The development of infectology in bosnia and herzegovina, with special emphasis on the development and history of infectious clinic, clinical center of sarajevo university.

CONFLICT OF INTEREST: none declared There is a relatively low amount of historical data about development of infectology in Bosnia and Herzegovina, but that does not mean that these medical disciplines didn't have important events and actors that are important for the development of this medical discipline in B&H. In this review we intent to show your several characteristic events and important persons, which left a lasting impression in the development of infectology service in BIH and especially in Sarajevo. Development center for this discipline was in Sarajevo. Experts on infectious diseases were sent from Sarajevo to other health centers to organize new ministry there. Infectology as an organized health care dates back to the Austro-Hungarian period, when a part of the State Hospital in Sarajevo formed a separate Department of Infectious Diseases. Thanks to the competent professional and later teaching staff in this discipline and the importance of health care of patients with infectious diseases, in Sarajevo and other cities in Bosnia, infectious diseases care has experienced expansion and increasing importance and quality. Infectious disease specialists were very quick in organizing their professional association and with exchange of knowledge and experience have contributed substantially to the above assertion. The "Association of infectious diseases of Bosnia and Herzegovina" was founded during the aggression on BIH, in 1994 and in 1997 they organized the first scientific congress of the Association of the infectious disease specialist with international participation. Improving the health of the population in the area of infectious diseases was significantly helped by infectious diseases clinics at clinical centers in BIH and departments for infectious diseases within the hospitals in B&H. Association of the infectious disease is a significant coordinator for scientific and professional activities, but also the environment in which infectious disease specialists are able to share their knowledge and experiences.

1. THE BEGINNINGS OF THE DEVELOPMENT OF INFECTOLOGY IN BOSNIA AND HERZEGOVINA

Opening of the asylum in Hadzi Sinan tekke in Sarajevo in the eighteenth century practically meant the beginning of an organized health services in Bosnia and Herzegovina (1). The first hospital was the one in Sarajevo, named Vakuf hospital, built in year 1866. Austro-Hungarian administration in our country begins to raise the health care level for population in all fields. A new era of health services employed specialized medical personnel from Austria, Hungary, Czech Republic, Italy and other countries, carried out a number of health care reforms, adopting legal acts etc. (1, 2, 3)

Following the development of infectology in B&H can perceive the overall presentation of the health development in Bosnia and Herzegovina following the rule of the Ottoman Empire as the oldest form of organized documented history of our region (5 waqf hospitals were founded during the time of Sheriff Topal Osman Pasha governing in the period since 1861 to 1869 (Sarajevo, Tuzla, Mostar, Banja Luka and Travnik) and during the Austro-Hungarian period (in Bosnia and Herzegovina was established State hospital in Sarajevo, 6 regional, 9 district and 22 municipal hospitals for the population of 1,890.440. In 1921st about 200 physicians worked in the health institutions. The State hospital in Sarajevo constantly recruited personnel for other institutions and services in B&H, including infectology services in health institutions in B&H, in which the most significant changes, the fastest and best quality development of health care in B&H occurred.

Monitoring the development of infectology is possible through a number of legal acts, records and decisions in medical documents and exhibits which are kept in the Fund of the State Archives–Archives of the Federation of B&H in Sarajevo, among which are worth mentioning (1):

Measures to prevent the appearance of cholera and measures to be taken during the epidemic in Bosnia and Herzegovina from 1886.

Order on mandatory vaccination of the population in B&H from 1890.

Founding of quarantine for those returning from the Hajj to Mecca and Medina in 1891.

Construction of barracks for the acceptance of patients in case of cholera or other epidemics in 1892.

Measures for the prevention of Cholera in the B&H from 1894.

An outbreak of typhoid in Sarajevo in 1907.

The fight against tuberculosis in B&H in 1908.

Report on the fight against malaria in B&H from 1910.

The fight against leprosy from 1911.

Purchase of serum against dysentery in 1912.

