro sul
fenomeno - i malati hanno una straordinaria capacita' autocurativa se
debitamente suggestionati''. Comunque, ''Quella che i sedicenti
stregoni chiamano bioenergia, dicendosi in grado di maneggiarla, non
esiste - afferma perentorio il fisico nucleare Vladimir Ajdacic - siamo
in grado di registrare energie subatomiche, infinitesimali. Se ci fosse
qualcosa come la bioenergia, i nostri strumenti dovrebbero essere in
grado di riscontrarla''. (ANSA). OT
10/08/2004 17:59
http://www.ansa.it/balcani/fattidelgiorno/200408101759161057/
200408101759161057.html
=== 2 ===
http://www.iwpr.net/index.pl?archive/bcr3/bcr3_200403_484_2_eng.txt
IWPR'S BALKAN CRISIS REPORT, No. 484, March 10, 2004
SERBIA: SICK HEALTH SERVICE NEEDS FIRST AID
Years of underinvestment have left a system that was a showcase for
socialism in ruins.
By Zelimir Bojovic in Belgrade
At the Belgrade Institute of Urology, head nurse Liljana Nikolic takes
unusual measures to compensate for years of underinvestment in the
nation's hospitals.
Touring the luxurious foreign-owned hotels in the new part of the city,
she asks them to donate their spare linen, which they no longer need
because it is torn or blemished. The building where she works is
crumbling and crowded. "It's all falling apart," she said, pointing to
a ward where 30 patients - most with cancer - share one bathroom and
two toilets.
With its ravaged 80-year-old façade, warehouse-style entrance, grey
corridors and crowded lavatories, the urology institute is a symbol of
Serbia's failing health service. Virtually ignored under Slobodan
Milosevic's 12-year regime, when money was channelled into nationalist
military projects [Note: THIS A BLATANT LIE. THE WEST FORCED YUGOSLAVIA
INTO WAR; ON THE OTHER HAND, DISINVESTIMENT AND DESTRUCTION OF THE
STATE-OWNED SANITARY SYSTEM ONLY STARTED AFTER MILOSEVIC WAS OUSTED BY
PRO-WESTERN POLITICIANS -- THOSE WHO ARE GOING ON KILLING THE COUNTRY,
RIGHT NOW. I.Slavo], the health service is on its last legs.
Money is short. Whereas Britain annually spends 1,500 US dollars per
person on health, Serbia and Montenegro spends 50. The monthly salaries
of the country's 26,000 doctors average 20,000 dinars, or around 300
euro - a fraction of what counterparts earn in the West.
The 130,000 workers in the state health system are a demoralised army.
From October 2 until late December last year about half were on strike,
demanding pay increases. The government could not even consider their
demands, as the budget for 2004 had not been adopted owing to early
parliamentary elections in December 2003. The health service unions
have warned they will resume their strike the moment a new government
is formed.
Although health workers' salaries are low, they consume 60 per cent of
the 1 billion euro total health budget. Many officials are demanding
staff cuts. "The system we have now is excessive," said the health
minister, Dragomir Marisavljevic. "It is too bulky and inert. It must
be reshaped."
In the meantime, underpaid hospital staff work part-time in private
clinics to make ends meet - to the detriment of their jobs in the state
sector.
Milan Spuran has worked for 13 years at the state-run Serbian Clinical
Centre in Belgrade. "Even including night shifts, my salary is only
24,000 dinars (350 euro)," he complained. In spite of holding down a
key job, he cannot buy an apartment, which is why he works part-time
elsewhere. "I do private medical examinations at times and also provide
consulting services," he said. "Hopefully, our salaries will soon be
higher and our equipment repaired and replaced."
But Spuran's hopes are unlikely to be realised soon. Though some new
equipment has been purchased, including X-ray machines, ambulances and
new operating theatres, real structural improvement depends on
continued foreign aid.
According to the health ministry, foreign aid for health has so far
amounted to about 100 million euro. Another 50 million euro is in the
pipeline in the form of a loan from the European Investment Bank. But
this money has been held up in parliament after some opposition
deputies complained it was adding to the country's massive foreign
debt.
