War Hospital

by Sheri Fink

  Ilijaz shivers with fear. The local commanders invite him to a gathering at the primary school to urge Srebrenica’s soldiers to fight. By 11 P.M., the school gymnasium, darkened without electricity, is packed with what Ilijaz thinks must be hundreds or thousands of soldiers. The head of the municipality and the head of police speak. Ilijaz ponders what to say. Now is not the time to focus on the fact that everyone is failing them—the international community that promised to protect them, the Bosnian government, and even their own commanders. It’s time to inject Srebrenica’s Twenty-Eighth Bosnian Army Division, the last hope for Srebrenica’s protection, with the will to fight.

  “Knives have been put to our throats!” Ilijaz shouts with no microphone, and he hears his voice quaver. “Are we going to stand here and wait for them to come and cut our throats and massacre our wounded? No! We are not going to stand and wait. We’ll fight, and we’ll fight for the sake of our families, for the sake of our wounded, for the sake of the living and even for the sake of the dead who gave their lives defending us.”

  Applause erupts from the crowd. Ilijaz rounds out his speech with a promise.

  “I will stay in the hospital. I won’t betray a single patient. Everyone else who respects our poor, injured patients should stay and protect them, too!”

  One after another men shout.

  “We should go for a defense!”

  “We should go and fight!”

  “You should be our commander!”

  “We want you for our commander!”

  This time Ilijaz knows his place is not on the battlefield. He returns to the hospital feeling like a hero from this, his proudest hour of war. Then he stays awake all night treating the injured.

  26

  AN UNACCEPTABLE SITUATION

  U.N. FORCE COMMANDER BERNARD JANVIER and the special representative to the U.N. Secretary-General, Yasushi Akashi, return to Zagreb, Croatia, from Geneva and finally receive a detailed report on the situation in Srebrenica. On the evening of Sunday, July 9, they order Dutch U.N. forces to establish defensive blocking positions around the city and authorize them to use force to prevent further Serb advances toward the city. The blocking positions are also aimed to test the resolve and intentions of the Bosnian Serb military. Will it stop when faced with resistance or do its leaders aim to take the whole enclave?

  When the order for the blocking positions comes down, Dutch commanders inside of Srebrenica wonder how, with their limited supply of functioning anti-tank weaponry and ammunition, they can effectively prevent the Serb advance. Clearly their efforts will have to be backed up by NATO close air support, and the blocking positions will facilitate those air strikes by establishing a zone between attacking and defending troops. For the first time, the acting U.N. forces commander in Sarajevo furnishes U.N. Force Commander Janvier with target information and a standing written request for close air support.

  Top U.N. military officials based in Bosnia and Croatia lay out their demands and threats to Bosnian Serb military leaders in writing and over the phone. The offensive must stop. The Bosnian Serb army must withdraw within two hours to the Srebrenica enclave borders and release all Dutchbat personnel and equipment or face a response with all available means. If Bosnian Serb army forces attack the new U.N. blocking positions, they can expect to be bombed by NATO fighter jets.

  The local Serb commander refuses to acknowledge that his forces are even attacking the U.N. soldiers and the enclave.

  * * *

  IN THE DARK EARLY MORNING HOURS of Monday, July 10, about 100 Srebrenica volunteers, armed mainly with Kalashnikov assault rifles and energized by last night’s rally, creep through the woods toward the enclave’s southern border. Some of the men situate themselves on a hill a half mile north of former OP-Foxtrot and send their only rocket-propelled grenade careening into a Serb T-54 tank 100 yards away. Sparks fly from the rear of the vehicle. The men fire their rifles at about thirty surprised Serb soldiers who have been sleeping outside. Serb survivors pick themselves up and run into the woods, beating a retreat from this, their northernmost position, and falling back to near the borders of the enclave in the south. The tank’s driver starts his engine and backs up, then stalls and is towed away by another tank down a winding road. The Srebrenicans rush in to grab the weapons the Serbs leave behind.