Law on Compulsory vaccination against smallpox in B&H from 1913.

Law on Protection against infectious diseases and their prevention from 1914.

Report of the police directorate in Sarajevo on the status of communicable diseases in November and December of 1917.

Report on the typhus cases from 1918/19.

Leprosy–Sarajevo district for the 1920.

Survey map of endemic syphilis in Bosnia and Herzegovina from 1926.

Report on infectious diseases in Bosnia and Herzegovina for 1928.

The rules of society to combat tuberculosis in Sarajevo approved in 1931.

The National Reader, “How do we combat typhus” and on itching from 1944. (1)

According to official data from 1875 the overall mortality of the population in B&H amounted to 24.4 per thousand, infant mortality was 261.8 per thousand. Poor social, economic and health situation has favored the occurrence of several large outbreaks of infectious diseases–cholera (1876, 1895, 1912.), smallpox (1880, 1888, 1889, 1890, 1901.), tuberculosis (1908 mortality rate was 12.5% of the total mortality rate), then in year 1901 in B&H was recorded 214 cases of leprosy, and 351 case of trachoma, and a large number of cases of other diseases such as pellagra, scurvy, etc.. During their rule B&H has recorded a total of 23 000 cases of syphilis.

It should be noted that of all infectious diseases the most attention has been given to venereal diseases, because they were responsible for as much as 17.52% of patients who were treated in hospitals during the the Austro-Hungarian rule (1). Although these diseases are now separated and processed at the Dermatology clinic – sector for venereal diseases, it should be noted that, in the past, they were treated as infectious diseases, as well as typhoid fewer, tuberculosis, cholera. The fact is that the major part in history of infectology development can be followed through observing frequency of syphilis, leprosy, tuberculosis and ways of their treatment.

Also, there were widespread variety of endemic and pandemic for the simple reason that it was an insufficient number of healthcare facilities and insufficient qualified health personnel (1). For example, in the State Hospital in Sarajevo (founded on July 1, 1894, with 4 divisions: Internal, Surgery, Gynecology and obstetrics and Dermatosiphylitic with a total of 204 beds), there was no pavilion for infectious diseases, so for purposes of this in 1895 they built a shack by the system of doctor Koch with 22 beds, enclosed with separate entrance and completely isolated in a remote area of 40 m from the rest of the hospital. Also the style differed from the other pavilions.

This ward serve for the required isolation of patients suffering from acute infectious diseases: scarlet fever, diphtheria, cholera, intestinal typhus and other infectious diseases. Infectious waste materials were burned in special furnaces. In 1896 they built one new floors due to increased demand (for a total of 67 beds). Tuberculosis patients were initially placed in the same room with the other internal (or infectious) patients. Therefore, the need appeared to separate tuberculosis patients from the others. The TBC pavilion was built in 1923, for better care and long-term treatment with generous food, as well as for isolation of patients with open TB from healthy family members. Initially, the department was managed by foreign doctors, nun’s nurses and paramedics. In 1897 was founded serobacteriological laboratory, important for the etiologic diagnosis of infectious diseases. For patients suffering from leprosy, in 1897 a special leprosaria was built and put into function, only one in Europe in that period, which caused the attention of European scientists, so in 1903 in Sarajevo, was organized the German-Bosnian congress of dermatovenereologists.

In the treatment of infectious diseases for which was not known etiologic agents, but only the clinical features, the popular form of symptomatic therapy were in form of balm–“coddle”, as those against children rashes, and various types of crusts and scabs itch. Recipes for some of these drugs among the people of this region are still in use as an effective means of treatment. This popular treatment is developed in families, so they were known families Humo in Mostar and family Kalajdzic, which kept the secret of recipes for their balms. In 1897 the State Government decides on free treatment of favus, leprosy, trachoma, and venereal diseases and these diseases will be treated in third class hospitals, for free.

