Pediatric Hospital Home PagePEDIATRIC HOSPITAL
In the last decade of the 19'th century was started a significant expansion of Sarajevo as an important commercial and cultural center; the number of inhabitants was increasing and consequently a need for a better rationalised organisation of medical care arose. The year 1894 saw the beginning of the construction of the State Hospital. The intention of the creators was to separate physically the different medical branches according to specialisation, and, in line with this philosophy, a maternity department with a few beds for children was built. The first head of that department was Otto Weise, docent of the Vienna Medical Faculty. In the past in Sarajevo, only three physicians were employed and people visited the Hospital reluctantly. However, as new physicians were added to the staff and as conditions of work improved with the introduction of rational methods of treatment, the reputation of the Hospital improved and a greater number of patients were received. The expansion of the Hospital was delayed by World War I, so that it was not until 1920 that a separate department for children was opened, with 30 beds, two pediatricians and one resident, which could better care for children and relieve the worries of their parents. Chroniclers from that period relate that all social classes were served by the Hospital, with the wealthy paying the appropriate price for treatment and the poor either paying only a symbolic fee or else receiving treatment for free. The people were grateful to the physicians for this care, and the doctors enjoyed a good reputation. According to data from that period, the most common diseases were: bronchopneumonia, bronchitis, enterocolitis, rachitis, meningitis, and tuberculosis. The Hospital remained at the same capacity until the end of World War II and serviced only the city and its surroundings. In the first year after the war, when the whole country suffered from great economic and other troubles from the war, the Pediatric Hospital continued to function, even under such difficult conditions.
Morbidity and mortality were at a very high level, with many patients being received dead. Under such circumstances, medical personnel were overburdened and only urgent therapy was administered. The post-war period demanded an intensive development of the health services, and the capacity of the Children's Hospital was expanded to 220 beds by 1968, at which level it remained until the beginning of the current war in 1992.
Activities of the Pediatric Hospital:
After the founding of the Medical Faculty of Sarajevo in 1947, the Children's department of the Hospital was transformed into the Pediatric Hospital and provided education and training in pediatrics both for students and doctors. The Pediatric Hospital organised the following:
1. Courses in social pediatrics for specialists and other doctors responsible for the solution of problems of basic health protection.
2. The hosting of the "International Week of Social Pediatrics" with the participation of lecturers from WHO and from the other former Yugoslav republics.
3. Organisation of the Pediatric Days of Bosnia and Herzegovina, with the collaboration of the Pediatric section of the Medical Association of B&H and aimed at both pediatricians and other medical doctors working to provide basic health protection to children.
The following activities were necessary in order to provide sufficient staff with the knowledge to decrease and prevent the high morbidity and mortality of children then current in the B&H:
1. The struggle against congenital syphilis, which was eradicated by 1960.
2. The struggle against TBC and the provision of the BCG vaccine to all children.
3. The struggle against intestinal infections which in the post-war period afflicted 50% of all children, but which by 1986 had an insignificant mortality rate.
4. The struggle against rachitis by the introduction and popularisation of prophylactic administration of Vitamin D3.
The above listed programs represent only a small part of the total activity of the Pediatric Hospital in promoting children's health in the B&H, which was enabled only by the continuing education of physicians in the field. After overcoming the problems of childhood pathology, the space and the staff of the Hospital were further expanded, so that, along with improvements in laboratory diagnostics, the Hospital was the unique institution in the B&H offering highly differentiated health protection for children with acute leukaemia's and other malignancies, diabetes, epilepsy, psychomotor retardation, difficult forms of pulmonary diseases (cystic fibrosis), renal diseases, and rheumatic diseases.
Pediatric Hospital after 100 years of service:
The month April, 1992 will never be forgotten by the citizens of Sarajevo and of he whole B&H, nor by the staff of the Pediatric Hospital. The entire city was blocked by barricades, personnel were prevented from coming to work, and parents were prevented from bringing sick children to the Hospital. Entry and exit from the city was difficult, almost impossible. In May 1992, savage shelling of the Hospital destroyed all vital capacities and resulted in the evacuation of the Hospital to a new location, during which six infants died, due to lack of oxygen, previously provided by respirators. This ended the formerly successful work of the Hospital.
The Children's Hospital is now located in Kosevo Hospital, with 60 beds, a space of 500 m2, 11 specialists, 8 residents, and 4 secondary physicians. Half of the rooms have neither windows nor natural light. We do not have enough electricity, water, or heating, nor is there sufficient oxygen for the survival of children with small birth weight with RDS, or diseases of the heart and lungs. We don't have enough incubators and other equipment for intensive care. We are short of therapeutic food for children with intestinal diseases. The supply of drugs is limited. The number of syringes and injection needles is also limited, nor are there sufficient reagents to permit most diagnostic tests. The work of the Hospital is very difficult under these circumstances, and our capacity to help sick children compromised. But the children are still sick. All 60 beds are constantly filled, and the minimal level of treatment continues in spite of all the difficulties. Since the beginning of the war, we have hospitalised 4500 sick children, some due to wounding. In addition to hospital work, the doctors have also offered help to outpatients through consultative and specialised services. We periodically receive some help from humanitarian organisations and from individual donors, but that help is not enough, and is not well coordinated and therefore often useless.
Plan:
In expectation of the soon cessation of the war and the reestablishment of communications between Sarajevo and other regions of the B&H, we have begun some activities aimed at the restoration and improvement of the work of the Hospital. The basis for further work will be the reconstruction of the building which formerly housed the Hospital. There is a detailed report about the war damages and a plan for reconstruction. The children of Sarajevo and of the Bosnia and Herzegovina always will know how to show gratitude for the help with the reconstruction of the Hospital, and the names of friends will be carved into the history of the restored Hospital.
By Esma Cemerlic-Zecevic, MD, PhD
July, 1995.
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