Wednesday, 12 January 2022

300,000 Croatians to Have Their Free Health Insurance Cancelled

January 12th, 2022 - Those who have left Croatia but keep using Croatian public healthcare at the expense of the state will soon be removed from the HZZO database

As many as 300.000 Croatians could soon have their public health insurance policies cancelled by the Croatian Health Insurance Fund (HZZO), reports Novi list. Namely, Health Minister Vili Beroš has announced that the HZZO would be cancelling the policies of those insured whose residency or employment status does not grant them the right to free health coverage anymore.

Most of that list consists of citizens who emigrated in the last decade and now work and reside abroad, but retain their Croatian public health insurance at the expense of the state on the basis of being unemployed in Croatia.

A large number of such policyholders prefer to use the services of GPs or dentists when they visit Croatia, as they find it much more affordable than the equivalent service in the country they currently reside in. It’s estimated that two thirds of Croatian emigrants avail of their health insurance benefits in such a manner.

The HZZO states that a considerably large number of people benefit from the rights guaranteed by their public health insurance despite not paying the compulsory insurance contributions. The exact number could become known in a month’s time, once HZZO and the Croatian Employment Service (HZZ) have merged their databases.

All citizens who are not on file with the HZZ, but avail of the free compulsory health insurance on the basis of their unemployment status, will have their health insurance policies cancelled, as well as their dependents.

According to the director of the HZZO Lucian Vukelić, those citizens who are not registered with the HZZ as unemployed persons could lose their free health insurance policies as early as in February 2022, once the two institutions have signed the data exchange agreement.

In recent years, many Croatian citizens have left their homeland in search of work; while the number of HZZ applicants dropped significantly as a result, they mostly remained on file with the HZZO and held onto their free health insurance.

A number of Croatian emigrants were removed from the HZZO database in the summer of 2021, after a data exchange with the Ministry of the Interior showed which citizens had cancelled their residency in Croatia.

According to the HZZO, at present it’s nearly impossible to find out which Croatian citizens work in other countries where they also pay their health insurance contributions and where they should thus avail of public healthcare as well. Even though it’s illegal to have public health insurance in two countries simultaneously, there still doesn’t exist a unified EU database that would reflect where citizens have contributory health insurance and use public health services.

‘Considering that there’s a bunch of different insurance providers in most countries, it’s impossible to obtain the data. You would have to search all over Europe for each policyholder individually to find out if they’re insured in a certain country. It so happens that no one in Croatia ever cancels their health insurance; [employers in] most EU countries are obligated to insure their workers upon employment, and so we end up with an enormous number of people who work abroad and are insured in Germany, Austria or Norway, whereas in Croatia their public health insurance remains covered by the national budget’, said Vukelić.

The HZZO does not have the exact figures regarding potential savings for the national budget if Croatians who are not factually unemployed were removed from the HZZO’s list of unemployed policyholders.

However, if we were to consider the 300.000 people in question, based on the health contribution rate of 16.5% of a monthly gross salary of e.g. HRK 5,000, the state is HRK 2,7 billion out of pocket each year. This does not even take into account the annual costs of health services in Croatia that such policyholders avail of.

The HZZO will also look to cancel the policies of Croatian citizens who have not left the country, but use the benefits provided by their health coverage even though they are not paying the contributions.

An example of this are undeclared workers who neither pay for the coverage nor are they on file with the HZZ, but retain their free health insurance. Such persons will need to register with the HZZ and find legal work, i.e. pay the relevant taxes and contributions.

 

https://www.novilist.hr/novosti/hrvatska/hzzo-cisti-evidenciju-besplatno-osiguranje-moglo-bi-izgubiti-300-000-ljudi-radi-se-mahom-o-iseljenicima/
Ljerka Bratonja Martinović

Thursday, 30 December 2021

In Praise of Croatian Public Health: My Triple Bypass Success Story

December the 30th, 2021 - The Croatian public health system is faced with a lot of criticism, much of it is unfounded, here's my story.

Last spring was promising me yet another wonderful, very long, carefree and rejuvenating time down by the sea. Retirement is a blessing. It offers freedom of movement (plus freedom of speech if you enjoy it properly) and, especially, total command over one’s time. That's the bright side of it.

Time is man’s only true possession - everything else is precarious, ephemeral, temporary or illusional, much like our own bodies and physical states, for example. They're precarious, ephemeral, temporary, limited, and certainly not a supporting companion to our soul. I think that babies start crying seconds after their birth not because they are terrified by the new environment, but because they experience physical pain. Pain is man’s first experience of the world. Our body is not our friend, and it is less and less so as time goes by.

Health of course is tied to what one does on a daily basis to try to preserve it. Some attempts are futile, most aren't. Some people understand that early on, most don't.

I'm proud to say that my life allowed me to sin for a major part. A lot. Heaps more than most people I guess. I have seen more dawns than twilights, so to speak. Because life in general was generous to me (well, even during the war it was rewarding in many ways when I think of it), serenity prevailed by far over all of my days. When you're young, you are supposed to be all kinds of things when you grow up and you can of course do anything, including becoming an ''adult'' while still underage, because you need to keep up with the boys from your quarter, all of whom are your seniors by quite some years.

You cannot afford to be called a sissy if you didn't smoke, which you would be. At least back then. So I started smoking when I had barely reached the ''ripe old age'' of 16, when of course I knew everything there was to know about life, as did you, I'm sure. Later on, in the long years of studying and then freelancing around the world, partying and booze came into the picture, too, inevitably. Not that I'd get wasted every night, of course, but, well, there was lots of partying and many dawns, and many an estranged taxi taking me to where my bed was while missing my sunglasses and a bottle of water most desperately.

I remember discovering ''The Memories of Hadrian'' somewhere in my early twenties and re-reading that book several times over. Among quite a few memorable points, despite myself being young and utterly healthy, my mind recorded that moment when Hadrian started to become tired of his body which was becoming a nuisance, a traitor, limiting and disabling him. Almost one half of a century later, Hadrian has come to my mind so many, many a time. What a piece of work is man, Master Shakespeare wondered. Indeed.

