Healthcare in Foca until opening of hospitals

Although through out the history Foca was known as trading center on the caravan route from Dubrovnik to the provinces, healthcare in it was vegetating. Through out all of the time of Turkish rule, there would only occasionally show up some educated health worker and health institutions did not even exist. The nearest hospitals were in Dubrovnik. The first vaccination was not mentioned until 1868. With the Austrian occupation stronger military garrisons were stationed in Foca. There were educated doctors in those units but their activities in the population were only occasional, out of regular duties. Only in the last decade of the 19th century in the valley of the Drina in the major towns hospitals started to open.

In Foca the first hospital was opened in 1896 and since then it has been constantly changing its location. Those small health facilities carried out only the most necessary triage, and difficult patients were sent to what was then Provincial Hospital in Sarajevo.

After the World War I there were formed so-called governor’s hospitals which had the same scope of work, and there was always one doctor. Between two wars in the hospital in Foca there were a number of doctors (Dr Grin, Dr Tarasov, Dr Idriz Begovic, Dr Milas) and in the infirmary of social security Dr Gavran Kapetanovic. After the liberation it was formed County health center in Foca, located in Medjurjecje. Among the doctors with the longer residence time in Foca there were Dr Tamunovic, Dr Kosnapfel, Dr Boras and others. Infirmary in Medjurjecje had about 40 beds. Within it existed a small maternity hospital in which were carried out labors and treated incomplete abortions. At that time there were a lot of infectious diseases which have appeared in minor or major epidemics. Because of outburst of tuberculosis first anti-TB dispensaries were formed, and first X-ray machines were installed in them. In the prison of Foca there was a small prison hospital for the prisoners suffering from the lung TBC. That hospital was led by Dr Marko Juric, a physiologist, who led ATD dispensary in health center and has helped in the first steps in the construction of the hospital, and as well, was a first president of the Board of the Hospital.

Igman’s Hospital

During the Second World War in Foca has undergone significant events, and all of them have left deep scars on the population of this region which suffered a lot during the war. In the hospital (in the health center building) were treated 172 soldiers of the First Proletarian Brigade- “Igmans”, of which 41 with serious injuries – frostbites, thirteen of “Igmans” have lost four to ten of their toes, and 22 of them have lost toes on one of their legs. Without anesthetics or serum, with poor surgical equipment the doctors cut off their body parts, among other they amputated 224 frozen toes. Without a scream the soldiers have lost their legs and toes and died as heroes. On the organization of the Igman hospital the most of the work was done by: Dr Gojko Nikolic, Dr Zarko Mikic, Dr Borislav Bozovic, and Dr Dejan Popovic. The people of Foca has accepted seriously wounded as their dearest and has helped as much as possible. The memory of the suffering and courage of the frozen wounded has grown into an idea that as a monument, a hospital should be built.

Opening of the hospital, a historical event

The decision to build a hospital had a special meaning and full justification. For the design a company “Architect” from Sarajevo was engaged, and preliminary and detailed project was done by Tihomir Ivanovic BSc architecture. The designer has chosen the field, and the responsible agreed that it should be built in the north part of Foca, one kilometer from the bridge on the Drina. Firm and rocky ground 15-20 meters above the level of the Drina offered optimal conditions for the building and possibility of expansion. The project envisaged that the hospital will have five departments: Internal with 35 beds, Surgical with 35 beds, Infectious with 18 beds, Pediatrics with 20 beds and Delivery department with 12 beds. The total capacity of the hospital was 120 beds with other supporting facilities. The project was complete block design with isolated rooms of the infectious department which was connected to the main building. There were a number of balconies, with enough light and sun for the patients. The hospital fits into the environment, into the ambience of the Drina River and its light and transparent water with hills and forests on its banks. Construction of the hospital began in 1953 with the fluctuations in the pace of construction. By the end of 1957 the building was glazed, central heating was installed, as well as sewage and pluming. At the end of 1957 the document of establishment of the hospital was adopted. In the spring in 1958 the decision on the opening was made. The work was intensified and began taking care of equipment and staff. Dr Aleksandar Goldberger came to the hospital and Prim.Adolf Goldberger,PhD,MD in February of the same year was appointed as the director of the building hospital, and after that he was appointed as the director of the hospital. Foca municipality has awarded scholarships for 20 students of medical school in Nis and Novi Sad, who came to work in the hospital. The hospital was opened on July 3rd 1958 and started to work that day.

Facts speak for themselves about what the opening of the hospital has meant to the population of the region. As soon as the guests have left the hospital the first patient with a fracture of lower leg came. The work started that day. On that day the surgery of the patient with perforated ulcer of the duodenum was performed and after that the trepanation of the skull due to brain contusion of a young climber who has crashed off some cliff and who was, unfortunately, the first patient who died in the hospital.

Already on July 5th in 1958 the number of patients has exceeded the number of beds, so the hospital was full. Regular work, admission, diagnostics and treatment, attendance, visits and all that makes life of the hospital have developed and the hospital functioned smoothly. That was not easy because the hospital has worked in an area without a hospital tradition. In the hospital worked three doctors, 22 persons as a nursing staff, of which 3 had working experience. There were 2 midwives, a few nurses, administrative and technical support staff. The hospital has treated all urgent and chronic pathology in the areas of Gorazde, Cajnice, Foca, partly Visegrad, Rogatica, Kalinovik and Gacko. Transport links were very bad. During the winter the roads were blocked with snow and narrow-gauge railway worked with small break during the whole year. It took 5-6 hours of travel from Sarajevo. The roads were gravel, and roads to villages and hamlets like goat paths.

