ORGANIZATION AND ACTIVITY OF THE HEALTH-SERVICE IN THE CROATIAN PROVINCE OF LIKA IN THE FIRST YEAR OF THE WAR

The aim of this report is to present the various aspects of the reorga nization of the health service in the Croatian province of Lika during the first year, 1991-1992, of the war in Croatia. In the former Socia list Republic of Yugoslavia, the health service was completely in the hands of the state, and Croatia was not able to transform it in the fi rst year of its independence. The paper documents the personnel, suppl ies, and equipment that the health service of Lika had at its disposal in the first year of the war, the division of the health service into the stationary and front-line medical corps, and the evacuation proto cols developed to transfer surgical patients to the rear-area hospital . The response of the health service allowed for rapid and successful patient treatment, emphasized by the fact that the usual time elapsed between wounding and delivery of the patient to the operating table wa s less than 30 minutes. All surgeries, with the exception of those inv olving severe craniocerebral injuries, were performed in the war hospi tals of Lika. After stabilization of their postoperative condition, ge nerally within 30 minutes, patients were evacuated to the rear-area ho spital in Rijeka, with artificial respiration. The distance by road fr om the mar hospitals in Otocac and Gospic to the rear-area hospital in Rijeka was 120 and 170 km, respectively. Collectively, the results of our work demonstrate that a nonmilitary health service can be transfo rmed successfully and efficiently into a war medical service. Yet, we believe that this is possible only under the extreme conditions of a d efensive mar.