Nephrology in Bosnia and Herzegovina: impact of the 1992–95 war

Abstract

It has now been more than two decades since the end of the 1992–95 war in Bosnia and Herzegovina. This may well be the proper time to provide the nephrology community with an appraisal of the care of patients with chronic kidney disease in the pre-war, war and post-war periods in the European transitional country. This report on nephrology in Bosnia and Herzegovina draws attention to the hurdles faced for three turbulent years on that burdensome path of providing quality care, and the chance it offered in developing a successful transplant programme while facing the dreadful chaos of war and a migrant crisis. The perception of war and natural disasters is quite different, from the victim’s point of view, from the standardized and well-arranged healthcare systems in the developed world. The guidelines, written in peace, are extremely useful, but are often hard to follow during natural disasters or barbarous wars. Each of the periods described had its specificities as well as its good and bad sides. Despite the unquestionable destructive nature of the war, it was a catalyst for nephrology in Bosnia and Herzegovina to move forward.

Sustainable Development Goals relevant to kidney health: an update on progress

“…Armed conflict has been associated with higher rates of CVD, diabetes, hypertension, and alcohol and tobacco use in civilians 167 , as well as CKD in injured soldiers 168 . AKI due to crush injury and sepsis is common, and toxic AKI from unusual causes such as mushroom or thallium intoxication have also been reported 169,170 . The impact of armed conflict on the onset and progression of early-stage CKD is less well documented, but the increased prevalence and sub-optimal management of diabetes, hypertension, diarrhoeal diseases and low birthweight, strongly suggest it has a negative effect 167 .…”

Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

“…Хворі на ХХН VГД мають значну коморбідність, яка з відомих причин може поглиблюватись та збільшувати частоту негативних наслідків під час війни [11][12][13][14].…”

“…Робота діалізних центрів в умовах війни ускладняється ризиками порушення водо-та енергопостачання, значними логістичними проблемами забезпечення лікарськими засобами, витратними матеріалами і т.д. Пацієнти та медичний персонал потерпають від негативних психо-емоційних впливів, погіршення побутових умов та харчування [11][12][13][14].…”

Mapping of Medical and Health Studies in Bosnia and Herzegovina using Scopus

“…Yugoslavia even had one of the most minimal new-born child death rates at fewer than 15 births for every 1,000 live births in the country. [2] Today, inside urban communities, most residents have sufficient medical services inclusion, yet in country rural regions, clinics are rare. Albeit the framework has improved inside the most recent twenty years, Medical and Healthcare in Bosnia Herzegovina actually needs further gatherings.…”