Makarska Hospital (05/30/08)

Great day for public health, we got to visit the hospital here in Makarska and talk to the school doctor (our equivalent of a pediatrician). Dr. Ivanca is the head school doctor for Dalmation and oversees 20 different schools in the region for a total of about 4,000 children. We had a chance to discuss with her the care that each child receives which starts when the prepare to enter 1st grade. Each child is given a physical exam upon their first visit to make sure everything is healthy, and certain immunizations are given at this time as well. The child comes back again in the fall after they have started school to ensure that they are developing appropriately at school. These check-ups continue to occur throughout the child`s schooling and different health education, screenings, and vaccinations are given at specific intervals.

We were very excited to learn about the hospitals dedication to prevention and the detailed information kept on each childs medical and behavioral history. We specifically talked about sexual health education and substance abuse among the kids (specifically cigarettes and alcohol). Starting in 5th or 6th grade students begin learning about sexual health and this continues through out later grades similar to how it is done in the U.S. Dr. Ivanca commented on teen pregnancy, stating that it was not that big of a problem here on the Dalmation coast. She estimated only around 3 pregnancies occurring each year and typically among high school seniors. In this culture it is common for the teens to get married when an unplanned pregnancy occurs and it is actually accepted fairly well by society. Dr. Ivanca joked that there are so few babies being born now (-2% birth rate) they will take whatever they can get!

Unfortunately problems with cigarette smoking and alcohol consumption are much more prevalent. Dr. Ivanca mainly talked about the extensive data that they collect on each child`s health behaviors including substance use. This data was collected through anonymous questionnaires and one on one interviews. Data collected shows that while a large percentage of students drink alcohol binge drinking is not a problem like it is in the U.S. We felt this was due to cultural influences such as the cafe lifestyle of slow leisurely drinking, as opposed to drinking for the sole purpose of getting drunk.

Dr. Ivanca also briefly talked about obesity problems which are on the rise among the student population here in Dalmatia. Area schools attempted to implement a healthy food program within the schools, but the intervention unfortunately backfired. Students in Croatia are released from school around lunch time and instead of eating the healthy snacks offered in the schools, students used their money to go and buy food from the many fast food restaurants which are springing up all around the school campuses. To further combat the issue area school boards are going to try pushing the idea of healthy eating at a younger age, targeting kindergartener`s which will hopefully make proper nutrition a habit instead of a chore.

Our visit to the Makarska hospital helped us understand what issues are important to people in this area and how they approach solving health related problems, - Maggie