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Epidemiologist's COVID-19 death raises concern in Bosnia

SARAJEVO – Less than three weeks ago, respected Bosnian epidemiologist Sefik Pasagic was fielding calls from journalists on how to prepare for the approaching coronavirus pandemic in the Balkan country.

The former World Health Organization liaison in Sarajevo offered simple advice: wash your hands, disinfect, stay home, trust the system and follow government orders.

On Tuesday, it was announced that the 60-year-old father of four died of COVID-19 complications, after what his widow described as an unnecessarily long and desperate struggle to get the help he needed. Health officials say they followed protocols and did their very best to save him.

“My husband was not killed by the coronavirus, he was killed by our health care system,” Elna Pasagic wrote in an open letter.

“When this can happen to a respected doctor and community health expert … what should a pensioner or a simple worker expect?” she asked.

Even before the pandemic Bosnia's health system was in poor shape, and the country has suffered severe doctor and nurse shortages since its 1992-95 civil war. In 2013, the last year for which reliable data is available, it had some 188 physicians to 100,000 people or nearly 2.4 times less than the norm prescribed by the WHO.

Health care workers are underpaid, overworked and short on protective and medical equipment. Bosnia’s largest hospital, in Sarajevo, has fewer than 2,000 in-patient beds, with only 173 in intensive care units.

According to Elna Pasagic' widely re-published account, the family begged doctors for over 10 days to examine her husband and test him for the coronavirus.

She was repeatedly instructed to dial various phone numbers, and told doctors cannot visit her husband at home or see him in a clinic because they lack protective equipment. They allegedly instructed her to administer antibiotics and feed him beetroot and spinach to increase his red blood cell count.

Under Bosnian government guidelines — similar to those in several countries — suspected COVID-19 patients are advised not to visit a doctor unless they develop serious symptoms, and cannot get tested in the public health care system without an epidemiologist’s recommendation.

Desperate, Sefik Pasagic turned to a private clinic where a CT scan revealed lung damage, although a coronavirus test was negative. New tests on March 31, when he was finally hospitalized, confirmed the infection.

Pasagic, a champion of healthy lifestyle with no underlining conditions, died Sunday while receiving general anesthesia to be put on a ventilator, five days after being admitted to an isolated wing of the Sarajevo University Hospital for COVID-19 patients.

His wife insisted in her letter that even in hospital he was not properly cared for, but rather left without breathing support for days.

Sefik Pasagic' local community health clinic and the Sarajevo University Hospital have rejected the accusations with the former saying doctors followed protocol and Pasagic was treated with “utmost care and professionalism.”

So far, over 7,000 of Bosnia's 3.5-million population have been tested for the coronavirus, and nearly 4% of 788 who tested positive died.

Most infected people suffer mild or moderate symptoms, but for some it can prove more severe, or fatal.

Bosnia's fatalities included a 52-year-old woman, reportedly with no underlying health conditions, who unsuccessfully pleaded to get tested for over a week after developing severe symptoms. She died in an ambulance on the way to a community health care center. The infection was confirmed after her death.

Sarajevo prosecutors have launched an investigation into her death, and said Pasagic’s case will also be investigated.

A tweet by Sarajevo-based journalist Dalija Konakovic after Pasagic’s death reflected growing anger and fear in the country as coronavirus cases and fatalities multiply.

“All over the world people stay home to protect their public health care system, only we are staying home to protect ourselves from ours,” Konakovic tweeted.