[kcc-news] Health-care: SYSTEMATIC AND PERVASIVE ABUSES BY SERBS AGAINST ALBANIAN KOSOVAR HEALTH PROFESSIONALS AND ALBANIAN KOSOVAR PATIENTS

[Mentor Cana]

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For Immediate Release
December 23, 1998

Contact: Jennifer Leaning, M.D. (781) 259-9108 / (617) 909-3559
        Barbara Ayotte (617) 695-0041 ext 210 / (617) 549-0152
		
                   MEDICAL GROUP DOCUMENTS SYSTEMATIC AND
             PERVASIVE ABUSES BY SERBS AGAINST ALBANIAN
             KOSOVAR HEALTH PROFESSIONALS AND ALBANIAN
                          KOSOVAR PATIENTS

	The systematic Serbian oppression of Albanian Kosovar
physicians in  Kosovo has escalated drastically since the conflict
began in February 1998,  according to preliminary findings released
today from a two-month study by  Physicians for Human Rights
(PHR). Abuses committed date primarily from late summer and fall
of 1998 and extend into the period beyond the  Holbrooke/Milosevic
agreement on October 12, 1998.

	The Boston-based group documents a pattern of Serbian
intimidation of  Albanian Kosovar doctors, jeopardizing the already
fragile health care system in a time when Kosovars returning to
their villages are in greatest medical  need.  The intimidation is
marked by instances of murder, torture, detention,  imprisonment,
and forced disappearances of ethnic Albanian Kosovar  physicians.
The PHR study, which will be released in early 1999, also cites
cases of Albanian Kosovar patients who have been abused by
Serbian police  and Serbian health professionals, including
instances where patients have  been beaten, chained to beds or
radiators, and placed under constant armed police guard.

	The health and human rights group, whose key
recommendations were  transmitted in a letter sent today to
Yugoslav President Slobodan Milosevic,  also cited interrogation
and harassment of Albanian Kosovar physicians,  including threats
of death, by Serbian police.  Medical facilities operated by  ethnic
Albanian Kosovar physicians have been searched, property
confiscated, and many clinics and health centers in contested
areas have  been burned to the ground.  Ambulance transport has
also been interrupted.

	"Attacks on health facilities, doctors, and their patients are
war crimes,"  said Jennifer Leaning, M.D., a member of the PHR
board of directors and one  of the lead researchers in the study.
"Albanian Kosovar physicians attempting to provide assistance to
people living in areas of conflict or currently or previously controlled
by the Kosovo Liberation Army (KLA)  have been harassed and
hunted in a campaign that disregards norms of  medical neutrality
that are protected under international human rights and
humanitarian law," said Leaning.  “The Serbian authorities have
defied the principle that civilians and combatants alike are entitled
to medical treatment  in times of conflict. Instead, Serb police have
branded medical practices as  acts of “terrorism” and abused
physicians and patients, calling them  “terrorists”.  Further, by
attacking community leaders such  as physicians and creating fear
throughout the population, the Serbian  authorities are conducting a
campaign against ethnic Albanian civil society."

	The Geneva Conventions, including both Protocols, specify
an extensive  array of protected acts, persons, and facilities in the
delivery of health care to  civilians and combatants, in a wide range
of conflicts, including the one now  being waged in Kosovo.
Wounded persons not engaged in combat,  including civilians, are
entitled to medical care.

	There has been a long history of discrimination against
ethnic Albanian  physicians in the Serb-run state health care
system in Kosovo--mass firing  from employment in 1990,
elimination of training opportunities in state  medical schools and
hospitals, and requiring the use of the Serbian language  rather
than Albanian in all interactions with patients, including the writing
of  prescriptions and instructional materials. During the same time,
ethnic  Albanians have been impeded access to the state-financed
health care  system. The current oppression of ethnic Albanian
Kosovar health  professionals, however, has acquired
an acutely violent character.

