HOW TO PRACTICE MEDICINE IN IRREGULAR CONDITIONS - A LETTER TO A COLLEAGUE

Dear colleague,

I go briefly through you last letter, point by point:

1. As to medical condition of a patient or future patient I can not accept - as a MD - to discuss it in public. It is contrary to the lege artis. It can be discussed only in related medical circle. But I welcome future discussions with you about the problem you mentioned. Also in medical work I prefer writing to talking because of need of documentation. We always must have proof for our decisions - particularly important in in-field work where documentation is regularly missing.

2. I never saw constitution act of SOS Ljuta Krajina (I was not interested). As a Medical Coordinator I also have limits in my role and I never intended to go beyond it. After legal constitution of SOS LJK it will be possible - for my expectation - to formalize working relations.

3. In my Diagnosis of Medical Situation with refugees in B&H (published at DfA blog) I pointed in the very beginning that HealthCare Law of FB&H is suspended (It allows health care to refugees and migrants). It is suspended in unknown way by unknown decision and by unknown actors but it is suspended since June 2018. I repeated this in nearly all my publications day by day. So, nothing, related to migrants in B&H, since June 2018, happens according to law. That is why medical humanitarian job is hard, because it happens in legal swamp. Many phenomena related to migrants in B&H only have look of legality but actually that is not the case. The rules of the game are changing during the game. So clarifying legal status of the volunteers is for me mystical. Today can be one way, tomorrow other way. The situation with refugees & migrants is in a way similar to the situation in war zone... So we discuss two different (but related) situations: medical and social/political.

Shortly, that is it. I hope we continue great work we started all together!

Best regards,

Dimitar

EUROPEAN UNION OR SAUDI ARABIA?

This winter refugees and migrants in BiH were often punished by one of EU police for their illegal crossing border by seizing their shoes. People were left barefoot in snow to walk back kilometers after being captured by police. For some of the refugees consequences were horrible what mostly depends on the outside temperature and the length of the walk.
From the common education provided by IOM for doctors and police officers we know that many of police officers who guard the border of the "Fortress of Europe" with such and similar means are often psychically broken but they are supported by the team of doctors (lead by psychiatrists). Here we find interesting ethical dilemma as medical professionals. One kind of doctors support refugees and human rights other doctors support system of repression. Doctors supporting refugees and migrants are often volunteers; doctors supporting repression are properly awarded. Even medical doctors are on the different ethical sides. 

Dimitar Anakiev dr. med