Data: 17/07/2002 23:39
Da: Vladimir Krsljanin
Oggetto: WORSENING OF MILOSEVIC'S HEALTH PRODUCES
RECESS OF THE "TRIAL"
WORSENING OF MILOSEVIC'S HEALTH PRODUCES RECESS OF THE "TRIAL"
From FREEDOM Association:
Consilium of medical experts appointed by "ICTY", in presence of the
long time personal doctor of President Milosevic, colonel Zdravko
Mijailovic, made on Tuesday afternoon a routine check-up of the
President's health.
They measured blood pressure of 120/200 mmHg!
Despite their findings, the "trial" resumed today.
After another strong appeal from the Yugoslav Committee (see below),
only today Afternoon, the "court" accepted doctors' advises and decided
that, due to the need to change the (practically unexisting) therapy and
to make additional check-ups and laboratory analyses, the "accused"
shell not appear in the "court" for at least next two days, until
further notice.
About two weeks ago, after the second break in the "trial", due to "flu"
(diagnosis of the prison doctor) which lasted this time two weeks, the
"trial chamber" issued an order to the "registry" to organize a
consilium check-up and to report the results. This decision was made
after many appeals from Yugoslavia and from abroad. After that,
additional efforts and appeals have been made to include in the
consilium at least one of Yugoslav doctors. "Tribunal" finally agreed
that consilium check-ups can be made in the presence of President's long
time personal doctor, colonel Zdravko Mijailovic, head of the
Cardio-vascular Clinic of the Military Medical Academy in Belgrade.
We still follow the developments, with lot of worry.
It is obvious that the prison conditions, lack of medical care and
inhuman conditions and length of the "trial", produced worsening of the
health of President Milosevic and increased risks.
Let us further act against this show-trial and its dangerous
consequences!
FREEDOM FOR SLOBODAN MILOSEVIC!
FREEDOM FOR YUGOSLAVIA!
Our today's message to the "Tribunal":
"FREEDOM" ASSOCIATION, BELGRADE, FR YUGOSLAVIA
July 17, 2002
- Mr. Claude Jorda, President, ICTY
- Mr. Richard May, President, Trial Chamber
- AMICUS CURIAE
- Mr. Hans Holthius, Registrar, ICTY
Most
Urgent!
State of health of President Slobodan Milosevic requires an urgent
action!
Dear Sirs,
Our information about the yesterday's medical examination of the state
of health of President Milosevic, made by the medical experts' team
appointed by ICTY Registry on the order of Trial Chamber, unfortunately
confirms our previous knowledge and our suspicions that the general
conditions in which President Milosevic is forced to live, without the
proper medical care, combined with inhuman length and conditions of the
ICTY proceedings, produce worsening of the President Milosevic's state
of health and to the dramatic level increases risks for his life.
We can not understand that the result of yesterday's examination has not
yet produced any action from your side. Our duty is to warn you once
again that denial of proper medical care for a person in such condition
is a matter of criminal responsibility.
In that respect, when a human life is at stake, no bureaucratic
negligence can be an excuse for absence of proper and urgent action.
Particularly since the Freedom Association has already been warning you
several times about this situation which is one of the worst and most
serious forms of violations of human rights. We can not avoid the
impression that this might be an intentional practice of ICTY. For this,
we refer particularly to our letter Nos. 18-21/2002 of March 27, 2002,
addressed to President of ICTY, III Trial Chamber, Chief of Prosecutors
and Amici Curiae, with whole appropriate medical documentation enclosed.
Our last warning (Letter No.45/2002) was sent to Judges Mr. Jorda and
Mr. May, as well as to the Registrar Mr. Holthius, on June 18, 2002.
We enclose this time again the same medical documentation, already sent
to you with our March 27 letter.
We appeal in strongest terms that measures to protect a human life have
to be taken without any further delay.
Yours sincerely,
Bogoljub Bjelica,
Chairman of the Citizen Association "FREEDOM"
Our March 30 appeal:
FREEDOM ASSOCIATION
/YUGOSLAV COMMITTEE TO LIBERATE PRESIDENT MILOSEVIC/
WARNS:
HEALTH AND LIFE OF PRESIDENT MILOSEVIC UNDER THREAT!
Level of health protection in former Nazi prison in the Hague is the
same like in Nazi concentration camps (two prisoners already dyed due to
lack of medical care)!
60-year old president Milosevic with malignant hypertension and specific
form of angina pectoris in an endless "trial" every day whole day is
treated by aspirins, when he got a flu (according to prison doctor -
general practician) with more then 10 days of high temperature!
He is under total life risk in such circumstances, say medical experts
of Belgrade University!
He needs urgent check-up by medical specialists, which NATO "tribunal"
prohibits up to now!
ACTION MUST BE TAKEN!
After the "tribunal's" negative answer to first such initiative, Freedom
Association sends the following letter (with medical documentation
enclosed) to "judges", "prosecution" and "amici curiae" of the now-days
Gestapo (in accordance with their "rules"), warning them about the
criminal responsibility:
UNITED NATIONS
International Criminal Tribunal for the Former Yugoslavia
To the III Trial Chamber
Your Excellencies,
Bearing in mind the intensive dynamic of the so-called trial, to which
President Slobodan Milosevic is exposed from day to day, we must warn
you that you carry the responsibility for his health and life.
Since you are evidently not enough informed with the general, but with
the current as well, state of health of President Milosevic, and since,
no matter of his illness, you do not show interest enough for the
improvement of his health, that is the reason why we are compelled, as
National Committee for liberation of Slobodan Milosevic, towarn you
about that.
We especially bear in mind your responsibility for the state of health
of President Milosevic that derives from your Statute and Rulebook on
Procedure and Evidence and a number of other international documents.
The treatment of President Milosevic as a whole finds itself in full
collision with the Convention on torture and other brutal, humiliating
sanctions and proceedings, adopted by the United Nations General
Assembly on December 10, 1984, came into force on June 26, 1987 and is
in collision with the equivalent Convention, adopted by the Council of
Europe.
