Serbia Trip Report
By Verica Seničić, Dr. Ivan Aksentijevich and Zoran Mladenović
Together with Verica Seničić, SAMA-Serbia board member, Dr. Ivan Aksentijevich and Zoran Mladenović visited Serbia during the week of October 3rd. Their goals were to evaluate the conditions of various hospitals throughout the country and identify projects for future funding.
KEY TAKEAWAYS FROM THE TRIP:
- SAMA’s work truly impacts many lives and makes a real difference.
- SAMA’s donations are appropriate, are not being misused and are fully utilized.
- Except for the very few, doctors and nurses are dedicated and absolutely know what is right for their patients.
- The lack of sufficient funding is obvious and overwhelming. However, wherever there is leadership and personal initiative, there is clear improvement and progress. As we would say: “Where there is a will, there is a way”.
- Institutions depend heavily on donations. Some of them even include potential donations as a point item in their budget. Many organization, government agencies, and individuals from the EU, US/Canada, and Australia contribute donations. However, this help is so fragmented that it clearly does not reach the potential it could have if it was synchronized under a systematic and united strategy. It is our objective to reach out as far as we can and hopefully maximize what SAMA can do for health care in Serbia.
Below is the trip report in more detail.
This past October, we visited several hospitals and health centers and met with numerous doctors and other health professionals. The objectives of our trip were to verify the completion and appropriate use of SAMA’ s previous donations, identify future projects, and to better understand the ongoing issues and challenges of the health care system in Serbia.
It is worth noting that no SAMA funds were used for this trip, as each of us covered our own travel expenses.
We visited hospitals in Vranje, Leskovac, Užice, Sremska Mitrovica, Smederevo, Pančevo, Belgrade (Children Hospital – Tiršova) and Health Centers in Lučani and Požega. We also met with Dr. Zoran Milosavljević, Deputy Director of Valjevo hospital, Dragoljub Prijić, General Manager at SRMA Group, Zorica Prtain director of Medigala, Dragan Čukalović and Bratislav Pejčić from Vlasotince and Marko Jovanović who helped us with the SAMA web site.
During our trip, we had numerous media appearances, trying to spread the message about SAMA, how the organization operates and what has been done over the past 3-4 years to help health care in Serbia. In addition to coverage of local media during our visits to Vranje and Lučani, we also appeared on the Radio Belgrade 1 morning program(“Uhvati Dan”), on the main news program on RTS1, and on magazine show “Tako Stoje Stvari”.
Vranje Hospital Pediatrics Ward (Southern Serbia)
The Department of Pediatrics occupies a 3 story building, with the ground floor serving for out-patient care and triage, while the second and third floor are being used for children who need in-patient care. Each year, just about 10,000 children visit this institution, and between 2,000 and 2,500 end up being hospitalized for further care. Last time this department received any type of investment or donation was in the 1970s. During our trip in September 2015, we identified that the department of pediatrics was in dire need of help.
Over the past year, SAMA invested $27,000 toward material and labor to remodel the in-patient pediatric wards. The initial focus of SAMA’s project was to completely rebuild the toilets and showers on the second and third floors, as well as create an in-patient isolation unit, which includes two patient bedrooms and a bathroom. In the later phase of this project all the floors were replaced with top quality materials specifically approved for use in medical institutions.
Leskovac Hospital, Department of Medical Oncology
Dr. Goran Živković, with his colleagues and staff gave us a tour of their institution, which was in the middle of being remodeled. It is worth noting that under the leadership of Dr. Živković, they were able to secure non-governmental funds to remodel the ward, get new treatment chairs and in-patient bed. They requested help purchasing infusion pumps.
Dr. Milena Stanković, Director of pediatric dentistry in Vlasotince, asked SAMA to help with the acquisition of a pediatric dental unit (chair, suction, lamp, motor, etc…) to help with the care of pre-school children who suffers from dental health and oral hygiene issues. Depending on what is included in the system, the estimated worth of this possible donation is between $2,000 and $10,000.
Užice Hospital – Trauma Center
We met with Dr. Aleksandra Vračarić, deputy director of the Užice Health System (including the hospital) and Dr. Dara Savić-Božović, head of the Pediatrics and Neonatology Department. As the fourth largest hospital in Serbia, Užice has struggled to meet the growing healthcare needs of the community it serves; the situation is made worse by a lack of functioning ultrasound machines. Unfortunately, the hospital does not have the financial means to purchase a new ultrasound machine, which costs approximately $25,000. This has become a very worrisome situation that has limited the delivery of health services to about 350,000 inhabitants of the Zlatibor district. In 2014, the radiology department performed 16,138 examinations. To make things worse, 2015 registered a 70% increase in the number of studies, totaling 27,386 cases (11,000 in-patient). In addition to this, the hospital does not have a defibrillator on the Pediatrics and Neonatology wards.
