War Hospital

by Sheri Fink

  * * *

  OVER THE DAY, with assaults and shelling of the Bosnian lines, the Serbs succeed in regaining the positions they lost in the early morning. The Srebrenica defense collapses. About 6:30 P.M., 150 Serb infantry soldiers appear on high ground overlooking the town, advancing across a ridgeline where the Dutch failed to establish their last blocking position. Dutch soldiers in another blocking position fire flares from their 3.2-inch mortar. Machine gun fire peppers the air above the Serbs’ heads. The Dutchbat commander requests close air support, and his request is approved at lower U.N. levels in Tuzla and Sarajevo and passed all the way to Commander Bernard Janvier’s U.N. Protection Force headquarters in Zagreb. Janvier orders that NATO planes be “cockpit ready” and convenes a meeting of his crisis staff in Zagreb.

  After about an hour, the Serb soldiers regress in a southwesterly direction behind the ridgeline. The B Company commander orders the blocking positions to fall back closer to town to avoid being outflanked at night. Panicked Srebrenicans surround the Dutch APCs. At the same time, fearful crowds of people move north, away from the town center and from the south of the enclave, collecting outside of the hospital and breaking into the B Company base in Srebrenica.

  Christina telexes Colonel Karremans “and everybody who is concerned” at Dutchbat, reporting that 10,000 people are massed before the hospital and that the mayor has requested the Dutchbat commander come to the post office building.

  “We urge you to take some immediate action,” Christina writes. “The population and the hospital are without protection and shelling is going on…. On behalf of MSF I request assistance for the population. This is a nonacceptable situation.”

  Medical staff and their families crowd into the small underground bunker. “We can hardly move anymore,” Christina reports to MSF headquarters, “and it is difficult with the screaming children to keep the radio contact.” She writes that the United Nations is failing to update her, and the population is relying on MSF to help them.

  The Serb advance halts around 11 P.M. The enclave quiets. Srebrenica soldiers push most of the population back to their homes in the center, but the dozens of local medical workers, along with their spouses and children, refuse to leave the bunker, demanding some sort of a solution to the crisis. Christina senses that they’re desperate and tired and that they want to leave their prison.

  “We’d love to help you,” she tells them, “but we can’t.” All she can do is contact MSF Belgrade again to report that the population wants to leave Srebrenica and that a solution must be found. She spends much time and energy trying to convince the locals that it won’t be possible to sleep with eighty people crammed into the small bunker. She tells them to leave and go sleep in the hospital. She has sympathy for them, yes, but she has to keep her own mind together to be able to continue with her job. Finally they leave, and she settles down for a few hours of sleep.

  Meanwhile, around midnight, Ilijaz breaks away from the hospital for a meeting of the high command—about fifteen military commanders and civilian authorities, including the mayor, deputy mayor, president of the executive council, and the Bosnian army chief of staff—in the post office building. Gathered by candlelight around a large table covered with maps, they discuss whether to launch another counteroffensive in the morning or plan a massive retreat from the enclave on foot through enemy territory toward Tuzla or elsewhere. The question is—if they retreat, what will become of the civilians? They can’t possibly take along all of the children, the elderly, and the infirm for scores of miles, and neither can they abandon them to the Chetniks. The only option seems to be to stay and fight.

  The command studies the maps and plans a counteroffensive. One brigade will attempt to defend the city while another, numbering about 1,000, will move to outflank the Serbs and attack their positions from the rear. The Srebrenicans have two factors in their favor: One, Serb tanks will be less effective at night. Two, the territory, since it falls inside the enclave boundaries, lacks land mines and is more familiar to the Srebrenicans than to their attackers.

  At the end of the planning meeting, Dutchbat Commander Karremans appears at the door. Ilijaz has the creepy feeling of having been spied upon. The commander sits down at their table, looking at their maps as if he’s been invited to join them.

  The commander announces that if the Bosnian Serb army has not withdrawn to the boundaries of the safe area by 6 A.M., NATO will conduct a massive air strike against Serb positions throughout the enclave. He points to the Chetnik troop locations, referring to them as “killing fields.” When the air strikes come, anyone in those regions will be incinerated, he says. Ilijaz infers that if the Srebrenicans are there, engaged in a counterattack, that would mean them, too.