If however, for the sake of accomplishing an unprecedented "project" of
a trial, you will further on allow, as it has been the case so far, the
deterioration of President Milosevic's health, you will carry full
responsibility for that.
Therefore, we demand to enable a number of medical experts (first of all
specialists for cardio-vascular diseases) from Yugoslavia, to make an
urgent examination of President Milosevic and give a proposal for
adequate treatment, in order to stop the further deterioration of his
health. The team of experts would be comprised out of Prof. Dr. Med. Sc
Bozina Radevic (cardio-vascular surgeon), Prof. Dr. Med. Sc Zdravko
Mijailovic (cardiologist), Doc. Dr. Med. Sc Dragana Bojic
(cardiologist), and Prof. Dr. Med. Sc Vojislav Suvakovic
(infectologist).
Starting from Rule 74bis of the Rulebook on Procedure and Evidence of
the Tribunal, according to which you are proprio motu able to issue
such an order, we demand from you to immediately enable a consilium
medical examination of President Milosevic. Attached you will find the
reports of Prof. Dr. Med. Sc. Zdravko Mijailovic of the Military Medical
Academy of Belgrade, dating from May 31, 2001 and June 4, 2001 (both in
English), together with the copies of the originals in Serbian, as well
as the medical report dated from March 25, 2002 related to the state of
health of President Milosevic.
Belgrade, March 26, 2002
For "SLOBODA" ("Freedom") Association
The National Committee for the Liberation of Slobodan Milosevic
Bogoljub Bjelica, President
MEDICAL REPORT
RE: SLOBODAN MILOSEVIC
Inspection of medical documentation and his previosly, well known healt
problems insigate and underline further facts:
The majority of people know what is hypertension. It is not
secret that hypertension has an inportant role of
cardiovascular mortality and morbidity. Effective treatment
significantly reduces relative risk of stroke up to 40%, and
of myocardial infraction by 20%. Slobodan Milosevic does not
have simply elevated blood preasure, he has hypertensive
crisis or malignant hypertension. His diastolic blood pressione
often, with abrupt onset exceeds 130 mmHg, systolic 200
mmHg. What does it mean?
Accelerated (malignant) hypertension occurs most commonly in
patients with essential hypertension. The risk of
complication is more closely linked with the rate of rise in
blood preasure than the absolute blood preasure level,
because patients auto regulate to compensate for chronic
hypertension. When blood preasure rises rapidly as Milosevics'
case, celebral, retinal and renal damage may ensue and the
patient may develop acute cardinale failure. It carries a high
mortality risk: untreated, 1-year survival in approximately 25%;
with treatment, 1-year survival is around 90%. Rapid
control of escalating blood presure is essential, but it has to
be achieved by slow, sustained reduction. There is no
prison hospital which can obtain this treatment. They can
provide only aggressive treatment. Aggressive reduction can
cause tissue and celebral ischaemia and infraction, because in
most cases the tissues have auto regulated to require a
greater than normal perfusion pressure.
His another heath problem is Prinzmetal's variant angina
pectoris. There is no pearson who does not understand what means
"angina pectoris". In the last few months Milosevic has been
having chest pain due to coronary arterial spasm which can
not be relieved by sublingual nitroglycerin. It occurs at rest
with abrupt onset or rapid deterioration of previously
stable condicion. Reason for deteriration his condicion is
inappropriate coronary vasoconstriction whish has been shown
to occur during exposure to mental stress.
In the other hand, anxiety is a normal reaction to cardial
illness and many patient will have symptoms as a result. The
tendency to categorize patient's symptoms as "genuine" and
"non-cardiac" is unhelpful. Relaxation and stress management
are fundamental problems particularly useful in managing angina
where (after exertion) stress is the second most likely
precipitant of symptoms.
Slobodan Milosevic is in the prison where there is no
possibility for appropiate medical treatment. He probably can get
pills or doctors' supervision. But underlying conditions ask for
high educated consultants, intesive care unit and above
all relaxsation. Only in this condition his cardiac properties
will not function related his chance to present evidence
of his innocent.
Prolonger trial and stress continuity increase risk of major
cardiovascular events. Slobodan Milosevic is undergoing
extreme phychical effort. Everyday rapid deterioration of his
health can cause sudden death. That is why he must be
rewieved and under care of medical experts from Yugoslavia who
know his medical history. They need to see him and after
serious examination decide about further treatment.
We are not talking about quality of life we are fighting for
life!
Professors of Belgrade University:
Dragana Bojic, Ph.D., MD, cardiologist
Vojislav Suvakovic, Ph.D., MD, infectologist
Milos Janicijevic, Ph.D., MD, neuro-surgeon
Done in Belgrade, March 25, 2002
FOLLOW-UP CARDIOLOGY EXAMINATION
PATIENT: SLOBODAN MILOSEVIC
The patient is 61 years old.
Risk factors for coronary arterial disease: smoker, hyper lipidaemia,
heredity, high stress, arterial hypertension (in earlier check-ups over
many years arterial tension ranged most frequently around 135-140/ 85-90
mmHg, with occasional therapy.
Maximum blood pressure readings ranged around 150/95mmHg and rarely
150/100 mmHg).
He is also aware of small cysts in kidneys. Echo examination of abdomen
a year and a half ago, changes in gall bladder observed, like a polyp or
calculus but no further investigation made because of the patients'
rejection.
Occasionally administered medicines:Presolol 100mg ¼ ili ½, Upsarin
effervettes 1 in themorning. Between 11.04.2001 and 13.04.2001 he was
hospitalized in the Military Medical Academy Hospital, where:
During echo cardiography: significant hypertrophy of myocardium
was proven in the left ventricles, global EF around 45%, but with
akinesy of the distal third of the septum, top of heart and distal third
of frontal and lateral wall of the left ventricle (Docent dr.A.
