A new hospital but few patients

Sasa Ivic is an anesthesiologist's assistant at a new hospital that opened five weeks ago in this Serb enclave in central Kosovo. The problem for Mr. Ivic is that there is no anesthesiologist to assist. And without an anesthesiologist, there can be no operations.

The hospital's operating room, with its gleaming tiles and shiny new machinery, sits dark and unused. Down the hall is a delivery room, but no obstetrician. The hospital has only three doctors, barely enough to stay open.

"We have patients, but we don't have doctors," complained Mr. Ivic. And not that many patients, either.

This near-vacant Serb hospital is a casualty of the growing struggle for power among the Serbs who have remained in Kosovo. It also illustrates how long the reach of Yugoslav President Slobodan Milosevic is. His Army and police were driven from Kosovo last June, but his regime continues to exert powerful influence from afar. The struggle is of deep interest to Western officials, who are trying to encourage leaders who are willing to work with them. So far they have not succeeded.

The Gracanica hospital was meant to be part of a much-larger effort by the international community to improve the living conditions of Serbs who still remain in Kosovo, and thus to encourage them to stay. Since NATO-led troops occupied Kosovo last year, half of the province's 200,000 Serbs have fled. Of the 100,000 or so who remain, most have retreated into all-Serb enclaves, where peacekeeping troops give them protection.

For political reasons, a hospital is badly needed. In purely medical terms, it's superfluous. Normally, seriously ill medical patients would go to the state hospital in Pristina, 10 minutes away. But since last summer, Serbs have no longer been welcome there. For anything that the local clinic cannot handle, Serbs have gone to a Russian military hospital about 15 minutes away, or traveled outside Kosovo.

Financed by the Greek government and Doctors of the World, the Gracanica hospital was meant to change this. But it was soon caught up in a different conflict than the one between Serbs and ethnic Albanians in Kosovo, this time among the Serbs themselves.

Serb doctors who might have worked in the new hospital were warned not to by the Yugoslav Ministry of Health in Belgrade. They were told they would lose their Yugoslav pensions and health insurance if they did. In some cases, says the hospital's medical director, Dr. Rada Trajkovic, they received personal threats. "They all want to work here," says Dr. Trajkovic. "They call me almost every day. But the [Milosevic] regime is threatening them."

The hospital is at the nexus of a struggle with at least three sides. On one side are moderate Serbs, including the leader of the Serb Orthodox Church in Kosovo, Bishop Artemije. These Serb leaders have expressed a willingness to cooperate with the West. They have frequent contact with the Western officials, including American officials like Secretary of State Madeleine Albright. They have denounced the Milosevic regime and have tried to foster connections with Serbia's political opposition.

They are opposed in part by more defiant Serb leaders in northern Kosovo, where Serbs live in an enclave that adjoins Serbia proper and is virtually cut off from the rest of Kosovo. These leaders have less to gain by cooperating with Kosovo's UN administration. While their relation to Mr. Milosevic remains unclear, they have resisted Western efforts to integrate northern Kosovo with the rest of the province.

On the third side are Milosevic and the Yugoslav regime. In February, American and NATO officials accused Milosevic of using his police to stir up trouble in the town of Mitrovica. In fact, Milosevic's influence reaches almost everywhere in Kosovo where there are still Serbs. Kosovar Serbs read the regime's newspapers and watch its television broadcasts. Because Kosovo is still officially a province of Serbia, Kosovar Serbs also are eligible for Yugoslav social services. Because of Yugoslavia's dire economic conditions, such benefits are not generous. But the prospect of losing them, and of being cut off from the Yugoslav state, was one of the things that made Todorka Slavkovic, a nurse, think twice before she went to work at the Gracanica hospital.

"We're all afraid," she says. "But we want to work here."

The Kosovo Serbs have always been divided between those willing to cooperate with the West and those determined to defy it. But the split widened last month when the moderate Serbs, led by Bishop Artemije, agreed to participate in an administrative council made up of Kosovars and international officials. This council, formed late last year, is part of the United Nations effort to share power with local officials. Until recently, the Serbs boycotted it.

After the agreement, a mob of more than 100 Serbs attacked the 14th-century monastery in Gracanica where Bishop Artemije makes his headquarters. Church officials blamed the attack on extremists sympathetic to Milosevic, but it reflected a broader lack of support for Serb moderates. "We don't have any political influence," Bishop Artemije acknowledged recently.

The West is trying to change this. It is importing opposition newspapers into Kosovo and is trying to help moderate Serbs start a radio station. "This is a really important struggle, a struggle for truth, a struggle for the souls of people, who are in danger of being taken in by a very brutal regime ..." says the Rev. Sava Janjic, a spokesman for the bishop.

The West also is trying to help the moderates by showing Serbs that cooperating with the West yields results. Kosovo's UN administration has begun to offer special services to the Serbs, including buses that travel between the enclaves. It is giving more help to Serb schools and health clinics. "It's very important to be able to demonstrate that there are other Serbs willing to help them, that they don't have to depend on Belgrade," a Western diplomat says.

For now, Milosevic and the more defiant Kosovo Serbs have the upper hand. The primary-care health clinic in Gracanica is run by doctors still loyal to Belgrade. It is a dingy place, but it is amply staffed and busy. "A hospital is a good idea, for the Serbian people and no one else," Dr. Mice Popovic, the senior doctor at the clinic, says brusquely. "But it should work under the Serbian government and not under the UN."

(c) Copyright 2000. The Christian Science Publishing Society