Bosnia Wounded Risk Gunfire for Haven in U.S.

The patients were whisked from their hospital beds Monday in armored cars, forced to dodge sniper fire on their way to the airport to begin what authorities called the riskiest evacuation thus far of those injured in the Bosnian war.

The daring maneuver culminates today when 18 wounded people and a 6-month-old with a heart condition are scheduled to arrive in the United States, part of the first medical airlift to this country from the ravaged city of Sarajevo.

“Operation Second Chance” was carried out by the United Nations and the U.S. Air Force in cooperation with a Swiss-based relief organization, but the woman behind the airlift was a Century City Hospital administrator who has spent the past three years trying to bring medical care to the sick and injured in the former Yugoslav federation.

This afternoon, when the injured land at Andrews Air Force Base in Maryland, Sonja Hagel will witness the fruits of her work. After they are examined by military doctors, the 19 patients--all of whom require specialized treatment they cannot get at home--will be flown to hospitals across the nation, most in California, for free care.

A 15-year-old girl who lost vision in one eye in a bomb explosion will be sent to Hagel’s hospital in Century City, where surgeons hope to perform delicate surgery that could restore her sight. A 40-year-old whose legs were blown off in a blast will go to Los Alamitos, where he could learn to walk again on artificial limbs.

In Delray Beach, Fla., doctors will administer bone grafts to a 25-year-old man whose leg was shattered by a bullet. In Dallas, a 36-year-old man with a fractured pelvis and shrapnel in his hip will undergo exploratory surgery and months of physical therapy.

While there have been other medical airlifts from the war-torn region, the arrival of this group marks not only the largest such humanitarian effort, but also the first time that patients have come directly from Sarajevo, where the most intense fighting is occurring. Previous airlifts emanated from Zagreb, in Croatia.

“Just getting a doctor to screen the patients so we could find out what sort of needs there were took four months,” said Francis Sullivan, an official with the International Organization for Migration, the Swiss-based agency that coordinated the difficult evacuation. “Wherever you go there are bombs blowing up, snipers, gunshots. People are fighting in the streets; every time you turn the corner it’s war.”

While the group’s doctors were selecting the neediest patients in Sarajevo, Hagel--who began her career as a registered nurse--was in the United States, trying to persuade hospitals and doctors to donate their services to the war victims.

It was not, she recalled, an easy task.

“This is a day and age when health care reform is on the table,” she said. “We are getting a whole lot less dollars, therefore our revenues are less. Now if you’re the administrator of a hospital and Sonja Hagel comes along and says, ‘Hi, can I have $100,000 or $200,000 and, by the way, give me your best doctors,’ what would you say?”

“I had to encounter many noes before I got yesses.”

Of the 18 hospitals participating in Operation Second Chance, 14--including Century City Hospital--are owned by National Medical Enterprises, a for-profit nationwide chain. Neither Hagel nor officials of the hospital chain could estimate how much the donated services will cost. That amount will not be known, they said, until doctors get a chance to examine the patients.

“We’ve got patients with one leg, half a leg, one arm, no arm,” Hagel said. “They require prosthetics. You’ve got to teach them how to do things, how to manage in society, the basics of daily living. They are going to have to relearn and rethink everything. These are very, very complex cases.”

A resident of Huntington Beach, Hagel first visited the Balkans three years ago, before the fighting erupted. In Croatia, she met a 14-year-old boy who had been badly burned at 4 and required intensive plastic surgery that was unavailable. When his family asked for her help, Hagel brought the boy and his mother home to live with her. She persuaded Century City doctors to care for the child.

She subsequently organized Hands Across the Sea, a pen pal project that linked California children with youngsters in Croatia. In January, after founding “Operation Second Chance,” she returned to Croatia with a team of surgeons and a film crew in an effort to bring medical aid to the injured there and to spread news of their plight to the rest of the world.

During that mission, doctors performed 30 plastic and reconstructive surgeries on war victims, and briefed Croatian physicians on state-of-the-art medical techniques. About the same time, the International Organization for Migration, a 42-year-old international agency headquartered in Geneva, asked her to recruit hospitals to participate in its fledgling airlift program.

The organization said it has helped 150 war victims from the former Yugoslav federation receive specialized medical treatment in Europe and the United States. During Monday’s evacuation, patients were taken from two hospitals in Sarajevo to the airport, which has been under frequent sniper fire. An Air Force C-130 touched down for 30 minutes, scooped up the patients and took them to Ramstein, Germany, where they spent 48 hours before leaving for the United States.

Hagel has never met the wounded who will be helped by her efforts; she learned their identities just five weeks ago, when Sarajevo doctors selected them. But during these past five weeks, the hospital administrator said she has spent nights and weekends learning whatever she can about those people, reviewing case files as she phoned various participating hospitals to see who could care for whom.

“We’re at the 99th hour,” she said Tuesday in a telephone interview from Washington. “I’ll be touching their souls, touching their very skins tomorrow, and I will sleep well tonight, knowing that I can do that.”