Bosnia: Treating psychological scars of war

National staff : 12

International staff : 6

Since the Dayton accords were signed in December 1995, the peace process has proceeded slowly. The return of refugees has been problematic owing to the ongoing ethnic tension between the Bosnian, Croat and Serb communities.

Since July 1996, MSF has run a mental health assistance programme in Gorazde. MSF trains Bosnian mental health professionals to treat the many people still suffering from the experience of living through the war. The team is now setting up a psychological rehabilitation centre in Gorazde together with psychologists working in Sarajevo and other parts of Bosnia as well as with the health ministry. The centre will cater for the needs of young and old.

More than 150 patients have been treated already. MSF also provides support to community networks (schools, women's' associations, etc..) capable of identifying people who need extra help in coming to terms with trauma and loss so that they can be referred to mental health structures where necessary. In collaboration with Sarajevo university, MSF is training a Bosnian psychologist in order to help the Bosnian health ministry pursue its activities.

In Tuzla and Pale, MSF runs a family medicine programme which focuses on facilitating access for families to first-line medical services. MSF is encouraging people to see general practitioners before resorting to specialists. The team runs training programmes for Bosnian health care staff in the rational use of medicine and is identifying other cost-effective methods of organising health care services for the benefit of all.

Since the end of August 1998, almost 22,000 Kosovar refugees have arrived in Bosnia as well as another 3,000 members of the Sandjak ethnic group who fled Serbia during the first half of 1999. MSF works in four camps and is monitoring transit centres. In these sites, MSF monitors and provides primary health care and carries out water and sanitation assistance. The team runs a mobile health clinic for the refugees. In Republika Srpska, MSF runs a mobile clinic, supports local health care structures and carries out the distribution of hygiene products. In the eastern part of the republic, MSF distributes medicines to health structures.