When you think how you hated your granny (and your mother, and aunt and practically every adult around) who scorned you for not wearing a sweater, not having your shirt tucked in properly, sitting on cold concrete that would certainly make your kidneys ''go bad'', for going out (on a date possibly) with your hair still wet from the shower as a safe way of getting meningitis and inflamed sinuses, not to talk about lessons on how bad smoking is for you and how alcohol damages your liver… But who would listen? All of those irritating pontifications might have been true, but they had nothing to do with you whatsoever in your mind.

And then, how many times have you heard that somebody died of ''a sudden heart attack''? Sudden!?  It took almost all my life so far for me to learn that there is no such thing as a sudden heart attack. Such events, rare as they are, are freak ones. Every stroke or heart attack has its silent and deadly history built up in the years, it has its progress and, especially its cause(s) that live with you for a long time before that. You pay no attention, and then you're suddenly being transported to an emergency ward. Genetics play a role of course, but the cause is - you. Or, in my case - me. Also because my granny got on my nerves so much. 

The experience I had was more that terrible, and I want to share some of it.

I was in London some eight years ago when the very first rays of warning shone up inside my brain. One day I was walking from an underground station to the house of my friends where I stayed. It was an everyday routine, nothing special, and quite a short distance too. I might have been less than 100 metres from the house when I felt my right calf suddenly become stiff, further steps were oddly difficult, I started limping and hardly made it to the gate. The remaining several days were highly marked by that. I had pains when walking, I could not walk for long, either. It was sudden. It was frightening. That is when I was reminded of the not-so-good genetics pertaining to arteries in my family. There I was. It has caught up with me despite my lack of attention. I should have listened.

Back in Zagreb I hardly made it upstairs, dragging a suitcase along with me to my apartment at the same time. All alarms then began ringing inside me. This was no pulled muscle, and no self-resolving, passing ailment. One or two calls to my friends sent me to a hospital right away. There was a clog in my artery that had stopped the flow of blood to my leg almost completely and the operation, performed under local anaesthesia, was carried out by a young doctor who I made laugh heartily while he dealt with the clog.

When you must not move an eyelash for almost two hours, it feels much longer than it is.  I was alone in a spacious room, I had a TV, my own internet and actually had a good time within the circumstances, however ''disturbed'' by frequent check-ups and controls by medics. The care was total and complete and made me feel safe and comfortable. It was proof that the Croatian public health system, while underfunded, was beyond excellent.

This happened somewhere exactly around Easter Day and I was glad I could avoid traditional lunches and coloured eggs. That’s for kids, I find. Five days later I was back in the normal world with a clean artery and feeling quite good, quite normal again. I avoided driving and public transportation and walked everywhere I could. That is how you control cardiovascular diseases which only require conservative treatment. I soon forgot about that.

Pain gone and experience fading, I soon regained my old lifestyle. A thousand parties and no work, as Gertrude Stein defined the Thirties in Paris. Well, almost. Freelancing allows for that, as anyone who has dabbled in that knows well.

As a heavily addicted smoker, I wasn't aware of what I was silently but lethally doing to myself. Friends and family would warn and rebuke me, some strongly. I continued believing that the slogans on tobacco packages about death, cancer and other pretty things could not possibly affect me. Larger than life I was. Isn't cognitive dissonance a strange thing?

I could not bring to my awareness that getting out from a warm restaurant into freezing rain just to have a smoke made my granny turn in her grave while my arteries were getting more and more clogged by the day, by every single puff on a cigarette, by every single drag. My life was so good again, so why should I listen?

Some years went by, the uneasy feeling in my legs was growing once again, slowly but constantly, until I reached the stage when I could barely make a distance of 50 metres and was in almost constant discomfort. My calf writhing with each step as my body desperately tried to transport adequate oxygenated blood. In vain.  

It was a wonderful evening with a gang of friends of an international composition, with so much fun, laughter, totally uninhibited by ''Weltschmerz'' and the futility of life. When we had to change the place because of a rapidly approaching closing time, I realised I would hardly make it on foot.  The other place was less than 200 metres away. The final alarm was on. Again.

One call to a doctor friend put me in hospital almost the same day. During the first check-ups it seemed it was to be an easy intervention, then they took some blood, did some tests and found out that my blood sugar was above 20. It was too dangerous to operate. I was diabetic too, apparently. I had no idea what my body was suffering from, how could I have been so detached? How dare I feel surprised by my neglect? It was almost one week before they managed to bring it down to an operable stage.

I had peripheral arterial disease. An incurable but controllable arterial disease which affects the limbs, mainly the legs. My femoral artery was entirely clogged, and so were some others. Well, there we go. Another operation, a big one this time, with general anaesthetic and consent forms galore. I woke up after some hours, the doctors couldn't believe how brilliant my readings suddenly were, how my body which obviously was in dire need bounced straight back after being given what it needed. Instead of a longer sojourn in intensive care, I was taken quite quickly back to my room to recover. Yet again, more very good care at the hospital, another operation gone well, expertly well. It made me think of all those accolades Croatian medicine has been getting from all over the world. It is very deserved. Take it from me.

A few more years passed by. My left leg still had a few problems, some due to nerve damage following surgery, but it was truly nothing in comparison to how I felt before that last operation. I got used to stopping when I walked, waiting for a minute or two when I experienced claudication, and continuing. Naturally, I didn't feel enthusiastic about walking at all. My legs felt heavy and not willing to be exposed to any strain. Because of the pain it caused, although that pain was actually my saviour which would help to treat my disease, I started avoiding going anywhere on foot.

Unlike that first time, the famous blue Zagreb trams became my favourite way of moving around the city, and driving too. Then, my doctor scolded me, telling me that I must walk, walk and walk some more. By walking and straining the legs, you help your body develop more collateral blood paths, you help your heart, you help your - everything. I did reduce my nicotine intake, with lots of effort and self-control, but I could not abandon it altogether. By the way, for all you dirty smokers out there - I reduced the number of cigarettes by allowing myself to smoke only on the terrace, outside, never  inside the house. It helped. Maybe you could try that, too. It was quite an achievement for me who once smoked 40 per day, but I still couldn't quite kick it to the curb. Idiotic, I know.

