ANATOMY OF DECEIT
Copyright©
1997 by Jerry Blaskovich. Electronic edition by Studia
Croatica, by permission of the author
Chapter 10:
Physicians, Leaders by Default.
In most
countries, an overwhelming majority of legislators and politicians come from
the legal profession; former Yugoslavia was no exception. Because Communist
Party membership was usually compulsory for politicians in Yugoslavia, the
anti-Communist sentiment that pervaded newly independent Croatia resulted in
the ouster of a great number of the old guard. Although unprepared for the
nuances of politics and governance, physicians filled the political vacuum by
replacing the ousted lawyers in the new government. The appearance of
physicians in government isn't unusual, but the large percentages that filled
Croatia's government offices is unique.
As a group, physicians were viewed with
suspicion by the Communist system. Aside from having work habits considered
abnormal for a socialistic society, their traits of ethics and humanism weren't
part of the Communist lexicon. Physicians were still able to flourish because
the practice of medicine was less dependent on politics than professions such
as economics, law, or journalism. Without political interference, physicians
were able to preserve their own free thoughts and individuality.
When it came time to replace the old regime,
the Croatian public readily accepted their physicians as leaders. The public
perceived them as intellectuals who possessed the qualities of credibility,
dedication, and integrity. Most importantly, many physicians weren't tainted
with past Communist Party affiliation. These virtues far surpassed their main
liabilities: naiveté and ignorance about the machinations of power and the
importance of public relations.
The innocents had been healing the physical
needs of society and were now nurturing the new democracy while rapidly
adjusting to their new roles. Ministries in the new Croatia, particularly the
Foreign Office, resembled medical conventions. The number of physicians holding
local political positions was equally impressive. Croatian physicians, perhaps
to a greater extent than other professionals, were driven by altruism and a
strong sense of patriotism, and put off satisfying careers to help manage the
new democracy. Given their professional experiences, the
physicians-turned-leaders approached the new nation as they would have an
infant with an unpromising prenatal history whose congenital abnormalities were
amenable to corrective surgery and rehabilitation.
None of the physicians suggested that they
planned to remain in government. The majority of the physicians planned to
return to practicing medicine when a cadre of qualified leaders had matured to
the point where they could effectively run the government. Most of the
physicians participating at the federal level were professors at the medical
school. All were specialists in their respective fields of medicine.
For example,
the position of Deputy Head of the Office of the President of Croatia was
filled admirably by Branimir Jaksic.
Prior to the conflict he had been a professor at the medical school and the
coordinator of the International Multicentric
Research Project on the Clinical Therapy of Chronic Lymphocytic Leukemia and
the European Organization for the Research and Therapy of Cancer.
Ambassador for
Human Rights and Deputy Prime Minister Ivica Kostovic had been the dean of Zagreb's medical school and a
professor of neuro-anatomy. He had received
postdoctoral training at John Hopkins University and had researched neuro-anatomy and neuropathology at Harvard, Yale, and
several prestigious institutions in Europe.
Kostovic, who is also the leading investigator of Serbian atrocities, has become
the victim of a bitter irony. His daughter was almost killed during a Serbian
missile attack on Zagreb in May, 1995, while walking to the children's
hospital, which the Serbs had targeted. Cluster bomb projectiles penetrated her
chest and abdominal cavities, severely damaging vital organs. Although she
survived a number of major surgeries, 18 pieces of shrapnel remain in the
tissues and muscles of her back.
Zdenko Skrabalo, who played a key role in the formation of the new
Croatian state, was a professor at Zagreb's Medical School and head of the
Diabetes and Endocrinology Institute before being named Deputy Foreign Affairs
Minister. He briefly served as Minister of Foreign Affairs. He's presently
representative to UNESCO and Ambassador to Switzerland. Skrabalo
was one of the few Croatian officials to recognize the importance of the media.
Addressing the World Congress of Croatian Physicians in 1995, he said,
"Croatia has overcome a number of major obstacles since declaring
independence. But it has not been able to overcome the most important
one--getting the message to the media."
Andrija Hebrang led the exodus of physicians into
government. Stumbling to get its sea legs, the newly christened Croatia has
been characterized by an extremely high turnover rate in the ministries.
Minister of Health Hebrang, probably the most
respected and charismatic individual in the government is one of those rare
exceptions who have remained in office since the day Croatia was formed.
Unlike its
counterpart in the United States, the health ministry in Croatia isn't merely a
symbolic office.
Aside from
being responsible for the entire country's health needs, it cares for the
social welfare of the citizenry.
Hebrang's talents haven't been limited to his work in the ministry. Even before
Croatia declared independence, he was an insider intimately involved in the
political aspects of running the government. To better understand why many
Croats, such as Hebrang, welcomed the overthrow of communism,
I should mention his family history. The history, an example of how the
Communists treated enemies of the state, isn't unique.
