Contact: Jennifer Leaning, M.D. (781) 259-9108 / (617) 909-3559
        Barbara Ayotte (617) 695-0041 ext 210 / (617) 549-0152
 
MEDICAL GROUP DOCUMENTS SYSTEMATIC AND PERVASIVE ABUSES BY SERBS AGAINST ALBANIAN KOSOVAR HEALTH PROFESSIONALS AND ALBANIAN KOSOVAR PATIENTS

        The systematic Serbian oppression of Albanian Kosovar physicians in  Kosovo has escalated drastically since the conflict began in February 1998,  according to preliminary findings released today from a two-month study by  Physicians for Human Rights (PHR). Abuses committed date primarily from late summer and fall of 1998 and extend into the period beyond the  Holbrooke/Milosevic agreement on October 12, 1998.

        The Boston-based group documents a pattern of Serbian intimidation of  Albanian Kosovar doctors, jeopardizing the already fragile health care system in a time when Kosovars returning to their villages are in greatest medical  need.  The intimidation is marked by instances of murder, torture, detention,  imprisonment, and forced disappearances of ethnic Albanian Kosovar  physicians. The PHR study, which will be released in early 1999, also cites cases of Albanian Kosovar patients who have been abused by Serbian police  and Serbian health professionals, including instances where patients have  been beaten, chained to beds or radiators, and placed under constant armed police guard.

        The health and human rights group, whose key recommendations were  transmitted in a letter sent today to Yugoslav President Slobodan Milosevic,  also cited interrogation and harassment of Albanian Kosovar physicians,  including threats of death, by Serbian police.  Medical facilities operated by  ethnic Albanian Kosovar physicians have been searched, property confiscated, and many clinics and health centers in contested areas have  been burned to the ground.  Ambulance transport has also been interrupted.

        "Attacks on health facilities, doctors, and their patients are war crimes,"  said Jennifer Leaning, M.D., a member of the PHR board of directors and one  of the lead researchers in the study. "Albanian Kosovar physicians attempting to provide assistance to people living in areas of conflict or currently or previously controlled by the Kosovo Liberation Army (KLA)  have been harassed and hunted in a campaign that disregards norms of  medical neutrality that are protected under international human rights and humanitarian law," said Leaning.  “The Serbian authorities have defied the principle that civilians and combatants alike are entitled to medical treatment  in times of conflict. Instead, Serb police have branded medical practices as  acts of “terrorism” and abused physicians and patients, calling them  “terrorists”.  Further, by attacking community leaders such  as physicians and creating fear throughout the population, the Serbian  authorities are conducting a campaign against ethnic Albanian civil society."

        The Geneva Conventions, including both Protocols, specify an extensive  array of protected acts, persons, and facilities in the delivery of health care to  civilians and combatants, in a wide range of conflicts, including the one now  being waged in Kosovo. Wounded persons not engaged in combat,  including civilians, are entitled to medical care.

        There has been a long history of discrimination against ethnic Albanian  physicians in the Serb-run state health care system in Kosovo--mass firing  from employment in 1990, elimination of training opportunities in state  medical schools and hospitals, and requiring the use of the Serbian language  rather than Albanian in all interactions with patients, including the writing of  prescriptions and instructional materials. During the same time, ethnic  Albanians have been impeded access to the state-financed health care  system. The current oppression of ethnic Albanian Kosovar health  professionals, however, has acquired an acutely violent character.

        The PHR team, composed of three physicians, one lawyer, and two  health researchers, conducted interviews with 105 individuals in Kosovo from  October to December 1998, collecting data relating to 75 cases of alleged  abuse of Albanian Kosovar health professionals and patients and 52 cases of  physician flight from Serbian threats.  The individuals interviewed included physicians, lawyers, representatives from major humanitarian organizations,  and eyewitnesses to abuses against Albanian Kosovar physicians and  patients.  Many of those interviewed requested anonymity for fear of reprisal  from the Serbian authorities.

        The widespread abuses committed by Serbian authorities against  Albanian Kosovar physicians and other health workers include:

Murder

        The PHR team investigated the murder of one Albanian Kosovar  physician who was tortured and killed because he was fulfilling his  professional obligation to provide care to patients in need.  Dr. Leci,a general  practitioner in a private clinic in Gradice was hunted by Serbian police on  September 24-25, 1998 and killed sometime between September 24-27.   Confirmed reports state that his body,when found, revealed that his right  hand had been cut off.

        Another leading physician in the ethnic Albanian Kosovar community,  not one known to have taken an active role in delivering medical care in KLA- contested areas, was killed on the evening of November 18, 1998 in  suspicious circumstances.  Dr. Zejnullahu, a physician in the town of Pec,  was attacked by three masked men who spoke fluent Serbian, carried  Kaleshnikovs, and fired several lethal shots at close range while Dr.  Zejnullahu’s family was by his side.