Researches were performed on infectious diseases on the State Hospital patients with even certain fundamental knowledge about syphilis, leprosy and favus in world literature, it originated from the experience of physicians in our region. For example, doctor Geza Kobler (manager of the State Hospital) did research on typhoid fever, and doctor Leopold Gluck on erythema multiform exudative.

Notwithstanding the increase in personnel, the country was still ravaged by epidemic of cholera, typhoid fever, recurrent, malaria, etc. After the First World War in 1918, B&H was faced with even greater poverty, and doctors who were mostly foreigners leave the country and outbreaks of communicable diseases ravages leaving serious consequences. In addition, economic and cultural backwardness and evident poverty of the population (that are favorable for bond related) are often caused outbreaks of infectious diseases, their repertoire was inexhaustible.

The highest mark in the creation of nuclei of Infectology department from this period in Sarajevo and Bosnia-Herzegovina gave a head doctor Hamdija Karamehmedovic MD (Trebinje, 1883–Sarajevo, 1968), extremely versatile and educated physician, but also the organizer of health services in B&H (2, 3). As the best student of the Vienna Medical School in 1909 (c-ring winner for his success during the studies) is coming to Sarajevo and start to work 1910 as a doctor in State Hospital. According to the established principle he practiced in all departments of the State Hospital, but he focused on organizing infectology service, because he recognized the importance of preventing and treating infectious diseases which covered a large percentage of the overall pathology. In 1918 with the title of Chief physician, he established Department of Infectious Diseases. He spoke seven languages and followed all available medical literature, had excellent organizational skills and in 1914, as a member of the Health Council of the Provincial Government in Sarajevo proposed law on health care institutions and gave the idea to establish the Sarajevo School of Medicine. If Gavrilo Princip did not make a shot and the First World War started the idea of doctor Karamehmedovic would be realized. His organizing skills enabled him the position of Minister of Health of the Kingdom of Yugoslavia in year 1921. After the dismissal of this function, he returns to the position of Head of the Department of Infectious Diseases, State Hospital in Sarajevo from 1924 to 1931 and he became governor of the State Hospital. Beside other great doctors, Andrija Stampar and Milan Jovanovic-Batuta he remained the most noted figure in medical science and profession in the first five decades of the 20th century. Unfortunately, seen as all great men, ended his career as a librarian in the library of the Central Public Health Institute in Sarajevo. He left an indelible mark there too, because alongside the professor Sacir Sikirić, he translated from Arabic, Turkish and Persian languages over 40 major papers that were used in medical education also in the later period. The best-known work which was translated by these two giants is a famous excerpt from Ibn Sina’s – Avicenna’s Code of Medicine, called. Mudgaz al-Kanun (translated in 1961 and printed in 200 copies). It presents the basic principles of diagnosis and treatment of the golden period of Arab medicine. After Chief physician Hamdija Karamehmedovic Department of Infectious Diseases (which was expanded and adapted) was governed by Chief physician Ivo Pehovac (leading it until he died from typhus), then Chief physician Asaf Sarac, who was the first chief of Clinic of Infectious Diseases, founded in 1946, when on the 16th ofNovember officially opened the first Medical faculty in Bosnia and Herzegovina (Sarajevo 1946, in Tuzla 1976, in Banja Luka 1978, in Mostar 1994, Foca in 1997.).