My close friend, Lauren, started to force me to walk. We'd take long walks, not just to a cafe. She would get me to do it daily, again and again. I felt better. The splendid Maksimir Park offers infinite combinations and paths to stroll, for as long as you can or want to. I was forced to make at least 6000 - 7000 steps each time. For orientation, I could make some 200 in one go. Imagine the effort! I had to stop many times, but I did it. Never without losing my breath, panting or anything, never feeling that my heart was suffering. But to tell the truth, my physical condition was not exceedingly good. To put it modestly.

Fast-foward to April 2021. The leaves on the trees were turning green, everything was in blossom, Maksimir Park looks truly fabulous at that time of year, permeated with the birds’ twitter and the gentle breeze in the thick tree tops. As nice as all that is, as a Dalmatian from Dubrovnik, I was craving the sea. Addicted to the sea and, especially, to swimming - at least for 6 months a year, usually - I started coining my plan to go to the coast much earlier than usual and to make the ''summer'' a very long one indeed. I decided to have myself checked properly, to be sure I could spend several months in a village, far from my doctor friends in case, God forbid, I needed one. 

I contacted my friend, a renowned vascular surgeon from Zagreb, and asked him if he would be willing to check me up ''properly'', with scans and the works, as I really wanted to know what was going on inside me, especially inside my arteries. At one of those check-ups, I ''demanded'' that he check my heart. Without any apparent sign of anything. I just wanted to be sure. It might have been genetic hint from some of my ancestors from ''up there''. I had no cardiac symptoms that I could discern, it just came out of the blue.

How unfortunately right I was! My blood pressure was through the roof. I was suffering from hypertension which is high blood pressure, a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause heart disease. The ultrasound not only found some other little flaws in my heart, but three main arteries were more or less clogged. I needed a triple coronary bypass in an emergency procedure. I was ordered to stay in the hospital that same moment. In other words, I had to be under permanent custody, linked up to various monitors, as my heart could collapse under the strain at any moment. How and why I had not had a massive heart attack during those thousands of steps in Maksimir Park will remain a secret forever. A miracle, in fact, as told to me by my doctor.

An important reminder: there are very, very few sudden heart attacks. They only hit suddenly, when the silently struggling heart can no longer cope.

I did not have a heart attack, as the intervention occurred just before the inevitable happened, and I did not fear one. I told myself I should have that operation as soon as possible in order to be able to - go to the sea. Baby steps.

I spent two weeks in an utterly nice, freshly renovated ward, feeling alright under the constant telemetric control. I became used to the idea that I must remember the cables attached to me round the clock. To me, there were no signs or signals that my heart was penting up to provide enough oxygenated blood to the rest of me. Once again, to praise the Croatian public health system, it is so good when there is a bunch of communicative doctors and, especially, nurses with who you can share a laugh or two. 

I loved the sliding doors that saved everybody from being woken up by doors slamming somewhere down the corridor. I ignored the fact that I was confined, in detention, it was for my sake and for my good. I also ignored the fact that the pandemic and the inability to have visitors made this period of isolation more conspicuous, in some cases even very cruel. I had all the care I needed, my doctor friend (from another ward) would visit sometimes bringing with him absolute confidence and peace to my soul.

Tests, scans, readings, as the big day arrived. Taken by an ambulance to the central hospital to be operated on, an efficient nurse accompanied me to my new room and a new roommate, and luckily a very funny one. Sarcasm is one of my favourite assistants. New doctors, kind and caring nurses. Preparations for the operation, some not pleasant at all, but all done with patience and total care. The Croatian public health system succeeded very well in making me feel safe, despite all the huge question marks and worries hovering in the air and above my own head. 

The surgery was done. I woke up feeling that I was tied to a bed in an unknown space. It was so dark, just one lamp offered a slip of light somewhere in the distance, at some corner or something, my anaesthetic-induced blurry vision and confusion limited my understanding of my surroundings. My throat felt as if it had been cleaned out by a bit of aged sandpaper. I needed water. I tried to yell, but I produced no sound. I realised I was still intubated. I was helpless. I needed water. There was an attentive nurse on the sentinel who discerned my growling sounds in the dark. It wasn't just water this time, it was the blessing of all the Gods that ever existed to me at that moment. Sleep. More water. Several rounds, a few tests. After some indefinite time, they rolled me back to my room. 

The time of colliding with reality, with the seriousness of my body, had come to me. Thank you, Hadrian, you were so right and I hope you were not this sick and unable. I felt like a broken piece of old furniture chucked out into the street from the fifth floor. One slightest move of any part of my body hurt like hell. I felt like I couldn't breathe properly. I needed air. I needed water. I could not get up. I was even afraid to move my head on the pillow so as to avoid more possible pain. I was just one huge battlefield of all kinds of pains spiced with a total lack of energy, breathlessness and a most absolute state of helplessness. I had done it. I'd reached the absolute pits of my life, the lowest point, a very, very miserable point at that.

All I wanted and could do was sleep, but the attentive staff would not let me enter into a deep and healing slumber, they were in every hour to check on me properly. The care was total, but also irritating. I should've been grateful, not irritated. Yet I was helplessly irritated and wanted only to be left alone. 

The very next day there was a guy of very athletic physique who had a very deep and commanding voice: ''Get up, we're going for a walk!'' the voice said above me.

''For a what? You must be kidding, I can hardly lie on this bed…''

''You must walk, come on, get up!''

I thought I would die right there and then, and the post-operation ordeal seemed totally pointless. He helped me out of my bed with his strong arms, I let out a shriek as my entire body stiffened into a complete and utter pain. My legs were shaky, insecure, pains probed me at random everywhere. We did two lengths of the corridor. I lay back on the bed, depraved of life, in brief. I felt I'd done a marathon. They kept coming in and checking on me and asking me about this and that, taking my blood pressure, my temperature, giving me some pills, pain relief, food, checking on my wounds, measuring this, that, asking similar questions over and over. Irritating at the time, but what amazing care from the Croatian public health system this was.

My sarcastic roommate was released and it made me very sad back then, how I longed to leave this environment. Then, finally the day came when they told me I was going back to my original room in the hospital I was checked in at first. There I found out - I who have been fit and slim all my life, had lost a massive 8 kg. I dared to look at myself in the mirror and immediately thought I'd qualify as a photo model for a labour camp. Even my eyes had changed, they were sullen, sunken, looking back at me hopelessly from some hollow spaces, somehow from afar. My greying skin seemed to have belonged to someone bigger, my arms were like two pieces of dry smoked meat. It was horrendous.