Neskovic-KBC Dedinje).
The selective coronography revealed coronary bridge ) suffocation of the
left coronary artery). Naked microcirculation and on other segments
epicardial coronary arteries only negligible changes. Left ventricle of
normal size, of hyperopic walls, in systole like hypertrophy
cardiomiopathy.
Under the decision of the medical consultation team the patient was
dismisses with medical therapy (dismissal letter attached).
In the meantime a check-up was undertaken (223.04.2001) when it was
concluded that the arterial hypertension has not been cured, with the
existence of probable angina pectoris, more intensive medicinal therapy
and additional examinations (ophthalmology examination, neurological
examination, analysis of the adrenal glands, abdominal echo and kidney
and adrenal glands echo, 24 hour halter monitoring of blood pressure and
halter ECG...follow up of ECG and additional assessment of
microcirculation (scintigraphy of the heart or PET scan..).
In the meantime he occasionally complained of chest sharp pain
propagating to the jaws and numbness in the jaws...he did not take
nitroglicerine... those disorders appear when in the state of rest, but
more often while walking when he occasionally sweats. Then he must sit
down and rest, when the troubles pass away gradually.
Occasionally he feels lack of air and speedy or irregular hear beat.
Sometimes mild headaches felt.
Regularly controlled blood pressure and pulse by the attending doctor.
Maximum measured blood pressure readings 220/13p mmHg on 30.05.2001,
pulse 120/mm.
The lowest TA value in the period under review was 140/100mmHg and pulse
88/min, once on 21.04.2001.
The most frequent TA readings were 190/115 mmHg and pulse around 100/mm.
Regularly were monitored electro cardiograms, where sinus tachicardy was
observed of around10/min, with symmetrically negative T waves in D1,
AVL and V2 to V6.
ECG dated 11.05.2001 shows sinus tachicardy around 11/min with deeply
negative T waves in D1, AVL, V2 to V6 even up to around 1.5 cm with
lowering of ST clip 2-3 cm.
Planned and appointed examinations suggested earlier were not carried
out in the meantime because the patient was not motivated.
According to the patient, the medication proposed earlier has been
regularly administered.
OBJECTIVE FINDING
Cordially compensated. Presently a febrile.
Obese according to general type. Veins in the neck not tense.
Over the neck arteries no suboclussion murmur is heard.
On the lungs vesicular breathing with rare low tone whistling.
Heart action is rhythmical, speeded to about 120/min, tones
somewhat quiet, without pathological noise. TA:200/120mmHg (after
regular therapy taken this morning).
Liver and spleen not palpable. No sensitivity of gall bladder to
palpation.
No signs of free liquid in the abdomen.
Kidney lobes insensitive to succusion.
No visible cardiac edema on lower legs, or deformities.
ECG : sinus tachicardy around 120/min, PQ=0.16, negative T in
D1, AVL, V2 to V6 with lowering of ST clip in the left pericardial
drains up to 2mm
DG: Hypertensio arterialis (unregulated)
Hypertrohpy of myocardium of the left ventricle
Angina pectoris (cor,bridge...microvasc.??)
TH: Dilatrend 12.5mg, 1 in the morning with the
control of TA and pulse. If TA remains unregulated, the dose may be
corrected with additional 1 in the evening.
Enalapril 20mg 1+1+0 with the check up of TA
Lometazid 1-2 a week.
Nitroglycerin as needed.
Demetrine tab. 2x1
OPINION:
Present hypertension and unregulated with the existing therapy (max.
220/130 mmHg and most often 190/115 mmHg with a pulse of some 100/min).
The above readings of hypertension increase the risk exponentially for
fatal events (relative risks of stroke is above 4, and for an acute
coronary event between 3.5-4).
According to the patient, he was taking the therapy regularly, but as
evident from the above analyses arterial hypertension is unregulated.
Apart from it the patient feels troubled chest of angina type with clear
changes in ECG, which are maintained.
Based on the above and starting from scientific, professional and moral
standards it is necessary to:
1. Ensure regular intake of adequate therapy
2. Complete the examinations recommended earlier
(Ophthalmology, neurology, analysis of hormones of adrenaline gland,
analysis of kidney function, abdominal echo, ultra sound adrenaline
gland check, 24 hour Halter monitoring of blood pressure, supplemental
examination of hypertrophy of myocardium, scinthigraphy of the heart,
PET scan and others..)
3. If the patient shall have repeated problems behind the
sternum of anginoide character, dizziness or the similar, ECG should be
repeated, cardio specific enzyme and promptly proceed along the
principles of care of such patients.
4. If the disorders will persist, the blood pressure reading
cannot be corrected and the proposed examinations cannot be carried out
in view of the above mentioned risks of fatal events in such patients,
it shall be necessary to ensure via competent means an adequate
correction of blood pressure, additional examinations of hypertrophy of
myocardium, microcirculation of the heart as well as other examinations
in hospital (VMA..) conditions.
31.05/2001 in Belgrade
Col.Ass.Prof. MD, PhD
Zdravko M.Mijailovic
FOLLOW-UP CARDIOLOGY EXAMINATION
PATIENT: SLOBODAN MILOSEVI?
Follow-up examination of 04.06.2001
The patient was examined previously on 31.05.2001.See the finding
attached.
The patient is 61 years old.
Of risk factors from coronary disease: smoker, hiperlipidaemia,
heredity, arterial hypertension ranging during many years in the past
around 135-140/85-90 mmHg with intermittenttherapy.
Maximum readings of the blood pressure used to be 150/95mmHg, and on
rare occasions 150/100 mmHg.
He is aware of smaller cists in kidneys.
On the earlier abdominal examination, changes were observed on the gall
bladder, which resembles of gallbladder polyp, although calculosis could
not have been excluded. Follow-up gastro enterologic examination with a
repeated echo examination of abdomen was not made due to lack of
motivation on the part of the patient.