  Meanwhile, the roughly fifty Dutch soldiers that B Company can spare rumble through Srebrenica in six armored personnel carriers on their way to set up blocking positions in plain view of several routes leading into the town from the west, south, and east. Their four prearranged vantage points, Bravo 1-4, will help them determine which route the Serbs might be planning to use to enter the enclave. Forward air controllers take up two positions in preparation for directing air strikes. The Dutch have two “Dragon” medium-range anti-tank weapons and a number of AT-4 short-range anti-tank weapons, along with .50-caliber heavy machine guns mounted atop their armored personnel carriers. Although the order from above is to oppose a Serb advance “by all available means,” the company commander, believing his forces to be insufficiently equipped and inadequate in number for the task, instructs each unit to respond only in the case of a direct attack. First fire warning shots, he tells them, and engage in direct combat only if strictly necessary.

  On the way to its position, one vehicle is targeted by Serb tank fire and skids off the road, stopping at the edge of a precipice. At first, the Dutch mistakenly believe the detonation to have come from a hand grenade tossed by a Srebrenica soldier, and they report this misinformation to superiors. The position the APC was heading to take, the one closest to town, is left unmanned.

  In the early morning, Christina shelters in the bunker as the cracks and booms of heavy machine gun fire and shelling fill the air outside. The telex prints a never-ending stream of messages: The Dutch agree to evacuate MSF in an armored personnel carrier should the team desire it; the B Company soldiers see smoke in the hospital area and ask for a report.

  “… we are unharmed in our shelter,” Christina types back. She has her short-wave radio tuned to the British Broadcasting Company, and she listens, incredulous, as Bosnian Serb army representatives deny that they are conducting an offensive on Srebrenica.

  Since the start of the attacks four days ago until yesterday, roughly fifty injured patients have been registered in the hospital, and ten have died of their wounds. Now, venturing upstairs and taking a few quick, adrenaline-laden steps into the hospital, Christina finds it filled beyond capacity with a mixture of civilians wounded in the shelling and fighters injured at the front lines. She passes soldiers crying beside wounded and bleeding comrades and finds a haggard Ilijaz upstairs in the operating room, struggling to concentrate on stitching together the delicate liver of a twenty-two-year-old man. Only moments ago, Ilijaz heard that yet another close friend was killed, one of his early war compatriots in the Kragljivoda Brigade.

  Christina meets with Srebrenica’s acting commander, Ramiz Bečirović, who promises to protect the hospital. Christina repeats her mantra. She wants the hospital to be a neutral zone so that it cannot be considered a military target. She pleads with hospital director Dr. Avdo Hasanović for armed soldiers to be kept out. As more and more injured fighters are carried in, though, she realizes that the request is unrealistic.

  Outside, lines of relatives wait to donate blood. People arriving from the town center warn the hospital workers to prepare for more casualties. Around 7 A.M., Christina goes back down into the bunker to send a situation report to MSF headquarters and raise the possibility of again asking one of the Dutch surgeons for help. She’s afraid that, with a big influx of wounded, the hospital might not be able to cope. She ends the update: “This offensive has to stop.”

  Local MSF staff members pick up the wounded in the MSF car and truck and drive them to the hospital. They circumvent Christina’s admonitions not to transport wounded soldiers—MSF policy, she calls it—by stopping the vehicles fifty yards before the hospital and carrying the inj
ured the rest of the way into the hospital. One of these drivers is surprised, from the moment he walks in the door, at the number of patients who’ve filled the hospital since his last run. They litter the floor of the entranceway, and he has to jump over people to get to the staircase. As he carries his charge up the stairs, the sight of more injured and their trails of blood disorient him. Frenzied medical staff brush past him, running up and down the stairs looking for supplies, and pricking fingers to test for blood groups. Patients cry for help. People who are not medically trained pitch in and bandage the wounded. Upstairs, he finds Fatima in the hallway bent over an injured patient. He peeks into the operating room where Ilijaz is working. Someone has moved an extra table inside. The sound of shooting has become so regular, like the patter of raindrops on a rooftop, that the hospital workers don’t even seem to notice it.

