Last month, David Poort of Al Jazeera English published a story about the secret work of Tripoli’s health workers during the country’s civil war:
Evading the terror in the hospital corridors, a group of doctors affiliated with the hospital were said to have set up a network of secret field clinics throughout Tripoli, away from the eyes of security forces.
Private homes, schools and other buildings were converted into makeshift operating theatres, supplied with medical equipment that the doctors smuggled out of the hospital’s storage rooms.
It was, according to the doctors, a dangerous undertaking, as stealing equipment from the hospital was sanctioned by severe punishment if discovered.
“We were undercover doctors,” Noureddine Hassan Aribi, a vascular surgeon who was recently appointed as the hospital’s director, recalls when asked about the days when it all started.
“It was a nightmare. There were horrible injuries. My colleagues and I treated many people in houses in the neighbourhood of this hospital. If the wounds were too complicated, we’d take them to a private clinic. We removed bullets and stabilised fractures, using primitive tools such a planks of wood and pieces of metal.
“We created 24 secret field hospitals all over Tripoli. Some of the doctors were caught by Gaddafi’s forces and were taken to prison. At least one of them was killed and another one is still missing,” doctor Aribi told Al Jazeera.
This is not the first time clandestine clinics have been established during civil conflicts. In the 1990s, Slobodan Milošević revoked the autonomy of Kosovo and expanded the power of the Serbian government over Kosovo’s institutions, including the police, courts, educational institutions, and health system.
The change devastated Kosovo’s health system. Almost two thousand ethnic Albanian health workers were dismissed including 263 doctors and 140 professors of medicine. Many others quit after threats and intimidation. By 1991, while ethnic Albanians made up 82% of Kosovo’s population, they made up less than five percent of Kosovo’s public health workforce. The remaining ethnic Albanian health workers were relegated to non-management positions. New rules set down by the Belgrade demanded that Serbian be the official language used in Kosovo hospitals — a language unfamiliar to many ethnic Albanian health workers and patients. Within a few years sixty-four percent of ethnic Albanian health workers had voluntarily or involuntarily left their jobs. The Milošević government filled the vacancies with health workers brought in from other regions of Yugoslavia and from outside the country, many lacking the appropriate expertise. The political interference in the health system undermined patient confidence. After the dismissal of over forty ethnic Albanian doctors, one obstetrics and gynecology department dropped from thirty deliveries per days to fewer than two because Albanian patients did not trust the Serbian health workers.
In response ethnic Albanians organized a “parallel” health care system including private practices in their houses and a network of clinics called the Mother Theresa Society. The Mother Theresa Society ran 96 clinics around Kosovo and was supported by volunteers and a parallel tax system. The ethnic Albanian medical professors and staff fired from University of Pristina even founded a parallel medical school. Instruction was conducted in Albanian and provided students with strong medical knowledge but, due to their lack of access to health facilities, weak clinical skills. During the 1990s this underground medical school graduated 600 doctors and 1,200 nurses. However, the clinic was not safe from violence: during the Kosovo War 90% of Mother Theresa clinics were looted or destroyed.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.