Helping to heal the wounds of war: Franciscan Health System has established a partnership with Croatian doctors


GREENVILLE – The war is over in Croatia, but the pain remains.

Five years of bombing and hatred that spilled over the country along the Adriatic Sea have ravaged the economy and ripped apart its people. Now the suffering and the war wounds are beginning to heal. Hope is slowly grabbing hold. The Croatians, however, still need plenty of help.

The Franciscan Sisters of the Poor Health System Inc. realized this and took action. It formed a three-year Croatian Partnership with the hospitals in Biograd and Zadar. Then it received a $2.1 million grant to teach their doctors the best way to raise funds for badly needed supplies, to operate efficiently under terrible conditions with antiquated equipment and to bring them up to date on the latest medical techniques. The grant lasts through July 1998.

A team of surgeons from Biograd and Zadar took advantage of that grant by flying into Greenville earlier this month to observe, to learn and to train at St. Francis Hospital.

Carolyn Bobo, director of public relations at St. Francis Hospital, said one of their most pressing concerns is orthopedic procedures.

“They have no arthroscopes in Croatia right now,” said Bill Munley, the administrator of the St. Francis rehabilitation center.

Without an arthroscope, surgery is long and tedious because it requires opening up a patient. An arthroscope would make that operation quicker and so much more efficient. Which is exactly what these Croatian doctors need right now because their hospitals are still jam-packed with patients, Bobo said. In fact, during the war, the Croatian doctors operated out of the basement of their hospitals because the Serbs had bombed their facilities, Bobo said.

It was the safest place to be, and the patients were stacked three-high on cots suffering and waiting for treatment, she added. Those conditions have eased since the end of the war, but there are still too many patients.

So St. Francis got a good deal from Dyonics for an arthroscopic system, and, with the efforts of McCarter Presbyterian Church, raised $25,000 to help pay for it. Now the hospitals at Biograd and Zadar can share one arthroscope, and their surgeons have received some experience operating it at St. Francis.

They are grateful because Croatia is still dotted with a couple million landmines. One misstep can maim and mangle a leg. And Munley, who has seen conditions in Croatia first-hand, said children are the biggest landmine casualties. “You don’t want to step off the road over there,” he said.

Another pressing problem that St. Francis is helping to address is infection control. The Croatian surgeons were operating in a basement in less-than-sterile conditions during the war. It wasn’t their fault. They did the best they could with what they had. And what they had was two hours worth of water for three days a week, spotty electricity and 20-year-old equipment that tended to break down and malfunction every so often, Munley said.

Croatian orthopedist Josip Labar compared it to the grimmest situations in “M.A.S.H.” Infections inevitably cropped up and had to be dealt with. St. Francis has held a couple of seminars on infection control, and these Croatian doctors are soaking up the knowledge.

Many of the hospitals in Biograd and Zadar have been rebuilt. Supplies, however, are still hard to come by, and equipment is old. So they are learning the quickest, yet most professional, techniques to move people through their hospitals.

They need everything, from personal computers and portable X-ray machines, to orthopedic implants, surgical gowns and gloves, medicine, antibiotics, penicillin, and anything to do with reconstructive surgery.

St. Francis is showing these doctors how to use the equipment the Croatians hope to obtain to ease the suffering. The staff has escorted them down to Charleston to visit the trauma unit at MUSC; the Clemson biomedical research facilities, where they performed operations via virtual reality; and to the Shriner’s Hospital and, finally, the Veterans Affairs Hospital in Asheville.

The experience has been invaluable.

Yet, getting supplies into Croatia can still be a problem. Bobo said Croatia has recently turned from a government-run economy to a free-market economy. Munley said, however, that any expenditure over $120 needs government approval.

That means a lot of red tape for anybody taking the initiative to send aid into Biograd and Zadar. Munley said that St. Francis and the Croatian government have set up a partnership that will cut through that red tape. He urged anybody wanting to send supplies to go through St. Francis. “We’ll make sure it gets to the right place,” he said.

Which brings up another problem: Money.

“If you don’t have money, you don’t get supplies,” Labar said. “Our economy is really bad. All our troubles start from a financial point of view.”

Bobo said Croatia is not a third-world country, but it has been devastated by years of daily bombing, and its economy has been torn to shreds.

“Ninety-five percent of our equipment is out of date,” Labar said as he described working with a 25-year-old X-ray machine. “You need money to buy equipment,” he emphasized.

St. Francis is helping out on that end too. The staff is teaching these doctors how to raise funds. “They never had to do this before,” Bobo said, because the government kept them supplied before the war.

All that has changed with their new free-market economy. The concept of corporate fund-raising is new to them, Bobo said. “They would have individuals giving them donations (to help rebuild),” he said.

Private donations, however, don’t stretch far enough, so these doctors are being given a crash course on courting corporate money. They don’t want a handout. They want to learn to do things for themselves.

“This is a country that needs a one-time boost for a couple of years to get back on their feet,” Munley said. Once the economy picks up and the chaotic conditions at the hospitals stabilize, Croatia can return to a normal life.

That is the hope of trauma surgeon Jasa Pavic and operating room manager Zelkja Toric. That is the dream of orthopedic surgeons Labar and Vjekoslav Antic. And that is also the wish of physical therapist Andelka Rogic, physiatrist Ljubica Labar and their translator Mila Labar.

They came to St. Francis for help, and now they are going home filled with hope.

Perhaps one day down the road they will be able to settle back into a peaceful practice.