UNDER RULES governing the conduct of war, health-care professionals are supposed to be exempt from attack. But in Kosovo, Serbs are seeking out doctors and shooting them.
TETOVE, Macedonia - Vesel Elezi lost his medical clinic and his patients when Yugoslav security troops roamed through the Kosovo city of Urosevac on April 4 and ordered residents to leave. He sought refuge in Lamaj, a remote hillside village.
Masked troops found him there a week ago, as they went door to door to drive away any residents still in south-central Kosovo, according to refugees who were there. A neighbor hiding 30 yards away said that when the troops confronted him, Elezi pleaded for his life, saying, "I'm a doctor. I'm a health worker." One of the soldiers replied, "You are exactly the person I am looking for," and Elezi was shot.
What Geneva Conventions say
Under the 1949 Geneva Conventions governing the conduct of war, doctors and other health-care professionals are supposed to be exempt from deliberate hindrance or attack. But in Kosovo, refugees say Yugoslav troops are targeting not only ethnic Albanian doctors but also their facilities, leaving virtually the entire remaining population without access to medical treatment.
The security forces apparently want to rid Kosovo of medical workers who might provide care to ethnic Albanian guerrilla fighters, according to humanitarian aid workers and refugees. The government also wants to make life in the province as difficult as
possible to encourage ethnic Albanians to leave.
Details of what has happened recently to medical-care facilities in Kosovo are difficult to verify, because no foreigners have been allowed free access there for weeks. But the accounts of refugees paint a uniformly grim picture of declining health among ethnic Albanians.
Since NATO airstrikes began March 24, soldiers have attacked and destroyed more than 90 community-based health-care clinics run by the Mother Teresa Society, according to officials of the organization who have fled here. Before the onset of ethnic violence in 1998, the clinics served about 2,000 patients a day.
"It is a catastrophe," said Isuf Dedushaj, president of the Kosovo Red Cross, an ethnic Albanian organization. With a serious food shortage and many people forced to live outside after being expelled from their homes, the lack of drugs or treatment means "there are big chances for epidemics to spread and Kosovo to be turned into a massive grave."
Virtually all of the ethnic Albanian patients at the public hospital in Pristina - including those with chronic diseases, and infectious ones such as tuberculosis - have been expelled in recent weeks by the Serbian hospital administrators and by government troops, according to several former patients who have fled to Macedonia.
Artillery moved to hospital
At the same time, the refugees said, the Yugoslav military has moved artillery, radar, some tanks and other armored vehicles onto the hospital grounds. This would constitute a violation of the Geneva Conventions upholding the principle of medical neutrality, said Sheri Fink, a doctor who works for the Boston-based Physicians for Human Rights and has been interviewing refugees.
Even before the Yugoslav government began an all-out war on March 20 against members of the separatist Kosovo Liberation Army, security forces had targeted ethnic Albanian health-care workers on the grounds that they must have been helping the rebels, said officials with the Mother Teresa Society and the Kosovo Red Cross.
Since last summer, 10 workers from the Mother Teresa Society have been killed, six have been permanently disabled by gunshots and one is missing.
Harassment since '89
Medical care in Kosovo has suffered since 1989 as a result of ethnic tensions, when Yugoslav President Slobodan Milosevic - then the president of Serbia - ordered thousands of ethnic Albanian professionals fired from their jobs and replaced by Serbs. The number of state-run medical institutions in Kosovo was cut by three-quarters, leaving most ethnic Albanians to rely on a rudimentary health-care system staffed by physicians in private clinics that lacked access to good equipment or modern medical texts.
After the purge, rare diseases such as neonatal tetanus, abdominal typhus, polio and hepatitis began to crop up in Kosovo, and more than 170 epidemics occurred from 1990 to '98, said Dedushaj, who is an epidemiologist. During widespread fighting last year, 17 small hospitals and 28 outpatient clinics were destroyed. At public institutions, ethnic Albanians had to pay in cash for medications, while Serbian patients received theirs at state expense.
As tensions rose in early February, when NATO threatened airstrikes to compel peace negotiations in France, ethnic Albanian physicians in the surgical, ophthalmological and gynecological clinics were fired.
"It is a disaster," surgeon Blerim Feka said.