Health care representatives are demanding ratification of the loan,
pointing out that there is no time limit on the repayment. They warn
that without the money, they might soon be unable to provide even a
minimum service.
Surgery and basic hospital care remain free of charge in Serbia and
Montenegro, but patients already have to pay for an increasing
percentage of their medical bills. For people on low salaries, these
sums are frightening.
Milinko, 52, is not only concerned about whether he will survive
complex surgery but about the cost of post-operative medications. A
doctor has sent his family a long list of drugs and therapies that he
will need to purchase for himself.
"I have already spent about 10,000 dinars (150 euro) on medication and
other materials before surgery," said Milinko, who earns 17,000 dinars
monthly. After, he says he will have to spend several thousand more, "I
will have to pay for it all, so my family is economising on other
things."
Milinko appears confused by his plight. His small hospital room is
decrepit with dirty walls on which paint has peeled away. On a beside
table lies the remains of a meagre hospital meal, which Milinko has not
eaten.
Even when the sums required of patients amount only to a few hundred
dinars, it is a heavy burden, especially to people on pensions or
refugees. Vojo, 55, a refugee from Drvar, in north-west Bosnia, was
trying to beg for 200 dinars from passers-by in front of a clinic where
his wife is undergoing treated for cancer. "So far I've paid more than
150 euro for examinations and now the doctors have told me to buy
medication which costs 200 dinars," he said. "It embarrasses me to beg
but I have no one here in Belgrade to borrow from."
The grinding poverty afflicting patients and health workers alike
creates a fertile breeding ground for bribery. In January, a police
anti-corruption unit detained Laslo Svirtlih, head of the Miroslav
Zotovic clinic, on suspicion of demanding unauthorised payments from
his patients.
Svirtlih was accused of insisting on a down payment of 300 euro to
admit a patient to his hospital and then another 100 euro to extend his
treatment few days later. The police caught him receiving money, having
been informed beforehand. The family of the patient had marked the
banknotes that they handed over. He is currently awaiting trial.
Zoran Ilic, leader of a union with many health worker members, says
combating crime within the system should be a priority, but that "small
progress has been made in this respect". In reality, petty corruption
has been part of the health system for years. Patients often expect to
routinely hand doctors "gifts" in cash or objects to secure proper
treatment.
Tomica Milosavljevic, a former health minister, insists Serbia still
possesses a relatively well developed network of health institutions
and that the problem comes down to poor maintainance. "Many of our
problems are simply banal ones," he said, "like burst pipes, windows
that won't shut, inadequate heating and poor food for patients."
Milosavljevic blames a relatively low level of health insurance, which
is mandatory but only 11 per cent of incomes, as opposed to a European
average of at least 13 per cent. He also wants to see higher percentage
of public spending going towards health care.
While he and his successor, Dragomir Marisavljevic, predict an upturn
in the Serbian health service over the next decade, the patients of
today will have to make do with run-down facilities and overstretched
staff. As one 58-year-old woman waiting for treatment in a Belgrade
clinic remarked, ruefully, "People with no money can't afford to get
ill."
Zelimir Bojovic is a Deutsche Welle correspondent in Belgrade.
(...) Balkan Crisis Report is supported by the Department for
International Development, the European Commission, the Swedish
International Development and Cooperation Agency, The Netherlands
Ministry for Foreign Affairs, and other funders. IWPR also acknowledges
general support from the Ford Foundation.
For further details on this project, other information services and
media programmes, visit IWPR's website: www.iwpr.net (...) The
Institute for War & Peace Reporting is a London-based independent
non-profit organisation supporting regional media and democratic
change. [sic]
Lancaster House, 33 Islington High Street, London N1 9LH, United
Kingdom. Tel: +44 (0)20 7713 7130, Fax: +44 (0)20 7713 7140 E-mail:
info@... Web: www.iwpr.net
The opinions expressed in Balkan Crisis Report are those of the authors
and do not necessarily represent those of the publication or of IWPR.
ISSN: 1477-7932 Copyright (c) 2004 The Institute for War & Peace
Reporting
BALKAN CRISIS REPORT No. 484