	The PHR team, composed of three physicians, one lawyer,
and two  health researchers, conducted interviews with 105
individuals in Kosovo from  October to December 1998, collecting
data relating to 75 cases of alleged  abuse of Albanian Kosovar
health professionals and patients and 52 cases of  physician flight
from Serbian threats.  The individuals interviewed included
physicians, lawyers, representatives from major humanitarian
organizations,  and eyewitnesses to abuses against Albanian
Kosovar physicians and  patients.  Many of those
interviewed requested anonymity for fear of reprisal  from the
Serbian authorities.

	The widespread abuses committed by Serbian authorities
against  Albanian Kosovar physicians and other health workers
include:

Murder

	The PHR team investigated the murder of one Albanian
Kosovar  physician who was tortured and killed because he was
fulfilling his  professional obligation to provide care to patients in
need.  Dr. Leci,a general  practitioner in a private clinic in Gradice
was hunted by Serbian police on  September 24-25, 1998 and
killed sometime between September 24-27.   Confirmed reports
state that his body,when found, revealed that his right  hand had
been cut off.

	Another leading physician in the ethnic Albanian Kosovar
community,  not one known to have taken an active role in
delivering medical care in KLA- contested areas, was killed on the
evening of November 18, 1998 in  suspicious circumstances.  Dr.
Zejnullahu, a physician in the town of Pec,  was attacked by three
masked men who spoke fluent Serbian, carried  Kaleshnikovs, and
fired several lethal shots at close range while Dr.  Zejnullahu’s
family was by his side.

Detention/Arrest for Delivering Medical Care

	Albanian Kosovar physicians have been accused of crimes
despite the  lack of credible evidence of criminal acts. PHR has
documented four cases of  physicians held in detention and five
cases of  physicians brought to trial,  with four of these resulting in
convictions.PHR has also received  unconfirmed reports of many
physicians in custody, which it is currently investigating.

	One physician told PHR he was arrested while trying to
calm patients  who had rushed into a clinic in advance of a Serbian
attack on his village.  Another was arrested while returning home
after fleeing from a Serbian  advance on his town, and a third was
arrested while maintaining a home  supply of medical drugs in a
KLA-controlled area deprived of medical  supplies.

	In these cases, the physicians were alleged (whether
formally charged or  not) to have engaged in the practice of
medicine on behalf of people labeled  “terrorists” and thus have
committed acts of terrorism themselves.  The  charges are brought
under Articles 125 and 136 of the Criminal Code of the  Federal
Republic of Yugoslavia and, in the cases where PHR has confirmed
 that these charges have been applied, Serbs have extracted
confessions from  physicians and imposed inhumane
prison conditions.

Torture/Physical Abuse

	Albanian Kosovar health workers reported many instances
of  torture  and/or physical abuse by Serbian authorities while in
police custody. PHR  has documented six cases of physical abuse
and threat of abuse by Serbian  police.  Physicians reported that
the abuse usually occurred within the first  three days of detention,
during which time the police are required to complete  their
investigation and present findings to an investigating judge.

	In the cases PHR documented, four Albanian Kosovar
physicians were  beaten by hand or stick applied to torso or hands;
one physician had a  plastic bag wrapped around his head,
resulting in near suffocation, and  another was threatened with
electric shock.

	A physician who requested anonymity told PHR that the
Serbian police:

	“
beat me like an animal; they beat me with the gun butt,
but they  were kicking me, they beat me with their fists
in the
police station.  I had  to sign everything they wanted to stop the
torture.. I signed one paper I  wasn’t allowed to read.”


	Police attempting to extract a confession from another
physician asked  him several times a day if he had changed his
mind about cooperating. He  was summarily beaten when he
declined to “confess”. Such confessions  have been used as the
sole evidentiary basis for subsequent cases.

Search of Medical Facilities/Seizure of Supplies/Destruction of
Medical  Facilities

	PHR has received reports of many instances and
documented eight  cases where Serbian police invaded medical
facilities and engaged in a range  of behaviors in violation of
international law: search of premises, seizure of  medical supplies,
destruction of facilities, and destruction of homes of  physicians.

