The South-eastern Europe Health Network (SEEHN) was established in 2001 to promote peace, reconciliation and health in south-eastern Europe and contribute to preparing the countries in the region for European Union integration. Its vision remains to achieve better health and well-being in south-eastern Europe through the collaborative efforts of SEEHN member states and partners. Since its inception, SEEHN has developed into a broad partnership for health that brings together southeastern European countries and organizations focused on improving health and well-being. The World Health Organization (WHO), SEEHN’s founding organization, has remained its most important partner, providing guidance and support to its policy and technical endeavours from 2001 until today. The most recent South-eastern European Health Ministers’ Forum, held in 2017 in Chisinau, Republic of Moldova, reflected on 15 years of regional collaboration in public health and endorsed the Chisinau Pledge, which presents the SEEHN framework for action until 2020. The Forum emphasized the complex and significant contribution of SEEHN to health and well-being, which in turn has had a positive impact on peace, stability and economic development in south-eastern Europe. The Forum highlighted the active role of SEEHN in influencing public health developments in both south-eastern Europe and in Europe as a whole, and in supporting its members in their response to international commitments. SEEHN ministers and partners agreed on the vast potential of SEEHN to deliver on the contemporary policy agenda, primarily related to the WHO European policy for health and well-being Health 2020 and the United Nations 2030 Agenda for Sustainable Development. This document has multiple goals: to reflect on SEEHN’s developments as a source of experience and knowledge, and on their potential to meet the demands of the contemporary context of health and well-being; to inform on SEEHN governance structures that are able to support future collaborative efforts for health and well-being in south-eastern Europe; to share examples of SEEHN’s success in leading and influencing positive health developments in south-eastern Europe; to set out a clear model for future collaboration with WHO and other partners; and to emphasize the exemplary role of the WHO Regional Office for Europe as an enabler and supporter of influential alliances for better health and well-being in the European Region.
The Fourth Forum, under the theme “Health, well-being and prosperity in South-Eastern Europe by 2030 in the context of the 2030 Agenda for Sustainable Development” was held in Chisinau, Republic of Moldova on 3-4 April 20017.
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The Forum was hosted by The Government of the Republic of Moldova and organized jointly by the South-eastern Europe Health Network in collaboration with the WHO Regional Office for Europe.
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The high-level representatives of governments in the SEE region and beyond, discussed in an open and constructive atmosphere and identified common challenges, strategic achievements and priorities of the SEE regional cooperation in public health. They mutually introduced joint subregional and national actions in the SEE region, for implementing and achieving the United Nations Sustainable Development Goals (SDGs), with the objective of better health, equity and accountability, as high priority for underpinning political cooperation and economic development in the SEE region.
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More than 15 years of SEE cooperation (2001–2016) is streamlining towards the global and European efforts, for achieving improved health, equity and accountability, building on major European resolutions, charters, communiqués, treaties, frameworks and action plans, including the new European policy framework for health and well-being, Health 2020.
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The endorsement of the Chisinau pledge, by nine south-eastern European countries – Albania, Bosnia and Herzegovina, Bulgaria, Israel, Montenegro, Republic of Macedonia, Republic of Moldova, Romania and Serbia, on April 4th 2017, established the basis for the continuation of the cooperation in public health, in the forthcoming period.
Recognizing the seriousness of the health workforce migration in recent years and the negative effects of brain drain and brain waste, the Republic of Moldova implemented the project “Better Managing the Mobility of Health Professionals” under the coordination of the World Health Organization.
Financially supported by the European Union, the project aimed to strengthen the capacity of the Republic of Moldova to manage the migration of Moldovan health professionals and to build up a better framework for the legal migration of health workers between Moldova and the EU in order to reduce or mitigate the negative impacts of migration on the Moldovan health system as well as to ease the reintegration of returning health workers.
Engaging a big team of WHO staff, experts, national authorities, medical institutions and medical education institutions both in the Republic of Moldova and from EU countries, the project incited and contributed to a 3-year-long fruitful collaboration that provided for substantial change in the HRH area in the country.
Achievements
One of the main project achievements is the development of a national information system (SIERUSS) to monitor the mobility of health professionals and the training of approximately 800 people in HRH governance and management and in using the SIERRUS database.
Furthermore, the project provided for the development of a relevant legislative framework and drafts of new regulations related to the employment and remuneration of health workers, improvement of both curricula for medical colleges and various postgraduate training programs, accreditation of the School of Public Health and Management as well as for the development of an e-learning platform at the University of Medicine and Pharmacy “Nicolae Testemitanu”.
An overview of all project activities, including the series of studies conducted in several European countries and the organization of dozens of policy dialogues, workshops and an information campaign, was given during the project closing conference held in March 2015. Also presented was a 20-minute movie summarizing the context, the challenges, the results and the lessons learned through views and opinions of Moldovan health professionals and WHO official representatives.
