HEALTH-SERBIA: After the Wars, the ‘Vietnam Syndrome’

By Vesna Peric Zimonjic Reprint | | Print |

Vesna Peric Zimonjic

BELGRADE, Oct 6 2003 (IPS) - It was only after a young policeman killed four of his colleagues last week that the phenomenon that has come to be called the "Vietnam Syndrome" has drawn attention in Serbia.

Vladan Rovcanin (32), went on a shooting spree, and killed four policemen in the southern Serbian town Nis before surrendering.

In the course of investigation he said he had been under "unexplainable psychological pressure" for months. The officers who arrested him described him as psychologically deranged and disturbed.

"We are definitely facing the so-called Vietnam Syndrome in Serbia," Interior Minister Dusan Mihajlovic said after the incident.

Experts say the "Vietnam Syndrome", or post-traumatic stress disorder (PTSD) as it is now called, is particularly common among war veterans. It was first described by doctors treating Vietnam war veterans. The disorder is seen as the consequence of traumatic experiences in battlefields.

"PTSD appears among people who cannot surmount such traumas months or even years later," Belgrade psychiatrist Ivan Dimitrijevic told IPS. "At first, they avoid facing the trauma, or try to forget it. Later, they become overwhelmed by constantly re-living the traumatic experience, which leads to accumulated stress."

Dimitrijevic describes some definite signs of such stress. "They become withdrawn and on the surface they look quiet," he says. "The accumulated stress can lead to aggressive outbursts that can be triggered by anything. Aggression can be turned against others, but also against oneself."

Rovcanin was about to lose his job as a result of the reforms within the Serbian police. That could well have proved the trigger in his case.

This is no isolated case, even though it has led to a new debate. Serb soldiers committed dozens of crimes after returning from the wars in Croatia and Bosnia that ended in 1995. Some killed their entire families, others committed suicide, mostly by blowing themselves apart with hand grenades.

"Some 100,000 men from Serbia took part as volunteers or paramilitary in wars in Croatia and Bosnia in 1991-95," psychologist Vladan Beara told IPS. "According to our statistics at least 25 percent suffer from PTSD. But only a fraction of them have sought treatment."

War veterans are reluctant to seek help because they are ashamed of their condition in a deeply conservative society, Beara says. "Besides, they find the views of many ordinary people deeply unjust."

The Serbian public was deeply divided over the wars in Croatia and Bosnia. The official propaganda of then Serbian president Slobodan Milosevic described the wars as "defence of the national interest of Serbs." Hundreds of thousands of ethnic Serbs lived in those former Yugoslav republics that gained independence from Belgrade. The wars led to some 240,000 deaths, mostly non-Serbs.

On the other hand, a part of the Serbian public strongly condemned the wars, and saw them as aggression against Croatia and Bosnia. The forces opposed to the wars toppled Milosevic from power three years ago, but a deep rift remains in Serbian society whether those wars were right or wrong.

It does not help that the prevailing feeling among the public is that Serbia lost those wars.

The picture is made more complicated by the trauma over Kosovo. Milosevic sent army and police forces in thousands into the southern Serbian province in 1998 and 1999 to quell the armed rebellion by the predominantly ethnic Albanian population. The fighting in Kosovo led to the death of more than 10,000 people, and the expulsion of 800,000 ethnic Albanians into neighbouring countries.

More than 200,000 Serbs fled the province at the time, fearing a reprisal by ethnic Albanians. Rovcanin was one of them.

"It is not only war veterans who suffer from PTSD," psychologist Mina Mitic who runs the Centre for Treatment of Victims of Torture in Belgrade told IPS. "We are treating hundreds of traumatised refugees, and also people who suffered from PTSD provoked by 11 weeks of constant NATO (North Atlantic Treaty Organisation) bombing." The Vietnam syndrome has taken its toll also in neighbouring Croatia and Bosnia. A book ‘PTSD, the Croatian Experience’ says that some 2,000 war veterans have committed suicide since 1995. Dozens have gone on shooting sprees, killing their families or strangers.

In Bosnia, a recent study by the Harvard Medical School suggested that up to 45 percent of civilians suffer from PTSD, apart from some 25 percent of war veterans.

Experts agree that the disorder needs to be handled by painstaking psychotherapy. But despite the availability of experts, and reasonably good health care systems, many are reluctant to seek help.