Detention/Arrest for Delivering Medical Care

        Albanian Kosovar physicians have been accused of crimes despite the  lack of credible evidence of criminal acts. PHR has documented four cases of  physicians held in detention and five cases of  physicians brought to trial,  with four of these resulting in convictions.PHR has also received  unconfirmed reports of many physicians in custody, which it is currently investigating.

        One physician told PHR he was arrested while trying to calm patients  who had rushed into a clinic in advance of a Serbian attack on his village.  Another was arrested while returning home after fleeing from a Serbian  advance on his town, and a third was arrested while maintaining a home  supply of medical drugs in a KLA-controlled area deprived of medical  supplies.

        In these cases, the physicians were alleged (whether formally charged or  not) to have engaged in the practice of medicine on behalf of people labeled  “terrorists” and thus have committed acts of terrorism themselves.  The  charges are brought under Articles 125 and 136 of the Criminal Code of the  Federal Republic of Yugoslavia and, in the cases where PHR has confirmed  that these charges have been applied, Serbs have extracted confessions from  physicians and imposed inhumane prison conditions.

Torture/Physical Abuse

        Albanian Kosovar health workers reported many instances of  torture  and/or physical abuse by Serbian authorities while in police custody. PHR  has documented six cases of physical abuse and threat of abuse by Serbian  police.  Physicians reported that the abuse usually occurred within the first  three days of detention, during which time the police are required to complete  their investigation and present findings to an investigating judge.

        In the cases PHR documented, four Albanian Kosovar physicians were  beaten by hand or stick applied to torso or hands; one physician had a  plastic bag wrapped around his head, resulting in near suffocation, and  another was threatened with electric shock.

        A physician who requested anonymity told PHR that the Serbian police:

        “…beat me like an animal; they beat me with the gun butt, but they  were kicking me, they beat me with their fists…in the police station.  I had  to sign everything they wanted to stop the torture.. I signed one paper I  wasn’t allowed to read.”

        Police attempting to extract a confession from another physician asked  him several times a day if he had changed his mind about cooperating. He  was summarily beaten when he declined to “confess”. Such confessions  have been used as the sole evidentiary basis for subsequent cases.

Search of Medical Facilities/Seizure of Supplies/Destruction of Medical  Facilities

        PHR has received reports of many instances and documented eight  cases where Serbian police invaded medical facilities and engaged in a range  of behaviors in violation of international law: search of premises, seizure of  medical supplies, destruction of facilities, and destruction of homes of  physicians.

Forced Flight from Medical Practice

        Over half of the 54 physicians interviewed by PHR had been forced to  leave their practice entirely or had limited their involvement dramatically since  the onset of the conflict in February 1998 out of fear of Serb harassment.   Lists of physicians who have left their established place of practice are  obtainable with difficulty, since those compiling the lists and those on the  lists are in danger if their names or whereabouts come to the attention of the  Serbian authorities.

        Two lists that could be compared and validated by the PHR team  indicated that 17 health care professionals (12 physicians, 2 anesthesiologists, 1 epidemiologist ,1 dentist and 1 nurse) from the area  around Pec in northwest Kosovo had either fled the country or were in  hiding. Thirty-five health professionals from the Decan area (26 health  professionals and 9 dentists) had either fled or were in hiding. The category  of "in hiding" includes those who left or were driven from their established practice and went deeper into KLA-controlled area to continue to provide  medical care to civilians trapped in the conflict; those who left one town and  went to live with their families elsewhere in Kosovo, while continuing to  practice informally; and those who left their established sites and stopped practicing altogether.

        PHR is particularly concerned about the fate of Dr.Hafir Salja, a physician at the Glogovac Medical Center.  On April 10, 1998,Dr. Salja was reportedly arrested from a car he was riding in with two colleagues and taken  to the Pristina Police Department. The two colleagues were released but Dr.  Salja remains missing. Some reports indicate hs seen alive and had  joined the KLA, others report that he is in custody at the Military Court in  Nis. PHR has not been able to confirm either story.

Police Harassment

        The 54 physicians interviewed cited frequent police harassment and  abuse.  Over 25% of them had been brought into police offices for "informative talks", a procedure where a person is held for an indefinite period  of time and subjected to threatening questions relating to his political leanings or affiliations. Physicians traveling on the roads are vulnerable to  such police action.

         As a result, physicians who try to reach villages that have been cut off  from medical support must travel circuitous back roads (increasingly at risk of  landmine injuries) and at night to avoid the frequent police checkpoints along the tarmac roads. One physician reported to PHR that it is safer to be caught  with a gun than with medical supplies.

