engleski

Sending Croatian and Bosnian children for treatment abroad

The armed conflict in Croatia in 1991 and 1992 has resulted in an estimated 13 000 killed and 30 000 wounded. Of these, 157 (1.2%) and 669 (2.2%), respectively, were children. Forty-one children lost both parents and 5 724 lost one. There were 250 000 internally displaced persons. Later in 1992, about 400 000 Bosnian refugees settled in Croatia. Children make up an estimated 35% of the internally displaced population and 56% of the refugee population. The hospital pediatric capacity of Croatia is 1800 beds. Refugee children accounted for 20% of emergency department visits and 30% of hospitalized children (unpublished data from the Department of Pediatrics, University Hospital Center, Zagreb, Croatia). Due to the scarcity of resources it has become increasingly difficult to maintain the prewar level of medical care The Committee for the Coordination of Relief and Health Care for Children was charged with sending pediatric patients for therapy abroad in order to alleviate this situation. In the period July through December 1992, there were 224 places offered in Western Europe and the United States by various charitable organizations. Eighty-five (38%) were specifically limited to the direct victims of war, 105 (47%) were offered for general convalescence and rest to the children without any family escort, and 34 (15%) were offered to sick children and their families. The committee looked for candidates through the health network and the Office for Displaced Persons and Refugees. In the free territory of Croatia there were 11 children eligible for major surgery due to significant war wounds or extensive burns (seven Bosnians, one internally displaced, and seven resident Croatians). The diagnoses included congenital heart disease (five), other malformations (three), connective tissue disease (three), chronic renal insufficiency (two), malabsorption (two), immunodeficiency (one), leukemia (one), eye disease (one), and war wounds (three). The remaining 13 places were cancelled by the relief partner. Summing up, there were 224 invitations, 45 (20%) proposed candidates, and 32 (14%) actual transfers. So far, all the children have received appropriate treatment or, where applicable, definitive surgery. The Bosnians have all remained abroad. The Croatians have returned home after treatment, with the exception of the two waiting for a renal transplant abroad. In war, some international relief organizations try to help war-injured children preferentially, even when these ware injuries are not the greatest threat to public health, but are the most sensational and produce the most compassion in the international community. With chronic care problems, such as leukemia, international relief agencies were more reluctant to deal with entire families, who have numerous problems and often do not want to return home after the conflict ends. A great deal of time and effort was spent working with many organizations to bring about very few international transfers of patients. It is possible that efforts to support the medical infrastructure of the country financially or to send well-chosen medical supplies or specialists would be more useful.

Croatia ; Bosnia ; war ; children ; treatment abroad

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