Medicinski vjesnik, Vol. 24 No. (1-2), 1992.
Other
Conservative medicine in war conditions in the Slavonian-brod hospital (until july 31, 1992)
Olga Jelić
Antun Jelić
Dragica Bistrović
Željka Ležajić
Martin Baričić
Abstract
Before the beggining of the war the services of the conservative medicine: for internal diseases, pediatry, infectology, neurology and hemodialysis had suitable rooms, number of beds, various and up-to date equipment and sufficient number of medical staff so they could, through polyclinical services and hospital departments give optimal health protection to the people of our and neighbouring communities of Bosanska Posavina. The capacity of the mentioned departments was 267 beds in adequate up-to-date and functional space. An adequate number (13) of specialist physicians and subspecialists (3 doctors, 4 magisters and a remarkable number of physicians with postgraduate study and diploma) with modern outfit for clinical, laboratorial and X-rays diagnostics enables fast and precise diagnosis, an adequate and efficient treatment and scientific work. The agression on our Republic had its influence on the work of health service as a whole, and on the work of conservative medicine in Health Center in Slavonski Brod as well. First attacks on our town began on September 15th, 1991 from the neighbouring Republic of Bosnia and Herzegovina and from the barracks of the former Yugoslav National Army in Slavonski Brod. In the same time the war extended in Eastern and Western Slavonia and more and more wounded were daily accepted in our hospital. Therefore more beds were located in surgeon department and utmost readiness of all vital services was commanded. The number of the beds in majority of conservative services was lessened and only heavy and urgent cases were accepted. For the security the large part of the building was protected by logs and sandbags. To shelter patients and medical staff from artillery and trench mortar blasts, some services of conservative medicine were dislocated to more secure places in cellars in suburban settlements or far away places. Due to the war the number of beds on departments of conservative medicine was reduced from 267 at the peacetime to 126 in wartime and this is reduction of 53%. The biggest number of beds was reduced in pediatry - for 80 to 20 or from 75%, and the least on internal department - from 89 to 69 or for 25%. From the reasons of security and because of reduced capacities only vitally endangered and heavy patients are accepted. In peacetime the number of hospitalized patients was 5 284 but in the wartime it fell to 3110 patients i. e. for 41% as it is shown on graph 1. The number of hospitalized was: 136 (4%) members of Croatian Army and police, 315 (10%) banished persons and refugees, and 2 959 (86%) civilians The biggest number of Croatian soldiers and policeman (103/136) or 76% were treated on Department of infective diseases. The biggest number of banished persons and refugees was cured on Children department: 195/315 i. e. 62%. The growth of mortality was from 60% in peacetime to 140% in wartime, and it is shown (by departments) on graph 2. The growth of mortality for 80% in war is understandable as only heavy patients were accepted to hospital. The hospitalization of banished and refugees with chronic diseases, many of them uncured, famished and psychicly destroyed old persons added a great deal to the growth of mortality. The growth of the number of prematurely born children from our and neighbouring communities of East and West Slavonia and Bosanska Posavina added to high mortality. In Service for hemodialysis there were more treated but also more passed away, especially wounded. Namely, in peacetime 500% stayed on life but in war it fell to 374% i. e. the mortality grew on 625%. The highest mortality in this service was with wounded (820%). It should be stressed that there were no important differences of the sick of some acute contagious diseases in war and peacetime. There were no records of any classical war contagious disease as were: abdominal typhus, spotted typhusor Q-fever. Also it should be recognized that up to now there have not been registrated epidemics of contagious diseases in spite of transit and permanent stay of large number of refugees and banished persons, nor with hospitalized, neither with out patients.
Keywords
conservative medicine; organization; war
Hrčak ID:
195227
URI
Publication date:
1.12.1992.
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