In 1923 within the General State Hospital of Sarajevo was founded the fixed bacteriologic station. As part of this and Hygienic Bureau also there will be infectological hospital departments and health clinic for tuberculosis. The period between two World Wars and during the Second World War was rather terse with data on the development of infectious diseases in Sarajevo and B&H. With the establishment of the Medical Faculty in Sarajevo in 1946 infectology as a health care branch is experiencing an expansion in professional and academic terms, so the Clinic of Infectious diseases of University Hospital Clinic in Sarajevo (renamed the General State Hospital to University Hospital Clinic) becomes the basis for teaching the subject of infectious diseases. First chief became a professor Blagoje Djordjevic, MD, PhD (in the period from 1949 to 1970), and after him this clinic led by: Professor Mohammed Teftedarija, MD, PhD (1971 to 1983), professor Dragan Djordjevic, MD, PhD (1984 to 1990), professor Sadzida Telalbasic, MD, PhD (from 1991 to 2001), professor Sajma Krkic-Dautovic, MD, PhD (2005-2008), and from 2009 to the present clinic is managed by professor Nada Koluder-Cimic, MD, PhD. The first Heads of institutes and clinics for infectious diseases on the medical faculties in Tuzla and Banja Luka were: professor Sava Sibalic, MD, PhD (Clinic in Tuzla was founded in 1976), professor Dragan Djordjevic, MD, PhD (Clinic in Banja Luka, founded in 1978), professor Ilija Kuzman, MD, PhD (Clinic in Mostar, founded in 1994).

2. A BRIEF HISTORICAL OVERVIEW OF DEVELOPMENT OF THE CLINIC OF INFECTIOUS DISEASES IN SARAJEVO

Clinic of Infectious Diseases in Sarajevo has experienced many radical organizational and functional changes, from its founding as a special clinic in the University Hospital in Sarajevo in 1946, especially in the organization of the University Clinical Center, 1974 and the Clinical Center of Sarajevo University, 1992 at the clinic numerous professional and skillful staff worked, who also performed as a regular activity of the infectious diseases of the tertiary level, but also the academic part–the training of students of Biomedical Engineering, University of Sarajevo. Too much space would be required to describe all the important events and participants in the work and the provision of hospital and other forms of health care in the field of infectious diseases. Let’s look at the latest and most impressive ones.

Since its establishment, the capacity of Infectology clinic in Sarajevo was increased. Upon completion of the Second World War, with the increasing number of beds and number of specialists and other staff, the organization of clinic changed. Admission triage clinics was formed and besides it, also three divisions with 6 sections. First Division (sections I-1, I-2) hospitalized patients of intestinal infectious diseases, tropical diseases, hemorrhagic fever, vague febrile illness and some rash children’s diseases (scarlet fever, immunization). Second Division (sections I-3, I-4) hospitalized patients from infectious hepatitis, other infectious diseases of the liver and urinary tract. Third Division (sections I-5, I-6) treated patients suffering from neuro-infectious and respiratory diseases.

Later in 1976 the modern intensive care units and intensive care ward has been founded with two apparatuses for directed mechanical ventilation, defibrillator, aspirator, noninvasive monitoring, oxygenation, chest x-ray machine, and transportable machine for plasmopheresis. Doctors and more nurses are educated in the infectology intensive therapy in Ljubljana, Zagreb, Belgrade, and the first head of the listed department, ass. professor Lejla Djinic, MD, PhD, completed education in France.

Established was a counseling ceter for infectious intestinal disease with cabinet for rectoscopy and fecal diagnosis. Doctors of Infectious disease with a subspecialty in gastroenterology in the seventies were the educators of endoscopic skills for internists and gastroenterologists of the future.

Within Infectious clinics operated Biochemistry laboratory, which founded the graduate engineer on chemistry, Franko Cetinic, as a professor. It is from this laboratory, in the early 70’s, that he formed the Central Biochemistry Laboratory for the entire hospital, which now operates under the Clinical Center of the Sarajevo University.

In addition, the Department acted within the bacteriological laboratory, which was responsible for the entire hospital. Later, inside the Infectious Clinic was focused on the diagnosis of anaerobic infections, led by professor Marija Miladinovic MD PhD. In Nineties it merged with the Institute of Microbiology.