After some days, some more blood tests, some more tests, some more questions, I was tested for covid and then released home. It was the very end of June. The temperature outside was around 30º C. I could make it to the kitchen owing to the help of my hands and door frames only, from one to another, aiming with concentration and focus. I had family there to help me and they couldn't do enough for me, which was a God send. My doctor friend came to check on me, to remove my stitches, to check my wounds. I began to walk, each day a little longer, I began to take my body as seriously as it had so nearly taken me for my negligence.

As I'm writing this six months later, I've put the weight I lost back on and I feel I belong to another, far more normal world with that wonderful sensation when you bend to pick something up and nothing hurts. I have taken up exercise regularly, even physiotherapy (another utterly professional service in the very heart of Zagreb), I try to walk as often as I can, to use my Orbitrek and, well, to be happy, meeting with friends for coffees and lunches with all serenity and joy, remembering well what Hadrian had eerily warned me of such long time ago.

Albeit at times when, indeed, there were also my grandparents and parents and aunts and uncles that I would not listen to regardless of their gender, age or advice. I was young enough to know everything, wasn’t I? Weren't we all?

Do not wait to be hit all of a sudden, don't harm your heart until it says no more, check your health thoroughly and profoundly, give up smoking (I know, it's preposterous coming from a filthy ex chain smoker of like 40 cigarettes a day), but if I can stop totally, you can too. Have a drink and be happy for as long as it lasts, because there is an expiry date and more often than not, it comes silently. 

Say what you want about Croatian corruption, politics, the lack of funding, the lack of... well, a lot. But Croatian public health stepped up and saved my life at the very last minute. There are a great many truly extraordinary doctors and other medical personnel in this country. Just in case you read this article with a cigarette in hand not having moved around for a few days... just sayin’. But why should you listen to me after all I have gone through? I'm not your mother, for God’s sake, so let me just wish you a Happy New Year - from my heart!

If you would like further reading material and/or if you're trying to stop smoking, it's worth noting that cardiovascular disease kill more people in Croatia than anything else. That's right, even the dreaded cancer comes second to the silent killer. Did you know there is an artery called the widow maker? There's a reason. Cardiovascular disease is the leading cause of death and accounts for more than half the overall mortality in this country. Furthermore, cardiovascular mortality has been constantly rising since the 1970s due to our dire habits.

Despite Croatia's observance of World no Tobacco Day, smoking is still killing many here, and it is continuing to cripple the Croatian public health system. Hrvatski dan nepusenja (The Croatian day of non-smoking) is also prominent. Can we reverse the trend? Be a part of it before it's too late.

Saturday, 25 September 2021

Vili Beros to Healthcare Workers: If You Don't Want Vaccine or Test, You Can't Come to Work

September the 25th, 2021 - Croatian Health Minister Vili Beros has issued a clear message to those not wanting to get vaccinated against the novel coronavirus, SARS-CoV-2, and those who don't want to frequently test for it to ensure they're negative.

As Poslovni Dnevnik writes, Vili Beros has stated that safety has no price, and that although costs can always be discussed, safety and security will always come before anything else.

''The process around covid certification is aimed at increasing safety, and safety like that has no price. We can talk about costs, but we will insist on safety above all. We're planning to carry out testing twice a week. We don’t know what to do with those people who choose to refuse a test and also refuse vaccination. In order not to discriminate against anyone, we've introduced the possibility of testing.

It will be free at first, but it can't be like that forever. If someone doesn't want to be tested for the virus, then they will have to enter it in the records of their working hours and will not be able to attend work and will create a problem for the system and for themselves. I can't talk about further actions at this moment in time, but everything will be done in accordance with the law,'' Vili Beros pointed out.

"No responsible person should resort to forgery. As far as I know, there have been no forgeries within the Croatian healthcare system,'' added the Health Minister.

Interior Minister Davor Bozinovic emphasised that covid certificates cannot be forged due to their specificities. Vili Beros repeated the fact that althoug he wants to avoid discrimination, he didn't know how long the testing procedure would be free for healthcare workers who don't want to be vaccinated against the virus.

"The funds for it been secured, but I can't say what the amount is. It's known that there is sick leave control, you have to have a justification for being off work if you're too unwell, and not wanting to be tested is not yet included in the classification of those diseases,'' he warned.

For all you need to know about coronavirus specific to Croatia, including the locations of testing centres and vaccination points, as well as travel rules, make sure to bookmark our dedicated COVID-19 section and choose your preferred language.

Sunday, 1 August 2021

Coronavirus Antibody Count: How to Check Zagreb Vaccine Results?

August 2, 2021 - With one in ten vaccinated people not developing immunity, how can we know our coronavirus antibody count? TCN reporter Ivor Kruljac found an option in Zagreb and learned whether or not his vaccination was a shot in the dark.

Given that a smaller part of vaccinated people (every 10th vaccinated person) fails to develop proper protection, it's necessary to adhere to the basic measures to prevent infection (maintaining social distancing, mask-wearing, maintaining respiratory and hand hygiene, and going into isolation in the event of the development of COVID-19 symptoms - says the paper containing some basic information about the COVID-19 vaccine I received when taking both doses. 

The paper also contains info on how to report side effects and lists some common ones (headaches, developing the shakes, sore muscles, a fever that lasts for a day or two). It also assures that people allergic to food, pollen, insect bites, animal hair, and similar issues can take the vaccine, while those who had a severe reaction to the first dose should either not take the second one or approach it with caution.

With all vaccines having their alleged ups and downs, I opted for Pfizer. Why team Pfizer? Well, the more unserious reasons would be that almost everyone I know at TCN took Pfizer, and I wanted to be cool like them, and also, if it was so good that Croatian elites pushed through to take it earlier in the year, then it is probably good enough for me. 

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Post-vaccine information paper © Ivor Kruljac / Total Croatia News

Check the data, check yourself

But, on a serious note, as with every vaccine you choose, reading the information from the right sources (such as the WHO that started explaining the different technologies and the types of COVID-19 vaccine back in January as well as updating people about the latest info) is the best way to make the choice you feel most comfortable with.