Forced Flight from Medical Practice

	Over half of the 54 physicians interviewed by PHR had
been forced to  leave their practice entirely or had limited their
involvement dramatically since  the onset of the conflict in February
1998 out of fear of Serb harassment.   Lists of physicians who have
left their established place of practice are  obtainable with difficulty,
since those compiling the lists and those on the  lists are in danger
if their names or whereabouts come to the attention of the  Serbian
authorities.

	Two lists that could be compared and validated by the
PHR team  indicated that 17 health care professionals (12
physicians, 2 anesthesiologists, 1 epidemiologist ,1 dentist and 1
nurse) from the area  around Pec in northwest Kosovo had either
fled the country or were in  hiding. Thirty-five health professionals
from the Decan area (26 health  professionals and 9 dentists) had
either fled or were in hiding. The category  of "in hiding" includes
those who left or were driven from their established
practice and went deeper into KLA-controlled area to continue to
provide  medical care to civilians trapped in the conflict; those who
left one town and  went to live with their families elsewhere in
Kosovo, while continuing to  practice informally; and those who left
their established sites and stopped practicing altogether.

	PHR is particularly concerned about the fate of Dr.Hafir
Salja, a physician at the Glogovac Medical Center.  On April 10,
1998,Dr. Salja was reportedly arrested from a car he was riding in
with two colleagues and taken  to the Pristina Police Department.
The two colleagues were released but Dr.  Salja remains missing.
Some reports indicate hs seen alive and had  joined the KLA,
others report that he is in custody at the Military Court in  Nis.
PHR has not been able to confirm either story.

Police Harassment

	The 54 physicians interviewed cited frequent police
harassment and  abuse.  Over 25% of them had been brought into
police offices for "informative talks", a procedure where a person is
held for an indefinite period  of time and subjected to threatening
questions relating to his political leanings or affiliations.
Physicians traveling on the roads are vulnerable to  such police
action.

	 As a result, physicians who try to reach villages that have
been cut off  from medical support must travel circuitous back
roads (increasingly at risk of  landmine injuries) and at night to
avoid the frequent police checkpoints along the tarmac roads. One
physician reported to PHR that it is safer to be caught  with a gun
than with medical supplies.

	PHR has received reports of four instances of police
interference with  ambulance transport, including one where the
physician interviewed said that  the Serbian policeman had held a
gun to his head, only lowering it when a  bus rounded the
curve on the main road. Another ambulance, clearly marked  with a
Red Cross, was stopped in Rahovic by Serbian police so that Serb
authorities could examine the bandage of the ethnic Albanian
patient to  verify she had an appendectomy as opposed to
a war wound. The Serbian  police beat the driver, technician and
nurse and slapped the patient. They  broke the windows of the
ambulance.

Abuses against Hospitalized Albanian Kosovar
Patients Include:

	While not the principal focus of PHR’s study, PHR has
received  numerous reports and comments from many parts of
Kosovo describing  instances and a general pattern of abuse of
dozens of ethnic Albanian  patients in state-controlled,
Serbian-run hospitals. Informants insisted upon total anonymity
and further specification of hospitals or the sources of our
information would jeopardize the safety of individuals still in
Kosovo.
	
	In three of the major state-run hospitals, informants
provided PHR with  examples of the nature of the dozens of abuses
committed against ethnic  Albanian Kosovar patients by Serbian
police, including: interrogating  seriously ill patients in the hospital,
despite efforts by their Albanian  Kosovar physicians to prevent this
practice; chaining patients who are  considered terrorists to
their beds or radiators on a 24-hour basis with armed  Serbian
police guards in or just outside their rooms; and extinguishing their
cigarettes on the backs of the hands of patients returning to the
recovery  room from the operating room, still coming out of
anesthesia.
	In one instance a post-operative patient with an external
fixation devise  fixed to his femur was prematurely removed from
the hospital by Serbian  police, dragged into a police station and
then imprisoned.  In another case,  Serbian police were
reported to agitate their batons in the wounds of patients,  risking
infection and the delay of healing.

	Informants also told PHR of cases where Serbian
physicians and nurses  slapped Albanian Kosovar patients
because they were crying or had a  wound perceived by the staff to
be consistent with a combat injury.

