By DASHNOR KALOÇI
Part Four
Memorie.al / Although it was greatly propagandized that “unlike the capitalist countries, in Socialist Albania the health service was free for all citizens,” throughout the entire period of the communist regime of Enver Hoxha and his successor, Ramiz Alia, it left much to be desired. In fact, in many aspects, such as the apparatus and equipment of hospitals and other health facilities with various contemporary medicines and medicaments, it was a problem that remained unresolved until the collapse of that regime. But one of the greatest wounds of the health care of the pre-1990s, it is said, has been that of the high number of deaths of children aged 0 to 1 year, or as it was otherwise known in medical terminology, “infant mortality.”
Among other things, this is also made known by several archival documents of the Ministry of Health of that time, where its correspondence is found with some of the highest party and state institutions and organs of that time, in which it is made known that only during the year 1971, in all the districts of the country, out of 72,771 births, 7,027 deaths were recorded in children aged 0 to 1 year.
But what shocked Tirana and alarmed the high party and state leadership of that time was the death of 27 infants in the Maternity Hospital of Tirana (today the “Nana Mbretëreshë” Maternity Hospital) only during several days at the end of September and the beginning of October 1972, a thing which forced the relevant organs of that time to close the Maternity Hospital of Tirana entirely. But why did such a high number of deaths occur in that maternity hospital at that time and what were the reasons that the decision was taken to close that Maternity Home? What is said in the report-informations of the Minister of Health of that time, Dr. Llambi Ziçishti, sent to the highest instances of the state, and what was the reaction and answer of the high leadership of that time, starting from Prime Minister Mehmet Shehu, Secretary of the Central Committee of the PLA, Hysni Kapo, First Secretary of the Party Committee of Tirana and member of the Political Bureau, Manush Myftiu, etc.?
The following archival documents, published for the first time, bring a detailed overview of the alarming situation of infant mortality in Albania of 1971, as well as the efforts of the state apparatus to bring under control this tragic phenomenon. Through the relation of the Deputy Minister of Health, Dr. Kleo Miho, as well as official reports signed by Dr. Bukurije Maçi at the Directorate of Mother and Child, the true picture of the medical service in the districts and villages during the communist regime is unveiled.
These official documents of the beginning of 1972 bring to light not only the high figures of infant mortality, where respiratory tract diseases such as bronchopneumonia accounted for up to 60% of cases, but also the deep infrastructural backwardness in rural areas. The documents reveal the failure of the plan for the construction of maternity homes and consultories, the lack of maternity leave and medical check-ups for children 0-3 years old, as well as the scandalous conditions of food in village kindergartens, where even the most basic items such as wheat bread and milk were missing. Through an administrative self-criticism, the reports also strike at the bureaucracy of the local health sections and the superficial or fictitious reflection of demographic data from the districts. Regarding this etc., the documents in question acquaint us, taken from the Central State Archive (fund of the former Central Committee of the PLA), which are published for the first time and with the relevant facsimiles by Memorie.al
Continues from the previous issue
REPORT-INFORMATION OF THE DIRECTOR OF THE DIRECTORATE “MOTHER AND CHILD,” AT THE MINISTRY OF HEALTH, DR. BUKURIE MAÇI, SENT TO THE PRESIDIUM OF THE PEOPLE’S ASSEMBLY, REGARDING THE HIGH NUMBER OF DEATHS OF CHILDREN DURING THE YEAR 1972
PEOPLE’S REPUBLIC OF ALBANIA Tirana, 10.1.1973
MINISTRY OF HEALTH
Directorate of Mother and Child
No. 472 Prot.
TO THE PRESIDIUM OF THE PEOPLE’S ASSEMBLY
Sector of People’s Councils
T I R A N A
Attached we are sending you a provisional table of infant mortality for the year 1972 and comparative with the three previous years. As can be seen, there is a decrease from the years 1970 and ’71, a decrease which is observed in all districts. If we take into account the great flu epidemic in the months of November-December, as well as the epidemic virosis of the months of June-September of this year (1972) which mainly affected small children, this decrease is relatively sensitive and approaches the year 1969, which has been the calmest year.
The measures that have been taken in the direction of protecting the health of the mother and child have influenced quite a lot and certainly, without the above-mentioned epidemics, infant mortality would be below the level of the year 1969. This strengthens our conviction that with the strengthening of all-around medical and social measures and with a greater interest of all organs, organizations, and the whole society, in the future infant mortality will progressively falls.
During the year 1972 a greater interest has been shown for the health of the child and the mother. In this direction, the taking in hand of the problem by the organs of the Party and Power at the base, the periodic analyses that have been made to this problem in the districts up to the people’s councils of the district, the control and help from above, as well as the two analyses that were made to this issue in the presidium of the Council of Ministers, have also helped.
During the year 1972 the highest mortality has been recorded in the districts of Dibra, Kukësi, Shkodra, and Puka, as can be seen in the table. The highest is in Dibra and the percentage of decrease in this district is almost imperceptible. A good role in this direction has been played by the increase of cadres and health institutions in the village, and in particular the placement of the nurse-midwife in every village.
But regarding the securing of the workplace of the midwife, the consultory, and especially the opening of the maternity home in the village, it must be emphasized that the majority of districts are still very behind, a thing which hinders the work of health cadres and the help of pregnant women and children.
