Geopolitics, Paralysis and Health Policy: On the Implications of the Dayton Peace Accords for Bosnia & Herzegovina’s Transplantation System

Abstract

ABSTRACT More than 25 years after Dayton Peace Accords (DPA), the shadows of the Yugoslav and of the subsequent construction of independent states based on ethnic division still looms over Bosnia & Hercegovina (BiH), its population, and the everyday life of people. The construction of its two major political entities – the Federation of Bosnia & Hercegovina (FBiH) and the Republika Srpska (RS) – is reflected in the health care system where it unfolds highly detrimental effects. Here, we can witness the severe impact on BiH’s ability to establish an effective system for organ donation and transplantation. Based on a series of 26 interviews with patients, patients’ organisations, clinicians and politicians BiH and its neighbours, the article identifies obstacles in clinical practices, post-Dayton bureaucracy as well as mistrust and corruption as major themes articulated by our respondents, ultimately imprisoning them in a Post-Dayton paralysis. Desperation amid the deadlocked structural conditions and contemplating alternatives ways of getting access to transplantation seem logical outcomes of a system widely regarded as deficient. This exemplifies the prosaic legacies of wars and the fragile state of BiH’s politico-administrative system.