While we witness many people refusing vaccines as they fall victim to fake news, conspiracy theories, and misinformation, some people refuse it for legitimate reasons. Those who suffer from blood clots have more than fair issues and questions about taking the vaccine.

It's worth noting that before you take the vaccine, a staff member will ask you a series of questions about your overall health (do you take any regular medications, have you already had COVID-19, do you have any chronic conditions, did you take antibiotics a month before, etc). Based on your answers, they will determine whether or not you should wait in the presence of medical staff for fifteen minutes, half an hour, or even longer following vaccination, and whether you should even take the vaccine in the first place.

Consulting with your trusty general practitioner and maybe even undergoing a physical examination ahead of vaccination is the best way to be as informed as possible to answer this series of pre-vaccine questions. Paired with general trustworthy vaccine info, your vaccine experience will likely be trouble-free.   

Whether your reason for refusing the vaccine is because of a reasonable concern based on the available information and perhaps your current state of health, or because of some rather absurd misinformation, the recently developed situation in the US best presents the efficiency of the vaccine for your personal safety.

As Bloomberg reports, American president Joe Biden warned Americans that COVID-19 is now a pandemic that strikes only those who aren't vaccinated (49% of Americans have been fully vaccinated at the time of writing this article).

''We've still got a pandemic for those who haven’t gotten the vaccination. It’s that basic, it’s that simple, if you’re vaccinated, you’re not going to die,'' Biden said in late July in Cincinnati.

Choose the (un)lucky number

But, let's leave Biden for a second and get back to the issue at hand, one in ten vaccinated people, unfortunately, fails to develop protection against COVID-19. Despite my best efforts, I couldn't really find any solid medical reason as to why that is, but I'll leave that to the scientists and the doctors.

When it comes to the Pfizer vaccine, after my first dose, I felt sleepy, and the moment I came home, I took a really good nap. Was it due to the vaccine or the fact that I had an early morning appointment and I didn't get much sleep the night before? I'm not sure. As for the second dose, I was prepared for a headache and fever. It seems that these side-effects are practically unavoidable when it comes to Pfizer.

The second dose was received on July the 15th, a couple of days went by, and nothing happened. On one hand, that's great, but why am I not experiencing what the majority seem to experience following their second dose? Could it mean it isn't working? Am I number 10? If I was a medical professional I'd have been able to get the vaccine more quickly, and I would get an antibody test to get a better idea of where things stand.

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Bloodstream © Pixabay

Public vaccine, private tests

The public healthcare system is one of the values Croats do like, despite their complaints. Pay your taxes and keep healthcare widely accessible. That said, sadly waiting lists can become quite long, and the overall debt left the public unsure whether the required medicines would perhaps be unavailable earlier in 2021. When it comes to non-emergency healthcare services, it may not be the worst idea to go see a private health professional (if you can afford it of course).

One such service is provided by Laboratory Breyer, founded in 1997 by a clinical chemistry specialist, Dr. Darija Breyer.

''Our motivation lies in never-ending research to better our service with the aim of increasing the care provided to our customers. Our best advertisement is the customer experience that serves as a starting point for all future appointments and is a foundation for long-lasting trust in our service. We justify the trust of our customers by expressing the highest concern for their health,'' says their official website.

The accessibility to the service is evident in Breyer now has two locations in Zagreb: Ilica 191 and Ede Murtića 9.

''Polyclinic Breyer is aimed at the customer: quality comes first with both customer and laboratory staff spaces combining maximum efficiency and modern design. Our complete service, starting from the reception to the test result is constantly re-evaluated and monitored. All personnel in both locations are included in all activities regarding quality compliance according to the written procedures and working instructions,'' they explain.

Open for communication; you can learn more and get in touch with the polyclinic here.

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Blood analysis © pixabay

(Anti)body count

The informative piece of paper I received says it takes a week after the second dose to reach immunisation, and that our covid certificates for crossing borders will not allow their holders to avoid testing before two weeks from the second dose have passed. So, the plan is simple, wait two weeks and check your antibody levels.

Additionally, sometime during the late evening hours of the eleventh day after the vaccine, the side effects kicked in. I got a bit of a headache, a low-grade fever, and I experienced a bit of shaking. it was of course not all that pleasant but I welcomed it anyway. My body was reacting, and something was happening. So, should I get my antibody levels tested?

Fortunately, with a private clinic being an option, I had time to make a decision, as no appointment in advance was needed.

''How long has it been since you took the second dose?'' the Laboratory Breyer receptionist asked me when I arrived and I said I wanted coronavirus antibody count.

''Two weeks and one day,'' I replied.

''Hm, it might be a bit too early, the time period needed for immunisation can stretch for a whole month after the second dose, that's usually the best time to do the test,'' the expert kindly explained.

An expert, which I'm not, and you should always accept that you can't be good at everything and that someone always knows better than you about something. Still, I kindly asked if I could take the test anyway. Due to the journey, I'm about to take (which TCN readers will have a chance to learn a bit more about in the following weeks), I wanted to see if something had started happening in my body or not. Alright, the immunisation isn't complete, but if they find at least one little antibody in my bloodstream after two weeks, at least we'll know something had started, right?

My turn came quickly, and the nice lady asked me to take a seat and a vile of my blood was quickly taken. The needle was a bit more painful than a mosquito bite typically is, but at least there was no annoying itching afterward. They said the results would arrive in a couple of hours via email.  

They carefully sealed the pierced point and suggested I take a seat in a waiting room. Careful examination of the vein a few minutes later confirmed that all was well. The test took a 220 kuna hit to my paycheck, which isn't that bad, maybe more like a slap.

The sample was taken at 11:09 AM, and results were issued at 15:03, so it was all pretty fast. Despite two weeks not being a long time, I already have 7,236 antibodies. So, the taxpayers didn't waste money on vaccinating me. Hip hip, hooray!

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Vaccine efficiency confirmation, screenshot: Ivor Kruljac/TCN

Of course, vaccines don't mean you can't get sick, but the chances of death or developing a severe clinical picture are unlikely. It's nice to know that the one act that has been saving humanity from diseases for centuries works like a charm, and hopefully, more and more people will follow this positive scientific tradition and take the vaccine—both for themselves and for others.

