sreda, 30. januar 2019

WHICH HUMAN RIGHTS HAVE BEEN VIOLATED TO REFUGEES AND MIGRANTS IN BOSNIA?

 
WHICH HUMAN RIGHTS HAVE BEEN VIOLATED TO REFUGEES AND MIGRANTS IN BOSNIA?

Health is a human right issue,
human rights are a health issue ,
human rights violation results in adverse health effects
                        Dr. Jonathan Mann (1947-1998), a former WHO official

  About four thousand refugees and migrants are caught in a trap made by the authorities of the EU / USA protectorate of Bosnia and Herzegovina and the so-called "humanitarian organizations". These organizations, although paid to help people (a sum of ten million euros to the IOM alone, was heard) are doing everything possible to make life of the refugees and migrants unbearable, in order to make them "voluntarily return" from where they came from (that is business, organized by the IOM). Human rights are in that way violated by those who are paid to defend them. Let's take a quick look at the list of violations of human rights to refugees in Bosnia following the Universal Declaration of Human Rights, signed by all UN members.

  Art. 3 - The Right to Life

  There is no official mortality data, and the figures recorded by the press refer to 15 people who died from drowning (in the river Kupa while attempting to cross the border), 2 people who died from the disease (in both cases from pneumonia, in the first case the treatment was delayed, in the second case it did not even begin) and 1 migrant who was killed by knife in a physical altercation for the use of a shower. This data is incomplete (18 death cases), but it is certainly an indicator of the degree of human rights violations because all of these deaths were the result of unfavorable conditions made by the authorities and "humanitarians". At this point it should be noted that in February 2017 Médicins du Monde (Doctors of the World) proposed the formation of "safe corridors" for the passage of migrants and refugees at their will (in accordance with the right to freedom of movement) which would allow for better health and well-being of people but would also offer better control of health and all of its side effects. Obviously, the EU policy went in the opposite direction. The results are in front of us.

  Art. 5 - Prohibition of torture, inhuman treatment and punishment

  International law considers a systematic refusal of medical assistance a torture act. In Bosnian UN agencies-run camps, people are dying because they are deprived of primary medical care and many are at risk of disability because their chronic illnesses are not adequately treated. In addition, refugees and migrants are physically abused, both by police of neighboring countries and by private security services in camps that were set up by UN agencies.

  Art. 13 - The right to free movement

  Refugees and migrants in BiH are banned from using public transport. This means that a migrant from Kladuša, referred by doctor for a diagnostic examination in Bihać, cannot attend the examination if he is not transported by the UN agencies, and in many cases they are reluctant to do so. A private individual may be accused of violating the law if he or she helps refugees in transportation. We know a patient in Kladuša who has been waiting for a transport to the hospital in Bihać for more than 2.5 months and although he has all the necessary papers and even has the money for the medical treatment (which has been collected by the activists) the humanitarian agency responsible for the transportation (IOM) does not want to transport him ... And whoever wants to go from Sarajevo to Kladuša (approx. 370 km through the mountains in the winter) must travel on foot.

  Art. 14 - Right to asylum

  Impassable borders, police officers who are beating, humiliating and kidnapping migrants, are well-known practices by EU members from the edge of this political group. This practice has been largely covered in the media, and therefore we are not analyzing it here, although it is crucial that a certain policy and resolution of a group of countries raise the violation of human rights to the level of their basic policy.

  Art. 25 - The right to health (and other rights under this article)

  Refugees and migrants are generally a vulnerable group, with specific categories of vulnerable groups within (disabled, women and children, elderly people ...), but their health and lives are threatened by the policy of reducing the health care of migrants (it is the EU “trade mark” that has been repeatedly criticized by officials from the UN, and two general secretaries even dedicated their speeches to this topic, furthermore, books and studies that have also been written about it). However, the situation we are able to encounter in BiH is specific for its triple reduction: firstly, the FBiH healthcare law which allowed refugees and migrants the access to the healthcare system has been suspended (of course, not through a democratic legislative procedure, but by secret “ad hoc” directive from above), secondly, primary health care has been replaced by casual and short-term humanitarian medical assistance, and thirdly, the humanitarian medical assistance has no mandate to actually treat the sick in accordance with their needs, but is there with the sole purpose of being present, formally staging over a period of several hours medical assistance where the majority of the diseases are treated with a paracetamol tablet and similar. Let us therefore look at the basic parameters of the right to health as defined by the WHO:

A-Availability
B-Accessibility (physical, economic, informative and non-discriminatory)
C-Acceptability (ethical, cultural and sexually sensitive)
D-Quality (safe, effective, human, timely, non-discriminatory, people-centered, integrated, efficient)