        PHR has received reports of four instances of police interference with  ambulance transport, including one where the physician interviewed said that  the Serbian policeman had held a gun to his head, only lowering it when a  bus rounded the curve on the main road. Another ambulance, clearly marked  with a Red Cross, was stopped in Rahovic by Serbian police so that Serb authorities could examine the bandage of the ethnic Albanian patient to  verify she had an appendectomy as opposed to a war wound. The Serbian  police beat the driver, technician and nurse and slapped the patient. They  broke the windows of the ambulance.

Abuses against Hospitalized Albanian Kosovar Patients Include:

        While not the principal focus of PHR’s study, PHR has received  numerous reports and comments from many parts of Kosovo describing  instances and a general pattern of abuse of dozens of ethnic Albanian  patients in state-controlled, Serbian-run hospitals. Informants insisted upon total anonymity and further specification of hospitals or the sources of our information would jeopardize the safety of individuals still in Kosovo.
 
        In three of the major state-run hospitals, informants provided PHR with  examples of the nature of the dozens of abuses committed against ethnic  Albanian Kosovar patients by Serbian police, including: interrogating  seriously ill patients in the hospital, despite efforts by their Albanian  Kosovar physicians to prevent this practice; chaining patients who are  considered terrorists to their beds or radiators on a 24-hour basis with armed  Serbian police guards in or just outside their rooms; and extinguishing their cigarettes on the backs of the hands of patients returning to the recovery  room from the operating room, still coming out of anesthesia.

        In one instance a post-operative patient with an external fixation devise  fixed to his femur was prematurely removed from the hospital by Serbian  police, dragged into a police station and then imprisoned.  In another case,  Serbian police were reported to agitate their batons in the wounds of patients,  risking infection and the delay of healing.

        Informants also told PHR of cases where Serbian physicians and nurses  slapped Albanian Kosovar patients because they were crying or had a  wound perceived by the staff to be consistent with a combat injury.

        Some ethnic Albanian families reported that they were prevented from  delivering food and clean clothing to their ill relatives for up to 24 hours.  Some patients’ families were extorted significant amounts of money by Serb  police and Serb physicians in order to secure adequate food, medical care,  and necessary pharmaceuticals.

        In a number of instances, PHR received reports that Serbian police  delayed taking injured men to the hospital in order to interrogate them or  arrested injured men while they were in the hospital regardless of their  medical condition and despite the protests of ethnic Albanian physicians on  staff.

        These abuses violate Yugoslavia’sobligations under the Convention  Against Torture and the Geneva Conventions, both of which it has ratified.  The Geneva Conventions stipulate that all persons in need of medical care in  war, whether civilian or combatant, and regardless of the nature of war, are  considered protected persons under the terms of Common Article 3 and Protocol II.

Abuses Against the Ethnic Albanian Kosovar Population:

        The pattern of interference with medical care and punishment of those  who try to deliver it sows widespread fear and anxiety in the Albanian  Kosovar population.  Their leaders are under attack and threat of death: as  the niece of the physician killed in Pec cried out to us, “Are they trying to kill the best of us, one by one?"

        The Albanian Kosovar physicians interviewed by PHR are afraid but, in  general, still resolute.  They feel a strong obligation to continue to serve their  people and provide needed medical care, but they are forced to be  inescapably aware of the personal danger and the danger to their families that  their insistence on medical practice now entails. A few of the physicians  interviewed by PHR showed signs of depression, even despair,and many are exhausted, on the verge of burn-out.

        The Serbian authorities, by conducting an assault on a most visible  group of community leaders and by blocking access to a service needed by  all people, particularly a people at war, have deployed a strategy aimed at  banishing the application of international law and obliterating a potent source  of comfort and support for the population.  Unless the international  community takes action to halt this assault on health care and those who provide it, the Serbian authorities will continue to pursue a policy this decade  has now made familiar: the imposition of great suffering on vast numbers of  civilians in open violation of international law and norms.

Abuses Against Serbian Health Professionals and Patients

        PHR has learned of one instance occurring on July 16-17, 1998  during the KLA offensive on Orahovic when KLA forces entered the hospital  and held a group of nurses (including 2 Serbian nurses) and patients on the  hospital premises in order, the KLA soldiers said, to ensure their protection from fighting outside.  No one was harmed and the troops left  after two days. During this instance, however, it was reported to PHR that one Serbian physician and one Serbian technician were taken by the KLA  and have not been seen since.  This report has not been confirmed but PHR  plans to continue its investigation of this incident and to report on whatever  further instances of abuses against Serbian medical staff it may find.

Recommendations:

     In separate letters sent to FRY President Milosevic and President Clinton  today, PHR urged the FRY Government and the United States and  international community to take the following immediate measures:

To the Government of the Federal Republic of Yugoslavia:

1. President Milosevic must immediately release without condition those  doctors and other health personnel who have been detained, including  those convicted, who were exercising their professional responsibility to  provide medical treatment to wounded or sick civilians or to combatants.   Such activities are protected under international humanitarian law, and  must be permitted in all circumstances in Kosovo.