His father, Andrija Sr., was one of the founders of the Communist Party
in Croatia. While serving as Party Secretary, he'd helped organize the most
effective fighting unit of the Partisans during World War II.
Despite his
power, status, and idealized commitment to communism, he was executed by order
of Tito; his sin had been Croatian nationalism.
Thereafter the Hebrangs were treated as second class
citizens. To punish them further, the authorities imprisoned Andrija Jr.'s mother for many
years and forbid her from seeing her son.
Since the
family name was considered anathema by the regime, the children were forced to assume
pseudonyms. School stipends were closed to them. Family members were harassed
frequently and followed sporadically, and when they were suspected of having
contact with personages of influence, these measures intensified.
Despite the
inordinate amount of pressure placed upon the family, they prospered
intellectually. Against all odds, Andrija was
accepted into the medical school. He eventually specialized in the field of
radiology and became a professor of medicine.
In the months
before the Serbian-led Belgrade government attacked Croatia, Hebrang's life was in jeopardy. Although Yugoslavia was
less rigid and dogmatic than other Soviet Bloc countries like East Germany, its
secret police (UDBA or SUP) were 100% Stalinist and probably the most effective
and sophisticated in the Eastern bloc. But by the late 1980s, many in the
secret police ranks had either lost faith, were jaded, or didn't care any
longer. Had SUP preserved its original zeal, it would've crushed any
opposition.
A few
committed Stalinists in SUP still relished the special cases assigned to them.
As the Hebrang name was an abomination to the
Communist Party, surveillance of them was stepped up. SUP sensed that Hebrang was up to something. But despite vigorous
surveillance, Hebrang and his medical colleagues,
Mate Granic, Ivica Kostovic, and Zdenko Skrabalo, the Big Four, were able to set up an ironclad
cell and become the nucleus of the physicians' movement. Anticipating the
imminent breakup of Yugoslavia, the Big Four's first priority was to draw up
contingency plans to maintain the health needs of Croatia's population. Their
calculation of 10,000 dead and 20,000 wounded Croats was remarkably close to
the mark.
The Big Four's
next step was to select trustworthy individuals to form new cells to implement
their plans. This task was formidable because some of their friends and
colleagues were members of SUP. At the time, SUP had approximately 22,000
members and countless informers in Croatia.
One of the
first acts of the new government was to revamp the secret police into a more
open intelligence gathering agency. SUP, the greatest nemesis of the Croatian
people, had been a law unto itself. The power it wielded and the fear it evoked
had kept the old regime in place. The new order was forced to make compromises
with SUP to prevent bloodshed. For other valid political reasons, the new
government had to keep some of the ruthless old guard in place. A few were even
given positions in the highest levels of the government.
The ex-SUP
members, regardless of how well they performed, were viewed with suspicion by
their new colleagues. Ironically, former suspects, such as Hebrang,
found themselves working alongside their former oppressors. But the new
government appointed individuals from outside the system to fill the most
sensitive positions. For example, Goran Dodig, a psychiatrist, was appointed the top official of
Military Counter-Intelligence and Assistant Minister of Defense.
In former
Yugoslavia, by design, only 17 of 500 military surgeons were Croatian. Weapons
of modern warfare, with their awesome projectiles, inflict wounds that are
difficult to repair for even the most sophisticated surgeon. Treatment requires
a special expertise other physicians lack. So Hebrang immediately assembled a team of the few experts
available in Croatia to write a practical handbook for treating war trauma.
Miraculously,
the book was delivered in 24 hours. Soon after its circulation morbidity rates
fell dramatically.
Immediately
preceding the conflict, the Serb-led JNA confiscated most of the supplies and
equipment from the military hospitals in Croatia. In contrast to other
countries, military hospitals in Croatia weren't limited to military personnel;
civilians were admitted as well. Because Croatia lacked even the most
fundamental supplies, such as dressings and gauze, the country was ill-equipped
to treat the enormous number of casualties, let alone patients with mundane
diseases.
Zagreb, the
capital of Croatia, gave no hint that the front lines were only 30 miles away.
But its hospital wards, filled with civilians without limbs, with gaping
visceral wounds, and blinded from shrapnel, painted a different picture--a
picture of a medical infrastructure that had been stretched to the breaking
point.
Hebrang, as Minister of Health, was confronted with an enormous number of
problems that demanded immediate solutions. An escalating war, a shortage of
weapons with which to defend themselves, an economy and infrastructure in
shambles, no cadre of experienced personnel, and nationwide psychological
stress caused by a system in transition from dictatorship to democracy, made Hebrang's job all the more difficult.
From the onset
of active fighting, the Serbs targeted medical complexes. So
basements, bunkers, and warrens created from destroyed buildings became new
medical centers, forcing patients and medical personnel underground. The
destruction of ten major hospitals in a country the size of Maryland proved
devastating.
