The Siege of Sarajevo lasted for years — now the city’s battle with Covid-19 is dragging on with no end in sight

In the hills above Sarajevo, thousands of uniform white headstones line the slopes, marking the graves of just some of the victims of the Bosnian War.

They’re a constant reminder of the bloody conflict in the early 1990s that claimed the lives of around 100,000 people.

This city, the capital of Bosnia and Herzegovina, was besieged for almost four years and 11,000 people died in Sarajevo alone.

Now the city is fighting a very different kind of war.

In recent months, the Covid-19 pandemic here has taken lives at a pace not seen since the siege of almost three decades ago. Between March 1 and April 28, 698 people have died of coronavirus in the city, according to the Canton of Sarajevo government — with an average daily toll of 13 and 10 in those respective months. The Siege of Sarajevo saw a daily average of seven deaths, including combatants, although it also saw gruesome mass-casualty incidents such as a marketplace bombardment in 1994 that took 68 lives.

Dr. Ismet Gavrankapetanović, the head of Sarajevo General Hospital, remembers treating the many victims coming through his doors every day with gunshot and shrapnel wounds during the 1990s blockade.

And — as Bosnia experiences its deadliest period of the pandemic so far — the 59-year-old Gavrankapetanović says there’s now a familiar feeling inside the emergency room.

“You can’t see your enemy and a lot of people are dying because of that virus. That is really a war,” he told CNN.

“[During the siege] in Sarajevo we were completely surrounded — a lot of injuries and a lot of troubles, but also in the last three months that was also very similar, so [it’s a] difficult situation.”

Gavrankapetanović says that among the victims of the pandemic have been many of his hospital colleagues — left vulnerable by a government that seems slow to get its act together.

“We have a feeling that … nobody cares for us,” he added.

Mediha Slatina, 53, lost her husband Dr. Enes Slatina to coronavirus in November. The 58-year-old was an ER physician at a clinic near Sarajevo airport.

Slatina says he did everything he could to protect himself, but could not avoid contact with Covid-19 patients. The doctor battled the virus for 16 days from a hospital bed before he died.

Two days before that, Slatina had lost her father to Covid-19, then four days later her mother-in-law also died. In a single week, the pandemic had claimed three of her closest loved ones.

Slatina told CNN she feels that Bosnians “have been left alone and betrayed.” She says her country is suffering from a lack of coordination between the dizzying web of regional and local governments and national institutions.

“The problem is not tackled by some joint action,” she added. “Everybody takes care for their own [region], but there is no common point, which would deal with this issue, we need something at the [national] level … and taking things seriously.”

CNN reached out to the office of the current President of the collective Federal state of Bosnia and Herzegovina, Milorad Dodik, which declined to make anyone available to comment.

Zoran Blagojević, public relations consultant to the Prime Minister of the Federation of Bosnia and Herzegovina, one of the country’s two autonomous regions, says his entity doesn’t even have a Health Minister at the national level. He told CNN that the national government — which has a presidency that rotates between the three main ethnic groups — should be leading and coordinating the two main regional governments.

“In many countries the system is not working, but in our country it doesn’t work at all. It’s a very huge problem about who is responsible for what and that is the reason why we are delayed and late for some of the problems like buying vaccines, respirators or ventilators,” Blagojević told CNN. “The epidemic situation actually helps us to see very clearly how many things inside the system don’t work.”

For Blagojević and many observers, the problems start breakdown in effective governance starts with the country’s constitutional law, which is based on a peace agreement, brokered in Dayton, Ohio in 1995, not on a traditional constitution. Since then, “nothing was changed to improve the functions of the country.”

Sarajevo has been largely rebuilt since it was hollowed out by war, but ethnic divisions are still entrenched on the ground — including in the system of government that requires largely Eastern Orthodox Serbs, Bosnian Muslims and Catholic Croats to share power.

This complex arrangement was enshrined in Bosnia and Herzegovina’s constitution after the war and designed to prevent future conflicts. Yet some observers say it has also made it difficult for the government to effectively tackle the pandemic. National institutions are weak and while the two main regional governments are strong, experts say they’re often reluctant to coordinate and work together.

Adnan Ćerimagić, a senior analyst at the European Stability Initiative, says his country pinned its hopes on purchasing vaccines from the COVAX program, which aims at helping poorer countries get doses, as well as getting surplus supplies from the European Union — which have yet to materialize.