Of drugs he was using Presolol 100mg ½ or ¼ in the morning and Upsarin
eff.
Between 11.04.2001 and 13.04.2001 he was treated in VMA hospital where
on Chocardiography considerable hypertrophy of myocardium was evidenced
on left ventricle (1.4cm), global EF around 45%, but with akinezy of
distal third of the septum, peak of the heart and distal third of
frontal and lateral walls of the left ventricle (Ass.Prof.
Dr.A.Neskovic- KBC Dedinje).
At the selective coronorography: visible coronary bridge (suffocation of
the left coronary artery( naked microcirculation, and on other segments
of epycardiac coronary arteries only negligible changes. The left
ventricle of normal size, of hypertrophic walls, in systole and by type
of hyperthrophic cardiomyopathy.
By the decision of the doctoral consultation team the patient was
dismisses with medicinal therapy (Letter of dismissal attached).
In the meantime a follow up was done (23.04.2001) when it was concluded
that arterial hypertension is unregulated with probable presence of
angina pectoris, the therapy was strengthened, and additional
examinations advised for abdomen and echo of kidneys and adrenaline
gland, 24 hour Halter monitoring of blood pressure and Halter ECG...
follow up of ECG, as well as supplemental assessment of microcirculation
(Scintigraphy of the heart or PET scan...).
Blood pressure readings were regularly controlled and pulse by the
attending doctor.
Maximum values of blood pressure were 220?130 mmHg on 30.05.2001, pulse
120/min.
The lowest read TA value over the period was 140/100mmHg and pulse
33/min, only once on 21.04.2001.
The most frequently obtained TA values were 190/115 mmHg with pulse of
around 100/mm.
Electro cardio grams were also regularly followed, where sinus tahicardy
was observed of some 100/mm, with symmetrically negative T waves in D1,
AVL and V2 to V6. ECG of 11.05.2001 revealed tahicardy around 110/mm,
with deeply negative T waves in D1, AVL, V2 do V6 even up to 1.5cm with
a drop of ST clip 2-3mm.
Planned and appointed examinations proposed earlier were not completed
due to the lack of motivation on the part of the patient.
In the meantime, since 31.05.2001 till today, he continued to com-plain
here and there to the chest pain propagating to the jaws and numbness
in the jaws...he did not take nitroglicerin...these troubles appear at
rest but more often while walking when he sometimes sweats. Then he must
sit down and take a rest, and the disorders pass away spontaneously.
From time to time he feels lack of air and irregular and speedy hart
beat.
Sometimes he has light headache.
Since 31/05.2001 till today no blood pressure was measured and no
examinations made, no electrocardiogram, either.
The planned and appointed examinations proposed earlier were not
completed in the meantime due to the lack of motivation by the patient.
OBJECTIVE FINDING
Cordially compensated. Now a febrile.
Obese according to general type. Veins of the neck not tense.
On lungs vesicular breathing, with rare low tone whistling.
Heart action is rhythmic, speedy up to some 130/min, tones somewhat
quieter without pathological hums.
TA 230?130 mmHg (following the morning regular therapy, Dilatrend
12.5mg, Enalapril 20mg, Lometazid...).
Liver and spleen not palpable. Gall bladder is not sensitive to
palpation. No signs of free liquid in the abdomen.
Kidney archinephrons insensitive to succussion.
No visible cardiac edema on lower legs or deformities.
ECG sinus tahicardy around 130min,PQ= 0,16, negative T in D1,AVL,V2 up
toV6, with lowering of 3T of clips in the left perocardial drains up to
2mm.
DG. Hypertensio arterialis (unregulated)
Hypertrophy of myocardium of the left ventricle
Angina pectoris (cor. "bridge"...microvasc.?? )
Obs.polypus(calculosis) v.feleae
TH. Dilatrend 12.5mg 2 in the morning with control of TA and
pulse. If TA remains unregulated the dose may be corrected with an
addition in the evening.
Enalpril 20 mg i+i+0 with the control of TA.
Norvasc 5mg 0+i=i
Isosorb R 2x1
Lasix i-2 a week
Bromazepam 3mg 2x1
Nitroglicerin as needed
OPINION
The extremely high value of arterial hypertension continued, and was not
regulated with the existing therapy (max. 230/130 mmHg at a pulse rate
of 130/min, and most often 190/115 mmHg with pulse rate of around
100/min.). These values of arterial hypertension exponentially increase
a risk of fatal incidents (brain stroke, acute myocardial infarct, hear
arrest, malignant disorders in heart rhythm...).
Next to that the patient has chest pain of angina type with clear
changes in ECG that are reflected.
These disorders could be an indication of threatening fatal coronary
accidents, and particularly in combination with enormous hypertension
which ranges on average to 195/115 mmHg for over two months, proven
hypertension of myocardium, alterations in microcirculation, found
phenomenon of "suffocation of left coronary artery" and enormous stress
the patient has been permanently exposed to).
Despite all measures undertaken as evident from the above stated
findings, the arterial hypertension remains uncorrected, angina
disorders are repeated and ECG alterations persist.
Based on the above, starting from high risk to the patient, and since
the treatment so far failed to yield results, and starting from
scientific, professional and ethic norms:
1. It is necessary immediately in hospital conditions to ensure an
adequate correction of blood pressure; implement earlier planned
additional examinations, ophthalmologyexamination, neurological
examination, analysis of the hormone of adrenaline gland, analysis of
kidney function, abdominal echo with ultra sound examination of
adrenaline, 24 hour Halter monitoring of blood pressure, Halter ECG,
supplemental examination of the nature of hypertrophy of myocardium and
assessment of microcirculation, possibly burden test, scintigraphy of
heart, PET scan and others...).