  Ramiz, the acting Bosnian army commander, expresses disbelief. He asks what his forces should do in preparation for the NATO air strike, if it is really to be delivered. Stay as far away as possible from the current confrontation line and take cover in your houses, the U.N. commander replies. The Srebrenicans decide to withdraw one and a quarter miles from Serb positions, and they give up their plans for a counteroffensive.

  In his desperation, Ilijaz believes the Dutch commander’s promise of air strikes. He returns to the hospital churning with anticipation for the sound of NATO jets and massive bomb explosions, which he expects to hear in just a few hours. For the moment, the night remains quiet, as if a ceasefire has already gone into effect. Not a single grenade lands in town.

  About 1 A.M., a Dutch orderly arrives at the hospital carrying a critically injured forty-five-year-old woman found not far from the U.N. base in Potočari. The Dutch medical team refused to use any of its “essential rations” to provide her even the most basic emergency care. She has lain untreated for hours in the Dutch compound. No laparotomy, the opening of the abdomen, has been performed to repair her intestinal injuries. No chest tube has been placed to drain the blood in her chest and prevent her lungs from collapsing. Not even an IV has been started to replace the fluid she is losing from bleeding. All she has received are shots of morphine. A shelling “red alert,” until it was lifted by the Dutch commander minutes ago, kept the compassionate orderly from leaving the U.N. base and bringing her to Srebrenica Hospital. The dozens of shrapnel wounds to the woman’s chest, abdomen, and leg have gone untouched.

  Ilijaz and Daniel O’Brien, the Australian generalist from Doctors Without Borders who is assisting Ilijaz in surgery, are shocked and furious. The neglect of the woman seems to defy all principles of medical ethics. Daniel thinks of Dutchbat’s “amazing” medical facilities sitting unused just a few miles up the road, while here the doctors and nurses struggle to save a few of the many patients who need them, risking their own lives every time they walk up the staircase to the single, exposed, top-floor operating theater. Daniel, just as the others, now feels a sense of dread every time he climbs these stairs. Still, once he’s in the operating theater surrounded by patients in need, like this woman, professional autopilot takes over. Ilijaz and Daniel stabilize the injured woman and then successfully perform the abdominal operation she needs.

  27

  KILLING FIELDS

  THE BLACK-BLUE NIGHT DIFFUSES into damp slate gray as morning breaks on Tuesday, July 11, 1995. At 6 A.M., NATO fighter jets lift off from an airbase in Italy and circle, awaiting orders.

  The yard of Srebrenica Hospital again fills with thousands of people. A creepy silence reigns. The sky presses down on the town with a thick, smoke-like fog that smells of gunpowder and makes the people whisper. Someone, they suppose, is marking targets for NATO. The people wait, eyes turned up the sky, ears perked for the sounds of the “killing fields.”

  North of the hospital in Potočari, Dutch soldiers sit in their bunkers wearing powder-blue U.N. hardhats and bulletproof vests, steeling themselves for massive air attacks and possible reprisals. Of the area held by the Bosnian Serbs: “No stone will be left on another stone,” the soldiers’ commander told them last night. In Tuzla,
the next link up in the U.N. chain of command, officers also wait expectantly for air strikes.

  In Zagreb, Croatia, the U.N. Force Commander, General Janvier, waits, too. But he waits for something different. He never approved last evening’s request for close air support, let alone initiating the other NATO option, massive air strikes. He has no idea that everyone in Srebrenica is expecting them. Somewhere along the U.N. structure—from Zagreb to Sarajevo to Tuzla to Srebrenica—the message, like one passed along in a game of “telephone,” has changed dramatically. What General Janvier awaits is another request for close air support from the Dutchbat commander—a target list with smoking guns, evidence that the Serbs are again attacking U.N. forces. The Dutchbat commander, expecting air strikes, not close air support, has no idea that he needs to make such a request.

  In Srebrenica, a dazzling sun burns away the fog and heats the valley. Ilijaz peels off the flak jacket that he agreed to wear at Christina’s behest. He, too, waits.