The Republic of Moldova as a SEEHN member
The example of the Republic of Moldova, one of the 10 member States of the SEE Health Network is to be commended. That was one of the reasons why the Republic of Moldova was authorized by the SEE Health Network to lead and coordinate the regional efforts on health workforce and its mobility through its designated Regional Health Development Centre in Chisinau.
Similar activities could and should be followed by the other SEE countries in either national and/or regional way. Health workforce is a major challenge for 9 of the 10 SEE Health network countries and is one of the four health objectives of the SEE 2020 Growth Strategy “Jobs and Prosperity in a European Perspective” which is currently in implementation with the support of the Regional Coordination Council, the European Commission DG Enlargement and many more international partners.
Croatia – How would I describe my life before liver transplant? I would say “normal”. Work, home, family, going out – nothing unusual, just an ordinary life. I was financially independent, having a job I loved, but suddenly it took me much more time to finish things, I had less and less time to go out, and I felt less and less like going out and spending time with my friends.
Unfortunately, the first symptom of my disease was fatigue, which, although I am a health care professional, I did not attribute to a disease. Day after day, and then after a few months fever appeared, with yellowing of my palms and the white of my eyes!
The diagnosis was terrifying – autoimmune hepatitis, cirrhosis, and a liver transplant is necessary. After the necessary tests, I was put on the transplant list; I was the first on Eurotransplant’s high-urgency list. During that period, I lost consciousness; I even fell into a coma for some time!
But I received my new organ; my liver came from Germany, as I was told later. Dialysis, pneumonia, wound infections, sepsis – this is only a part of what happened later, as if the entire universe was against me. Solve one complication, and another one appears. The human heart has a nasty habit of calling fate only that which tries to ruin it!!
Stubborn and persistent, there were occasions when I was ready to give up… but fortunately, the University Hospital Centre Zagreb transplant team were far more persistent than I was, and equipped with knowledge, they kept pushing me on.
It was hard, long; I don’t even know how I endured it all. But I do know one thing: without a new liver, I would not be alive today. Someone, someone I haven’t met, decided to be generous at the moment of their greatest sorrow and pain, and give someone else, me, a new life, a new opportunity.
Gratitude and pride are difficult to express in words.
Today, four and a half years later, I’m proud of the person that I’ve become, and grateful for everything I have. It might not seem a lot, but I have my head firmly on my shoulders, I can walk alone, I can hear, see and feel.
And most importantly – I have endless love and support of family and friends!
Private photography by Martina Capan
Story prepared by: Martina Capan (translated to English by Start Ltd.)
Croatia – I remember that 8 November 2007 as if it was yesterday – always a hyperactive boy, a good athlete, an excellent student with a pale face. That day I was as white as a sheet, I felt weak, everything around me became black, and the air barely got to my lungs. That was the first time I ended up in the hospital, and realized I may not be quite as healthy as I thought. However, doctors in Čakovec weren’t able to diagnose me correctly for three days. On the third day they realized what was wrong with me and immediately sent me to Zagreb. And then – shock.
Get this, an athlete, 13 years old, with a heart disease. I couldn’t believe it. I remember the first thing I asked the doctor after he told me that my heart is weak, and that I would need a heart transplant: “Doctor, tell me honestly, what my chances for survival are?” At first, the doctor was shocked that I would ask him that, but then he said: “Look, the transplantation itself has a 95 % success rate.”
But what he didn’t say was that first you have to survive until the transplantation. I realized this one night when I almost died because my heart rate jumped to 300 per minute, and I had to be resuscitated with a defibrillator. And so, in 2007, I spent my birthday, Christmas and New Year’s in the hospital, only to be released from hospital without transplantation.
I was still sick, my heart was so weak that I barely managed to get to the second floor, but I still had the need to function normally. It was not easy to give up sports you were addicted to or some basic activities just to be able to function normally. I got used to it, and from 2007 to 2011 I lived “under enormous scrutiny”. This lasted until 2011, when I ended up back in the hospital when my health condition rapidly deteriorated. At one point my heart stopped, the pressures equalized, and I ended up in an induced coma on ECMO for six days. The machine replaced the function of my heart and lungs. And you already know what followed next. The inevitable – heart transplantation. I must say, I was apprehensive at the thought of transplantation and was terrified by this idea because I was still afraid of ending up in that 5% of unfortunate cases during organ transplantation.