While the rest of the Western world is accelerating inoculation rollouts to head off another wave of infections, as of late April Bosnia and Herzegovina has only received 226,800 vaccine doses — many of them donated from Turkey, Serbia and China — according to central government figures and Ćerimagić’s tally. With a population of 3.3 million, that works out as about seven doses for every 100 people — well behind the mid-April European average of 29 doses for every 100 citizens.

More than one-third of the country’s vaccine supply was either procured or donated to a local or regional government, not a federal institution. One of the main regional governments, the Republika Srpska, then bolstered its supply with an order of 67,000 Sputnik V vaccines from Russia, according to Ćerimagić.

The government’s failure to purchase enough vaccines prompted protests in Sarajevo in early April.

“Those protests were well-intended, and were basically a reflection of the state of mind of [the] majority of the population,” said Ćerimagić.

“For months they were told that the authorities are not doing anything when it comes to purchasing vaccines while Croatia has started the vaccination program and Serbia is a global success on vaccinations,” he added.

Indeed, Serbia’s rollout has been such a success that it is letting its citizens choose which of its five vaccine brands they’d like to be injected with.

Last month, Bosnia’s Balkan neighbor even opened its vaccine program to foreigners. Bosnians streamed across the border to get a shot in response. So far around 40,000 foreigners have been vaccinated in Serbia, the largest group among them Bosnians, according to figures from the Serbian prime minister’s office.

“We are a small region, and if you’re not safe, even when we get the collective immunity, we’re not going to be safe,” Serbian Prime Minister Ana Brnabić told CNN at the time.

In response to surging infection rates, Sarajevo imposed curfews and restrictions in March — but, as in many places around the world, its fragile economy can’t afford to stay closed for long.

Ćerimagić says that restrictions were loosened at the first sign of declining case counts. While the overnight curfew has remained, shops and cafes have reopened, with some even serving indoors.

This cycle of lockdown restrictions isn’t sustainable, Sarajevo Mayor Benjamina Karić maintains.

“We will lockdown the city, we will lockdown the people, but without vaccines it doesn’t mean a lot,” she said.

The mayor is also frustrated by the failure at higher levels of government to procure enough vaccines.

“I think that the worst possible thing is that this could be stopped, in the same way as the war could be stopped during the 90s. Now we can buy vaccines, we have money to buy vaccines, but we do not have a system,” she added.

Her sentiments are shared by Dr. Bakir Nakaš, a retired physician who specialized in infectious diseases and managed Sarajevo General Hospital during the war. He now lives in small wooden country house surrounded by green rolling hills just outside the city. That’s where he feels safest, away from the crowds of Sarajevo. Nakaš says that not only have Covid-19 restrictions been too weak, so has the vaccine procurement effort.

“Everyone in our region started to vaccinate their citizens from the January of this year and Bosnia Herzegovina didn’t have enough vaccines to allow us to start to do this,” he said.

Nakaš blames the delay on a lack of government coordination, and he’s not optimistic it will improve. “I can’t be sure that citizens of Sarajevo will be protected by the end of this year,” he added.

The current hospital chief, Gavrankapetanović, agrees. “Without the vaccination, I’m sure that we will have a fourth wave soon. And I am also sure that this will be a never-ending crisis,” he said.

Last month, central Sarajevo’s Bare cemetery struggled to keep up with the pace of burials. Moving across this huge complex, as the white gravestones marking the Bosnian War dead end, the freshly sealed graves of the pandemic victims begin.

In the cemetery, Ramiza Tahirović buys flowers to lay on the grave of her nephew Ismet Osmanović, who died from Covid-19 just seven days earlier. At 45 years old, he spent more than two weeks in the hospital hooked up to oxygen.

“Then after 15 days they moved him to the ICU unit and put him on a ventilator and we never spoke to him or saw him again,” Tahirović said.

Asked if she is afraid of the virus, she replies: “I cry, I am scared. I am 75 and I don’t see any progress … still so many people are dying.”

Despite her age, however, Tahirović says she won’t get the vaccine, as she isn’t convinced of its safety. Amid Sarajevo’s mounting deaths, she isn’t convinced of much anymore.

“I don’t trust the doctors, I don’t trust the government, I don’t trust anyone,” she explains. “The trams and buses are full of people, many of them are asymptomatic, I just don’t feel safe.”