	Some ethnic Albanian families reported that they were
prevented from  delivering food and clean clothing to their ill
relatives for up to 24 hours.  Some patients’ families were extorted
significant amounts of money by Serb  police and Serb physicians
in order to secure adequate food, medical care,  and necessary
pharmaceuticals.

	In a number of instances, PHR received reports that
Serbian police  delayed taking injured men to the hospital in order
to interrogate them or  arrested injured men while they were in the
hospital regardless of their  medical condition and despite
the protests of ethnic Albanian physicians on  staff.

	These abuses violate Yugoslavia’sobligations under the
Convention  Against Torture and the Geneva Conventions, both of
which it has ratified.  The Geneva Conventions stipulate that all
persons in need of medical care in  war, whether civilian or
combatant, and regardless of the nature of war, are  considered
protected persons under the terms of Common Article 3 and
Protocol II.

Abuses Against the Ethnic Albanian
Kosovar Population:

	The pattern of interference with medical care and
punishment of those  who try to deliver it sows widespread fear and
anxiety in the Albanian  Kosovar population.  Their leaders are
under attack and threat of death: as  the niece of the physician
killed in Pec cried out to us, “Are they trying to kill
the best of us, one by one?"

	The Albanian Kosovar physicians interviewed by PHR are
afraid but, in  general, still resolute.  They feel a strong obligation to
continue to serve their  people and provide needed medical
care, but they are forced to be  inescapably aware of the personal
danger and the danger to their families that  their insistence on
medical practice now entails. A few of the physicians  interviewed
by PHR showed signs of depression, even despair,and many are
exhausted, on the verge of burn-out.


	The Serbian authorities, by conducting an assault on a
most visible  group of community leaders and by blocking access
to a service needed by  all people, particularly a people at war,
have deployed a strategy aimed at  banishing the application of
international law and obliterating a potent source  of comfort and
support for the population.  Unless the international  community
takes action to halt this assault on health care and those who
provide it, the Serbian authorities will continue to pursue a policy
this decade  has now made familiar: the imposition of great
suffering on vast numbers of  civilians in open violation of
international law and norms.

Abuses Against Serbian Health
Professionals and Patients

	PHR has learned of one instance occurring on July 16-17,
1998  during the KLA offensive on Orahovic when KLA forces
entered the hospital  and held a group of nurses (including 2
Serbian nurses) and patients on the  hospital premises in
order, the KLA soldiers said, to ensure their protection from fighting
outside.  No one was harmed and the troops left  after two days.
During this instance, however, it was reported to PHR that
one Serbian physician and one Serbian technician were taken by
the KLA  and have not been seen since.  This report has not been
confirmed but PHR  plans to continue its investigation of this
incident and to report on whatever  further instances of abuses
against Serbian medical staff it may find.

Recommendations:

     In separate letters sent to FRY President Milosevic and
President Clinton  today, PHR urged the FRY Government and the
United States and  international community to take the following
immediate measures:

To the Government of the Federal Republic of
Yugoslavia:


1. President Milosevic must immediately release without condition
those  doctors and other health personnel who have been detained,
including  those convicted, who were exercising their professional
responsibility to  provide medical treatment to wounded or sick
civilians or to combatants.   Such activities are protected
under international humanitarian law, and  must be permitted in all
circumstances in Kosovo.


2. The Serb authorities must immediately end their attacks and
persecution  on both medical personnel and their patients who
come from areas  formerly or currently under KLA control
and permit health personnel to  operate without interference.


3.The Serb authorities must immediately end their impediments to
the  transport of medical supplies and pharmaceuticals, stop all
harassment at  checkpoints, and permit free access to all parts of
the country to  Albanian Kosovar doctors and health personnel.


4.   The Government of Serbia should provide extensive assistance
to the  local Albanian medical community for purposes of rebuilding
and re- equipping the clinics and hospitals that its forces
have destroyed in the  course of the past year.

