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British doctors in Kosovo appeal for NHS help

Kevin Weaver , Kosovo

British doctors working for KFOR's peace keeping mission in Kosovo are urgently trying to secure funding for the treatment in Britain of four Albanian youngsters badly injured as a result of the war.

Based at 22 Field Hospital in Lipljan in the British sector, near Pristina, the doctors say that their attempts to arrange airlifts of the worst cases to the United Kingdom are being frustrated by bureaucratic delays. Roger Hackney, an orthopaedic surgeon working there since mid-June, told the BMJ: "We don't have the kit for specialist surgery, and most charities are not interested in secondary care as it's expensive and not very glamorous. The Germans have already ... taken over 60 children back to Germany for treatmentwe [Britain] haven't been able to take even one."

One urgent case is "Lulu," a 14 year old Albanian girl who stepped on a mine that blew off her right leg and blinded her in one eye. Charing Cross Hospital in London has told the British doctors at Lipljan that it may be able to treat the bone infection she has developed if funding is forthcoming. Lulu also needs a prosthetic limb and a false eye.

Another case involves Jehona Bogujevci, aged 9, and her cousin, Seranda, aged 14, who survived a massacre by Serb paramilitaries in Podejevo four months ago despite being shot several times. Sixteen men, women, and children died in the attack. Jehona saw seven members of her family slaughtered including her mother, elder sister, and brother. She has a bullet lodged in her back, and two other bullets punctured nerves in her arms and left leg. She urgently requires muscle and nerve grafts to both arms and a bone graft on her shattered wrist.

The Stanmore Royal Ortho-paedic Hospital in Middlesex has been asked whether it could treat Jehona if funding is found. The British government and the International Organisation for Migration are said to be keen to facilitate her treatment in Britain. Rachel Downs, planning manager at Stanmore hospital, says that the funding is available to treat both girls through the "out of area" treatment fund, but the problem is with the immigration department; the hospital is awaiting the go ahead from the Home Office, which it understands could take a fortnight. Dr Rolf Birch, an orthopaedic specialist at Stanmore hospital, who wants to treat the two girls, is frustrated at the delay: "There are no structures in place to enable speedy medical evacuations."

Lieutenant Colonel David Vassallo, a general surgeon with the Royal Army Medical Corps, also working with 22 Field Hospital, has been frantically emailing hospitals in Britain and the Netherlands to get specialist advice on complicated operations as well as funding. He uses an Olympus C1400 XL camera to take high quality pictures of operations and of x rays. He then emails these around the world for expert advice using a Nera satellite phone (worth £14000; $22400) donated by Olympus. He has so far found three UK hospitals interested in treating the four Albanian youngsters. Lieutenant Colonel Vassallo is particularly anxious to arrange extensive facial surgery for a 22 year old Albanian man, Besim Kadriu, who could be treated at Leeds General Infirmary (which has offered to pay for the treatment). Mr Kadriu, who was married only 8 months ago, was shot in the face by Serb police near Mitrovica and has lost an eye and his nose.

More than half of the casualties whom Lieutenant Colonel Vassallo has treated have been due to cluster bombs. He and Mr Hackney operated simultaneously for three hours on a 14 year old Albanian boy who had stepped on such a devicehe had to have both legs amputated below the knee and lost the whole of his left arm. "Within 20 minutes of stepping on the cluster bomb, he had arrived here by helicopter and was treated by a most experienced team of medicsone that would be almost impossible to see assembled in a normal UK hospital. But the severity of his injuries meant that we still lost him," said Lieutenant Colonel Vassallo.

The prospects for the youngsters surviving seem dim if they are denied treatment in Britain; Pristina Hospital, which is the main hospital for the whole of Kosovo, was stripped of most of its medical equipment by the departing Serbs. Most of the doctors and nurses were Serb (Belgrade sacked all Albanians in 1989), and the Albanian staff now returning to their old jobs are underqualified to deal with the current crisis.    

(Credit: KEVIN WEAVER) Doctors in plea to UK authorities: Roger Hackney (top right) Lieutenant Colonel David Vassallo (below)