Serbia’s total death toll from coronavirus is relatively low, around 3,600, but its rate of fatalities in the medical profession is far higher than in other nations.
Data from the Union of Doctors and Pharmacists (UDP) have revealed that as many as 72 doctors have died from coronavirus in Serbia, a country of seven million people, compared to 43 in the UK, which has a population of more than 60 million.
Serbia has seen just 3,600 deaths in total compared to the UK’s more than 80,000.
Critics blame the state of the country’s healthcare system, which has been massively underfunded since a 2013 hiring freeze on public sector workers, which includes doctors and nurses. When the coronavirus hit, the health sector was not ready.
“Bad organisation, the fatigue of personnel, lack of the equipment: all of it contributed to a high number of deaths among doctors,” Rade Panic, the president of the UDP, told Euronews, adding that the death toll could be higher than the 72 they have counted.
Another issue, Panic said, is that the senior positions in Serbian hospitals tend to be political appointments, meaning the loyalty of hospital managers to the country’s ruling elite is more important than their managerial abilities.
'Our members are afraid'
From the beginning, he said, Serbian hospitals have failed to maintain separate sections between patients with COVID-19 and other illnesses, while the medical sector has suffered from a stark shortage of personal protective equipment (PPE).
When healthcare professionals, via the media, have tried to raise their concerns, he said, the journalists writing the stories have been sanctioned, including one reporter who was arrested in April after highlighting the dire conditions in one hospital.
“There is no free information flow in Serbia, so we collect the data in semi hiding. Even our members are afraid to talk publicly about problems in the health system,” said Panic.
Euronews reached out to Serbia's ministry of health for comment but received no reply.
Serbia’s healthcare sector has struggled for years, as doctors leave the country and its salaries - around €750 per month for a general practitioner and €880 for a specialist - for elsewhere in Europe.
Medical professionals working in COVID-19 red zones during the pandemic receive a 10% salary increase and can be granted an additional €30 - or more - per month, Panic said, but the rules vary and neither the raise nor the bonuses are guaranteed.
They are expected to work 24-hour shifts with two or three days rest.
The government has also alienated medical professionals with statements such as by the head of its COVID-19 response team, Predrag Kon, who on Serbian TV on Tuesday claimed doctors had contracted COVID-19 on their lunch breaks, not at their hospitals.
Kon, who in November was awarded a medal from President Aleksandar Vucic for his work fighting the virus, retracted the statement after a public outcry.
Zoran Radovanović, professor of epidemiology at the University of Belgrade and a former colleague of Kon, told Euronews that he was shocked by the statement.
“Could you imagine that doctors, with the protective gear taking a coffee break? Some even do not even drink fluids before going to work, because it is not practical to go on a toilet break”, he said.
Radovanovic also fears the number of medical professionals who have died after contracting coronavirus could be higher than the 72 suggested by the doctors’ union.
The lack of PPE is acute, medical professionals say, with doctors in the early days of the pandemic given dust masks rather than medical masks to protect themselves. This at a time when Vucic was referring to medical staff as “fighters on the front line”.
Panic said that at the beginning of the pandemic patients in hospitals received antibody tests rather than PCR tests, which can be inaccurate as COVID-19 antibodies can take a week to develop. This resulted in infected patients being treated on regular wards.
“Sick people were taken to 'clean' wards where they were treated by doctors without protection,” he said.
Even two new hospitals - equipped with donations from China, the European Union, Russia, and the UAE - have suffered from severe staffing shortages. Long lines can be observed outside Serbia hospitals, including pregnancy wards.
It has prompted some, like retired pulmonologist Slavica Plavsic, to take matters into their own hands.
Angry that the government has not - as in other European states - drafted retired doctors to help treat coronavirus patients, she has started offering her expertise on Twitter. In at least one case, she told Euronews, she was able to save somebody’s life.
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