04.06.2001 in
Belgrade
Col. Ass.Prof.MD, Phd,
Zdravko M.Mijailovic
To join or help this struggle, visit:
http://www.sps.org.yu/ (official SPS website)
http://www.belgrade-forum.org/ (forum for the world of equals)
http://www.icdsm.org/ (the international committee to defend
Slobodan Milosevic)
http://www.jutarnje.co.yu/ ('morning news' the only Serbian
newspaper advocating liberation)
Da: Vladimir Krsljanin
Oggetto: WORSENING OF MILOSEVIC'S HEALTH PRODUCES
RECESS OF THE "TRIAL"
WORSENING OF MILOSEVIC'S HEALTH PRODUCES RECESS OF THE "TRIAL"
From FREEDOM Association:
Consilium of medical experts appointed by "ICTY", in presence of the
long time personal doctor of President Milosevic, colonel Zdravko
Mijailovic, made on Tuesday afternoon a routine check-up of the
President's health.
They measured blood pressure of 120/200 mmHg!
Despite their findings, the "trial" resumed today.
After another strong appeal from the Yugoslav Committee (see below),
only today Afternoon, the "court" accepted doctors' advises and decided
that, due to the need to change the (practically unexisting) therapy and
to make additional check-ups and laboratory analyses, the "accused"
shell not appear in the "court" for at least next two days, until
further notice.
About two weeks ago, after the second break in the "trial", due to "flu"
(diagnosis of the prison doctor) which lasted this time two weeks, the
"trial chamber" issued an order to the "registry" to organize a
consilium check-up and to report the results. This decision was made
after many appeals from Yugoslavia and from abroad. After that,
additional efforts and appeals have been made to include in the
consilium at least one of Yugoslav doctors. "Tribunal" finally agreed
that consilium check-ups can be made in the presence of President's long
time personal doctor, colonel Zdravko Mijailovic, head of the
Cardio-vascular Clinic of the Military Medical Academy in Belgrade.
We still follow the developments, with lot of worry.
It is obvious that the prison conditions, lack of medical care and
inhuman conditions and length of the "trial", produced worsening of the
health of President Milosevic and increased risks.
Let us further act against this show-trial and its dangerous
consequences!
FREEDOM FOR SLOBODAN MILOSEVIC!
FREEDOM FOR YUGOSLAVIA!
Our today's message to the "Tribunal":
"FREEDOM" ASSOCIATION, BELGRADE, FR YUGOSLAVIA
July 17, 2002
- Mr. Claude Jorda, President, ICTY
- Mr. Richard May, President, Trial Chamber
- AMICUS CURIAE
- Mr. Hans Holthius, Registrar, ICTY
Most
Urgent!
State of health of President Slobodan Milosevic requires an urgent
action!
Dear Sirs,
Our information about the yesterday's medical examination of the state
of health of President Milosevic, made by the medical experts' team
appointed by ICTY Registry on the order of Trial Chamber, unfortunately
confirms our previous knowledge and our suspicions that the general
conditions in which President Milosevic is forced to live, without the
proper medical care, combined with inhuman length and conditions of the
ICTY proceedings, produce worsening of the President Milosevic's state
of health and to the dramatic level increases risks for his life.
We can not understand that the result of yesterday's examination has not
yet produced any action from your side. Our duty is to warn you once
again that denial of proper medical care for a person in such condition
is a matter of criminal responsibility.
In that respect, when a human life is at stake, no bureaucratic
negligence can be an excuse for absence of proper and urgent action.
Particularly since the Freedom Association has already been warning you
several times about this situation which is one of the worst and most
serious forms of violations of human rights. We can not avoid the
impression that this might be an intentional practice of ICTY. For this,
we refer particularly to our letter Nos. 18-21/2002 of March 27, 2002,
addressed to President of ICTY, III Trial Chamber, Chief of Prosecutors
and Amici Curiae, with whole appropriate medical documentation enclosed.
Our last warning (Letter No.45/2002) was sent to Judges Mr. Jorda and
Mr. May, as well as to the Registrar Mr. Holthius, on June 18, 2002.
We enclose this time again the same medical documentation, already sent
to you with our March 27 letter.
We appeal in strongest terms that measures to protect a human life have
to be taken without any further delay.
Yours sincerely,
Bogoljub Bjelica,
Chairman of the Citizen Association "FREEDOM"
Our March 30 appeal:
FREEDOM ASSOCIATION
/YUGOSLAV COMMITTEE TO LIBERATE PRESIDENT MILOSEVIC/
WARNS:
HEALTH AND LIFE OF PRESIDENT MILOSEVIC UNDER THREAT!
Level of health protection in former Nazi prison in the Hague is the
same like in Nazi concentration camps (two prisoners already dyed due to
lack of medical care)!
60-year old president Milosevic with malignant hypertension and specific
form of angina pectoris in an endless "trial" every day whole day is
treated by aspirins, when he got a flu (according to prison doctor -
general practician) with more then 10 days of high temperature!
He is under total life risk in such circumstances, say medical experts
of Belgrade University!
He needs urgent check-up by medical specialists, which NATO "tribunal"
prohibits up to now!
ACTION MUST BE TAKEN!
After the "tribunal's" negative answer to first such initiative, Freedom
Association sends the following letter (with medical documentation
enclosed) to "judges", "prosecution" and "amici curiae" of the now-days
Gestapo (in accordance with their "rules"), warning them about the
criminal responsibility:
UNITED NATIONS
International Criminal Tribunal for the Former Yugoslavia
To the III Trial Chamber
Your Excellencies,
Bearing in mind the intensive dynamic of the so-called trial, to which
President Slobodan Milosevic is exposed from day to day, we must warn
you that you carry the responsibility for his health and life.
Since you are evidently not enough informed with the general, but with
the current as well, state of health of President Milosevic, and since,
no matter of his illness, you do not show interest enough for the
improvement of his health, that is the reason why we are compelled, as
National Committee for liberation of Slobodan Milosevic, towarn you
about that.
We especially bear in mind your responsibility for the state of health
of President Milosevic that derives from your Statute and Rulebook on
Procedure and Evidence and a number of other international documents.
