Not-So-Fun Adventures in Serbian Healthcare

Just as I arrived last week for my vacation in Serbia, a close friend fell seriously ill and was taken to the Sombor hospital. From the outside, it looks like the setting for a Dr Who TV show, or perhaps The Jetsons. Futuristic design a la 1965, that probably belongs in an architectural tourbook, proving that while Communist Europe was building concrete monstrosities, Yugoslavs had a more creative soul.

Get a little closer and it looks like the setting for one of those "After the Apocalypse" movies, where it's a generation after the atom bomb fell and everything's been untouched and falling apart since. Large plants growing out of gutters, siding falling away in chunks... an abandoned building in the process of turning into rubble.

We push through the only remaining working door to find a huge dark lobby. The reception desk has been pushed to one side because there is clearly no reception anymore... you wander in and find your patient on your own. There's only one sign of life, a small shop in the corner where you can buy, among other things, rolls of toilet paper and bottles of water to bring your patient, because these are apparently not provided by the administration.

I learn you are also supposed to bring cookies, chocolate, fruit juice, or bags of coffee. These are not for your patient but meant for leaving in the nurses' lounge in hopes that they'll pay your patient a bit more attention. But doctors often apparently require studier fare, perhaps a very good bottle of whiskey for a quick in-office consultation or a wad of cash for more significant services. Unfortunately for us, there's just been a medical corruption scandal in Serbia that led to actual arrests, so all the corruptible doctors are a bit shy right now. It seems you need good personal connections to be able to bribe someone! So even corruption is not on a level playing field here.

Sitting by my friend's shadowy bedside (there are very few lights in the rooms or hallways either), I'm appalled to see the food she is served - a large bowl of boiled potatoes in a sauce that smells like Vegeta and chicken fat. I'm pretty sure it's all-wrong for her condition. It's also the same exact meal everyone else in the ward is served, no matter what their condition is. (This is not unusual for the Balkans, in Croatia, my Father-in-Law had the same experience, albeit with spaghetti.)

I remember when my own father was in his local US hospital recently for a knee operation. He was a bit dismissive of the four-page room service menu, so he called us from his private phone to ask us to bring in some of his favorite foods from home, while he surfed the Web using the room's excellent WIFI and the nurses came in to "pester" him every 15 minutes. All courtesy of Medicare.

There are no private nurses or medical services we can find to help our friend in Sombor. Or that we know of in Novi Sad either. But yesterday, due to a complete coincidence, I was in Belgrade to visit one of Serbia's first private hospitals with a different friend who needed a quick chat with a doctor. It's in one of those shiny, glossy new buildings in the business center of Novi Beograd. The enormous hospital lobby is glistening with marble and decorated with huge flat-screen TVs and an official-looking security guard. We perch on Italian leather sofas with chrome legs waiting for the Doctor. The beautiful receptionists, who all wear medical-looking white scrubs, assure us the Doctor will come at 8pm. 8pm? Well, it seems the doctor may also have a day job at the military hospital close-by (where services are free even for civilians, but you must get on a wait list to enter, and presumably there is no marble, chrome, or flat screens.)

At last the doctor is ready to see us. She does look a bit tired, in her also-enormous white room. But she has the latest US medical technology including MRIs at her command.

I sit there, in my comfortable white visitor chair, observing the detailed discussion, which I haven't 1/100th the Srpski required to follow. She hands over, without our asking, copies of the MRI plus a detailed diagnosis memo, so we can take it to another doctor if need be. But, it seems everything is fine. Then we walk out past the security guard into the night. I think, this is what a millionaire feels like.

If they had this in Sombor, I would pay for it in a heartbeat for my friend there. But they don't. And my frustration is intense.

New York's Nice, but Belgrade is the Center of the World...

So my husband and I are lazing around our kitchen table in the US one morning when he says it..."Belgrade is the center of the world."

He doesn't mean to say it out loud. He isn't even really aware he has said it out loud; in fact I'm not sure if he knows he consciously thinks it. But there it was.