From previous laboratory, which belonged to Infections Diseases Clinic, the others are to act microhematocitological laboratory with a reduced number of laboratory technicians, who have made cytological analysis of CSF in Neurological and Neurosurgical Clinic. Since 1985 within this laboratory works also the referral laboratory for the diagnosis of viral hepatitis and HIV/AIDS, which leads untill the war Chief physician Dubravka Ungar MD PhD, and during the war ass. professor Danko Lupi MD PhD until the decision of the Director General that complete laboratory with high medical personnel move and merge with the Institute of Microbiology.

Infectious disease Clinic in Sarajevo was the first in the former Yugoslavia which formed the out-patient ambulatory infectology service that extends to three ambulances but organizationally within the hospital, where specialists in infectious diseases 5-7 of them worked. Work was performed in clinics, but the service also organized home visits where possible.

During the war, because of reduced capacity and staff, the clinic was reorganized. The departments where abolished, there were only two working departments, intensive and semi intensive unit care, and Clinic (one located at the clinic and the other two in Primary health care centers “Center-Vrazova ‘DZ and’ Omer Maslic”). After the war, these clinics are canceled, but long acting infectological clinic in Primary health care center “Stari Grad” was, but due to chronic lack of personnel or the inability to organize work, this was also abolished. After the War Department of Clinic is reorganized several times, the last time in 2008 and as such rganization exist today.

3. PROFESSIONAL TEACHERS AND INFECTIOUS CLINIC IN SARAJEVO”

Since 1949 the number of doctors was constantly increasing. The Clinic of Infectious Diseases is also formed. The doctors were elected to the position of teachers and assistants. The medical profession requires immediate professional training, so the subspecialists where recruited. At the beginning of the aggression on B&H at the Clinic for Infectious Diseases were 34 doctors, 26 specialists in infectious diseases, 7 subspecialist (gastroenterologist, hepatologist, two clinical pharmacologists, immunologist, cardiologist, medical informatics), 14 Chief physicians, 6 residents, 2 general practitioners on training, 19 senior nurses, 86 secondary nurses, 10 administrative employees and 24 unskilled workers. The Clinic department had two professors, three assistant professors, a total of 6 doctors of medical sciences, 5 Masters of Medical Sciences, 2 senior assistants, and 6 assistants.

Aggression and war operations caused the attrition of staff. Number of physicians has been reduced to 15. Some of them went to the side of the aggressor, the other in exile, the third was retired. At the beginning of the war in the title of a specialist clinic received three doctors exiled from other medical centers, three are residents, 3 pre-war residents, who have a specialist examination in the war. Two infectious disease specialists go to the Clinic for Infectious Diseases: ass professor Bakir Kapetanovic MD PhD, 1993–passed the specialist exam in internal medicine and moves cardiology part of clinic and Chief physician Zlatko Cardaklija MD MSc moved to the Ministry of Health of Sarajevo Canton. Besides the reduction of human resources, hospital accommodation was reduced to 60 beds.

4. THE ORGANIZATION OF INFECTIOUS CLINIC DURING THE AGGRESSION ON B&H (1992-1995)

Combat operations in surrounded Sarajevo, lack of energy, water, food, removing the waste have led to two major outbreaks of infectious intestinal diseases, including highly malignant form of unexpected dysentery and viral hepatitis, and extremely increased number of patients with hemorrhagic fever among the soldiers of the Army of B&H. Due to limited space in the new hospital building, at the time of the epidemic, the Clinic outsourced some parts of the premises of the Clinic for Endocrinology and the Psychiatric Clinic. As a result of a lack of necessary clinical space decreased the length of hospitalization of these patients, which resulted in the occurrence and recurrence of protrached forms of intestinal infections, especially dysentery, infectious hepatitis, and botulism.

In the war of unexpected infectious disease was first encountered in one child with a malignant form of diphtheria, tetanus, but the expected occurrence is absent due to proper immunization before the war, and wartime. Actualized as posttraumatic/postoperative meningitis with polymicrobial flora, including gram-negative bacteria, other bacterial meningitis, sepsis, osteomyelitis of long bones, spine, skin infections and soft tissue infections, nosocomial infections, herpetic encephalitis, polyradiculoneuritis, leukoencephalitis, AIDS.

