Some Aspects of Beginning of a Co-operation Between Psychiatric Hospitals in Yugoslavia: Continuing Research on “STATIONS FOR MENTAL DISORDERS” in Sarajevo

Author: Urska

Date: 28. October 2019

Continuing research related to the organization of psychiatric care in Austro-Hungary, (the history of psychiatry in the Kingdom of Yugoslavia), researcher dr. Jelena Seferović analyzed the official documentation on the work of the “Station for people with mental disorders”. The station was part of the Vakuf Hospital in Sarajevo. She also analyzed newspaper articles recorded in the Sarajevski list. In October, she again visited the Archives of Bosnia and Herzegovina, in which she read archival material dating from 1907 to 1908, with a focus on the last operation year of the “Station”. In the Sarajevo Historical Archive, she browsed through the digital postcards database of Sarajevo and read Todor Krusevac’s book Sarajevo pod Austro-Ugarskom upravom (1878.-1918.), with a focus on the chapter on the history of health. In the library of the Commission to Preserve National Monuments of Bosnia and Herzegovina, she explored the historical literature on the issue of general social circumstances in Sarajevo in the late 19th and early 20th centuries. She analyzed the book Gazi Husrev-Beg i njegove zadužbine, authored by Ahmed Mehmedović and Sarajevo između dobrotvorstva i zla, written by Nijazij Kostović. The text below was based on the archival research mentioned above and the information collected in the available literature.

Nadmlini, street in the old part of Sarajevo that leads to the “Station for People with Mental Disorders” of the former Vakuf Hospital. On the postcard, up in the left corner, the building is still visible; postcard code 918.ZFR-1848, owned by the Historical Archive in Sarajevo.

The “Station for people with mental disorders” opened on July 1, 1894, at the Vakuf Hospital premises. It was the first healthcare institution in Bosnia and Herzegovina. It became undercapitalized and as a consequence, they built a general hospital in the Sarajevo settlement, called Koševo. At the beginning, “Koševo” had 250 beds, but the institution was supposed to accommodate up to 300 patients. In the “Station” building, on the other hand, there were about 40 beds intended for people with mental disorders. According to a report on the number of hospitalizations in mid-December 1904, 32 patients were treated in this hospital, while in October 1907 the number doubled and reached 70. As the hospital space was too small to receive all the population from this area, the patients of “Station” were transferred to a psychiatric hospital in the suburbs of Zagreb, called “Stenjevec”, when there were obvious psychological disorders.

Previous research carried out as part of this project has shown that in “Stenjevec” one of the dominant treatment methods was occupational therapy, while Sarajevo’s “Station” was more like a place for safekeeping the people with mental disorders. The reason why the Sarajevo Psychiatric Hospital did not have advanced occupational therapy could be explained by the fact that the Vakuf Hospital was built on the Nadkovači hill. Therefore it did not have land suitable for agricultural activities, livestock breeding or craft workshops, as was the case in “Stenjevec”. From a letter of one paramedic sent to the administration of this station, dated July 29, 1907, it is obvious that he must care for the patients there day and night, that he must always be awake because they lack hospital staff. The signed paramedic points out that a large number of patients are “restless and upset” and must be guarded against harming themselves. With that being said, “in such cases, patients and our clothes are torn apart and do considerable harm to us.”

As for the doctors themselves at “Station”, it seems that there were no specialized psychiatrists. Until the occupation of Austria-Hungary in 1878, several military doctors and 2 civilians, Dr. Kečet and Dr. Kramer, worked in Sarajevo. By the end of World War I there were about 40 of them, but they never mention any psychiatrists. In addition, a question arises as to which profession was truly a paramedic whose contents of the letter were previously referenced, since the first courses for the education of paramedics were not organized until 1910. Despite the literature saying that “psychiatric observation was carried out at the station. treatment and patient care”, it remains an open question as to how well psychiatric diagnoses were provided to patients, as well as how expertly they were approached, given that staff was not adequately educated.

Considering that the “Station for people for mental disorders” was built of brittle material and that minimal resources were allocated for its maintenance, in the end, the building was destroyed. As already mentioned in the July report, the building was declared a cultural monument in 2007 and placed under the protection of the Commission to Preserve National Monuments of Bosnia and Herzegovina. Although small in size with a minimum number of beds to accommodate patients, this “Station” has played an important role in the care of this population residing in Bosnia and Herzegovina. Temporary accommodation and care provided to the patients of this institution could not contribute to a significant improvement in their emotional and social functioning, it is likely that it has, at least to some extent, made it easier for them and their families to cope with the demands of their health conditions.

Speaking about the organization of the psychiatric care system during the First World War and the interwar years in the Kingdom of Yugoslavia, it would be indispensable to mention the phenomenon of fluctuation of patients with mental disorders between several psychiatric institutions in the area at that time. Considering the geographical area that is the focus of this research project, it would be indispensable to mention the cooperation between the psychiatry department at “Koševo” with the psychiatric hospital “Stenjevec”, ie Vrapce and the one in Pakrac. Also, it should be pointed out that there are frequent cases of cooperation between the aforementioned institutions with the psychiatric hospital “Polje” in Ljubljana and the Pokrajinska ludnica in Šibenik. It should be noted that both institutions mentioned above started operating at the very beginning of the 80s of 19 century. In this way, they have contributed to the positive changes in the development of the position of people with mental disorders and their organized psychiatric care in Austria Hungary.

Graditeljska cjelina – Hastahana (zgrada Vakufske bolnice) u Sarajevu, opština Stari Grad, FBiH (“Sl. glasnik BiH”, br. 3/08,48/13)