Osijek's
General Hospital, the largest hospital closest to the battle line, was blasted
by rockets and heavy artillery, but continued to function inside the remaining
20% of its structure. All medical and surgical care was conducted in a maze of
tunnels beneath the hospital.
Meanwhile the
director of Osijek's Hospital, radiologist Kresimir Glavina, after having served valorously during the trying
days of Osijek's bombardment, was elected to serve as a representative in
Croatia's Parliament. Another war hero, Juraj Njavro, who was chief surgeon during the siege of Vukovar, became Minister of Health. After the fall of Vukovar, the Serbs imprisoned Njavro.
His experiences and exploits were duly recorded in his book, Glava Dolje: Ruke
Na Ledja ("Head Down: Hands on the Back in
Front").
The Serbian
ethnic cleansing program in Croatia resulted in hundreds of thousands of
displaced persons and severely strained Croatia's remaining medical facilities.
But the enormous influx of refugees from Bosnia-Herzegovina, many suffering
from major trauma, further overtaxed the already fragile health care system.
The Health
Ministry was responsible for operating the refugee camps. By December, 1992,
663,493 refugees and displaced persons from Bosnia-Herzegovina had found safety
in Croatia. Despite adverse conditions, Croatian medical personnel were able to
keep the rates of refugee mortality and infection morbidity at almost the same
level as the general population. Fortunately there were few epidemics. The
statistics reflect good hygienic conditions, nourishment, and selfless medical
management. But caring for the refugees placed an enormous strain on the
teetering Croatian economy. Croatian citizens bore 70% of the cost of operating
the camps; the international community donated the rest.
Slobodan Lang
serves as Administrator for the Red Cross and special advisor to the chief of
the Croatian Office for Displaced Persons and Refugees. A human rights activist
since his student days, Lang is also vice-president of the Croatian Helsinki
Watch Committee. Lang is no mere armchair human rights dilettante. At great
peril to his life, Lang has run many Serbian blockades to deliver humanitarian
aid in Croatia and Bosnia-Herzegovina. He's also an assistant professor at the medical
school.
Many
physicians in Croatia have become critical of Hebrang.
But much of the criticism is self-serving, arising
soon after Hebrang abolished the "envelope
system." Croatian patients, like patients in many communist countries,
bypassed the bureaucratic boondoggle by offering tokens of appreciation to
medical personnel.
Originally the
tokens were commodities, like hams or chickens. As the country became more
prosperous, money became the token of choice.
After
communism imposed its will in Yugoslavia, the practice became more common. By
the mid-1980s the corruption was rampant. The process of seeing specialists
after being referred or admitted to hospitals for elective procedures was
snail-paced. Producing an envelope had the same magical effect as the words
"Open sesame."
Although
illegal, the envelope system became the accepted norm. The system's tacit
approval was the way the Yugoslav government controlled the medical profession.
If a physician was perceived by commissars as deviating from the ideological
party line, the government would invoke the law against him. Instead of
receiving a political trial, which would come under the scrutiny of
international human rights groups, the physician would be tried in civil court.
Before the breakup of Yugoslavia, Human Rights groups had cited Yugoslavia as
having one of the worst records of abuses.
Because the
envelope system provided physicians with a large share of their incomes, Hebrang's ban seemed draconian. Yet even his most vocal
detractors admit the envelope system had corrupted and compromised the ethics
of the profession.
Economics
proved to be the main problem for the Health Ministry. Unbelievable as it may
seem, the medical system in Croatia had been operating without a budget for years,
with absolutely no form of accountability. "Cost containment" was an
expression unknown in the Croatian medical vocabulary. To make the system
function effectively, revolutionary changes were necessary. The expectations of
the medical personnel and patients had to be altered.
The delivery
of health care in Croatia was a true miracle. Although the Health Ministry had
70% less money in its budget during the war than it had in 1990, Croatia's
morbidity and mortality rates remained almost constant through 1994. The
statistics were much better than those from all other formerly communist
countries.
The Croatian
statistics seem more impressive when taking into account the fact that none of
those other countries was at war, or taking care of refugees and displaced
persons. The credit belongs to the cost containment programs instituted by the
Health Ministry and the cooperation of most of Croatia's physicians.
Several other
individuals from the health field participated in Croatia's government. Josip Juras and Ivan Majdak are veterinarians. Juras
became Minister of Labor, Social Welfare and Family; previously he was chairman
of the Executive Council of the city of Sibenik. Majdak, besides being a veterinarian, is also a medical
doctor. He became Minister without Portfolio as Advisor for Economic and
Regional Development Questions for the President's Office.