  Outside, under deafening fire from Serb forces, the westernmost Dutch blocking unit, Bravo 1, placed unwittingly just under a Srebrenica artillery position (an old-fashioned M-48 howitzer), repeatedly relocates to safe positions. Grenades explode, sending clouds of smoke and dust swirling and lightly wounding several Dutch soldiers. Serb shells also impact close to another blocking position, Bravo 3. The Dutch watch as howitzers and tanks pound Srebrenica from a high point just east of the enclave, blowing apart house after house.

  The shelling of the blocking positions triggers a call for close air support. The Dutch commander sends his request with a list of fifteen Serb targets at 8:55 A.M. It never reaches higher levels. Around the same time, U.N. Force Commander Janvier—impressed by the misinformation that Bosnians are firing at Dutchbat—suggests at a meeting that the root of the problem in Srebrenica is the Bosnian army. The army is strong enough to defend its own territory, he says, and the Bosnian government may be trying to force the United Nations to take a position it doesn’t want to take, to defend Srebrenica. Janvier fails to sign the request for close air support received from Sarajevo last night. The false rumors that Srebrenica soldiers are attacking Dutchbat lead some in NATO and the United Nations to consider using close air support against the Srebrenicans.

  At 9:15 A.M., the driver of the Doctors Without Borders truck blares his horn as he comes down the hill to drop off another six wounded at the hospital. The nurse in charge of registering patients looks overwhelmed. Upstairs, Ilijaz, with Dževad assisting, operates on a patient with explosive injuries to his arm and face and a rupture of his left upper arm’s main artery. About 11 A.M., Ilijaz is focusing intently on repairing the delicate blood vessel. He finds the two parts of the artery and his fingers begin to make tiny, precise sewing movements with a needle attached to thread-like suture.

  Just then, a strong artillery blast shakes the operating room violently and shatters the windows. The building shudders as if it is about to collapse. Smoke and dust billow into the room. A moment passes. Ilijaz becomes aware of himself. He’s standing like a statue over the sleeping patient, hands in the wound, still holding the needle. He looks around. His colleague Dževad is under the table. The rest of the operating staff is nowhere to be seen. He calls for them. One of the anesthesia technicians enters and bursts out laughing when he sees Ilijaz standing in the exact same position at the operating table.

  “Chief,” he says, “you have the reflexes of a dead horse.” Ilijaz laughs at the joke and continues the operation. He simply didn’t have time to be afraid. But he can’t remember, besides the time a shell hit near his parents’ house in Gladovići at the start of the war, having ever come so close to being killed.

  * * *

  UNDERGROUND, in the bunker next to the hospital, Christina is doing anything but laughing. Stunned, she’s frozen as stiffly and instantly as if she was dipped in liquid nitrogen. She’d left the cellar door open. The shell hit just across the street. It seems as if an hour passes before she can move and control her body again. She realizes with a cold fear, the first one she’s felt all week, that the hospital is now a target. She types an “urgent appeal” to a Dutchbat captain for an update about security and war activities.

  “We want to continue working in the hospital in order to offer assistance to the many severely wounded,” she writes. “This is only possible if the shelling of the surrounding of the hospital stops.”

  A telex response arrives in under a half hour from the Dutchbat operations room. “In spite of some shelling the situation in the enclave is stable,” it says. Christina finds this more than a little hard to believe.

  The Dutch inquire about the numbers of wounded and offer Plexiglas to help fix the broken hospital and pharmacy windows. What a sign of helplessness , Christina thinks. In the early afternoon, the Dutch report that they are still trying to establish observation points in the south. They haven’t succeeded yet, they say, because every time they try to move their blocking positions south of the town, the Serbs shower their soldiers with tank and mortar fire.