Opening of the hospital in a very modest area of health as well as general culture, has created conditions in this area for finding specialists, and a significant number of workers with secondary and high education, as well as medical and other structures.

The hospital has made significant conditions for a rapid development of region. The population felt safe, because the hospital always ensured that all urgent cases are handled promptly and professionally, no matter what time of the day. Credits for such success go to specialist medical staff, which’s selfless work and sacrifice has maintained the 24/7 work of the hospital. It did not happen to a doctor to decline the call for an intervention.

Hospital on the frontline

The wars have always represented a great danger for people and always had catastrophic consequences. A large number of injured among soldiers and civilians, in a short period of time in the subsidiary space with an altered structure of the injuries have imposed a different organization and methods needed to achieve treatment and disposal. For Foca Hospital that was this part of the Republic of Srpska.

In terms of system of phased disposal we have adjusted to the current situation: approached the line of contact, quit the multiple phases, and provided a quick and efficient evacuation by designation into surgical facility for definitive care. The hospital was disabled to apply all of the principles and postulates of war surgical doctrine at all time. Those were the basic moments which have influenced the course of medical events during the four year of war in this part of the Republic of Srpska. Poor transport communication and lack of medical supplies, medicines, suitable equipment depicts the cruel destiny of injured who were facing it.

Experiences in the care of the injured in this war are important, both because of the results, and due to some specific features and innovations that were applied in health care. Imposed situation served as the possibility to change the validity of some previously existing principles of organization and care of the injured. Logical and the simplest explanation is that the injured in the critical regions due to the prolonged and difficult evacuation would ended fatally if the hospital surgical team was not able, ready, organized and provided with materials to complete disposal from primary to definitive.

Transformation to the Clinical Center

Since the establishment in 1958 to this day, the hospital has undergone the journey of transformation, imposed by time, needs of the population, highly professional personnel and equipment. The idea that the hospital is a monument from people of Foca dedicated to brave “Igmans” who in this city have been given a fraternal help, had lived until 1957. Until then there was talk about “Igmans Hospital”.

In the spring in 1958, when the preparations for the celebration of the war events have started, the hospital got the name Memorial Hospital “Proletarian Brigades”. It had 5 sections and by the end of 1958 it had six with 216 beds, and in the 1965 it had all of the services. By Referendum in 1968 the Medical Center “Proletarian Brigades” was formed and it contained, apart from the hospital, the entrances of Health Center, Health Station RMU Miljevina, and after that a pharmacy “Partizan”. Since then the hospital, along with other integrated organizations, has worked on securing the overall health care of Foca.

The first director was Prim.Aleksandar Golberger,PhD,MD. The integration into Regional Medical Center “Proletarian Brigades” has happened at the end of 1972 and early in 1973. Integration included health institutions from the municipalities of Foca, Gorazde, Cajnice, Visegrad and Rudo. The system of integration has left out the health stations of companies “Maglic”, “Azot”, and “Pobjeda”. For director Prim.Aleksandar Goldberger,PhD,MD was elected, who left Foca, and after that Dr Reuf Tafro was appointed. The director of the hospital was Neda Kraljek-Savovic and after her departure Dr Marko Vukotic was appointed. After it was deeply rooted, thanks to Dr Puba and his associate Simo Stankovic, a lawyer, the health care went upwards in organization, as well in professional, scientific and educational sense. At that time the conception of overall health care was relied on young personnel who have been raised in this area, with maximum openness for the staff who came from other areas.

During the eighties the hospital was in organized health giant SOUR Regional Medical Center “Proletarian Brigade”. Together with other health institutions there were: Foca, Gorazde, Cajnice, Visegrad, Rudo and Kalinovik. With the departure of Dr Vukovic to Sarajevo, as the director was appointed Dr Sekul Stanic, who managed the institution until 1993. By his work was done a lot on adaptation of old and building new working spaces.

At the beginning of the war the health care was preparing for the new situation. Health centers in the municipalities undertake the obligation to organize and provide help to great number of wounded.

Hospital in Foca, together with other hospitals, in 1993 has formed Clinic Center of the Faculty of medicine. In that way the population of this part of the Republic of Srpska was provided with highly professional and complete health care. Clinical Center of the Faculty of medicine Srpsko Sarajevo-General Hospital in Srbinje, was founded by the Declaration of Government of the Republic of Srpska.

The ratification of new Law of health care, was followed by the compliance with it, or the new organization and structure of the organization units of Clinical Center Srpsko Sarajevo. Government of the Republic of Srpska, first with a decision at the end of 2001 and after that in early 2003, gives approval of Statute concerning the organization of Clinical Center Srpsko Sarajevo.

Clinical Center East Sarajevo, as health institution on secondary referral level, provides complex examination and treatment of patients from whole territory of the Republic of Srpska, specifically from its eastern part from Zvornik to Trebinje. The current director of Clinics and hospital services in Foca is Prof.Veljko Maric,MD,PhD.