So the staff has been working under difficult circumstances, unseen till then and not experienced, but those who remained at the clinic and the city, with great efforts and sacrifices were conducted its core business, and more.

At the beginning of the war, ass. professor Danko Lupi MD PhD being wounded by shrapnel in action of withdrawing from Primary health care center Ilidza colonoscope machine. Alija Drnda, MD, nurse Dusanka Babic risks their lives saving from the Jarcedoli one of our staff. Jasna Topalovic-Cetkovic, MD and nurse Mirsada Kucinovic go through the famous tunnel in Butmir to retrieve the donated medicines for the clinic. In the winter of 1993/1994 rounds with the aggressor destroys the lateral position of the wall on the second floor and springs into the room so called ten, but fortunately there was no room in the patients. Material damage was high. In that period on the first floor of the room springs into medical rounds, which are driven into the floor, but not exploding. In June 1995, citing a shell into the so-called Six, the order goes through a series of rooms full of patients. The consequence was three deaths of patients, major trauma for the present and virtually incapacitated the second floor for the reception of patients.

During the war, the clinic is part of the lives and peaceful staff. Staff trough self education bring us a doctor guides for diagnosis and treatment of patients. At the clinic until the end of 1993 operates a library by master lybrarian Jelena Koprivica. Establishment of the Institute for scientific research fused to the remaining staff together with the valuable library fund in which we were known. Our 3 specialist trainee pass the exam, they receive the three doctors on specialization, promote two Chief physicians, participates in the work of two naval symposium, evaluate the war results, diagnostic and therapeutic approaches from which to extract the essence of the first congress of surgeons.

After the war, the clinic was in late 1997 restored with the help of the European Community Humanitarian Office ECHO Cooperazione Internazionale MOVIMONDO.

Since the beginning of the war in 1992 was introduced systematization of the clinics that simplify the organization of the clinic in four departments, which has been retained to 2004. That automatically implies the impossibility of restoring the frame. The period since 1996 2004 is once again characterized by a large dissipation of the frame so that the total work is organized with only 11 specialists. At the same time work at the clinic is hampered by reducing the working space, the elimination of outpatient clinics in the Old City, Omer Maslic and Ilidza, the equipment was obsolete, and newer related to work on hepatitis and HIV, stripped and connected to the Central Laboratory of the Clinical Center. Infectious disease doctors inaugural conference organized by the B&H Association of infectious diseases specialist in 1994, which continued organized activity of infectology profession. Nurses take exams at the Higher School of Medicine.

5. INFECTIOUS CLINIC, CLINICAL CENTER UNIVERSITY OF SARAJEVO TODAY

After the last war, new personnel changes started in terms of arrivals of refugees, from other medical centers, specialization, and retirement, to other jobs in the city and abroad.

The main activity of the clinic is the professional, scientific and educational fields of infectious diseases. Clinic performs admission, diagnosis and treatment of patients with infectious diseases through the hospital, then, Outpatient Clinic, cabinet, and advisory services. Clinic is engaged in research work and training of staff. Clinic for Infectious Diseases have 7 departments with the appropriate wards, and counseling for sexually transmitted diseases, counseling for antibiotics, counseling for prevention of nosocomial diseases, counseling for the infection of pregnant women and prevention of congenital anomalies, Cabinet of intestinal infection with endoscopy, Section for hepatology and Diagnostics, Neuroinfections Cabinet, Cabinet for AIDS and immunodeficient states and Cytological laboratory.