  The Dutchbat commander, finally alerted to the fact that NATO air power hinges on his issuing another request for close air support, in addition to the already standing order, tries to fax the necessary paperwork to his superiors at the U.N. office in Tuzla. The fax machine in Tuzla is broken. Eventually, after much back-and-forth, the request reaches the next level in the chain of command, in Sarajevo. The person who receives the request rejects it because it’s on the wrong form. Further delays follow over the question of whether, since the Serbs have momentarily halted the attack, the criteria for close air support have been met. In a Catch-22, the rules for air support require an ongoing attack on a U.N. target, but by the time a request ambles through the bureaucracy to the top decisionmakers, the U.N. soldiers will have withdrawn from the positions under attack.

  Finally, around midday, the air support request, resubmitted on the correct form, reaches U.N. command in Zagreb. General Janvier and the Special Representative of the U.N. Secretary-General, Yasushi Akashi, are pressured, at last, to sign it. Five days into the Serb assault on Srebrenica, the U.N.’s rusty air strike “key” has turned. Now only NATO is needed to unlock the force.

  But the request arrives at the worst possible moment. NATO jets, airborne since 6 A.M., need to land for refueling. For various reasons, the option of in-air refueling is not available today. Considering that the Serbs have not attacked Srebrenica since last night, the planes are sent back to Italy, to be ready again by 2 P.M.

  * * *

  UNABLE TO SIT STILL, Ilijaz buzzes back and forth between the hospital, the bunker, and the post office building. Every minute that passes without air strikes leaves him more convinced that the Serbs will take the town. The fate of the roughly eighty patients in the hospital weighs heavily on his mind. He thinks of Vukovar—where in 1991 Yugoslav soldiers removed dozens of people from the hospital and massacred them in a nearby field. Vukovar was where Eric Dachy had arrived too late, the place that made him resolve to “interpose” somewhere else before such evil happened again. Vukovar was what led MSF to Srebrenica.

  Ilijaz wants to evacuate patients to the U.N. military hospital in Potočari. The other physicians agree, and they meet with Christina to discuss the plan. She doesn’t share their expectation that Srebrenica will soon be overtaken. In any case, she explains, the hospital is a protected, neutral location according to the Geneva Conventions, whereas the Dutch compound is a potential military target. She expresses her preference to keep the patients here.

  Ilijaz likes Christina and admires the calm bravery she’s shown these past few days. But Christina, because she’s only been here a couple of weeks, doesn’t know what he knows about the character of the war. How could she possibly know? Ilijaz reminds her about the Vukovar massacre, where the Geneva Conventions that Christina respects so much failed to protect the hospital. One after another, the other local medical workers express to Christina their fear that Bosnian Serbs will enter Srebrenica Hospital and murder those they find there.

  Christina listens. She doesn’t share the locals’ pessimistic vision, but she sees their determination, and she respects and accepts their decision. She figures this evacuation, like most evacuations in MSF history, will be temporary. She gets on the HF radio and demands that those outside recognize and understand the extent of the locals’ desperation.

  “Is there another source who can confirm your information?” someone on the other side of the radio asks.

  “Well, people,” Christina replies. “I went there with my car. I was collecting injured people. And I saw the Serbs at the entrance of the city. What else do you need?”

  Ilijaz and Commander Ramiz drive to the Dutch Bravo compound just north of the hospital. A large crowd mills outside the base, and Ilijaz has to push through it to reach the gate, which is locked and guarded by armed Dutch soldiers. Ilijaz and Ramiz identify themselves and ask to speak with the guards’ superiors. An officer appears.

  “What do you want?” he asks.

  They explain in fractured English that they think the military situation is hopeless and that they want to evacuate their patients to the Dutch medical base so that at least the helpless, injured people can be saved. The officer categorically refuses, telling Ilijaz that the Dutchbat soldiers don’t want to get involved in the conflict. Ilijaz boils.

  “I’m going straight back to the hospital,” he says. “I’m putting the injured people on properly marked trucks, and in a few minutes those trucks will go to your base. If you don’t open this gate, we’ll break through it with the truck. And your soldiers, if they don’t move, we’ll drive over them.”

