Peace through health in Bosnia and Herzegovina

16 World Health • SOth Year, No. 6, November-December 1997

Peace through health in Bosnia and Herzegovina

Gregory Hess

S

Herzegovina was unrecognizable.

The damage was overwhelming.

Faces of apartment buildings were pocked by shelling and scarred by fire. Burnt-out frames of the trolley cars remained stuck in their tracks.

Barricades of destroyed cars pro- tected women from sniper fire as they risked their lives daily to collect a few litres of water from one of only two water depots open in the city.

At the western end of Sarajevo, barbed wire surrounded the airport, one of the few areas of the city under the control of the United Nations peacekeeping forces. The surround- ing area was the ground for some of the most fierce fighting in the war.

Criss-crossed by front lines, the airport was a tiny quasi-safe haven for international forces. It was here that WHO initiated its first set of reconciliation activities - almost a year before the end of the war.

At that time, water and sanitation infrastructures were non-functional.

Huge piles of garbage had accumu- lated around the city. Rivers were polluted with rubbish and untreated sewage. Comprehensive public health programmes had ceased three years previously. In these conditions, rodent populations flourished and brought with them an increasing threat of communicable diseases, including haemorrhagic fever and tularaemia.

Even during the fighting, health proved to be an issue which could be lifted above politics, hatred and war.

In the airport meetings, WHO brought together health professionals from the warring parties to discuss public health measures to protect the civilian population from rodent- borne diseases. The meetings were

Boys carrying a wounded person on a stretcher in a Bosnian refugee comp. Opponents in civil wars have the some health problems. Finding common solutions con be a way towards reconciliation. Photo WHO

secret to protect the health workers, and minutes were not taken owing to the sensitive nature of the discus- sions. Short management action plans guided those present in their efforts to prevent increased suffering of the population.

Since that time, the Dayton Peace Agreement has brought about a sustained, albeit fragile, peace. Yet restricted communication impedes efforts to strengthen this precarious peace. Restricting communication is a tool by which nationalist extrem- ists maintain and solidify their power. Moderates who seek peaceful means of conflict resolution are denied opportunities to do so. As examples, three different types of vehicle licence plates communicate political affiliations and prevent free movement around the country, international phone connections are easier than calls between the differ- ent parts of the country, and factious and monopolized media prevent

information exchange and promote tensions.

Some of the most positive and progressive developments to counter this communication repression have come about in the health sector. The ministers of health of the two entities meet regularly and have issued a Joint Statement to the International Community. Health policy-makers have met to discuss common issues.

Supplies have been exchanged be- tween communities. And joint public health interventions are being initi- ated to protect neighbouring commu- nities from common threats.

Many of these positive examples would not have occurred without the neutral umbrella and facilitation provided by WHO staff in Bosnia and Herzegovina. WHO initiatives to foster reconciliation between health professionals have evolved into a programme entitled "Peace Through Health". The fundamental objective of activities in the programme is to

World Health • SOth Year, No. 6, November-December 1997

strengthen reconciliation through priority health activities.

Communication, peace and health

Communication, in various forms, is the most important element of WHO's Peace Through Health pro- gramme. In general, health commu- nication in this context entails sharing information and facilitating contacts. Common to any of WHO's reconciliation strategies is a focus on health issues of mutual concern. The following examples illustrate some of the communication barriers to health that WHO has tried to over- come.

Health information

The misuse of information and data is one of the most destabilizing factors in Bosnia and Herzegovina.

Domestic media reporting often promotes ethnic nationalism and misrepresents information in order to strengthen political agendas and the divisions among people. Health data were particularly sensitive during the war, leaving a legacy of reluctance among health professionals to share data or trust data from another area.

In the post-war period, WHO acts as a neutral filter for presentation of data. In a position of trust and re- spect, WHO shares information with all sides to encourage open commu- nication and to promote solutions which deal with health issues, not politics.

Facilitating contacts

Isolation and polarization are two of the most detrimental long-term effects of the war. As a country, Bosnia and Herzegovina has been very much isolated. Health profes- sionals, for example, have had very few external contacts over the past five years, either directly through participation in European networks or even indirectly through literature and exposure to health develop-

17

A woman returns home through the rubble of Sara;evo. Photo WHO

ments. Furthermore, within the country, health professionals have been forced to choose sides and prevented from contact with their former colleagues.

Developing external links is a vital WHO role. As health profes- sionals from Bosnia and

Herzegovina are brought into contact with European and global counter- parts, the health sector becomes increasingly stable. On an individual level, attention is lifted from the pessimistic cycle of daily politics to a renewed hope for a peaceful and satisfying future.

Internal contacts also stimulate hope and provide some much desired relief from political pressures which stifle communication. WHO-spon- sored joint activities among health professionals ensure neutral and safe environments for the re-establish- ment of communication. When brought together, former colleagues find that they have a lot in common and reunions are often emotional. A recent meeting in Republika Srpska exhibited some characteristics com- mon to many health professional reunions in Bosnia and Herzegovina.

After the initial fears (for security and professional repercussions) subsided, the doctors quickly shifted into personal relations, asking each other of the whereabouts of former colleagues. The meeting ended with greetings for colleagues with whom

communication had been severed and an expressed desire to renew these contacts.

Protecting the health of the population is the incentive for meet- ing together. The realization that working together for health is the best- indeed the only-way forward is the incentive for future coopera- tion and collaboration. WHO is facilitating the first part of this equation by promoting opportunities for communication. If preliminary examples hold true in the long term, health professionals in Bosnia and Herzegovina will carry this momen- tum forward, creating constructive dialogue, a stable health sector, and a catalyst for other people also to choose peace and reconciliation. •

Gregory Hess is Public Information Officer, World Health Organization Regional Office for Europe, Bosnia and Herzegovina Office, c/o Public Health Institute, Marsala Tito 9, 71 OOO Sara;evo, Bosnia and Herzegovina.