To the United States Government and Countries Engaged in
Monitoring the  Conflict in Kosovo

Neither the agreement brokered by Ambassador Richard Holbrooke
nor  the October 1998 Organization for Security and Cooperation in
Europe  (OSCE) Agreement to place a verification mission in
Kosovo includes an explicit human rights mandate or makes
specific demands on the FRY government with regard
to ceasing human rights abuses.  Therefore,PHR recommends that:


1. A human rights component must be incorporated into the
Kosovo  Diplomatic Mission  (KVM) mandate and given high
priority.  A  suitable number of personnel placed in the field should
have  adequate training in human rights principles and human
rights monitoring.

2.The protection of members of the Albanian Kosovar medical
community and their patients must be a top priority in all
diplomatic dealings with Belgrade.  The representatives of those
governments  involved in the KVM must exert themselves to the
maximum possible  extent to  provide protection and assistance to
Kosovo's beleaguered civilian population, including physicians and
other  health personnel in the performance of their duties.

3.The Kosovo Diplomatic Mission should make every effort to set
up  local offices throughout Kosovo, particularly in those areas
that  were once under KLA control or are under KLA control now.
The  diplomatic monitors should live in the communities and open
readily  accessible offices where they can receive witness
testimonies of   human rights abuses.  Monitors should be
guaranteed the right to  travel to any site.  They should report
publicly on all incidents,  including impediments placed
on their access by the Serb authorities.

4.The international diplomatic community, including the KVM
monitors, should monitor and denounce the persecution of
independent Albanian Kosovar doctors and health
professionals.  They should attend trials of doctors and medical
personnel, protest harassment, imprisonment, and other abuses,
and  accompany the independent doctors whenever possible when
they  deliver medical services, particularly to areas of former or
present  KLA control.  International monitors should also be
present at State- run hospitals and clinics to help deter abuse and
discrimination  against Albanian Kosovar patients.

5.Diplomatic monitors should be present at every place of detention
or  imprisonment to deter abuse and torture of detainees and to
help assure the regular access of the International Committee of
the Red  Cross to those in detention.

6.The International Criminal Tribunal for the Former Yugoslavia
(ICTY)should open criminal investigations into the destruction of
health clinics and hospitals and the murder bySerb authorities of at
 least one and perhaps two Albanian Kosovar doctors as violations
of international humanitarian law within the Tribunal's purview.
 	
7.International humanitarian organizations should continue, to the
maximum extent possible, to collaborate with local independent
Albanian doctors in Kosovo, employ them to participate
in mobile clinic visits to displaced communities, share with them
supplies and pharmaceuticals, and cooperate with them to
rebuild the network of  independent health clinics that were
destroyed by the Serb army and  police.


To the International Medical Community

    PHR urges the international medical communityto call for the
protection of  their colleagues in Kosovo and to demand that those
providing medical care  to those in need be allowed to do so.

   A full report of PHR’s work in the region will be released in
February 1999.

                                 ###

Physicians for Human Rights (PHR) mobilizes the
health professions and  enlists support from the
general public to protect and promote the human
rights of all people.  Since its founding in 1986,
PHR has conducted dozens  of investigations in
countries throughout the world to document
torture,  political killings, prison conditions, and
the health consequences of armed  conflict.  As a
founding member of the International Campaign
to Ban  Landmines, PHR shared in the 1997
Nobel Peace Prize.  PHR has worked in  Bosnia
since 1993. Its several projects in the region
involve working with  the relatives of the missing:
the Antemortem Database Project, the
Identification Project, the Forensic Monitoring
Project, and the Forensic  Needs Assessment
Project. PHR has provided evidence of war crimes
for  both of the International Criminal Tribunals
(former Yugoslavia and  Rwanda). Charles
Clements, MD, is President; Carola Eisenberg,
MD, is  Vice-President, Leonard Rubenstein, JD,
is Executive Director, Susannah  Sirkin is Deputy
Director; Mary-Jo Adams is Director of
Development;  Barbara Ayotte is Director of
Communications; Holly Burkhalter is  Advocacy
Director; Gina Cummings is Director of
Campaigns; and Richard  Sollom is Senior
Program Associate.


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