All districts have not fulfilled even 50% of the maternity homes in the village and the majority of consultories they have in one room with the treatment ambulance. However, we must accept that there is a turning point and if the necessary measures are insisted upon further, certainly in the future infant mortality will undergo an even more sensitive decrease.
FOR THE DIRECTORATE
Dr. Bukurije Maçi
REPORT-INFORMATION OF THE MINISTER OF HEALTH, PROF. DR. LLAMBI ZIÇISHTI, SENT TO THE EXECUTIVE COMMITTEES OF THE DISTRICTS, REGARDING THE SEVERE SITUATION IN THE MATERNITY HOSPITAL OF TIRANA AND THE HOSPITALS OF KUKËSI, PUKA, AND ELBASAN, AS WELL AS THE MEASURES TAKEN AND THE PUNISHMENTS GIVEN FOR THE RESPONSIBLE DOCTORS
PEOPLE’S REPUBLIC OF ALBANIA
MINISTRY OF HEALTH
“T H E C A B I N E T”
Tirana, 13.4.1973
No. 434 Prot.
TO THE EXECUTIVE COMMITTEE OF THE P.C. OF THE DISTRICT
P r e s i d i u m
DIRECTORATE _________________
Despite the attention that has been continuously drawn to the organs and health institutions regarding the mistakes and faults from carelessness in service, there still exist such cases, which have endangered the lives of patients or have caused their death.
This shows that with the medical personnel a sufficient educational and technical-professional work is not done, that the proper attention has not been paid to the materials of the Party and the instructions of the department regarding responsibility and correctness in service.
The leading organs of health in the district and those of the central institutions do not make as much as they should an harsh war against the manifestations of sluggishness, of the work of “hit and run” and without responsibility; they have not everywhere taken the necessary measures for the strengthening of control and the perfection of organization in all the links of the service. Here is also the source of the ugly events that have happened recently in some institutions of our country.
In the Maternity Home in Tirana, as a result of the weak measures for the prevention of nosocomial infection in newborns and of the reconciliation with unacceptable conditions for an institution of this nature, a few months ago an epidemic infection with pathogenic coli broke out, which caused the death of more than 25 children. This is one of the most shocking events in the field of medical service.
In the hospital of Elbasan, after the act that caused the death of a patient sensitive to penicillin to whom from carelessness a such medicament was mistakenly injected, again in the surgery ward, during a surgical intervention a patient with reinforced appendicitis was left with a gauze in the abdomen, which was found after the second intervention following which the patient died. This act of carelessness on the part of the surgeon Elez Elezi was followed by another ugly act, which severely violates medical morality and ethics.
The doctors present at the second intervention decided to keep this action secret, they did not document it at all in the patient’s personal card and did not inform the leading organs. There is a heavy responsibility for this act not only for the doctor Elez Elezi, a member of the fault, but also for the doctors Kol Papajani, Head of the surgery ward, the surgeon Perikli Sheti, and the radiologist Engjëll Kongoli, etc., who tried to cover up the fault.
In the district of Shkodra, the nurse of the Dajçi zone lies to the health organs regarding the vaccinations against diphtheria, which he reports as carried out. As a result there was a pronounced increase in cases with this disease. The same thing was also proven in the district of Kukësi with the nurse Muharem Parllaku. In this district there was also passivity – death from diphtheria.
In the district of Puka, in the hospital of Gjegjan, from the carelessness of the nurse Marie Mëhilli, instead of the pyramidon solution, a spoonful of perhydrol was given to the sick child, which according to the medico-legal expertise was the cause of the death of the little patient. The Collegium of the Ministry analyzed these heavy faults and decided that for the persons listed below the following measures are taken:
In the Maternity Home in Tirana, the doctor Ilir Gjylbegu is dismissed from the functions of director of the institution, the doctor Apostol Lira, Deputy Director of this institution is given a remark with warning, and the doctor Marie Sina, responsible of the children’s ward is dismissed from duty and removed from the Maternity Home.
In the Hospital of Elbasan, the head of the surgery ward Kol Papajani is dismissed from responsibility and sent to work in the district; the doctor Perikli Sheti is given a remark with warning. The doctor Elez Elezi has been arrested by the prosecution organs.
The nurses Abaz Lala of the district of Shkodra, Muharrem Parllaku of the district of Kukësi, and Marie Mëhilli of the district of Puka were handed over to the judicial organs.
The Ministry of Health once again draws the attention of the health organs to strengthen their work in the direction of the ideological and professional education of the workers, for the merciless fight against all manifestations of sluggishness in the attitude toward duty and toward the sick.
Health workers must become an example of correctness and devotion in work. The collectives of the institutions must maintain a harsh stance toward all cadres who with their weak and careless work damage even a little the health of man.
The last speech of Comrade Enver must be studied continuously and carefully. Through it, all the subjective defects that hinder the proper conduct of work in the health sector must be reviewed once again.
The measures taken recently by the Ministry of Health should become an example so that every health worker has it clear that despite the great successes achieved in the medical sector, every act of carelessness in work, every attitude foreign to socialist morality and ethics must receive the deserved punishment.
This letter should be worked on with all the health workers in the district. / Memorie.al
M I N I S T E R
Prof. Llambi Ziçishti
