“The biggest problems are the traumata”

A review by humedica doctor Caterina Schulte-Eversum

by Caterina Schulte-Eversum/LKO,  2015/07/21

The distress of the people in Kosovo is not always visible at first sight. After all, this small Balkan state is situated in the middle of Southern Europe and has been supported economically with comprehensive subventions after the war in the 1990s. But the appearances are deceiving: With an unemployment rate of more than 30 percent, massive social inequality and a poor health system, most of the Kosovars live under the most difficult conditions.

With regular missions of teams of doctors, humedica assures the basic medical care of the rural population, which has got no access to medical consultations and medicine because of the local situation. The German surgeon, Caterina Schulte-Eversum has been part of this help. The impressions she has got of the country and the people still preoccupy her today:

“In fact, I didn’t know anything about Kosovo, apart from the fact that there had been a war many years ago. When humedica asked if someone was ready at short notice to leave for a mission providing basic medical care, I had time and agreed to leave. And thus, little later, I arrived in the Kosovar capital Pristina, with the red humedica cap as identification, dangling at my backpack.

What was awaiting me at my destination, Krushe e Vogel? I knew nothing about it, apart from the fact that there had probably been most of the war victims during the conflict in Kosovo. Later, I would learn that this still had consequences for the people’s lives and their medical care. And also, which consequences had the opening of the mass graves, which had been started shortly before my arrival.

The local humedica staff member, Alban and Korab fetched me. I would accompany them during the following ten days. The one-hour trip led us through green countryside, bordered by mountains. Everywhere, I saw quite new houses with unrendered facades. The many old cars were repeatedly overtaken by expensive cars which, as I was told, most of the time were owned by relatives living in Switzerland or Germany. On the streets, there were mostly very young or very old men. There were no middle-aged men.

Arriving at the humedica house and kindergarten in Krushe e Vogel, I first tried to get a general overview: Which medicine and devices do they have? How much material is ready for use? And how do I best pack the medicine boxes? On the next morning, we left for our first stop in a district of the Roma minority. There in the local town hall, we installed our small “surgery” and started our work.

Despite the often quite difficult communication, the troubles became quickly clear: Many patients suffered from high blood pressure, diabetes, back aches, always accompanied by visible existential fear and enormous distress. The insights into the fates behind the persons overwhelmed me again and again.

The next day, we worked in yet an even poorer Roma village. Given her bad state of health, I wanted to send my first patient, a cute old lady with headache and dizziness, into the next hospital. But her family was so poor that they couldn’t afford her treatment there and so we came to the agreement that I supplied her with the necessary medicine and that she should come back for a control. However, the pills I gave her would only last for a short time. This turned out to be a basic problem.

I have been deeply moved by the conversation with an about 45 year-old woman with continuous headaches, who had lost her husband in the war and who has cared for her family quite alone since then and who – as it is usual – lives with her parents-in-law’s family. She even thought she knew what she could do to relax a little bit and to get away from everyday life for some time: going for a walk in the fields. But as she feared that the people would thing that she took too much time for herself and didn’t mourn her husband adequately, she didn’t do it.

I have heard similar stories, asking many women about stress and fear. Asking them about it, some men with continuous headache or very high blood pressure described “inexplicable” outbreaks of fury. Other patients already came to the “German doctor” with the results of pre-examinations, in order to have it all checked. Others came to have their medicine refilled. Some were also looking for help fur the purchase of expensive medicine, like this father with his daughter being treated with anticonvulsants.

Many patients have suffered of continuous head or neck aches and outbreaks of fury for ten years already. The life story which has shocked me most, was the one told by an old woman. She had lost her husband and four of her six sons in the war. The body of one of her sons had already been retrieved during the war; a second one had been identified not long ago during the excavation of the mass graves. Two others are still missing. Of both her living sons, one needs renal dialysis and the other one suffers from cancer. What should I say? What should I do? I don’t know.

Even if most people suffer from a similar fate, nobody seemed to talk about his problems, losses or fears. An impression which my local colleague confirmed, telling me that there were no psychological consultations, therapy possibilities, self-help groups or similar things for the people here.

So in the end, what does this mission mean to me? The most important probably is to be present as a person for the Kosovars. Even if most of the patients I could treat will need further medical help, the biggest problem is another one: the psychological traumata in this early after-war period. And especially during my commitment there, this problem was very present.

With the help of my sensitive translator Korab, I have tried to listen to the people I was seeing and to make them understand that living and sometimes even taking time for themselves doesn’t mean that they don’t mourn their relatives and also that painkillers or expensive blood pressure medicine are not a solution. For long-term help they will need mother-tongue psychologists, psychosomatic specialists or focus groups.

The medical treatment provided by humedica is a first step, gives hope and shows the people that they are important and that we want to support them. The Kosovars are thankful anyway. A symbol for this is a woman, whom we had treated in the morning and who returned at lunchtime to bring us something to eat. Especially for us she had brought two servings of self-made bread, cheese and peppers. A delicious thank you.”

Years will pass, until the people in Kosovo will have overcome the physical and psychical consequences of war. So it is all the more important to show them during all this time that they are not alone and that help exists. Against this background we cordially ask you to support our work in Kosovo with a directed donation. Thank you very much!

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