Croatian Medical Corps in Bosnia and Herzegovina during the 1992-1995 War

Military Medicine,  Nov 2003  by Bagaric, Ivan,  Eldar, Reuben

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Objective: The purpose of this study was to review the establishment and operation of the Croatian Medical Corps in Bosnia and Herzegovina in the 1992-1995 war. Methods: We analyzed pertinent documents available to one of the authors (B.I.) who served on the Headquarter of the Corps, the study of the 17 published articles describing medical activities in various parts of Bosnia and Herzegovina during the war, as well as other relevant medical-military literature. Results: The Corps functioned effectively and, in fact, served as a new health care system for the Croats in Bosnia and Herzegovina. It was initiated, planned, and operated voluntarily by members of the medical community, established before the defense forces, and later incorporated within them, but retaining its autonomy. Conclusions: The development of the Corps represents a unique phenomenon in the history of military medicine.

Introduction

We physicians tend to remove ourselves from the sometimes sordid areas of politics and armed conflict so that we can focus on values of personal medical care and humanitarian assistance. For more than a century, many examples of valor, self-sacrifice, and humanitarian activities of physicians during armed conflicts have been reported. The 1992-1995 war in Bosnia and Herzegovina (BH) was no exception, and humanitarian work performed received wide attention.1-3 Despite great physical and psychological strain,4,5 with physicians and medical institutions targeted directly and intentionally,6,7 they adhered to the highest moral principles and exerted tireless efforts in optimally treating all people.6,8 Nova Bila is a small village where local physicians and Franciscans established a war hospital in a church in 1992. This small medical community provided one of the many examples of efforts to maintain medical care in the midst of war and of commitment, determination, and willingness of physicians to work together through difficult times.9 Sometimes, however, these do not suffice. An armed conflict may confront the medical community not only with professional but also with critical, nonmedical demands, which physicians cannot ignore and where they have to undertake organizational tasks for which they are not educated or trained, with there being no one else able to perform them. Such was the precarious state in which the medical community of the small Croatian population of BH found itself at the outbreak of the 1992-1995 war. Croats in BH numbered only less than 800,000 people. The attacking Serbian forces had an enormous material and logistic advantage over Croats and Muslims who had no preorganized defense, military experience, or knowledge of military medicine. There was rapid, extensive destruction or occupation of the sparsely available medical facilities in areas populated by Croats, and heavy losses were inflicted on the civilian population of the country. The entire system of administration and services, medical services included, was collapsing.10

A few weeks before the outbreak of war, several Croat physicians in BH, sensing that Serbian aggression was imminent and aware of the insufficient medical infrastructure, began to plan and organize the establishment of improvised war hospitals, field medical stations, routes, and vehicles for the evacuation of casualties and for the provision of supplies. The network growing out of their plans became the Medical Corps that later became part of the Croatian defense forces in BH.11

There are many publications describing establishment, organization, and functioning of war hospitals under difficult conditions in many Croat-populated parts of BH.12-17 There are also reports on activities of one hospital in Croatia, bordering with Northern Bosnia18,19 that cared for casualties from that area and on another hospital bordering the country in the South that served as the secondary and tertiary institution for the wide battlefront in south BH.20,21 However, each of these interesting and valuable reports described isolated, local activities in various parts of the country.

The purpose of this article is to present a more complete picture of the efforts of the Croatian medical profession of BH in the planning and setting up of the network of the units, their organization, management, and provision of supplies that led to the formation of the Medical Corps.

Background

Before the 1992-1995 war, BH was one of six republics within Federal Yugoslavia with 51,129 km^sup 2^ and a population of 4.3 million, consisting of three nations, officially equal and constituent; they were Muslims (43.4%), who later called themselves Bosniacs, Serbs (31.2%), and Croats (17.4%), the remaining 8% consisting of various minorities. On February 28, 1992, BH proclaimed its independence after a vote in the parliament and a referendum with Serbs voting against. In April 1992, the Serbian aggression started aiming to occupy BH by force. The war ended in November 1995. (Table I describes its main time frame.) Croats successfully defended most areas in which they were the majority but lost to the Serbs a major part in northern and some areas in central Bosnia where they ended up in enclaves surrounded either by Bosniacs or Serbs. Fatalities were huge on all sides, but exact data are not available; it is estimated that nearly 250,000 people were killed, 20,000 of them Croats (i.e., 2.5% of the prewar Croatian population of BH).22 There also were a high number of wounded and displaced persons.