Wednesday, June 1st ~ Makarska, Croatia

Andie

The itinerary for today included a walking tour of Makarska, a visit to City Hall, and then we attended a lecture by Dr. Luce Ivanda, a physician at the local public health clinic. We were given the afternoon free to explore the city and get settled into our apartments.

While walking around Makarska and visiting the local site, you cannot help but notice the contrasting vistas that surround the city. Makarska was built on the sloping coastline, nestled between a beautiful mountain range and the dramatic Adriatic coastline. The weather was a bit dreary, with low hanging clouds that covered the tops of the mountains making them appear surreal, which is pictured above. Many people commented on how the scenery looked like a set at an amusement park. We had to be careful while walking as there were narrow, slick and uneven sidewalks which posed a slipping and tripping hazard, especially for those of us entranced by the views. Our walk ended at City Hall where we were able to meet some of the city staff and they informed us about the political structure of Makarska. The local government is made up of the Executive Branch which includes the Mayor, and the Legislative Branch which includes the City Council. The government is being streamlined and laws are being adapted to align with the European Union to make acceptance and transition into the EU more efficient. During the off-season, Makarska has about 14,000 residents and this number increases to approximately 25,000 residents during the tourist season. To ensure proper functioning in the city, additional public safety officials, food safety workers, and sanitation workers are hired and trained to account for the increase in the population and the stress on the local resources.

Once the meeting was over, the Public Health students walked to the local hospital. Dr. Luce Ivanda spoke to us about school medicine, which includes children through university students. The Makarska Hospital provides prevention, education, treatment and other services to this population, and serves approximately 3700 children in the region. While we were waiting for Dr. Ivanda to finish with a patient, the class took time to look at the various health education and promotion materials available in the waiting room. A poster promotion HIV/AIDS awareness and education is included. 

While Dr. Ivanda was talking to us (pictured above), she asked one of her patients to come in and meet with the group. Katarina was a first grade student who was at the clinic for a general health check, which included a dental exam, blood work, a general assessment of her height and weight, as well as other assessments. I found it interesting that Katarina stood there for over 20 minutes, very polite and attentive while Dr. Ivanda explained her medical history to the class. This is another instance where the U.S. and Croatia differ with regards to the privacy of medical information.

Dr. Ivanda then showed us a blank medical record, which is a comprehensive document that follows the child throughout their life. It documents their immunizations, growth, medical conditions, medications, as well as cognitive development. The records are also being entered electronically; however the paper copies are the primary source of information currently. All children receive vaccinations, including Measles, Mumps, Rubella, Tetnus, Polio mellitus, and Diphtheria. It is required by law that children are vaccinated, and are only exempt in the case of a religious exception. If a child does not receive proper vaccinations, the local officials are involved until the parents comply.

During the course of their schooling, students also receive various screenings and health education and promotion programs in their schools. In kindergarten, first and third grades, vision is screened and students learn about infectious diseases. In the fourth grade students learn about healthy eating, and in the fifth grade they receive a general health screening while also receiving information about puberty. In the sixth grade they receive a general health screening while also being assessed for Scoliosis. In the eighth grade they receive another general health screening, as well as instruction about sexually transmitted infections and other diseases. In high school, they learn about drugs and other addictions, as well as any pressing health issues relevant at that time. Teachers and parents are involved in the children’s education to ensure it is comprehensive. One fact I found quite interesting was the teen pregnancy rate in the area. In 2010, there were three pregnancies to teens in the region, and to date in 2011 there have been zero pregnancies to teens. This was surprising when thinking about the U.S., as the teen pregnancy rate is much higher, especially when looking at Georgia specifically. Once the meeting with Dr. Ivanda ended, the group dispersed for some much needed leisure time. We are all excited and eager to see what this region of Croatia has to offer!