The treatment of President Milosevic as a whole finds itself in full
collision with the Convention on torture and other brutal, humiliating
sanctions and proceedings, adopted by the United Nations General
Assembly on December 10, 1984, came into force on June 26, 1987 and is
in collision with the equivalent Convention, adopted by the Council of
Europe.
If however, for the sake of accomplishing an unprecedented "project" of
a trial, you will further on allow, as it has been the case so far, the
deterioration of President Milosevic's health, you will carry full
responsibility for that.
Therefore, we demand to enable a number of medical experts (first of all
specialists for cardio-vascular diseases) from Yugoslavia, to make an
urgent examination of President Milosevic and give a proposal for
adequate treatment, in order to stop the further deterioration of his
health. The team of experts would be comprised out of Prof. Dr. Med. Sc
Bozina Radevic (cardio-vascular surgeon), Prof. Dr. Med. Sc Zdravko
Mijailovic (cardiologist), Doc. Dr. Med. Sc Dragana Bojic
(cardiologist), and Prof. Dr. Med. Sc Vojislav Suvakovic
(infectologist).
Starting from Rule 74bis of the Rulebook on Procedure and Evidence of
the Tribunal, according to which you are proprio motu able to issue
such an order, we demand from you to immediately enable a consilium
medical examination of President Milosevic. Attached you will find the
reports of Prof. Dr. Med. Sc. Zdravko Mijailovic of the Military Medical
Academy of Belgrade, dating from May 31, 2001 and June 4, 2001 (both in
English), together with the copies of the originals in Serbian, as well
as the medical report dated from March 25, 2002 related to the state of
health of President Milosevic.
Belgrade, March 26, 2002
For "SLOBODA" ("Freedom") Association
The National Committee for the Liberation of Slobodan Milosevic
Bogoljub Bjelica, President
MEDICAL REPORT
RE: SLOBODAN MILOSEVIC
Inspection of medical documentation and his previosly, well known healt
problems insigate and underline further facts:
The majority of people know what is hypertension. It is not
secret that hypertension has an inportant role of
cardiovascular mortality and morbidity. Effective treatment
significantly reduces relative risk of stroke up to 40%, and
of myocardial infraction by 20%. Slobodan Milosevic does not
have simply elevated blood preasure, he has hypertensive
crisis or malignant hypertension. His diastolic blood pressione
often, with abrupt onset exceeds 130 mmHg, systolic 200
mmHg. What does it mean?
Accelerated (malignant) hypertension occurs most commonly in
patients with essential hypertension. The risk of
complication is more closely linked with the rate of rise in
blood preasure than the absolute blood preasure level,
because patients auto regulate to compensate for chronic
hypertension. When blood preasure rises rapidly as Milosevics'
case, celebral, retinal and renal damage may ensue and the
patient may develop acute cardinale failure. It carries a high
mortality risk: untreated, 1-year survival in approximately 25%;
with treatment, 1-year survival is around 90%. Rapid
control of escalating blood presure is essential, but it has to
be achieved by slow, sustained reduction. There is no
prison hospital which can obtain this treatment. They can
provide only aggressive treatment. Aggressive reduction can
cause tissue and celebral ischaemia and infraction, because in
most cases the tissues have auto regulated to require a
greater than normal perfusion pressure.
His another heath problem is Prinzmetal's variant angina
pectoris. There is no pearson who does not understand what means
"angina pectoris". In the last few months Milosevic has been
having chest pain due to coronary arterial spasm which can
not be relieved by sublingual nitroglycerin. It occurs at rest
with abrupt onset or rapid deterioration of previously
stable condicion. Reason for deteriration his condicion is
inappropriate coronary vasoconstriction whish has been shown
to occur during exposure to mental stress.
In the other hand, anxiety is a normal reaction to cardial
illness and many patient will have symptoms as a result. The
tendency to categorize patient's symptoms as "genuine" and
"non-cardiac" is unhelpful. Relaxation and stress management
are fundamental problems particularly useful in managing angina
where (after exertion) stress is the second most likely
precipitant of symptoms.
Slobodan Milosevic is in the prison where there is no
possibility for appropiate medical treatment. He probably can get
pills or doctors' supervision. But underlying conditions ask for
high educated consultants, intesive care unit and above
all relaxsation. Only in this condition his cardiac properties
will not function related his chance to present evidence
of his innocent.
Prolonger trial and stress continuity increase risk of major
cardiovascular events. Slobodan Milosevic is undergoing
extreme phychical effort. Everyday rapid deterioration of his
health can cause sudden death. That is why he must be
rewieved and under care of medical experts from Yugoslavia who
know his medical history. They need to see him and after
serious examination decide about further treatment.
We are not talking about quality of life we are fighting for
life!
Professors of Belgrade University:
Dragana Bojic, Ph.D., MD, cardiologist
Vojislav Suvakovic, Ph.D., MD, infectologist
Milos Janicijevic, Ph.D., MD, neuro-surgeon
Done in Belgrade, March 25, 2002
FOLLOW-UP CARDIOLOGY EXAMINATION
PATIENT: SLOBODAN MILOSEVIC
The patient is 61 years old.
Risk factors for coronary arterial disease: smoker, hyper lipidaemia,
heredity, high stress, arterial hypertension (in earlier check-ups over
many years arterial tension ranged most frequently around 135-140/ 85-90
mmHg, with occasional therapy.
Maximum blood pressure readings ranged around 150/95mmHg and rarely
150/100 mmHg).
He is also aware of small cysts in kidneys. Echo examination of abdomen
a year and a half ago, changes in gall bladder observed, like a polyp or
calculus but no further investigation made because of the patients'
rejection.
Occasionally administered medicines:Presolol 100mg ¼ ili ½, Upsarin
effervettes 1 in themorning. Between 11.04.2001 and 13.04.2001 he was
hospitalized in the Military Medical Academy Hospital, where:
During echo cardiography: significant hypertrophy of myocardium
was proven in the left ventricles, global EF around 45%, but with
akinesy of the distal third of the septum, top of heart and distal third
of frontal and lateral wall of the left ventricle (Docent dr.A.