By reviewing these parameters, it becomes obvious that the right to health of refugees and migrants in BiH has practically been violated in full (partial exception is Potemkin's village in Hadžići) and that "humanitarian" organizations are only staging the medical assistance, probably to justify the millions of euros received with the number of paracetamol tablets issued.
Two more things need to be added here:
First of all, it should be mentioned, that the doctors in BiH, despite the very poor conditions in which they operate, have prepared themselves well for work with migrants. In May 2018, in accordance with FBiH law, the FBiH Public Health Institute issued detailed and highly competent medical instructions on the migration problem and health effects on the migrant population (as vulnerable groups) and the local population, guidelines for the formation of medical stations, instructions for the formation of migrant centers, instructions for the recruitment of doctors (among young and unemployed), etc. The “higher force” however did not permit that to be implemented. It should also be mentioned that up until June (when MSF appeared in the field) BiH's impoverished healthcare successfully carried out integrative treatment of migrants and refugees and kept the the public regularly informed about it. An apt example is the Health Center in Velika Kladuša; reports on the work of this institution with migrants are still available in local media. All of this has been stopped, suspended and turned into a large and staged humanitarian action that costs millions and de facto results in massive violation of human rights.
Secondly, all other provisions of Article 25 have either been denied or are insufficiently and inadequately provided. Accommodation of people is inadequate, food is sparse and of very poor quality (hundreds of people remain hungry after hours spent in line waiting for food every day), there is an insufficient number of showers (approx. 50% below standard), a large number of showers are not functioning and warm water is rare ... Together it paints a picture of determination (established policies) to violate human rights in order to establish a system which prevents life in camps for migrants and refugees.

  Dimitar Anakiev, dr. med
Photo: Boštjan Videmšek

torek, 29. januar 2019

CILJ JE "DOBROVOLJNI POVRATAK" (Nidžara Ahmetašević)

Vrlo tačan i poučan komentat koji je napisala Nidzara Ahmetasevic uz ovaj video(1) snimljen u Miralu u Velikoj Kladuši: "Tretman koji izbjeglice dobijaju u BiH u kampovima u kojima se o sigurnosti brinu privatne agencije koje je unajmio IOM.
Medijima u BiH ovakve priče nisu zanimljive. U međuvremenu, bolesna djeca umiru u tim kampovima jer nemaju medicinsku njegu, ljudska bića žive u uslovima kakvi podsjećaju na logore više nego na izbjegličke centre koji bi trebali da osiguraju human i dostojanstven tretman, bolesni su, iscrpljeni, često gladni, i uvijek poniženi.

Za sve to odgovornost snose institucije ove države, ali i međunarodne organizacija koje upravljaju procesom migracija, ne samo u BiH nego i u drugim zemljama. Cilj im je ustvari stvoriti tako nepodnošljive uslove za život, da se ljudi opredijele na "dobrovoljni povratak" (za koji je posrednik IOM), umjesto za nastavak puta ka EU. E pa dobro im ide za skoro 10 miliona eura koliko su dobili za sada.
Nama u BiH je loše, ali ne moramo da se iživljavamo ili tolerišemo iživljavanje nad onima kojima je sigurno gore nego nama."

(1)video pokazuje kako služba bezbednosti maltretira migrante, snimak telefon, krišom

petek, 25. januar 2019

IN-FIELD TRAINING AND EDUCATION FOR PARAMEDICS IN HUMANITARIAN SITUATION (PART FOUR)


Corn/callus (singular: callus, callosity) and Clavus (clavi; singular: clavus, corn)




Very common occurrence in different forms.
Corns (clavi) are very well demarcated and usually are less than 1.5 cm in diameter. Clavi may be further classified as a hard clavus (heloma durum) or a soft clavus (heloma mole). Calluses are poorly demarcated and can be of any size. Both are due to thickenings and increases in the density of the epidermal stratum corneum along with changes in the deeper layers of the skin. (unsuitable shoes, unwashed /fat/ socks, etc.)

Usual people's treatment (everyday treatment or cosmetic treatment) is putting the foot in washbowl with hot water and domestic “keratolytics” like apple vinegar, salt etc. (at least 10 minutes but longer better) then treatment with rough stone (scraping).


