BOSNIA-HERZEGOVINA

PROJECT TITLE: Medical and Psychosocial Support and Sustainable Community Health Services For Victims Of Torture/Ethnic Cleansing During The Balkan Conflict

PROJECT AREA: REPUBLIKA SRPSKA, BiH

CONTEXT OF THE PROJECT

During the Balkan conflict of 1992 to 1995, Bosnian Serb civilian, police and military officials, in collaboration with paramilitary troops and former Yugoslav Army reservists called in from Serbia and Montenegro, took over the target area of this project, established a wartime government and planned the expulsion of the non-Serb population. The majority of these were Bosnian Muslims who experienced some of the worst atrocities of the Balkan war. They were subjected to persecution and abuse in their home villages in Serb majority areas with validated reports (including Kofi Annan UN report 1999) of rape, beatings, use of electric shocks, forced eviction from their homes, forced witnessing of the murder and mutilation of loved ones and nutritional deprivation.

A network of detention centres was established where non Serb civilians were detained, tortured, raped and either expelled, killed or ‘disappeared’. Those that survived, often just the women and children of a family, became internally displaced persons (IDPs) for the duration of the conflict, living a miserable existence in refugee camps in neighbouring areas.

Many have now returned to their home villages but continue to suffer both physical and psychological consequences from their experiences. Physical difficulties include general weakness, deafness, speech difficulties and other developmental delays in young children. Psychological issues include anxiety, depression, psychotic illness, poor educational performance and the break-up of families.

Living conditions in the project’s target area are primitive with poverty, malnutrition, outbreaks of infectious diseases and extremely limited access to basic healthcare leading to high levels of death and disability. The health service in remote areas is drastically under-resourced and although the new system of health insurance will improve access to health services for those beneficiaries suitably registered in Republika Srpska, this system is far from comprehensive, there is still a huge distrust of Serb-led services amongst Bosnian Muslims and the distances involved will continue to restrict access.

The process of identifying ‘missing’ relatives continues with the ongoing exhumation of mass graves. ICRC and the International Commission for Missing Persons (ICMP) are actively working with the local communities on the identification of post-mortem remains and DNA testing. This is a traumatic process and can be devastating for families whether or not a positive identification is made.

RESPONSE INTERNATIONAL’S PROJECT

The project commenced in December 2004, and has just secured additional funding to continue activities in 2006. The following services are provided by our team of doctors, community nurses and social workers:

Medical

• A comprehensive package of primary health care services, with both acute and chronic disease management
• Home-based care for the elderly and disabled
• Mother and child health promotion
• Wound care
• Health education
• First aid training for community volunteers, recognising their relative isolation, transport difficulties and difficulty accessing local services
• An environmental health assessment, to advise on the siting of pit latrines, protection of water sources and safe refuse disposal

Psychosocial

• Legal and welfare benefits advice (refugee status, health and social insurance registration, and pensions)
• Support for those families still enduring the painful process of identifying “missing” relatives, continuing our close liaison with ICRC and ICMP
• Advocacy on their behalf with municipal, regional and national authorities and the international community
• Liaison with municipal health and social services, helping to re-establish trust in these services and coordinate our activities.
• Psychological support, in terms of simple counselling, normalisation, coping strategies and the identification of those requiring specialist mental health services (a psychiatrist will be available each month to provide clinical supervision for our staff and to see these beneficiaries)

The beneficiaries of the project are the communities of Snagovo, Divic (including the neighbouring villages of Liplje and Josenica) and Dulici within Republika Srpska. These communities are composed of approximately 600 families and a total population of 1,700. Over 90% are Bosnian Muslims returning to their pre-war homes from refugee camps in the Tuzla canton but there are also internally displaced Serb families in Divic and Dulici. All ages are represented. 75% of the beneficiaries are women with a significant proportion of female-headed households.

SPONSORS AND PARTNERS

Building on lengthy and productive relationships, the project team will continue to work closely with the Ministry of Health for Refugees within Republika Srpska and the regional office of UNHCR. In addition, regular liaison with ICRC and ICMP on the process of identifying ‘missing’ persons will continue.

The United Nations Voluntary Fund for Victims of Torture (UNVFVT) is the major sponsor of this project. Response International has also received funds from the Norwegian Government and the Ajahma Trust (UK) and has made applications to a number of other donors.

In 2003-4 prior to the commencement of the project, Response International cooperated with the Leonard Cheshire Centre for Conflict Recover in the production of a report on the circumstances of the beneficiary group. This remains probably the most up to date report available and can be viewed here

For details of our previous EC funded project in the Tuzla Canton of BiH please Click Here.

FUTURE DIRECTION

A number of applications are currently being processed that may secure the funding to continue to provide key elements of this project and mine action services for both IDPs and returnees in the Tuzla canton and Republika Srpska.