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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The MCHQ initiated, prescribed, and coordinated preventive activities. It ensured the provision of adequate drinking water, looked after appropriate sanitation, and performed immunization against tetanus and influenza.11 Bacteriological and chemical content of water stored in cistern tanks at the front line was tested and controlled.15 Food control was conducted by checking field kitchens, slaughterhouses, bakeries, and waste disposal. Field latrines were established and maintained. The MCHQ organized municipal boards for the health examination, selection, and deployment of soldiers and organized one supreme medical board for appeals. It formed four central depots of supplies and equipment, from which items were delivered to war hospitals and to military units. The main sources of supplies and equipment were donations by individuals and groups of Croats living in foreign countries as well as by humanitarian and catholic charitable organizations.

Organizational Aspects

With the beginning of the war, which was mainly static, the 14 planned war hospitals were activated; some were destroyed or occupied so that in 1993 there was a need to establish five additional hospitals, some very near to the front line; one had its operating theater in a private home with patient beds in the basement and triage premises in an adjoining church.13 War hospitals were of different sizes; they included 5 to 30 physicians, 20 to 70 other health personnel, and 10 to 130 beds. They did not have a prescribed organizational structure; rather they functioned according to needs, capability, and the initiative of their commanders who had considerable autonomy. For example, they could in the case of scarce local personnel retrain a dentist into an assistant surgeon, a medical technician into provider of anesthesia, or by personally calling potential volunteers, absorbing and deploying them within the hospitals. They also organized supplies through local donations. Although located within operational zones, these hospitals were under the direct command of the MCHQ.

Most war hospitals were equipped with operating tables, anesthetic machines, X-ray apparatus, basic laboratory equipment, electrocardiogram monitors, and other medical equipment14,15,17. Most of the equipment came from donations that were solicited, organized, and supplied by the MCHQ. However, one hospital had only one operating suite with a wood-burning autoclave.16 Some hospitals were independent of outside energy,14,15 others had only intermittent electrical supply.16Most had several donated ambulances and other vehicles. The personnel consisted of local general practitioners and other health professionals, strengthened with surgeons, volunteers who sometimes came (solicited and coordinated by the MCHQ) as complete, surgical teams from Croatia, working in the hospital for 7 to 14 days in rotations,12 or in some situations for long periods.14,15,17 There were also teams from other countries and Croat physicians volunteering individually (usually born in the affected areas, with families still living there). Two first such hospitals began functioning even before the CDC and field military units were established.12,17