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When doctors become heroes


DR. HASAN Baiyev opened a small war hospital in the village of Alkhan-Kala, his hometown in Chechnya, at the first clash between Chechen insurgents and the Russian army in 1994. The one-story cement block building contained few medical supplies and a staff of just eight nurses and a handful of volunteers. Baiyev was the sole physician.

Refusing to side with either, he treated soldier and civilian, Chechen or Russian. "My plan was to stay despite the bombs and the shelling, to stay until the last minute," he said.

Baiyev never intended to be a hero. His position should not have been heroic. The Geneva Convention, which governs the conduct of combat forces toward civilians and prisoners of war, demands medical neutrality. All sides are to keep hands off medical teams and facilities not engaged in combat and permit wounded soldiers to receive medical care without interference.

In Chechnya, however, those rules were ignored. Indeed, illegitimate, illegal attacks on physicians and patients have become an all-too-common occurrence in recent wars.

During the months preceding the war in Kosovo, for example, Kosovar Albanian physicians were harassed, their offices searched, and some prosecuted for the "crime" of providing medical care to members of the Kosovo Liberation Army. In Turkey's emergency zone, an area around Kurdistan, physicians have been killed, tortured, imprisoned, exiled and legally sanctioned. In Bosnia, several hospitals were deliberately and repeatedly shelled by Serb and paramilitary forces.

From the first, Baiyev risked retaliation from all sides. The Wahabis, a group of Chechen muslim militants, forced Baiyev at gunpoint to treat their own wounded soldiers ahead of patients with more serious injuries, and issued death threats for his treatment of Russian soldiers.

One day last January, Russian soldiers saw Baiyev walking from the hospital, where they knew wounded Chechens were being treated.

They pushed him against a wall and were about to execute him until more than 20 of the town's elderly citizens gathered between the physician and the soldiers. "If you want to kill our doctor, kill us first," they said. The soldiers backed down.

January 31 marked the most intense fighting experienced around the village. Throughout that night, Baiyev listened to distant reports of landmines blowing up beneath the feet of the 3,000 Chechen fighters retreating from Grozny. By morning, a steady overnight snowfall had blanketed Alkhan-Kala and softened the appearance of the shell-torn buildings and the broken earth. There was no concealing the human damage however, as a stream of maimed Chechen soldiers began arriving on stretchers at Baiyev's small hospital.

With only local anesthesia and the drugs in his supply closet, Dr. Baiyev performed more than 100 operations in the first 24 hours, including 67 amputations and seven invasive skull surgeries. He worked without interruption for two days.

Among the 300 patients brought to the hospital was Shamil Basayev, a native of the village who had become a Chechen commander, leading an infamous 1995 raid on the Russian town of Budyonnovsk. The only way to save Basayev's life was to amputate his shredded right leg, and Baiyev wasted no time doing it. Afterward his soldiers whisked Basayev away to the mountains to recover.

As the doctor continued cutting and stitching the torn flesh of both neighbors and hardened insurgents on Feb. 2, Russian federal forces entered the town in close pursuit of the retreating Chechens. Baiyev fled on foot wearing his white medical coat to try to arrange for the evacuation of his patients. Unable to get the help, Baiyev discarded the coat and headed back to the hospital.

Russian soldiers were already there loading patients, both combatant and civilians, on buses and taking them away. Across town, Russian soldiers arrested Baiyev among other Chechens on the streets, unaware of who he was.

After 18 hours of detention in a boxcar, Baiyev was released, his anonymity intact. He returned to the hospital in hopes of continuing his grim work, but the building was in ruins, dead patients on the floor and in the hospital beds. He found only a dozen alive, hiding in the hospital cellar, and he took them to his home for treatment.

Talking of it now, Baiyev, a burly, 37-year-old former wrestling champion, lapses into periods of silence, his hands fidgeting nervously.

"They were my patients," he says. "I knew them and their life stories."

He knew staying in Alkhan-Kala would mean his death. As his family had done months before, Baiyev made his way into Ingushetia, and eventually traveled to the United States. He is currently observing American surgical practices and hospital conditions as a guest of Physicians for Human Rights and Amnesty International.

The United Nations Human Rights Commission recently condemned Russian behavior in Chechnya. This resolution was unprecedented in that a permanent member of the UN Security Council had never been condemned for such egregious abuses. The commission, however, declined to authorize an independent international commission of inquiry, as had been summoned most recently in East Timor. Indonesian activists have credited such an international comission of inquiry with pushing the Indonesian government attorney general to conduct a vigilant national process that has led to the naming of five generals as possibly responsible for atrocities.

Is it too much to ask the United States and its European allies to take firmer steps than mere condemnation? Shouldn't we demand accountability, or at least get independent investigators on the ground to help prevent further carnage?

"The most important thing is the person," Baiyev has said. "War always gives birth to hatred. Regardless of all these horrors, each patient remains, whether Russian or Chechen, a human being."

Leonard S. Rubenstein is executive director, and Nathaniel Raymond is media and public affairs coordina tor of Physicians for Human Rights. The group shared in the 1997 Nobel Peace Prize for its work in the Inter national Campaign to Ban Land Mines.

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