  With that, Ilijaz turns around and starts to leave.

  “Stop! Stop!” the officer yells after him. “Let’s talk.”

  There’s still plenty of time, he tells Ilijaz. Let’s wait to see what happens, and if it really becomes necessary then we can arrange proper medical transport to the base at Potočari.

  Ilijaz believes the officer’s playing for time Srebrenica doesn’t have.

  “We’re coming,” he says simply, and returns to the car.

  In front of the hospital, medical workers prepare two trucks, covering their cabs with white sheets marked with a red cross. They pack patients inside like sardines, too quickly to count.

  As they’re working, explosions begin again, the familiar boom of Serb tank fire, not NATO bombs. One of the volunteer drivers flees in panic. A patient, half of whose foot Ilijaz amputated a few days ago, volunteers to take his place. The other driver is the cheerful drummer whose left arm Nedret and Ilijaz amputated without anesthesia in 1992. The trucks drive off to the Dutch compound.

  As the day spins forward, the population fractionates on the weight of their expected fates. One MSF translator rushes down into the bunker to find Christina dressed in her bulletproof vest, hardhat, and the “MSF”emblazoned clothing that distinguishes her from the local Srebrenicans. For several days now, the translator has asked Christina what will happen to the thirteen MSF local staff members if the Serbs take the town. Will MSF provide protection for himself and his family? He hasn’t felt as if she’s given him a clear answer, and now he needs one.

  “Christina,” he begins, “I have a four-and-a-half-month old baby…. Can you give protection for myself and my wife?”

  “No,” she answers. “I can’t guarantee your protection.” She doesn’t believe she has the power. In fact, in the entire history of MSF and most humanitarian organizations, it has been rare for internationals who choose to evacuate during times of insecurity to take along their local staff. In Rwanda in 1994, hundreds of the local hires from humanitarian aid and intergovernmental organizations were left to their killers as their employers fled. The MSF Srebrenica security plan discusses what equipment expatriates should take with them in case of an evacuation, but does not address the issue of what to do with locals. But even as the staff panics around her, Christina clings to the belief that any evacuation that might occur in Srebrenica will be only temporary.

 
Another local aid worker, the employee of another nongovermental organization, the Swedish Rescue Services Agency, which doesn’t have an international presence in Srebrenica, jogs down the steps into the bunker to send a final message to his bosses that the town is falling. He has used the MSF telex twice to send messages to them, but now Christina tells him she doesn’t want him to use it anymore. She is afraid to let locals use the machine out of fear that they will send military information in a telex that carries the MSF imprint.

  The local aid worker is furious. Christina seems too cool to him. How can she be going about her job so calmly, asking for numbers of injured, numbers of dead, and smiling? And how can she refuse him now? Doesn’t she realize that the town is about to fall?

  The worker has seen so much death these past years that he is not afraid of it any more, but he is still afraid of pain. He has scoured the hospital for pain killers to take with him if Srebrenica falls, but the strongest he’s found is pentazocine. He wants morphine. He turns to Daniel, the Australian, noticing that the young doctor has taken the time to comb his hair neatly, as if trying to convince himself that the situation is under control, but his body language belies fear and utter exhaustion. The local worker asks for some ampoules of the strong pain killer, thinking mistakenly that Daniel might have them. Daniel looks at him strangely. “Why do you need that?” he asks. The local worker looks back at him, speechless. That’s when he realizes that MSF’s Daniel and Christina have no idea what is about to happen, that thousands of people are about to flee across enemy territory in a desperate bid to reach safety that could last days or weeks.

  * * *

  ILIJAZ CROSSES THE STREET to the post office building, where he watches Srebrenica’s acting commander and war president attempt—and fail—to reach the Bosnian president by ham radio to report that Srebrenica is falling. Ilijaz hears that two shells have fallen on Camp Bravo, where the patients were delivered, reinjuring some. He runs back across the street to the hospital and joins the nearly complete contingent of 125 local medical workers, who’ve gathered in the surgical department to decide what to do. Nurses are crying. The air fills with a cacophony of opinions.