Learn more about health in Croatia, including insurance, what to do in an emergency, and how to find dentists and doctors on our TC page.

For more about COVID-19 in Croatia, follow TCN's dedicated page and choose your preferred language.

Tuesday, 11 May 2021

Feasibility Study For Hospital Project in Osijek to be Prepared

ZAGREB, 11 May, 2021 - The 35 million kuna contract on the elaboration of a feasibility study for the construction of a new complex housing the hospital centre in Osijek was signed on Tuesday in that biggest eastern Croatian city.

The document on preparing the feasibility study was signed by Health Minister Vili Beroš, the Osijek Hospital Centre head, Željko Zubčić and the representative of the consortium of bidders. As many as 30 million kuna will be provided from European funds, whereas the health ministry will cover the remaining 5.2 million.

Regional Development and EU Funds minister, Nataša Tramišak, said at the contract-signing ceremony that the co-funding from the EU funds was ensured through the "Slavonia, Baranja and Srijem" project.

She said that the construction of the future hospital centre was estimated at two billion kuna, and the exact sum would be known after the Osijek hospital centre provided full information.

Zubčić said that the new hospital centre "is a greenfield investment", and would be built at a new location. He said that the new hospital complex "is a necessity for Osijek and Croatia's east.

The elaboration of the feasibility study is expected to take a year.

(€1 = HRK 7.5)

For more about health in Croatia, follow TCN's dedicated page.

 

 

Saturday, 8 May 2021

Doctors at KBC Zagreb Successfully Perform a Caesarean Section on Respirator-Bound COVID Patient

May 8, 2021 – Doctors at KBC Zagreb were forced to use an unconventional procedure to save two lives when faced with a pregnant COVID patient whose condition was becoming life-threatening.

Doctors in University Hospital Centre Zagreb (KBC Zagreb) managed to perform quite a feat. They did a successful C-Section procedure on a pregnant woman with a bad case of COVID. The patient had to use a respirator to help her breathe. The procedure in question is a brand new technique that is rare in practise.

The University Hospital Centre Zagreb dates back to 1942 and is the country's biggest hospital. It also acts as a teaching hospital for the University of Zagreb's medical programs. KBC Zagreb is one of the country’s most renowned medical institutions with a long tradition of highly skilled medical professionals. So, it doesn’t come as a surprise the team at this institution was the one to do such a complex and risky procedure so successfully.

Urgent Procedure

As reported by index.hr the patient was 32 weeks pregnant. She came to the hospital with a bad case of COVID. The disease compromised her lungs and the doctors decided to put her on a respirator. Seeing how the condition was life-threatening to both the patient and her baby, they eventually decided to do a Caesarean Section. The procedure involved using an unconventional method that was technically very demanding. Circulation was routed through a dialysis machine and special filter in order to reduce the inflammation process and stabilise the patient. At the same time, aided by a team of gynaecologists, the C-Section was successfully performed and the baby was saved.

Both the mother and the child recovered. The hospital released the child already, while the mother is expecting to go home next week. In the end, the exciting story got a happy conclusion. KBC Zagreb doctors once again proved they are deserving of their professional reputation.

Medical professionals in Croatia continue their exhausting fight against the COVID19 epidemic. They urge the population to follow the safety guidelines and help prevent the spread of the disease. It is important to note how KBC Zagreb is working at full capacity. But the recent trend of a slow, but steady drop in the number of new cases is making everyone a bit more optimistic

For more about Covid-19 in Croatia, follow TCN's dedicated page.

Wednesday, 5 May 2021

INA to Donate HRK 1.4 Million To Healthcare Sector

ZAGREB, 5 May, 2021 - The INA oil company will donate HRK 1.4 million to healthcare institutions this year, aware of the exceptional circumstances that the system is faced with due to the coronavirus pandemic, the company said in a press release on Wednesday.

In the wake of last year's earthquakes in Sisak-Moslavina County, INA has donated HRK 500,000 to the Sisak General Hospital and an additional HRK 900,000 to other institutions.

INA plans to donate HRK 150,000 each to the Oncology Department of the Hospital for Children's Diseases in Zagreb and the Clinical Hospital Centre (KBC) in Rijeka as well as HRK 100,000 each to KBC Osijek, the tissue and cell bank at the Sisters of Mercy Hospital in Zagreb, the Hospital for Infectious Diseases in Zagreb, the Cardiology Clinic in Split and two civil society associations.

The Sisak Health Care Centre and the Special Children's Hospital in Gornja Bistra will receive HRK 50,000 each.

The donations are intended for the improvement of diagnostics, procuring new equipment and improving accommodation for patients and working conditions for medical workers.

In addition to money donations, the hospitals will receive a total of 500 litres of INA's Dezinol disinfectant which was developed by INA during the pandemic.

In the past 10 years INA has invested HRK 6.5 million in healthcare in Croatia.

(€1 = HRK 7.5)

For more about business in Croatia, follow TCN's dedicated page

Tuesday, 4 May 2021

Health Minister Vili Beroš Expects Hospitals To Provide Patients With Medical Services

ZAGREB, 4 May, 2021 - Health Minister Vili Beroš on Tuesday said that the solution to acute problem of the shortage of radiologists in two hospitals in Zagreb was within the responsibility of those hospitals and that he expects those institutions to provide patients with appropriate and immediate health services.

"The solution to the acute problem of the shortage of radiologists at the Sisters of Mercy hospital and the clinic for treating cancers, which is part of that health institution, is up to the administration at the hospital and I expect them to provide all the patients with the appropriate medical services, and in particular oncology patients and those with grave diseases," said Beroš.

He underscored that patients have to be above organisational problems of an institution.

Beroš underscored that patients must not be left without services because of organisational problems or human relationships.

"That's my clear message to directors and all their associates who are responsible for managing those processes in hospitals. Problems have to be resolved," said Minister Beroš.

He added that Croatia has an increasing number of younger radiologists with experience in working in clinical centres and health institutions that could be the core of creating a system based on the example of developed countries with advanced health systems.

"Creating an efficient system of radiology services at the country level that could provide efficient, quality and financially rational services to a larger number of health institutions that are faced with a shortage of staff such as radiologists, which surfaced in the Sisters of Mercy hospital, are an inevitable step towards resolving this and similar problems," he underscored.

