Vladimir J. Simunovic, MD, PhD
Split University, Croati
During the war in Bosnia-Herzegovina the number of health care professionals declined precipitously. None of those who stayed were trained or mentally prepared to work under war conditions. Nobody had taught us skills that would be useful in war, and some of us found ourselves in roles we never expected to play.
New times and one accidental hero
The rules of civil society do not apply in war. Suddenly we realized that authority and power lie in the hands of those with guns. In Sarajevo under siege there was no regular army structure, and the city’s defense forces were organized on a regional principle, meaning that almost every neighborhood or district had its own gang led by a warlord, usually a former or actual criminal. The politicians opened the doors of the jails and madhouses, letting robbers, rapists, and killers to walk free. New players entered the scene: the warlords Juka, Rifle, Crow, Baldy I – VIII(there were really so many Baldies, as this was the most popular nickname), also Aba, Cannon, Grandpa, Saber, Khan, Pearly, Uncle, Rusmir “The Russian”, and dozens more. Their underlings came from the same social pool, perhaps uneducated but not naïve. They organized the gangs under the name of “military police” or “special police forces” and continued what they knew best: stealing, black-marketing, smuggling, and killing if necessary.
Each gang had its own headquarters, with kitchens and prison, a fleet of stolen cars, fuel tanks and a warehouse full of liberated goods. The town was carefully and strictly divided, and many inner-city battles were fought because someone had intruded in someone else’s territory. The hospital, unfortunately, was their favorite place for wandering. There one could meet them at any time of the day, enraged, drunk or drugged, barging in everywhere, even in operating rooms during surgeries. On such occasions the doctor in charge had to project the image of a resolute and fearless person, annoyed as hell and demanding that they behave. Their first response was simple, they pointed their guns at me to show who is in charge. Pretending not to be scared, I would tell them that in that case they could do the surgery themselves. Confronted with such an option, they would try to calm down the mad doctor, apologize, and retreat. Perhaps the biggest compliment I received was when after a harsh exchange one of the chieftains said that he respected my request, because “you ain’t one of them, you are one of us.”
Role of negotiator
I had to make my new role work to my advantage, because I had many other roles to play, including that of negotiator. In spy novels this is called “building a legend,” and a legend was what I had to create. But heroic ultimatums did not always work. Often one had to resort to lengthy negotiations. The most unpleasant ones were at the beginning of the war, when some characters forced their entry into the hospital and tried to take away a wounded war prisoner to torture and execute him. Another time an officer came to take hostage a young surgeon in order to exchange him for his captured brother. Several times I had to visit “prisons” (each paramilitary unit had at least one) and negotiate the release of colleagues. Their favorite victims were a professor of thoracic surgery, who after four ”imprisonments for interrogation” was killed, and a urologist who survived and now lives in New Zealand. Often all arguments fell on deaf ears, and their brutal perverseness could be confronted only with decisive resolve.
Negotiations became part of everyday life. It was almost always a question of survival. At times one had to persuade a chieftain that diesel fuel for hospital generator was more important than their mad racing through town in stolen cars. Not an easy task, not at all. In hospital we had a small but thirsty generator that needed thirty liters of diesel per hour to run, and we enshrined every drop as holy water. One night a small-time chieftain came to the hospital to tell me, grateful for who knows what, that his men had liberated some diesel fuel and that as a good citizen he would donate some of it to the hospital. But then the self-appointed general and war leader Baldy IV heard about this and sent his heavily armed men to seize our diesel reserve, “because the General needs it for military activities!” But on that night Baldy I, chief of military police, coming to the hospital to see how his men were recovering, was told that one of them needed surgery, but could not have it because Baldy IV had seized every drop of diesel fuel.
Baldy I growled with contempt: “What a scumbag. Come with me.” We sat in a Mercedes that I recognized immediately as belonging, before it was liberated, to a friend of mine. We found Baldy IV in his favorite tavern, so drunk that he could not stand up and hardly able to speak.
“My Brother,” asked Baldy I, his voice sweeter then honey, “I heard that you cleared out hospital’s diesel reserve, and they cannot operate anymore. Is it possible? You said you need it for your military activities? What activities, if I may ask?”
Brother tried to stand up, “No, I did not, I would never, I respect the doctor, he takes good care of us and he is one of us.” Then adding with a cunning smile: “I just said to my boys that I needed some gasoline for our cars and I had no idea that they will pillage the hospital.”
Baldy I had enough: “Is that so? Bring all diesels back, up to the last drop. Otherwise, I will confiscate all of your cars, and you will not need fuel at all.”
It was a formidable threat. To be in war time Sarajevo without a car meant to be without means of transportation, and to be deprived of status. Anyhow, the fuel was back the same day, with several cartons of Marlboro cigarettes as apology. From this day on nobody ever tried to satisfy his needs at the expense of hospital.
Role of the bodyguard
As the city was under siege and all external supply lines cut, shortages of medicine, solutions, and medical materials became immediately evident. Many months would pass before the first humanitarian aid was allowed to enter the city. In early summer of 1992 electricity transmission was cut, resulting in a total blackout and cutting off the water supply, probably one of the most terrifying experiences one has to endure.
In my department, the very prominent warlord Rusmir “the Russian,” who had some “unsettled business” with another famous warlord Juka, became a patient. Thanks to his presence, we were told to expect an attack from Juka’s “Wolves.” One night, because the Russian’s bodyguards had to leave the hospital to defend their territory, I was given a pump-action shotgun, (ideal, they explained to me, for close-quarter battle) and was instructed to shoot anyone who approached the boss. “This gun shoots when you hold it and move to and fro – I was told – and you don’t even have to aim, just shoot. Everybody in the corridor at a distance of twenty meters would be dead.” So I spent the night (until four in the morning, when his bodyguards came back) sitting in my office, door open, expecting an attack, feet on my desk, shotgun across my lap, with half a bottle of whiskey given to me by “the Russian” to raise my spirits. Nobody attacked, the opponents probably having heard of the fearless and utterly dangerous new bodyguard. And everybody believed that I was that brave one.
Vladimir J. Simunovic. Balkan Army Surgical Hospital – B.A.S.H.: Recollections of a wartime neurosurgeon. Charleston, SC: CreateSpace Independent Publishing Platform: 2013. ISBN 978-1489528957.
trained in Sarajevo and at Harvard and New York University Medical Center. He is professor of surgery and neurosurgery, and worked as head of the neural trauma service in the Sarajevo (1985-92), in Sarajevo and Mostar war hospital during the 1992–95 war, as Deputy Surgeon General in Sarajevo (1992–93); as Adviser to the Minister of Health; and team manager in health related projects of the World Bank). He also worked as vice-dean for science in the School of Medicine at Mostar University, and professor of medicine and chair of medical humanities and clinical skills at Split University (2009-2013).