I was wittering away about some reality TV show on American television that's basically real estate porn for people who love Manhattan. I was saying how we could someday sell our house here, because we are planning on moving to the Balkans full-time in a few years, and buy a flat in New York. The idea being, if you're only going to visit the US intermittently, why bother with the upkeep of a house and garden in a small New England town; instead why not own a flat in New York?

And he looked at me and, nearly under his breath, said, "New York's nice, but Belgrade is the center of the world. If you really want a city apartment, we should get one there instead."

The conversation then quickly devolved into how much we could afford; how big a terrace we could get for that; Novi Beograd versus Zemun versus Starigrad; and Belgrade real estate ideas of what counts as a bedroom (living-rooms) vs American ideas (only actual bedrooms.)

All the while, his little heartfelt but already half forgotten exclamation about the center of the world remained there in front of me. I suddenly thought that when I talked about New York, I could have been talking about Sydney Australia. A big city, A very famous and exciting big city. A big city where there are a bunch of Serbs no less. But really, not exactly in a central location.

Etiquette for Foreign Travelers in Serbia - Got Tips?

An American reader of this blog just emailed me to say she's planning a two-three month visit to Serbia next year with her family. She wanted to know about etiquette.

She wrote me, "In particular, I am interested in small things that would not be obvious to someone who has spent much of her life in the US. For example, when we visited Paris a few years ago, it helped me so much to know that it was important for me to speak first when entering shops (to say "Bonjour Madame!" to the woman helping me in the boulangerie or asking directions for the metro).

It would be nice to know about things like this for Belgrade. For instance, do waiters treat you differently in Belgrade than in Cleveland? How much to tip? How do you greet the post office employee? How about my young children?"

I think I need help answering this question...because I can't think of many things at all. In my experience, Serbs are extremely friendly to travelers, so much so in fact, that as long as you are not an overtly rude person, you'll get along very well. Here are my limited tips:

-> Take your shoes off when entering a home - usually the hosts will offer a pair of spare slippers to put on. And, to expect to have lots coffee and snacks thrust upon you whenever you visit people. If they visit you, you are expected to make coffee immediately, no matter what time of the day or night.

-> The first time you visit someone's home, it's good to bring a small gift such as a bottle of wine, flowers, etc. Be sure to ask for flowers appropriate for the home and make sure there are an odd number of flowers in the bouquet. Many flowers sold are for graveside visits. (In fact, on my mistaken advice, my husband went to see a friend in the hospital recently with a bouquet in his hand, and got many very strange looks from everyone!)

-> Waiters in Serbia are usually long-term professionals, with an air of dignity to them. These are not kids with temp jobs before "real" life begins. I tip them as I would in the US, but have no idea how the natives do it.

-> I've also noticed the male/female thing. There is a sense, at least in Sombor where our home is (which is not as sophisticated as Belgrade, but perhaps not that far behind either), that an adult woman who speaks to a man at length may be engaging in some type of come-on behavior... even if it's nothing of the sort. Every day conversation is totally fine, but an extended one-on-one conversation might be a bit suspicious.

-> However, cheek kissing is completely approved and expected between you and all your friends no matter what sex they are. You grasp their hand lightly and kiss three times quickly -- one side, the other side and then the first side again. (In Croatia, it's often just two kisses, which can leave me feeling flat-footed.) It's something in between an air kiss and a hearty buss. More like a light tap.

-> You'll want to get a temporary Serb cell phone if you can so people can reach you, and also so you can pay for parking in Belgrade which is often on a text messaging basis.

-> Lastly, be sure to set aside a week of time at the end of your trip for leave-taking social activities. Each of your new friends will want to have you to dinner or at least coffee at their house. And you should try to take them out to dinner at a nice restaurant. People will be offended if you don't make an effort to say goodbye.

Does anyone else reading this blog have advice for this young American family? Love to hear it!