He underscored that as Minister of Health he has already "launched certain activities to provide organised radiology services based on the experiences of other countries that have proved to be efficient and economically justified and are appropriate to our needs and capacities.

For more about health in Croatia, follow TCN's dedicated page.

Tuesday, 4 May 2021

Opposition Parties File Motion of No Confidence in Health Minister Vili Beroš

ZAGREB, 4 May, 2021 - Parliamentary opposition parties have filed a joint motion for a vote of no confidence in Health Minister Vili Beroš over the accumulated problems in the healthcare sector and scandals related to the minister, Social Democratic Party (SDP) leader Peđa Grbin said on Tuesday.

"The reasons for this move are clear to all citizens - the accumulated debts in the healthcare system resulted in the suspension of deliveries of medicines to hospitals at the height of the pandemic. There are also huge problems with the vaccination system, and we have learned of favourable treatment in the development of the cijepise.hr vaccination registration system," Grbin said.

"The development of this non-functioning system was awarded to people connected with Minister Beroš. There are also suspicious public procurement procedures at the Health Ministry such as one where IT services were awarded to a florist and tenders were fixed for former HDZ health ministers Andrija Hebrang and Neven Ljubičić, which have been cancelled but only after media started writing about them," he added.

"The Health Ministry is simply not functioning. There are no reforms, and the extent to which this affects people's lives could best be seen in a recent case at the Clinic for Tumors where citizens suffering from malignant diseases could not receive adequate care," Grbin said, naming Beroš as the person most responsible for this.

"We want Beroš to go because right now he has done nothing positive for the healthcare system, and all the negative things he has done pose a direct threat to people's health and lives," the SDP leader said. "His departure, however, will not be enough and we will all have to come to grips with the accumulated problems together."

Grbin said that a discussion on Beroš must be held within 30 days, and whether it will be held before or after the 16 May local elections "depends on Prime Minister Andrej Plenković and Parliament Speaker Gordan Jandroković."

The initiative was signed by all opposition groups in parliament except the Croatian Sovereignists, but they have announced that they will vote in favour Beroš's resignation, Grbin said.

MOST's Nikola Grmoja said that his party had been warning for a long time about the problems faced by the healthcare system, including huge debts to drug wholesalers and long waiting lists.

"Beroš, of course, is not the only one to blame, the whole government is responsible. With our signatures we also want to encourage a reform of the healthcare system. All of us in the opposition agree that changes are necessary and should be launched urgently," Grmoja noted.

Sandra Benčić of the green-left We Can! platform said that they supported all the reasons for a no-confidence vote in Beroš, but stressed that the responsibility for the crisis in the healthcare system and the poor management of the coronavirus pandemic mostly lay with Prime Minister Andrej Plenković.

"None of the ministers, and certainly not Minister Beroš, makes decisions on their own. They were not chosen as competent persons in their departments but were chosen based on their loyalty to the prime minister who ultimately makes all decisions. The prime minister cannot be exonerated by his purported unawareness of the scandals for which we seek Beroš's resignation. That's why we ask whether the country can be run by a prime minister who does not know or who does not get key information," Benčić said.

Homeland Movement MP Stjepo Bartulica said that the Croatian healthcare system was too politicised. "There are countless problems and the possible resignation of Minister Beroš will not change things much. We have insisted from the start that the healthcare system should be governed by market principles because now we don't see any mechanisms that will bring about change to the system as this government resists structural reforms," he said.

For more about politics in Croatia, follow TCN's dedicated page.

Monday, 28 December 2020

Croatian Healthcare Workers: Christmas's Forgotten Heroes?

December 28, 2020 – Amidst the difficulties of a second lockdown, a socially distanced Christmas and yet more earthquakes, have we forgotten about Croatian healthcare workers? TCN decided to interview a doctor working on the front line of the fight against COVID

During the first lockdown, it was all about the balconies. Saxophonists, DJs, opera singers – we were entertained on social media by a string of balcony-based stunts that somehow showed resilience, community spirit, humour. Zagreb was no exception. A trend of clapping on balconies in appreciation of healthcare workers passed from country to country and was picked up in Zagreb. After the applause finished, people went back inside. Nothing much had changed. It was a nice enough gesture.

Since the start of summer, no such applause has been heard. Perhaps the release from lockdown gave the signal that the lives of Croatian healthcare workers had also become much easier? That certainly wasn't the case. Though the number of people infected with COVID has grown significantly over recent weeks, Croatian healthcare workers have been treating people sick with COVID since springtime.

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Croatian healthcare workers are currently busier with COVID patients than at any time before. And yet, there are no more trips out onto the balconies to show our appreciation for them. Perhaps it's now too cold outside? Perhaps some aren't aware how busy Croatian healthcare workers currently are with COVID patients? Are we perhaps guilty of taking Croatian healthcare workers for granted? Or, maybe we have simply put Croatian healthcare workers to the back of our minds as we struggle with our own challenges?

Throughout this year, TCN has been pleased to report many instances of generosity and innovation directed towards the fight against COVID. Certainly, not everyone in the country is guilty of forgetting about the Croatian healthcare workers who are on the front line fighting this disease. But, how much impact do these instances have on the general lives of Croatian healthcare workers? What is it like to no longer hear the nightly appreciation from our balconies? And, just what is life like as one of the many Croatian healthcare workers battling COVID in the year of the pandemic? TCN decided to interview one to find out.

The doctor we spoke with is a resident physician, working at a smaller community hospital in the continental part of Croatia. They agreed to speak with us on the condition that they do so anonymously.

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Looking back at the first lockdown, we didn't know so much about COVID back then. We didn't know exactly how it was spread, the different manifestations of the disease, what course the disease took, nor what the recovery could be like. I think the government did a really good job of responding to the threat as they saw it. We had a small spike in cases, but that is minuscule to what we have now.

I think people generally did what they were told because they thought it would be temporary and they could see the sense in starving the disease out.

At the hospital, we were at first caught a little off guard with the amount of PPE we had and some other resources that we needed. For ICU and ventilators, we were well equipped.

