Kosovo radiologists plan for independent future

Kosovo is a small region in the Balkans, currently a U.N. protectorate after years of Serbian occupation. It is still rebuilding after the war that ended in 1999. Healthcare, especially radiology, is the one of the sectors that was most devastated.

Kosovo has about 30 radiologists and 20 radiology residents among an overall population of approximately 2.5 million people. The main radiology center, the Institute of Radiology, is located in the University Clinical Center in the capital city of Prishtine. Until recently, all imaging at the institute was performed on very old Siemens equipment that was not maintained properly over the years and for which no spare parts were available.

As part of an international effort to rebuild Kosovo, the European Agency for Reconstruction (EAR) has replaced the old equipment, primarily with units from the French company Apelem. The institute also has two Shimadzu CT machines, one of which is spiral. Angiography equipment has not worked since the war, and the institute has no MR machine. There is no functioning mammography machine.

Another five nonspiral CT machines can be found in private clinics in Prishtine, Peje, and Prizren. Two private MRI machines (0.2T and 0.5T) are installed in Prishtine.

Under the leadership of Dr. Halit Ymeri, head of the institute, we developed a strategic plan to equip the Institute of Radiology with digital imaging equipment-CT, MRI, digital subtraction angiography, and ultrasound-and to introduce interventional procedures. The strategy has been presented to the board of the University Clinical Center and to the prime minister, and we hope to present it to the Ministry of Health when its leadership positions are established. We don't know if or when it will be accepted, but at least the need for the equipment and its value will have been established.

During the Serbian occupation, Kosovar health workers, including radiologists, were excluded from any kind of professional advancement and from professional contacts with colleagues in the international community. As a result, there are only two professors of radiology in Kosovo: One is retiring, and one is a docent.

In May, Kosovar radiologists met for the first time to present their work and papers. Guests from institutions in other regions, including Sarajevo in Bosnia and Herzegovina, participated in the meeting.

Cooperation among radiologists and other specialists is minimal so far, with no established consulting system and no participation by a radiologist in meetings of other medical disciplines. Discussions of cases of interest do occur between colleagues, but not in formal meetings. The health system in Kosovo at present has no means to support continuing education for radiologists. A local nongovernmental organization, with help from the EAR, sent 49 residents to Sarajevo; Tirana, Albania; and Zagreb, Croatia, last year for three months of training-three radiology residents were among them. This project was the first of its kind in postwar Kosovo.

Dr. Bujar Gjikolli, a native of Kosovo, is a second-year radiology resident at the University of Sarajevo.