2. The Serb authorities must immediately end their attacks and persecution  on both medical personnel and their patients who come from areas  formerly or currently under KLA control and permit health personnel to  operate without interference.

3.The Serb authorities must immediately end their impediments to the  transport of medical supplies and pharmaceuticals, stop all harassment at  checkpoints, and permit free access to all parts of the country to  Albanian Kosovar doctors and health personnel.

4.   The Government of Serbia should provide extensive assistance to the  local Albanian medical community for purposes of rebuilding and re- equipping the clinics and hospitals that its forces have destroyed in the  course of the past year.

To the United States Government and Countries Engaged in Monitoring the Conflict in Kosovo

Neither the agreement brokered by Ambassador Richard Holbrooke nor  the October 1998 Organization for Security and Cooperation in Europe  (OSCE) Agreement to place a verification mission in Kosovo includes an explicit human rights mandate or makes specific demands on the FRY government with regard to ceasing human rights abuses.  Therefore,PHR recommends that:

1. A human rights component must be incorporated into the Kosovo  Diplomatic Mission  (KVM) mandate and given high priority.  A  suitable number of personnel placed in the field should have  adequate training in human rights principles and human rights monitoring.

2.The protection of members of the Albanian Kosovar medical community and their patients must be a top priority in all diplomatic dealings with Belgrade.  The representatives of those governments  involved in the KVM must exert themselves to the maximum possible  extent to  provide protection and assistance to Kosovo's beleaguered civilian population, including physicians and other  health personnel in the performance of their duties.

3.The Kosovo Diplomatic Mission should make every effort to set up  local offices throughout Kosovo, particularly in those areas that  were once under KLA control or are under KLA control now. The  diplomatic monitors should live in the communities and open readily  accessible offices where they can receive witness testimonies of   human rights abuses.  Monitors should be guaranteed the right to  travel to any site.  They should report publicly on all incidents,  including impediments placed on their access by the Serb authorities.

4.The international diplomatic community, including the KVM monitors, should monitor and denounce the persecution of independent Albanian Kosovar doctors and health professionals.  They should attend trials of doctors and medical personnel, protest harassment, imprisonment, and other abuses, and  accompany the independent doctors whenever possible when they  deliver medical services, particularly to areas of former or present  KLA control.  International monitors should also be present at State- run hospitals and clinics to help deter abuse and discrimination  against Albanian Kosovar patients.

5.Diplomatic monitors should be present at every place of detention or  imprisonment to deter abuse and torture of detainees and to help assure the regular access of the International Committee of the Red  Cross to those in detention.

6.The International Criminal Tribunal for the Former Yugoslavia (ICTY)should open criminal investigations into the destruction of health clinics and hospitals and the murder bySerb authorities of at  least one and perhaps two Albanian Kosovar doctors as violations of international humanitarian law within the Tribunal's purview.
 
7.International humanitarian organizations should continue, to the maximum extent possible, to collaborate with local independent Albanian doctors in Kosovo, employ them to participate in mobile clinic visits to displaced communities, share with them supplies and pharmaceuticals, and cooperate with them to rebuild the network of  independent health clinics that were destroyed by the Serb army and  police.

To the International Medical Community

    PHR urges the international medical communityto call for the protection of  their colleagues in Kosovo and to demand that those providing medical care  to those in need be allowed to do so.

   A full report of PHR’s work in the region will be released in February 1999.

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Physicians for Human Rights (PHR) mobilizes the health professions and  enlists support from the general public to protect and promote the human rights of all people.  Since its founding in 1986, PHR has conducted dozens  of investigations in countries throughout the world to document torture,  political killings, prison conditions, and the health consequences of armed  conflict.  As a founding member of the International Campaign to Ban  Landmines, PHR shared in the 1997 Nobel Peace Prize.  PHR has worked in  Bosnia since 1993. Its several projects in the region involve working with  the relatives of the missing: the Antemortem Database Project, the Identification Project, the Forensic Monitoring Project, and the Forensic  Needs Assessment Project. PHR has provided evidence of war crimes for  both of the International Criminal Tribunals (former Yugoslavia and  Rwanda). Charles Clements, MD, is President; Carola Eisenberg, MD, is  Vice-President, Leonard Rubenstein, JD, is Executive Director, Susannah  Sirkin is Deputy Director; Mary-Jo Adams is Director of Development;  Barbara Ayotte is Director of Communications; Holly Burkhalter is  Advocacy Director; Gina Cummings is Director of Campaigns; and Richard  Sollom is Senior Program Associate.