More and more doctors in politics, while healthcare gets sicker

By: Ernad Metaj

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The healthcare system in Bosnia and Herzegovina is on life support. Proof of this are the white coats who frequently demand their rights and salaries on the streets. The image of healthcare is dilapidated tin containers that in Bihać replace COVID clinics, where often there are only about ten PCR tests. As a rule, the public is appalled by this information, a Facebook uprising begins that disappears as quickly as it flares up. The fact that Bosnia and Herzegovina is one of the leaders in patient mortality from coronavirus remains in silence. Patients in Bosnia and Herzegovina are also „quietly dying“ from cardiovascular diseases because the mortality rate compared to the European average is twice as high. Organ transplantation is a separate story, it is mostly not performed.

There is a lack of money, and there is an increasing shortage of doctors, a grim perspective for the healthcare system in Bosnia and Herzegovina. Due to a debt of 22 million KM, healthcare workers in Konjic recently had to demand payment of three overdue salaries by stopping work. White coats in the Una-Sana Canton, due to political disputes, entered the new year knowing they would not receive their salaries because there is no majority to adopt the budget and work plan of the Health Insurance Institute. The procurement of medicines and medical supplies for hospitals and health centers is a real ordeal because debts in healthcare have exceeded 300 million KM. There is no salvation for us, we will not collapse. The logic is the politics that daily gamble with the lives of citizens, and no one is held accountable. From time to time, only a sharp political polemic occurs, which still serves no purpose other than collecting political points.

The political bickering culminated in the Sarajevo Canton. First, the Party of Democratic Action called the troika government dangerous to the lives of citizens. They demanded the resignations of the prime minister and the minister of health. The reason, as they state, is insufficient testing of citizens, queues in front of clinics, and the „promotion“ of the private healthcare sector. The response was not long in coming. A list of 51 failures during the Party of Democratic Action – era rule fits into one sentence of the current Minister of Health Haris Vranić: „pot calling the kettle black“. Our Party stood up in defense of its prime minister with the message: "Whoever survived the rule of the Party of Democratic Action will not find hell too hard to bear". Applause for the Party of Democratic Action, or for Vranić, does not improve the situation in healthcare.

In the noise and pandemic, no one pays attention to the fact that the Federation of Bosnia and Herzegovina lacks about 500 doctors. According to Dr. Amila Bećirović, president of the Medical Chamber of the Federation of Bosnia and Herzegovina, this is no longer just a problem of small communities; doctors and medical staff are also lacking in large cities. Family clinics are closing, or in better cases, they work only one shift because there are no family medicine doctors. Hospitals lack infectologists, pulmonologists, anesthesiologists. Only a few have responded to the appeals of the Medical Chamber to permanently employ all doctors registered with the Employment Services, and to hire 1,000 nurses and other medical staff due to the coronavirus.

Without money and without people in white coats, the outlook for citizens of Bosnia and Herzegovina is bleak. An increasing number of doctors are turning to politics. The more doctors in parliaments and assemblies, the sicker healthcare became. Every mistake in healthcare is costly, often with patients' lives. It is reasonable to demand accountability, but it is unreasonable to expect no mistakes when doctors and medical staff are overburdened, working multiple jobs at once. The Bosnian Podrinje Canton Goražde has one anesthesiologist; practically, that doctor is on call 24 hours a day. It is a devastating realization that Bosnia and Herzegovina has experts, but transplants are almost never performed. Patients seek salvation abroad, and increasingly so do doctors and medical staff because they are undervalued, and their health insurance is not regularly paid.

We know it is not normal, but we only worry when it personally affects us, or when our closest and dearest end up in the hospital. Then it is too late.