In Sickness and In Health

Crossing borders always presents the potential for a hold-up. When I prepared to cross the border from Macedonia (or Skopje if you are Greek), into the tiny nation of Kosovo, preparation was the key. I had one mission: to visit the hospital in the capital, Pristina. I travelled by car to the border where a contact of mine in Macedonia had arranged for another car to meet me and drive me across to the other side. I would be travelling with an ethnic Albanian who was well-versed in dealing with the officials. Macedonia has experienced its war wounds in recent years but in Kosovo these wounds are healing but very visable. Lines of hardship tell the story of the past across many faces that I saw.

The border is still protected by UN peacekeepers and unfortunately, violence and ethnic clashes are daily. However, the country is also fighting for its re-growth and development. On the motorway not far from the border is a state-of-the-art service station complete with a widescreen TV in the forecourt. On entry to Pristina are scores of newly built houses.

We headed straight to the hospital. Set on a huge compound, the buildings are deterioated and very tired. Here is the heart of the people’s trauma where ethnicity must be overlooked. I wandered around and came across the paediatric department. The conditions were very poor. Patients often need to travel to neighbouring countries for treatment if they can afford it. Whilst medical care is, in theory, free, there is anecdotal evidence that some doctors expect payment for their services. It is difficult to locate ethics in the midst of so many conflicting battles for survival.

The country’s exterior is flourishing but what about its health? What about the body of the country? The effects of war and divided ends can only serve to spread through a new generation a fractured picture of what health means. Is health the same as survival? Is health the standing amongest the dead? Is health ever restored once the mind has experienced the destroying of humanity? The hospital certainly presented a negative picture and I left feeling very bleak. Health is as much about the past as it is about the future. I wondered what may be in store for a generation being born after the conflict has ceased but are being nursed in the living grave of a country trying to grow into independence.

I had come to the hospital to find humanity. Amongest all the suffering that the people of Kosovo had endured, would there be some shards of the human spirit still shining through? Would the hospital be the place to find this treasure? We often hear of the victim’s story. The families who have been blighted by the injuries of war and of the trauma that follows in the aftermath. And the doctors who have saved them. Somehow though, perhap as another casualty of our privileged distance, we fail to collect a complete picture of the paradoxes of war.

At the hospital, I was reminded by all the different battles I was observing, of a passage from a book called “War Hospital”. This memoir recalls the journey of a group of young doctors during the war in Bosnia-Herzegovina. In one passage, one of the doctors asks a psychiatrist “What am I doing here in all this violence?” She returns the question with the answer “When people are in violent situations, it’s usually because they’ve been there before.” Then, the reader observes the doctor’s reflection: “Now he realises what he is doing, he knows that any changes he is going to make as man must come from the inside, not the outside. His past does not condemn him to a violence-saturated future. He doesn’t need a warzone to catalyse his personal growth – he can resolve his emotional issues in other ways” (p. 209).

Medicine is even more than saving lives. There is a world within each doctor and each patient, sometimes embroilled in as much an internal conflict as there is externally. It is these wounds which a doctor can heal from through healing, that a patient can recover from through experiencing peace from another person and a country can learn how to grow again. In Kosovo, there is suffering but there is growth. In its hospital there is humanity and there is internal conflict. These paradoxes are the working of medicine and the working of the nature of survival.

Reference: War Hospital. By Sheri Fink. PublicAffairs Publishers, 2003.

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