Neskovic-KBC Dedinje).
The selective coronography revealed coronary bridge ) suffocation of the
left coronary artery). Naked microcirculation and on other segments
epicardial coronary arteries only negligible changes. Left ventricle of
normal size, of hyperopic walls, in systole like hypertrophy
cardiomiopathy.
Under the decision of the medical consultation team the patient was
dismisses with medical therapy (dismissal letter attached).
In the meantime a check-up was undertaken (223.04.2001) when it was
concluded that the arterial hypertension has not been cured, with the
existence of probable angina pectoris, more intensive medicinal therapy
and additional examinations (ophthalmology examination, neurological
examination, analysis of the adrenal glands, abdominal echo and kidney
and adrenal glands echo, 24 hour halter monitoring of blood pressure and
halter ECG...follow up of ECG and additional assessment of
microcirculation (scintigraphy of the heart or PET scan..).
In the meantime he occasionally complained of chest sharp pain
propagating to the jaws and numbness in the jaws...he did not take
nitroglicerine... those disorders appear when in the state of rest, but
more often while walking when he occasionally sweats. Then he must sit
down and rest, when the troubles pass away gradually.
Occasionally he feels lack of air and speedy or irregular hear beat.
Sometimes mild headaches felt.
Regularly controlled blood pressure and pulse by the attending doctor.
Maximum measured blood pressure readings 220/13p mmHg on 30.05.2001,
pulse 120/mm.
The lowest TA value in the period under review was 140/100mmHg and pulse
88/min, once on 21.04.2001.
The most frequent TA readings were 190/115 mmHg and pulse around 100/mm.
Regularly were monitored electro cardiograms, where sinus tachicardy was
observed of around10/min, with symmetrically negative T waves in D1,
AVL and V2 to V6.
ECG dated 11.05.2001 shows sinus tachicardy around 11/min with deeply
negative T waves in D1, AVL, V2 to V6 even up to around 1.5 cm with
lowering of ST clip 2-3 cm.
Planned and appointed examinations suggested earlier were not carried
out in the meantime because the patient was not motivated.
According to the patient, the medication proposed earlier has been
regularly administered.
OBJECTIVE FINDING
Cordially compensated. Presently a febrile.
Obese according to general type. Veins in the neck not tense.
Over the neck arteries no suboclussion murmur is heard.
On the lungs vesicular breathing with rare low tone whistling.
Heart action is rhythmical, speeded to about 120/min, tones
somewhat quiet, without pathological noise. TA:200/120mmHg (after
regular therapy taken this morning).
Liver and spleen not palpable. No sensitivity of gall bladder to
palpation.
No signs of free liquid in the abdomen.
Kidney lobes insensitive to succusion.
No visible cardiac edema on lower legs, or deformities.
ECG : sinus tachicardy around 120/min, PQ=0.16, negative T in
D1, AVL, V2 to V6 with lowering of ST clip in the left pericardial
drains up to 2mm
DG: Hypertensio arterialis (unregulated)
Hypertrohpy of myocardium of the left ventricle
Angina pectoris (cor,bridge...microvasc.??)
TH: Dilatrend 12.5mg, 1 in the morning with the
control of TA and pulse. If TA remains unregulated, the dose may be
corrected with additional 1 in the evening.
Enalapril 20mg 1+1+0 with the check up of TA
Lometazid 1-2 a week.
Nitroglycerin as needed.
Demetrine tab. 2x1
OPINION:
Present hypertension and unregulated with the existing therapy (max.
220/130 mmHg and most often 190/115 mmHg with a pulse of some 100/min).
The above readings of hypertension increase the risk exponentially for
fatal events (relative risks of stroke is above 4, and for an acute
coronary event between 3.5-4).
According to the patient, he was taking the therapy regularly, but as
evident from the above analyses arterial hypertension is unregulated.
Apart from it the patient feels troubled chest of angina type with clear
changes in ECG, which are maintained.
Based on the above and starting from scientific, professional and moral
standards it is necessary to:
1. Ensure regular intake of adequate therapy
2. Complete the examinations recommended earlier
(Ophthalmology, neurology, analysis of hormones of adrenaline gland,
analysis of kidney function, abdominal echo, ultra sound adrenaline
gland check, 24 hour Halter monitoring of blood pressure, supplemental
examination of hypertrophy of myocardium, scinthigraphy of the heart,
PET scan and others..)
3. If the patient shall have repeated problems behind the
sternum of anginoide character, dizziness or the similar, ECG should be
repeated, cardio specific enzyme and promptly proceed along the
principles of care of such patients.
4. If the disorders will persist, the blood pressure reading
cannot be corrected and the proposed examinations cannot be carried out
in view of the above mentioned risks of fatal events in such patients,
it shall be necessary to ensure via competent means an adequate
correction of blood pressure, additional examinations of hypertrophy of
myocardium, microcirculation of the heart as well as other examinations
in hospital (VMA..) conditions.
31.05/2001 in Belgrade
Col.Ass.Prof. MD, PhD
Zdravko M.Mijailovic
FOLLOW-UP CARDIOLOGY EXAMINATION
PATIENT: SLOBODAN MILOSEVI?
Follow-up examination of 04.06.2001
The patient was examined previously on 31.05.2001.See the finding
attached.
The patient is 61 years old.
Of risk factors from coronary disease: smoker, hiperlipidaemia,
heredity, arterial hypertension ranging during many years in the past
around 135-140/85-90 mmHg with intermittenttherapy.
Maximum readings of the blood pressure used to be 150/95mmHg, and on
rare occasions 150/100 mmHg.
He is aware of smaller cists in kidneys.
On the earlier abdominal examination, changes were observed on the gall
bladder, which resembles of gallbladder polyp, although calculosis could
not have been excluded. Follow-up gastro enterologic examination with a
repeated echo examination of abdomen was not made due to lack of
motivation on the part of the patient.
