Dr. Bakir Nakaš: The General Hospital will not fall in silence

By Dr. Bakir Nakaš/Radio Free Europe

This is not the first attack on the integrity of the "Prim. Dr. Abdulah Nakaš" General Hospital; there have been several since 1992…

The state hospital "Sarajevo" was formed in the premises of the former Military Hospital Sarajevo, successor to the first Turkish military hospital in Sarajevo built in 1866, in 1992, after members of the Yugoslav Army left it on May 10, 1992.

During the 1425 days of the siege, the hospital did not cease its operations for a single moment. Located just over 300 meters from the front line, the hospital was hit by more than 200 projectiles/shells of various calibers, along with constant exposure to sniper fire from the surrounding hills.

On the day of departure, 35 employees and 50 "bedridden" patients remained in the hospital. Shortly after the hospital was formed, employees who had left it for various reasons in the previous period returned. About 190 of them provided health services to numerous patients until the end of the blockade of Sarajevo.

The hospital shared the fate of the city of Sarajevo. It maintained its function and treated nearly 10,000 wounded without energy, heating, gas, water, as well as food, medicine, and medical supplies. In the four-year period, more than 15,000 major operations under general anesthesia were performed, and more than 1.5 million laboratory, microbiological, radiological, and other tests were conducted.

In the period before the aggression, the hospital did not have maternity hospital capacities, but due to the specific situation and needs, this unit was formed, where more than 2,000 new residents of Sarajevo were born.

The pre-war Military Hospital had a contract with the health insurance fund/SIZ for the treatment of civilian patients. Before the aggression, almost 60% of the capacity of the then Military Hospital was filled with civilian insured persons. After the outbreak of hostilities, due to the presence of armed individuals in the hospital and their actions against citizens, animosity towards this institution developed. One of the results of this animosity was the hasty order from the Crisis Staff of the Clinical Center to evacuate the hospital immediately after its handover to the authorities of Bosnia and Herzegovina, and to transfer all medicines, consumables, food, and equipment, as well as personnel, to the Clinical Center, while the hospital building and associated facilities were to be repurposed.

Through the efforts and special endeavors of the employees, the procedure for registering the hospital in the court register was carried out in May, which prevented this forced integration. The aspirations did not cease in the following years either, with offers after the end of the aggression to integrate the hospitals, and to offer the hospital director the position of medical director of the Clinical Center, which was not accepted.

During the aggression, the entire hospital activity took place in the ground floor and basement rooms because it was constantly exposed to artillery fire from the surrounding hills. Less than 200 meters from the front line, during the siege, the hospital was hit by more than 200 projectiles from various artillery weapons, resulting in significant destruction of the overall hospital capacity. Thanks to the assistance of the Government of the Hellenic Republic, the hospital was fully reconstructed from 1996 to 1997 and continued its work under new conditions.

In the period from 1998 to 2000, pressure continued for the hospital to become an Institute for Mother and Child, as a replacement for the destroyed Gynecology-Obstetrics and Pediatrics Clinic "Dr. Zehra Muidović" at Jezero. The then Ministry of Health of Sarajevo Canton engaged the Institute for Public Health of Sarajevo Canton, a professional referral institution for health organization, which prepared a study on the place of the State Hospital in the network of hospital health capacities of Sarajevo Canton. As a result of this task, a report was prepared with a proposal to establish a General Hospital with a capacity of 300 beds within the capacities of the then State Hospital Sarajevo, with facilities that, according to health protection norms and standards, correspond to the level of a General Hospital. Finally, in 2000, the Assembly of Sarajevo Canton took over the founding rights for the establishment of the General Hospital Sarajevo, and as such, it remains in the network of health institutions of Sarajevo Canton. It is important to emphasize that the hospital did not cease its operations at any moment during the aggression, reconstruction, and subsequent work.

After the premature death of the long-time head of surgical disciplines, chief surgeon of the Army of Bosnia and Herzegovina, founder and president of the Independent Trade Union of Health Workers, Dr. Abdulah Nakaš, at the proposal of patients, the Assembly of Sarajevo Canton changed the name, and the hospital has since been called: Public Institution General Hospital "Prim. Dr. Abdulah Nakaš", which, with a total of 330 beds, continues its work to this day.

With the arrival of new management led by director Prof. Dr. Sebija Izetbegović, in March 2013, the hospital is not developing in accordance with the development program presented by the candidates during the election process for the position of hospital director. The number of laboratory and other analyses is continuously decreasing, the pathology department is being closed, and analyses are being entrusted to a private institution within the hospital, employment contracts are being changed, the admission of "severe" patients is prohibited, the cooperation in the diagnostic and treatment process with the Clinical Center, which was common until then, is not supported, and the bed occupancy rate falls from 70% in 2011 to 50%.

In this way, through the policy of preventing normal operation, the question of the institution's operational profitability has been raised. Without a quality analysis and consultation with experts, a working group was formed at the end of 2015 with the sole task of carrying out the closure and abolition of the General Hospital under the guise of rationalization and consolidation of all hospital capacities in Sarajevo Canton within the University Clinical Center Sarajevo.

Unfortunately, the implementation of this non-transparent process in the way it is being carried out further complicates the already bad situation in the healthcare of KS and causes unrest and concern among the citizens of Sarajevo who are users of the services of this health institution. It is to be believed that reason will prevail and that the symbol of the city, the General Hospital that belongs to all citizens of Sarajevo and BiH, will not fall in silence.