When I woke up, at first I did not believe that I was a transplant recipient, I kept asking everyone around me who gave the permission for the transplant to go ahead. But I’ve came to peace with that fact as soon as I saw that it was easier for me to breathe, and as soon as they told me that my heart was pumping normally. Oh, it was a song to my ears. After the heart transplant, I spent nearly two months at the hospital, and every day was a struggle with my mental and physical condition. I believe that I drove my parents completely crazy. It was so hard to get back on my feet after everything, after my muscles have nearly atrophied, and I also had to come to terms with the fact that I was in a hospital, and not with my class mates on the last days of school. It was difficult but I made peace with it. As soon as I got home, my condition immediately improved. When I finally walked around my neighbourhood for the first time, it was a joy, except for the strange looks of passers-by gave me because I was wearing a protective mask. Once I even almost caused a crash. So, if you ever see anyone wearing a mask, do not turn your head around and stare, they are probably wearing it for their own protection, and you can cause a crash. Basically, my condition was improving daily; I grew both mentally and physically, and was getting stronger every day. Four months after the transplantation, I returned to school. I took exams from two years all at once, went to competitions, won third place in the country, and achieved more and better results each day. After the transplantation my cerebral blood flow was improved, so I passed both the third and the fourth grade without any problems. I won awards and achieved successes in competitions and tried even harder every day. After graduation, all doors were wide open for me, I had a direct entry into various faculties thanks to all the prizes I had won during high school, and I also had the opportunity to work. Yes, I decided to work. Now a young man of nineteen, I own a company which develops mobile applications, websites and does marketing. I’m still achieving my goals and setting new ones, my life is better than ever, I went back to sports, my life is good… the best. I use my new life to its maximum – from an excellent student and top athlete, then a sick boy, I came back stronger than ever, became a hard-working man, a recreational athlete and a much better person than I was. This disease has changed me, I have become more serious, sometimes too much; I have become more sensitive, caring, but what is most important – I have become a better person.
Private photography by Luka Vugrač; Luka with class within the National youth campaign on organ donation and transplantation in Split, May 2014
Story prepared by: Luka Vugrač (translated to English by Start Ltd.)
Croatia – Each story begins the same way – you live a normal life like everyone around you, you go to school, you go out, you have friends, you fall in love…University, seaside and holidays, sports. You play water polo, like me, you swim, dive, fish, ski in the winter with friends, snowboard… You enjoy the moment and don’t think too much about tomorrow, even though you have a dream that you follow, you save money and open a store with extreme sports equipment. And you’re on a roll, you work and work, but you also enjoy life… And then you start having headaches, but you think it is a migraine. After a couple of years you have eye-sight problems, and go to see an oculist who tells you that you dioptre is 0, and that you should go to see a doctor, who takes a blood sample, and finds high urea and creatinine levels. He immediately sends you to a hospital where you are instantly put on the dialysis preparation program, because your kidneys are operating with only 10 % of their capacity, and it’s only a matter of time when you’ll end up on dialysis…Your entire world suddenly comes crashing down.
But you start building it from scratch – you do not give up. Your daughter, born only one month after you start home dialysis treatment (peritoneal dialysis), gives you the strength to go on. Ten hours every night on the machine for automated peritoneal dialysis takes away a lot – but it also gives you the independence from the hospital and haemodialysis centre, and you travel, push your old life style, you go skiing, to the beach, continue to dive and swim, and even start competing for Croatia as an athlete on dialysis. You even win medals in world championships! You become active in the association of kidney patients on peritoneal dialysis, you fight the system to get the same standard of treatment that patients in Europe get. You join with the Croatian Transplant Association, and you raise awareness on the importance of organ donation, and after seven years New Life finally comes – transplantation.
Your donor didn’t only save your life, but also brought the life back to normal for all those people around you who have suffered and fought with you for years. And he helped create a new life, because your son is born three years after the transplant, a son that perhaps wouldn’t have been born if you stayed on dialysis. Your donor lives in you and through you, and his star will shine as long as yours does – and that is why it is so important to talk about transplants, about your views and considerations regarding organ donation, because it is really important and it’s the biggest decision you can make in your life. Express your attitude towards transplantation to everyone – discuss it at home, because you never know when someone’s star will start fading away fast and suddenly and if the only way for it to shine would be to join another star – just like the transplantation saved and prolonged my life, so we can be a happy family that will fill the sky with new shiny stars! And that is why this is important, why we are all important – so let’s talk about matters of such great importance.
Private photography by Jurica Ester; Jurica Ester with his family
Story prepared by: Jurica Ester (translated to English by Start Ltd.)
Towards the end of 2008, larger number of youngsters age 15 to 19 have reported to a doctor with swollen glands on the neck. The numbers further escalated in January of 2009, requiring announcement of epidemic outbreak of mumps in 10 larger cities in Macedonia. Especially vulnerable were teenagers, and the Ministry of Health did not have sufficient supplies of vaccines for extraordinary immunization of particular population groups…
On March 15, 2008, beginning as a quiet day in the village of Gerdec, just miles away from Tirana, Albania, an unfortunate chain of events led to massive explosion of an old ex-military ammunition stockpile going up at once. On the ground, there was no exact information on the number of wounded, but the country already knew that its regular supply of blood donations of 7/1000 inhabitants would not be enough to respond to this immediate need in the incurred emergency situation… (more…)