Medical Treatment Options:

1. Removal of mechanical stress, eg, properly fitting shoes, moleskin, cut-out foam adhesive pads, diabetic socks (in case of diabetes)
2. Keratolytics
- 40% salicylic acid pads and plaster
- 40% urea cream
- 12% lactic acid cream
Patients with peripheral neuropathies should avoid using keratolytics.
Lesions are managed primarily by removing the mechanical stress that caused the lesion and by appropriate use of keratolytics when necessary. Special care must be taken to be sure the patient does not have diabetes mellitus or peripheral vascular disease in the relevant area.
3. Dermatological treatment (laser)


sreda, 16. januar 2019

MEDICINE FOR REFUGEES AND MIGRANTS AT THE EDGE OF EU AND THE PROTECTORATE OF BiH: SUSPENSION, BAN AND PLAYACT


MEDICINE FOR REFUGEES AND MIGRANTS AT THE EDGE OF EU AND THE PROTECTORATE OF BiH: SUSPENSION, BAN AND PLAYACT
A while ago, I met in Bira camp for migrants in Bihac, a refugee with severe chronic disease: osteomyelitis (inflammation of the bones). The consequences of such inflammation may be lost whole limb. The official response during his visit to the humanitarian doctor in the camp (because of the pain) was one tablet of paracetamol. Again, I recently met the case of a migrant with a worsening chronic skin disease of very drastic appearance (psoriasis), again from the official humanitarian doctor in the camp he got one tablet of paracetamol for the treatment of psoriasis . Or still a current case of a patient from Kladuša who has been sent to diagnostic procedure by two local doctors and he is waiting for humanitarian transport to Bihać for more than two months, although the responsible actors on the daily basis were invited and called, and the money has been collected for the diagnostic procedure to be paid. Yes, but they will not / do not want to transport the patient ... These and similar cases are not an exception but practice with different humanitarian medical organizations. It is not simply that the FBiH law that allows refugees and migrants to access the local health system is suspended (in undemocratic way), it is not even a matter of denying access to primary healthcare for refugees and migrants with the advent of humanitarian organizations (although the UN agencies falsely report that refugees and migrants in BiH have access to primary health care), but it is actually the question that leaves us breathless because humanitarian medical assistance is only a play. Indeed, it is so reduced, doctors are so degraded that we can freely say that it is a "fake news" and not a medical help. The money spent on the organization and salaries of staff serves are only a lavish show and in no way help migrants. I started work with refugees and migrants in 2015 and stayed in it for the fifth calendar year, but the situation I see is still not experienced. The standard of medical assistance to refugees and migrants has eroded so much that it turned into a lie. I have to say that I have never seen fake medical help at work until now, and I am shocked to the extent that panic attacks are almost confronted. Is that possible at all? It is known to me that at the time of the rule of apartheid in the South African Republic, the so-called "apartheid-adapted medicine" ("one medicine for whites, the other for black people") was the so-called "dual loyalty" obligation for doctors, and such medicine could be seen in the 19th century in colonies . However, I could not imagine that in the 21st century I would look at something like that in Europe, in the Balkans, in my home, therefore. And what does a doctor do if he or she is offered a job in fake medical care? To take the money, act and stay silent? Or to retreat into renegades? Is there any third option?

Dimitar Anakiev, dr. med
Photography by Boštjan Videmšek


e-CLINIC BIHAĆ

DfA e-Clinic for refugees and migrants in Slovenia has about 70 patients (mainly chronic diseases). It is an excellent way to get fast doctor response to medical problems of people deprived for the rights of primary medical care by the authorities of EU - the main violators of these rights in the world today (along with USA authorities).
This skin condition is reported by N.T. from S.O.S. Ljuta Krajina Medical Volunteer Team (MVT) -Bihać team. She filmed this photo at the leg of the migrant situated in notorious BIRA camp, Bihać. In this camp ruled by IOM migrants/refugees too can not sleep by the night because of fear that they will be attacked and looted. That is why they try to sleep only during the day. It is clear what kind of stress they permanently bear faced also with no individual destiny (only collective destiny for people in the camp) and soon they are totally exhausted and psychically ruined. Sometimes it is not possible to get food after many hours of waiting in the line (few days ago over 300 hundred people stayed without lunch)... Medical treatment twice a week offers the DRC (Danish Refugee Council), also not on the very high level, that is why refugees and migrants often seek medical help from the MTV S.O.S. team Ljuta Krajina -

Bihać team.
Anamnestic data shows that this skin condition is chronic. It has typical clinic visage of psoriasis ("ljuskavica") a disease of unknown origin (probably genetic) which passes through phases of improvement and deterioration. The clinical condition is very sensitive to stress. DRC medical team treated this condition by a tablet (?)
In Slovenia we often treat this condition by Daivobet gel which is quite an expensive drug from the last generation of drugs against psoriasis. We tried to find it in Bosnia without a result. In BiH it is usually treated by Dermavit creme (37 KM) or even more expensive  Aloe Vera gel. It is important to suggest to the patient to avoid stress situation but it is not an easy task in camps like BIRA or MIRAL. The condition is dry, it does not need any Betadine treatment or bandage and similar tools used in acute skin conditions.

