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Conference

Genocide in Europe, again"Warum krieg?" is the title of the Freud-Einstein

correspondence of 1933 on display in the Sigmund Freudmuseum in Vienna. "Why war?" hung as a question over the6th European Symposium of International Physicians forthe Prevention of Nuclear War (IPPNW) held in Vienna onOct 2-4. Why war, what is the medical role in prevention,and can war ever be justified (as in self-defence)? Discussionin Vienna-with its own uncomfortable history of "ethniccleansing" half a century ago and its location just a fewhundred kilometres away from the fighting in formerYugoslavia-was dominated by the war in the Balkans.Through the acrid smoke of the Balkan conflict, IPPNW

struggled to get a clear view, both of what was happeningand of what its own role should be. A few representativesfrom recently established prospective IPPNW affiliates inCroatia and Serbia were present.

Feelings were very strong in the Croatian delegates.Associate professor Dzenana Rezakovic, cardiologist andpresident of the Croatian Physicians for Peace, referred togenocide by Serbian forces in Croatia and Bosnia-

Hercegovina (citing Helsinki Watch in support), claimingthat a systematic approach was evidenced by 111 I

concentration camps where 100 000 non-Serbs had beendetained and 16 "bordello" camps where 25 000-30 000women had been raped. Civil war was an inappropriatedescription, because Bosnia-Hercegovina and Croatia weredemocratically established and internationally recognisedcountries. It was a war of territorial aggression, associatedwith a project of mass killing of non-Serbs.

Rezakovic and her colleagues described how 24 Croatianhospitals had been badly damaged, with evidence that thiswas deliberate in some instances ;1,2 they described woundedchildren (there are said to be 30 000 in Bosnia), healthproblems of refugees, shortage of medical supplies, and allthe other predictable and horrific medical sequelae of war.They warned of between 200 000 and 400 000 people dyingin Bosnia-Hercegovina over the winter if nothing more wasdone.

Peace workers are accustomed to interpretingdescriptions of "inhuman" activities by opponents in termsof the social psychological phenomenon of the enemy image.But was there not a danger of using these factors as aresistance against knowing what is actually going on inEurope now (the Vienna Jews of 50 years ago could hardlyhave had an exaggerated view of their enemy)? Thecustomary conference talk of mediation and conflictresolution was too gemiitlich by half for the Croatiandoctors. With the blast of war blowing in their ears, it wasnot the time for modest stillness and humility, and their painand horror demanded a hearing.

Serbian doctors are involved in widely differing ways inthe war. Although two of the Serbian leaders have beenpsychiatrists-the late Dr Raskovic in Croatia and DrKaradzic in Bosnia-the Serbian doctors present wereopposed to the currently dominant policies. They believedthat all sides have been guilty of atrocities, and supported theidea of all war crimes being brought before an appropriatetribunal. Dr Milan Popovic, a Belgrade psychiatrist andpresident of the Serbian Medical Association for Peace,described the medical role in opposition. Around 1000doctors had joined large demonstrations over several days inJune in Belgrade. The Serbian Medical Society, and

especially its ethical committee, which he chaired, maderepresentations regarding human rights to the 50 or soSerbian doctors who are MPs. The Serbian doctors presentalso described adverse health effects of sanctions, with lackof fuel for ambulances, heating for hospitals, and drugs forchronic conditions. Surgical operations went ahead only ifanaesthetic agents and sutures were bought on the blackmarket.What is IPPNW’s role? The feeling was that it could

usefully help to publicise the existence of opposition inSerbia. Attempts had been made, from last year, involvingNick Lewer of MEDACT (the UK affiliate ofIPPNW) andBradford University’s department of peace studies, to

mediate with a small group of Croatian and Serbian doctorswho had set up Physicians for the Prevention of War. Oncefighting had escalated, however, only very limited aimscould be achieved. There was much support for installationof UN peace-keeping forces when conditions allowed,together with a prophylactic strategy in areas bordering onthose where fighting was in progress.A call was issued to the UN to lift sanctions affecting the

health of the civilian Serbian population (the Croatiandelegates dissented). Delegates struggled in their ownconsciences with questions as to whether being anti-warmeant opposing any use of military force, includingpermitting Bosnian and Croatian means of self-defence inadvance of a negotiated settlement. IPPNW members arefaced with greater moral complexity after than during thecold war.

Jim Dyer1. Croatian Med J 1992; 33: war supplements 1 and 2.2. Medical Testimony of the Vukovar Tragedy, 1992. Croatian Med J

(special edition). Zagreb: Medicinska Naklada, 1992.

ObituaryWilliam Drukker

When nephrology burst into life in the late 1950s therewere almost no trained renal physicians, so most of thepioneers were drawn from other backgrounds. Few broughtto the task such a wide experience as William Drukker, whodied on Aug 22, aged 82.Drukker had served as a doctor in the 1935-45 war and practised

as a pathologist, general physician, and neurologist before taking upnephrology. Haemodialysis was born in the Netherlands butdeparted with Dr Willem Kolff to America in 1946. Drukker,appointed assistant professor of medicine at the University ofAmsterdam in 1948, and later reader in medicine and haemodialysisthere, reintroduced it in 1959 and set up the first Dutch regularhaemodialysis programme for chronic renal failure in 1963. He stillmanaged in these hectic years to found Nederland Ptigdschrift vanGeneeskunde (with Professor Lindeboom) and to edit it for its firstsix years. He went on to launch the National Kidney Foundation ofthe Netherlands. For these and many other contributions to clinicalmedicine and clinical investigation he was decorated by QueenJuliana as Officer of the Order of Orange Nassau in 1975. In hisretirement years he continued to practise clinically and remained aregular attender at medical meetings while developing his otherinterests as President of the Board of Trustees of the DutchChamber Orchestra.To the wider world of nephrology Drukker will be remembered

for three enterprises that he planted and nurtured. In 1964 he wasthe moving spirit in the foundation of the European Dialysis andTransplant Association (now the European Renal Association); heorganised its first congress in Amsterdam and became its first

Secretary Treasurer. The following year, with Dr Frank Parsons,he started the two registries of dialysis and transplantation that were