Today the clinic have 21 doctors, 18 infectious diseases specialist, 3 residants, 6 chief nurses and 34 nurses, 1 administrative worker and 14 unskilled workers. Chair consists of one doctor of medical sciences, associate professor, 3 masters of medical sciences, a senior assistant, three assistants and one associate assistant. Faculty of Health Studies attended four nurses. Professional teaching staff of the Clinic for Infectious diseases are: professor Nada-Koluder Cimic MD PhD, infectious disease and clinical pharmacologist, head of the Clinic and the Department of Infectious Diseases; Chief physician Alija Drnda MD MSc, infectious diseases specialist, department head, Chief physician Snjezana Mehanic MD MSc, infectious disease specialist, the head of department; Chief physician Fikret Pinjo MD, infectious diseases specialist, department head, Chief physician Vesna Hadziosmanovic MD, infectious diseases specialist, department head, Chief physician Planinka Muratovic MD, infectious diseases specialist, department head, Chief physician Merdina Ferhatovic MD, infectious diseases specialist, department head, Enra Lukovac MD, infectious diseases specialist, department head, Chief physician Jasna Topalovic-Cetkovic MD, infectious diseases specialist, Chief physicial Akif Osmic MD, infectious disease specialist, Nermin Mostarac MD, infectious disease specialist, Meliha Hadzovic-Cengic MD, infectious disease specialist, Belma Gazibera MD, infectious disease specialist, Ilhama Jusufi Huric MD, infectious disease, Rusmir Baljic MD MSc, infectious disease specialist, Refet Gojak MD, infectious disease specialist, Amir Hadzic MD, infectious disease specialist, Velida Mulabdic MD, infectious disease specialist, Aida Begic Ahmetspahic MD, resident, Alma Sejtarija Memisevic MD, resident; Selma Hasimbegovic Ibrahimovic MD, resident.

Department currently have 70 employees, and the accommodation capacity is 80 beds. In addition to insufficiency in a highly educated staff, the Clinic have chronic lack in nursing and senior staff. The process of the Clinic work depends on the epidemiological situation on the field. Inside the building, space in the low ground was converted into a VCCT center, counseling centers and day hospitals. Represents specified part of the strategic plan development clinics. Now we have concentrated on equipping intensive care units with related equipment including the two apparatus for artificial respiration, which we suspended its work in the intensive therapy internist and a parallel is to educate young staff.

6. CONCLUSION

Infectious diseases care as an organized health care dates back to the Austro-Hungarian period, when a part of the Provincial Hospital in Sarajevo formed a separate Department of Infectious Diseases. Thanks to the capable and qualified teaching staff, also later in this discipline with the importance of health care of patients with infectious diseases, in Sarajevo and other cities of Bosnia and Herzegovina has experienced expansion of infectious diseases and the growing importance and quality. Infectious disease specialists are very quick to organize their professional association and exchange of knowledge and experience has contributed substantially to the above assertion.

In last war, in 1994 was founded the “Association of infectious diseases of Bosnia and Herzegovina” and in 1997 was organized the First Congress of the Association of the infectious disease specialist with international participation. True, such an association has existed since 1959 in the framework of the Association of B&H doctors, but as the Infection Section, led by teachers and associates of the Clinic for Infectious Diseases in Sarajevo. Since 1972 until 1991, the interrepublic and intersectional meetings were held with the infectious disease association of Macedonia. In the framework of the Yugoslav Association of infectious diseases was held five conferences on infectious diseases, of which the first was held in Sarajevo in 1971.

This brief overview of the development of infectious diseases as a medical profession in our area from late 19th century to the end of the 20th century shows the determination and modernity of doctors in our area to raise the level of population health of these diseases are the most common and fastest passed and ravaged the population. Once an infectious disease is under control, we can say that the whole demographic picture is changing for the better, which is not so obvious and dramatic case with other illnesses.

Improving the health of the population in the area of infectious diseases significantly helped infectology clinics at clinical centers in Bosnia and Herzegovina and infectious disease departments within the hospitals in B&H. Association of the infectious disease specialists is a significant scientific and professional activity coordinator and the environment in which infectious disease specialists are able to share their knowledge and experience from practice, and the ability to publish these experiences and make them available to the wider scientific community in and outside B&H.