Of drugs he was using Presolol 100mg ½ or ¼ in the morning and Upsarin
eff.
Between 11.04.2001 and 13.04.2001 he was treated in VMA hospital where
on Chocardiography considerable hypertrophy of myocardium was evidenced
on left ventricle (1.4cm), global EF around 45%, but with akinezy of
distal third of the septum, peak of the heart and distal third of
frontal and lateral walls of the left ventricle (Ass.Prof.
Dr.A.Neskovic- KBC Dedinje).
At the selective coronorography: visible coronary bridge (suffocation of
the left coronary artery( naked microcirculation, and on other segments
of epycardiac coronary arteries only negligible changes. The left
ventricle of normal size, of hypertrophic walls, in systole and by type
of hyperthrophic cardiomyopathy.
By the decision of the doctoral consultation team the patient was
dismisses with medicinal therapy (Letter of dismissal attached).
In the meantime a follow up was done (23.04.2001) when it was concluded
that arterial hypertension is unregulated with probable presence of
angina pectoris, the therapy was strengthened, and additional
examinations advised for abdomen and echo of kidneys and adrenaline
gland, 24 hour Halter monitoring of blood pressure and Halter ECG...
follow up of ECG, as well as supplemental assessment of microcirculation
(Scintigraphy of the heart or PET scan...).
Blood pressure readings were regularly controlled and pulse by the
attending doctor.
Maximum values of blood pressure were 220?130 mmHg on 30.05.2001, pulse
120/min.
The lowest read TA value over the period was 140/100mmHg and pulse
33/min, only once on 21.04.2001.
The most frequently obtained TA values were 190/115 mmHg with pulse of
around 100/mm.
Electro cardio grams were also regularly followed, where sinus tahicardy
was observed of some 100/mm, with symmetrically negative T waves in D1,
AVL and V2 to V6. ECG of 11.05.2001 revealed tahicardy around 110/mm,
with deeply negative T waves in D1, AVL, V2 do V6 even up to 1.5cm with
a drop of ST clip 2-3mm.
Planned and appointed examinations proposed earlier were not completed
due to the lack of motivation on the part of the patient.
In the meantime, since 31.05.2001 till today, he continued to com-plain
here and there to the chest pain propagating to the jaws and numbness
in the jaws...he did not take nitroglicerin...these troubles appear at
rest but more often while walking when he sometimes sweats. Then he must
sit down and take a rest, and the disorders pass away spontaneously.
From time to time he feels lack of air and irregular and speedy hart
beat.
Sometimes he has light headache.
Since 31/05.2001 till today no blood pressure was measured and no
examinations made, no electrocardiogram, either.
The planned and appointed examinations proposed earlier were not
completed in the meantime due to the lack of motivation by the patient.
OBJECTIVE FINDING
Cordially compensated. Now a febrile.
Obese according to general type. Veins of the neck not tense.
On lungs vesicular breathing, with rare low tone whistling.
Heart action is rhythmic, speedy up to some 130/min, tones somewhat
quieter without pathological hums.
TA 230?130 mmHg (following the morning regular therapy, Dilatrend
12.5mg, Enalapril 20mg, Lometazid...).
Liver and spleen not palpable. Gall bladder is not sensitive to
palpation. No signs of free liquid in the abdomen.
Kidney archinephrons insensitive to succussion.
No visible cardiac edema on lower legs or deformities.
ECG sinus tahicardy around 130min,PQ= 0,16, negative T in D1,AVL,V2 up
toV6, with lowering of 3T of clips in the left perocardial drains up to
2mm.
DG. Hypertensio arterialis (unregulated)
Hypertrophy of myocardium of the left ventricle
Angina pectoris (cor. "bridge"...microvasc.?? )
Obs.polypus(calculosis) v.feleae
TH. Dilatrend 12.5mg 2 in the morning with control of TA and
pulse. If TA remains unregulated the dose may be corrected with an
addition in the evening.
Enalpril 20 mg i+i+0 with the control of TA.
Norvasc 5mg 0+i=i
Isosorb R 2x1
Lasix i-2 a week
Bromazepam 3mg 2x1
Nitroglicerin as needed
OPINION
The extremely high value of arterial hypertension continued, and was not
regulated with the existing therapy (max. 230/130 mmHg at a pulse rate
of 130/min, and most often 190/115 mmHg with pulse rate of around
100/min.). These values of arterial hypertension exponentially increase
a risk of fatal incidents (brain stroke, acute myocardial infarct, hear
arrest, malignant disorders in heart rhythm...).
Next to that the patient has chest pain of angina type with clear
changes in ECG that are reflected.
These disorders could be an indication of threatening fatal coronary
accidents, and particularly in combination with enormous hypertension
which ranges on average to 195/115 mmHg for over two months, proven
hypertension of myocardium, alterations in microcirculation, found
phenomenon of "suffocation of left coronary artery" and enormous stress
the patient has been permanently exposed to).
Despite all measures undertaken as evident from the above stated
findings, the arterial hypertension remains uncorrected, angina
disorders are repeated and ECG alterations persist.
Based on the above, starting from high risk to the patient, and since
the treatment so far failed to yield results, and starting from
scientific, professional and ethic norms:
1. It is necessary immediately in hospital conditions to ensure an
adequate correction of blood pressure; implement earlier planned
additional examinations, ophthalmologyexamination, neurological
examination, analysis of the hormone of adrenaline gland, analysis of
kidney function, abdominal echo with ultra sound examination of
adrenaline, 24 hour Halter monitoring of blood pressure, Halter ECG,
supplemental examination of the nature of hypertrophy of myocardium and
assessment of microcirculation, possibly burden test, scintigraphy of
heart, PET scan and others...).
04.06.2001 in
Belgrade
Col. Ass.Prof.MD, Phd,
Zdravko M.Mijailovic
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