Some of the residents were given some paid leave. It was important to put human resources into tiers. Croatian healthcare workers were certainly more predisposed to catching the disease, simply because they were around it every day.

After such great early successes, I was surprised that everything was relaxed later on to allow the tourist season to take place how it did, and for events like the Vukovar commemoration. It felt like it was a calculated risk. The lockdown we are now in is perhaps too little, too late. The disease is out there now, wild. The numbers of infected people are significantly higher.

The difficulty with this disease is that people can be infected and have very few or no symptoms at all. They might not know they are spreading the virus. You might not know you're sitting next to someone who has it.

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Even though we're not at the centre of care for a major population area or city, we saw cases of the disease almost immediately. Our community hospital services an area containing around 150, 000 people. The first cases in April came from nursing homes – elderly, vulnerable people, many with pre-existing conditions. We were well equipped to handle it. Now, we are stretched on a daily basis. We fill the beds with sick people as soon as we empty them.

We wear masks and PPE all day, all the time. All Croatian healthcare workers in hospitals currently do this. Every patient who comes in, regardless of their symptoms, we treat them as though they are carrying the disease.

A lot of residents like me, who are working towards getting their specialty, go to do some periods of work in larger hospitals in the bigger cities. Now, many of those residents have been called back to their community hospitals – we are short on human resources.

The hospital has had to restructure itself significantly. Lots of doctors have been asked to provide cover in the emergency department. Over half of that area is now fully dedicated to COVID.

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What do COVID patients look like in regards to their symptoms? It depends on their age and risk group, but you see people who look like they have flu or bacterial pneumonia, you see people who are in acute respiratory distress. Sometimes they have neurological changes, some of them look like they have had a stroke. Some people who have been infected and have supposedly got over the worst of the symptoms, come back in after a month or two with blood clotting problems – blood clots in the legs, which have a tendency to travel up to the lungs and cause a pulmonary embolism. That's a pretty big medical emergency. Some who have pre-existing heart conditions come in with a heart attack triggered by them catching COVID – it's more complicated trying to revive someone when you know they have COVID. The presentation of the disease is so variable.

It's not only older people. I've seen young people be admitted with serious reactions to COVID - young, healthy people who have no pre-existing conditions. I've seen young people come in with mild symptoms, they are sent home with antibiotics and steroids. That is the standard treatment – antibiotics to prevent a bacterial super-infection and steroids to prevent an acute reaction by the body's immune system to COVID. - that's what can cause big problems later on, in the course of the illness. But, sometimes that's not enough. I had a young patient just last week - super healthy, worked out regularly, no pre-existing conditions – and his lungs just looked awful. He had to go to the ICU immediately (sadly, this patient later died). That's like no disease I've ever seen before. Really, COVID is a completely new kind of animal.

The new strain of COVID? There is evidence that it can be spread more easily, and that it can affect more younger people, but there is no evidence that it is any more severe. The vaccines will work against it.

We're short on ventilators now. Really, we need two free ventilators at any time, in case there is an emergency admission. We are not currently in the position where we always have two free ventilators – sometimes they are all in use. That's a worry. I worked one shift where the anaesthesiologist said “We just don't have any more space for them – we will just have to put them in the hallway”. I've never seen that before.

I've heard of Croatian healthcare workers, colleagues in other hospitals getting sick with COVID and the hospital asks them to prove they got sick at work. It's pretty clear that's the most likely place they would have got sick because they're working with COVID patients. They were forced to be off work, but only on a lower level of sick pay. If you get ill because of being at work, you get full pay. But, they couldn't prove it, so they didn't get that.

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I've been lucky – I haven't caught COVID yet. Well, as far as I know. My pay hasn't gone down, it's gone up – but only because I'm working so many double shifts. I volunteer to provide cover when other members of staff get sick. The specialists – the consultant doctors – they have it worse than us resident doctors. They are more responsible, so they are expected to work more hours. Nobody is pressured or threatened into picking up extra shifts, it's just something that almost all of us just do.

I've read some nice stories about fundraising efforts and donations to Croatian healthcare workers and hospitals in different parts of the country. Everything is appreciated. But, I personally haven't seen any effect of that on our day to day lives at work. Not at our hospital. Maybe there were PPE donations or cash donations, but it hasn't impacted the daily lives of me and the Croatian healthcare workers who are my colleagues. I think I heard that a local garage was giving free cups of coffee if you show your medical ID. Every little is appreciated.

For me and the Croatian healthcare workers who are my colleagues, instead of any kind of personal discounts or donations to staff, we would much prefer if people just took this disease more seriously. Things look very different when you work in a hospital compared to someone outside who maybe doesn't know anyone who got sick.

I came off a particularly difficult double shift a couple of months ago – it was just non-stop COVID admissions, some severe cases. As I was walking home, I walked past a bar that's near to the hospital. They had signs on the walls telling people to keep their distance. But, the bar was absolutely packed – full of young people. It just felt so disappointing. I couldn't help but think of the older relatives they would come in contact with, some who might get really sick.

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Instead of people clapping on balconies, I think Croatian healthcare workers would just prefer more general vigilance and personal responsibility – wear your mask, wash your hands regularly, no more parties in the basement. Clapping on balconies is a nice gesture, but ultimately it's an empty one.

How does it feel to know that there are some people out there, in every country, all around the world, who believe COVID is a hoax, or a plot, or not so serious, or that the vaccine is dangerous or something other than what it is?

Well, it's not always the content of the conspiracy theory that appeals to these people as much as it is their inability to accept facts – the truth – because they have little faith in the authorities that are telling them this. Here in Croatia, I think that distrust is quite high – a lot of people are disillusioned with the state and politics, because of corruption. Sometimes over 50% of the population choose not to vote. The dissemination of misinformation over social media doesn't help - if that's where people get their news from. If you look at that example from your own country, where strict measures about movement were put in place by your government, and immediately afterward, the Chief Advisor to the Prime Minister, was caught breaking them to travel across the country with his family to a second home in the countryside, going out on day trips. And he was defended by his colleagues after he was found out! When people see those kinds of things happening, the distrust between people and the authorities just grows.

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All of the images in this article are used as illustrations only. None of the places or people depicted are in Croatia or Croatian, except for the first image, a panorama of Zagreb

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