  * * *

  AROUND THE WORLD, the Serb offensive against Srebrenica begins to draw responses. The Brussels and Paris country sections of Doctors Without Borders release a press statement, which Christina receives in English translation from MSF Belgrade. It describes intensive shelling in the center of “the protected UN zone” and appeals, to no one in particular, for respect of the hospital’s neutral status and the civilian population.

  A discussion about Srebrenica also takes place at the U.N. Security Council in New York, which has received some inaccurate information about the Serb offensive and the role of the Bosnian army in attacking the Dutch. Delegates from the U.S. and Russia disagree over whether a NATO air strike is an appropriate response to the Serb military action. In the end, the council fails to issue any kind of resolution condemning the attack.

  * * *

  AROUND 4 P.M. THE SERBS SEND multiple eighty-inch-long rockets screaming into the center of Srebrenica. One plows into a line of mainly elderly civilians waiting for water in the area of the town bazaar near Ilijaz’s apartment building and the linden trees, exploding into fragments and sending bodies and body parts flying.

  Ten minutes later, nine wounded are already in the hospital. They are severely, grotesquely injured, some missing arms and legs, shrapnel holes dotting every part of their bodies. Those in the hospital hear heavy machine gun fire as the wounded are being transported—Christina can only guess that the front lines are moving closer to the town.

  Patients now fill the hallways of the hospital and every able-bodied staff member works to assess them, start intravenous lines, and stabilize their conditions. Ilijaz examines a man whose arm has been ripped from his shoulder and whose abdomen has been blown open—he can’t believe the man is still alive. About eleven people need urgent surgery. Ilijaz asks Christina to beg Dutchbat for help, knowing he cannot possibly perform all the needed operations in time to save lives. Let’s transport some patients to the Dutchbat hospital, he suggests; we can send them with all the materials they need. If not, then at least have them send one of their surgeons here to help. It’s a matter of life and death.

  Christina sends a telex to Dutchbat. She has a feeling they’ll refuse, so she requests that at the very least they send an armored personnel carrier to help transport the wounded to the hospital. This time the response comes not from the surgeon but the second-in-command of the battalion, Major Robert Franken, who answers without consulting the medical team.

  UTC Time: 16:20:15, in 14:48:04 10 July, 1995

  From: Maj Franken

  To: MSF Christine

  • Again with a troubled mind I must state that we are not able to support you in giving actual medical aid.

  • Although really very willing I have a responsibility in securing medcare for my soldiers

  • my medstocks are at the minimum

  • in spite of the fuel situation the only help I can offer is an APC ambulance to help evacuating casualties

  • I have to make one restriction and that is that the vehicle can only be used in town, due to the fact that i
n case of an emergency I need him for my own soldiers which have priority

  • please inform me if you want this (little) help

  * * *

  THE ROCKET ATTACK MARKS A TURNING POINT for many of the operating room staff, and for Fatima and other doctors and nurses. With no or little medical experience at the war’s beginning, they have come to feel competent and useful; they have come to love their work. But now, as the wounded again fill the corridors and blood again covers the clothes, hands, and hair of the doctors and nurses, many of them find themselves unable to function. Their work turns back into the nightmare it was before Srebrenica’s demilitarization two years ago.

  Since five days ago, when the attack started and he collapsed after surgery, Ilijaz has worked like an automaton in the operating theater. When he’s stolen a few moments to rest his head on the doctors’ room bed, merely the thought of things getting worse and worse, far worse than 1993, has kept him tossing and turning. He hasn’t slept, showered, shaven, or changed. He hasn’t gone home in days. His only comfort is the presence of his colleagues.

  Ilijaz operates nonstop. The man with the arm and abdomen wounds dies on the operating table before Ilijaz even begins to treat him. Another patient with liver injuries doesn’t make it through his operation. While Ilijaz works, five others die waiting in their rooms. One is a boy of about thirteen.