Dimitar Anakiev, dr. med

e-CLINIC VELIKA KLADUŠA

DfA e-Clinic for refugees and migrants in Slovenia has about 70 patients (mainly chronic diseases). It is an excellent way to get fast doctor response to medical problems of people deprived for the rights of primary medical care by the authorities of EU - the main violators of these rights in the world today (along with USA authorities).
This skin condition is reported by Petra Steurer from S.O.S. Kladuša Medical Volunteer Team (MVT). She received this photo from migrant situated in MIRAL camp, Velika Kladuša. In this camp ruled by IOM migrants/refugees can not sleep by the night because of fear that they will be attacked and looted. That is why they try to sleep only during the day. It is clear what kind of stress they permanently bear faced also with no individual destiny (only collective destiny for people in the camp) and soon they are totally exhausted and psychically ruined. Medical treatment twice a week offers the MSF, not on the very high level, that is why refugees and migrants often seek medical help from the MTV  S.O.S. team Kladuša (approximately 30 patients each day).
The condition showed on the picture was treated by Fenistril gel because of itching but without results. The location is typical for fungal infections (wet areas) and also condition visage is typical fungal. So the only correct therapy should be antimycotics (Canesten cream 3 times a day). Also wearing dry and clean underwear.

Dimitar Anakiev, dr. med

ponedeljek, 7. januar 2019

FIRST IMPRESSIONS AFTER SHORT VISIT OF ADMISSION CAMP FOR REFUGEES AND MIGRANTS “BIRA”, BIHAĆ, B&H

After the UN agencies did nothing to accommodate refugees and migrants from June to December, although they were on the ground all the time, "temporary admission camps" were now formed, in which for the first time the will was demonstrated to do something about the housing of this vulnerable population . But, man! Again, we are faced with a system that understands people's accommodation in the worst possible way. There are about 2,100 refugees (adult individuals, unaccompanied minors and families) in the Bira camp in Bihac, accommodated in a manner that the medicine does not suggest: this is "barracks accommodation" and ghettoization. An integrative principle is being broken, which is the basic principle of organizing the accommodation of refugees and migrants. Although large forces are now visible in the field (in the form of numerous and varied uniformed people), the effects in meeting the basic hygiene standards are not yet satisfied. While the number of toilets is close to the hygienic minimum (94 WCs of the prescribed 105 for this number of migrants, however we do not know the frequency of discharge and maintenance of hygiene), the number of showers is dramatically below the hygienic minimum (of the 210 required showers for the number of refugees in Bira only 45 showers are installed and we know that many of the showers do not work, and that hot water is not always available when needed). Equally dramatic is cooking (in terms of quality) and food distribution (in two infinite lines), alternatives are not allowed. However, it seems the health care is the worst link : not only because we did not find the doctors in their camp-clinic at the time when they had to (and that is already being repeated twice), but the discussion with patients shows their great dissatisfaction. We met patients who can not come to the checklist after 2 weeks of waiting, others say that the visit to the doctor is a waste of time because the doctor gives everyone the same tablet (universal drug is paracetamol) and have brought us a patient with a temperature of 41C for whom they called the EMS, but they did not want to come because only the elevated temperature was not for them that important reason. Here we should remember the recent death of a young Pakistani who for four days complained about abdominal pain but could not reach the doctor (the authorities have not yet published the results of the autopsy or the name of a deceased young man, which shows in practice the effect of ghettoization of refugees). In addition to this, it should be added that the offered concept of the organization of health care is extremely disadvantageous for the doctors who work in the camp because it is degrading them by lying them down to the role of a nurse. The doctor is not a "one man band" but a medical team leader and when there is no  such team, and he can not use different diagnostic procedures (laboratory, X-ray, EKG etc.), and this can not be done despite the law of the FBiH open to migrants and refugees, then the doctor is degraded and forced to give everyone the same pill, and consequently he is not motivated to be in his own clinic during the working hours. It is a system that deliberately and intentionally disadvantages the health care of migrants and fugitives, it is a political decision to reduce the medical care of a vulnerable group, which is the same EU policy as we learned in Slovenia. In fact, the violation of human rights in the field of health care is the most typical feature of the European Union's policy, and the methods we see in the Bira camp in Bihać are a typical manuscript of this political group whose obviously racism is not too far away. The only remedy for this situation is the organization of volunteer doctoral work in Bihać, just as we did in Slovenia. Because the state bound to the principles of the EU will perform all actions to prevent the regular health protection of refugees and refugees. That is why it is necessary to find interested doctors in Bihać who will be engaged in organizing an alternative voluntary and sponsoring network of health care for refugees and migrants in Bihać; who will also seek and find allies in the part of humanitarian organizations that are not corrupt and want to help people. In addition, it is necessary to exercise constant democratic pressure and to constantly face the authorities with its inhuman face.

Dimitar Anakiev, dr. med