Ivica Kracun, head of the Laboratory of Neurochemistry, Chemistry
and Biochemistry, at the Zagreb School of Medicine, also serves as Deputy
Minister of Science. Drago Stambuk,
an internist, unable to tolerate the system in Yugoslavia, chose exile in
England over ten years ago. He became renowned in the clinical aspects of HIV
positive patients. By avocation a writer and poet, he is well regarded in
literary circles in London. Long before the onset of hostilities in former
Yugoslavia he took up the gauntlet to combat the misinformation that was so
prevalent in the British media regarding Croatian affairs. His commentaries had
a strong influence on Margaret Thatcher. Once Croatia was independent he
abandoned his brilliant medical career to serve Croatia's diplomatic needs.
After a stint in London, he was appointed ambassador to India.
Croats at
large should also be proud of another achievement. At a time when Serbs
controlled over 25% of Croatian territory, the Croats were taking care of
refugees whose numbers equaled over 25% of the indigenous population. The
Croats accomplished this feat with an economic output that was less than 50% of
pre-war production.
By relating
these stories about physicians now in government, I don't mean to detract from
the exemplary work of the physicians who continued to practice their art under
unimaginably adverse conditions. I simply mean to illustrate how individuals
from that most honored of professions unhesitatingly changed roles to assist
Croatia during its birth as an independent nation.
Although a few
physicians serving in the government have proved to be inept administrators,
all have been sincere in their patriotism. A surgeon with golden hands, Franjo Golem, put his medical career on hold when he was
named the first Foreign Minister of Croatia. But his forte wasn't diplomacy,
and so he was removed from his post. To honor his loyalty to the cause, Franjo Tudjman ignored objections from the cabinet and
appointed Golem the first Plenipotentiary of the Republic of Croatia to the
United States. Golem's performance in Washington D.C. was viewed by many as
less than satisfactory.
Mate Granic, an internist, professor at the medical school, and
deputy director of the Vuk Vrhovac
Institute who had done post-graduate studies for several years at prestigious
institutions including Harvard, exceeded all expectations when he blossomed
into a world caliber diplomat as Minister of Foreign Affairs and Vice Prime
Minister of Croatia.
Bosnian
Foreign Minister Irfan Ljubijankic
was also a physician. Ljubijankic was elected to
parliament in 1990, and the Bosnian government hierarchy soon realized that his
inherent political talents surpassed his formidable medical skills. So Ljubijankic was appointed President of the Bihac district. In April, 1992, Bihac
became a major target for Serbian bombardment. While the Serbian attacks
intensified, and Bihac's civilian
population suffered huge numbers of casualties, Ljubijankic
divided his energies between the healing art of surgery at Bihac's
hospital and service in the political realm. He reluctantly agreed to serve as
Bosnia's Foreign Minister, in October, 1993. Unfortunately, he didn't live to
see the seeds of his peace negotiations bear fruit because he was killed when
his helicopter was shot down by Serbian artillery in May, 1995.
By a
remarkable coincidence, individuals from the medical professions seem to be the
main actors in the tragedy being played out in other parts of former
Yugoslavia. Although contrary to naturalization laws, the United States
government allowed a naturalized American citizen, Milan Panich,
to serve as Prime Minister of Yugoslavia. Panich is
the owner and founder of ICN Pharmaceuticals, one of America's largest drug
firms.
Milan Babic, the Serbian rebel leader in Croatia, is a dentist.
The Bosnian-Serb leader, Radovan Karadzic, is a psychiatrist who did
post-graduate training in the United States. Another psychiatrist, academician,
and professor, Jovan Raskovic, was president of the
Serbian Democratic Party. British peace negotiator Lord David Owen is also a
physician. Given their performances in the conflict, it seems to me that
Doctors Owen and Karadzic either kept their fingers crossed or were absent when
they were supposed to take the Hippocratic Oath.
- - - - - - - - - - - - - - - Aviso - - - - - - Advertisement - -
- - - Oglas- - - - - - - - - - - - - -
Servicios jurídicos – Traducciones – Propiedades inmuebles –
Bienes raíces –Sucesiones – Poderes – Inscripción de propiedades – Contratos –
Testamentos
Legal services: Civil and commercial –
Translations – Real Estate – Probate Proceedings – Powers of Attorney – Property
registration – Contracts – Wills
Pravne usluge – Prijevodi – Nekretnine – Ostavinski postupci – Punomoći – Upis pravo vlasništva – Ugovori– Oporuke
Dra. Adriana Smajic – Abogada y
Traductora pública de idioma croata – Attorney at Law – Odvjetnica – Abogado croata
– Traductor croata www.adrianasmajic.blogspot.com adriana.smajic@gmail.com
Joza Vrljicak
– Master in Economics
(Concordia U, Montreal) joza.vrljicak@gmail.com
(+54-11) 4811-8706 (+54-911) 6564-9585 (+54-911) 5112-0000