It should be noted that the Health System in Užice receives government money only for staff salary, and they are not receiving any money for the purchase or servicing of equipment. The estimated cost for both a stationary ultrasound with multiple probes and a defibrillator is about $30,000.
Update October 2017: SAMA has donated new ultrasound system and defibrillator to the Užice Hospital. You can find more details about this project here.
Lučani Health Center
The Health Center in Lučani serves a municipality of about 20,000 people. Together with the Health Center in Guča, it also serves 8 rural clinics, which are visited by doctors on a weekly basis. Lučani was affected twice (2014 and 2016) by flooding. While they were able to reconstruct most of their facility, they were not able to replace the only autoclave (sterilization unit) and a needed 12-lead EKG.
In May 2016, SAMA collected the necessary funds during the second annual “Walk for SAMA” fundraiser, and purchased both instruments, which totaled $13,000. The impact of the autoclave is significant, as it allows for the physicians to perform procedures requiring sterile instrumentation, such as delivery, and repair of small traumatic injury. The EKG is also crucial both as a tool for screening and to evaluate acute cardiologic disorders.
You can find more details about SAMA project for HC in Lučani here.
The director, Dr Gordana Gašović and physicians and staff were very thankful to all the SAMA donors. Please take a look of the report emitted on Telemark Čačak TV.
Požega Health Center
In 2016, SAMA donated a portable ultrasound, valued at $15,000, to the Požega Health Center. During our visit, we were able to confirm that the instrument is being fully and appropriately used. Every month, Dr. Marija Stojanović performs more than 200 studies on pregnant women, babies, children and adults.
You can find more details about this project here.
University Children’s Hospital Tiršova, Belgrade
One of the most common disorders affecting newborns is hyperbilirubinemia (an elevated bilirubin level in the blood). This is particularly a problem for premature babies whose brain tissue is more sensitive to the toxic effects of elevated bilirubin in the blood and are more at risk for developing brain damage and hearing loss. The standard procedure for the patient is to have a bilirubin level measured on average 3 times per day for 3 days. Currently, the hospital is able to measure bilirubin levels from blood obtained via venous or capillary puncture, which is quite painful for the child and can lead to fear, stress and sleep disorders. Also, this method exposes the children to a risk of infection. Annually, about 1,650 laboratory tests of bilirubin level are performed, which inflates hospital costs. The use of a transcutaneous bilirubinometer could easily improve the outcome associated with the diagnosis and treatment of these children. Not only is this instrument less abrasive to children, but it would also represent a cost savings of $1,200 per year for the hospital. The estimated cost of the instrument is $6,000.
Update August 2017: SAMA donated a new billirubinometer to Tiršova Hospital. You can find more details about that project here.
Visit to Sremska Mitrovica Hospital
In Sremska Mitrovica, we visited the Department of Pediatrics where we met with Dr. Ljiljana Bančević, Head of the Department, and Dr. Nenad Golubović. They run the only pediatric department in the Srem region, serving 4,000 out-patient children with about 1,000 hospitalizations every year. Many of the children undergoing treatment are affected with pulmonary disease, or other upper air-way infections. As part of the care provided, they often have to give these children oxygen, which is of vital importance. The department seems to be in pretty good shape, and at the moment they are able to help these children by bringing oxygen bottles from other buildings. Unfortunately, sometimes the bottle runs out of oxygen, and they have to run to get a new one from elsewhere, putting the children at risk. They have requested our help to stock oxygen in the outpatient department. This project would cost an estimated $1,500.
Update August 2017: SAMA financed installation of oxygen supply to the pediatric ward. You can find more details here.
Without exaggeration, we can say that the hospital in Pančevo has the worst internal medicine department we have seen so far in Serbia.
The hospital received donations from the EU in the early 2000s, which were used to remodel the surgical block of the hospital. Unfortunately, these funds were not sufficient to remodel the hospital admission and urgent care area, and the internal medicine wards. The whole story is not very clear, but apparently a contract to design the remodeling project ended in dispute, making it impossible to start construction.
The hospital’s poor financial condition has left the medical floor in a deplorable state and lacking most basic necessities including: patient beds, mattresses, sheets, nursing uniforms, basic furniture, examination tables, ultrasound machines, equipment to measure blood pressure, basic surgical instruments, autoclave, baby scales, wheelchairs, transport beds, bed side commodes, cleaning material, staff uniforms, etc. This is frankly a CATASTROPHY for both patients and health care providers, and an embarrassment for the administration.
The estimated cost for reconstruction of the medical floors: $100,000+. The estimated cost to furnish the supply material: $30,000+. The latest we have heard, is that the city of Pančevo has come up with a solution, and that work may start soon (link). To be followed…
Verica, Ivan and Zoran