(Published on 15/06/2010 by Giuseppe Scurci)
One year in Serbia (Giuseppe Scurci, Giuseppe Tolve) "I stay another four hours on my Vespa, driving until the sun is nearly at sunset, according to a healthy consuetude that I had to miss sometimes, before to stop in a village to spend the night. One of the feelings that i love, and which so often gave me the illusion of being free and owner of my life is the indefinable consistency of a bunch of minutes, when it is still dark and there is not anymore daylight, and you come to a place that you've never heard, knowing that tomorrow you'll be far away, and in other months, for other years, for other clusters of minutes of the same intensity is going away, following the wind out of a ball whose wire unrolls between your hands and ends across the world. " From "Brum Brum - 254,000 kilometers in Vespa" of Giorgio Bettinelli When we won the scholarship in the summer of 2008, the project Basileus was totally new and perfectly suitable for our needs. The Basileus is a project of the European Union and is part of a wide program defined "Erasmus Mundus". It is an exchange between universities of the European Union countries and the Balkan countries universities. Basileus provides scholarships for all the people that are part of the university system, with the possibilities to carry out a wide range of activities from exams to internships from research to the investigation of particular issues. We were the first two students in Europe to be selected for this scholarship: for this reason there was an undoubted pioneering charm but we were faced to the typical problems of not walked track. Unlike the exchange projects tested and well-defined such as Erasmus, our work from the beginning was marked by an ongoing definition and a continuous negotiations. There were no well-defined rules and procedures, so we had to create a sort of network that was able to adjust our activities, to justify Our presence in Belgrade and our scholarship. The only activity planned at the university was a language course that gave us the bases of the Serbian language. With these assumptions began our year in Serbia, a wonderful experience from the human point of view and certainly an excellent training for two students near to the graduation. According to our supervisor , Prof. Viviana Langher the main objective was to carry out a research for our thesis; the design included two clinical groups and a control group to be found in hospitals and state schools. We began to work in the first structure called " Specijalna bolnica za cerebralnu paralizu i razvojnu neurologiju. The hospital is part of a complex of clinics and it is an institution dedicated to the Cerebral Palsy consists of two substructures: the first has an outpatients unit and a residential part and represents the Headquarters; the second is a day hospital that is located in another district of the city. Our experience on the field began from the headquarters of the hospital, meeting Dr. Predrag Vidovic, chief psychologist and our tutor in the hospital. Our permanence in the structure was characterized by an atmosphere of great hospitality. The approach to clinical activities started from an initial period of observation, switching later to a direct involvement with patients and to the collection of data for the research. During the first period we visited the hospital following all the clinical activities. In this hospital are collected applications for diagnosis for children with suspected Cerebral Palsy. The child arrives in the special hospital following a multidisciplinary diagnostic procedure. If is diagnosed Cerebral Palsy is planned an option of hospitalization, especially if the family does not have the opportunity to assist the children for economic problems, or because they live in a rural areas faraway from specialist hospitals. The children is accepted in the institute with his mother. For they is scheduled a room in which they stay for a period of about three years, after which the mother leaves the hospital and the child continue to follow the therapies inside with the possibility to come back home on weekends and during holiday periods. Every day the child follows a process of rehabilitation includes physiotherapy, speech therapy, work therapy and recreational groups under the supervision of the psychologist; moreover he follow a school inside the hospital. The school is divided in two parts: the normal school, which adopts the educational programs for children that dont suffer any disease, and the special school, that use a simplified teaching programs for children with learning disabilities and cognitive impairment. During this first period we had the occasion to discuss with Serbian colleagues about a system that is different from the Italian one and faraway from our point of view. In this regard argue was continuous, often without convergence. We discussed with colleagues of hospitalization process efficacy and of the not inclusive scholastic model. Even now we wonder why is useful, from a clinical point of view, the inclusion of mothers in that long-term rehabilitation process and how, at the same time, it can be bad for the whole family. The way to organize and manage the disease is linked to way of imagine clinical psychology and professional practice. The profession of clinical Psychologist reveal a concept of our discipline as a big field of competence in assessment process on cognitive and neuropsychological bases. We often discussed with the colleagues of the utility of a strong diagnosis without the planning of a clinical psychological intervention. The second part of our work with patients with Cerebral Palsy was exercised in the other structure: a Day hospital located in another district of the city. This has two parallel functions: one of special school, structured in the same way as the head office and another of specialist assistance for patients with Cerebral Palsy resident in Belgrade. The services are scheduled for children attending school inside the hospital, and adults with Cerebral Palsy. In this hospital we followed the work done by one psychologist specialized in diagnosis who described us all the assessment used in the hospital with a special focus on theoretical assumptions and measurement. In these structure each patient goes to a psychologist regularly subjecting them to routine testing for the measurement of cognitive abilities and intellect. The second part of our staying in the structure has been characterized by research management and an involvement in the activities carried out by the other two psychologists in the hospital. During this period we was able to recruit our sample, in a pleasant atmosphere of participation. We had also a good and close relationship with patients and colleagues, rich of content and emotions that we have not been experienced in Italy. Our presence aroused a lot of curiosity and the short time that we spent in company of these people, was pervaded by a strong human warmth, combined with the excitement that is typical for the new things; we spent a lot of beautiful mornings talking in our laughable Serbian, causing great hilarity among all patients for our mistakes. Human contact enriches and impress. Thus patients were opened to us showing their human side, their passion and their dreams, fantasies common but unfulfillable. During a morning spent checking medical records, to make a list of the participants who met the criteria for research inclusion that we set, a group of patients visited us trying to speak in Italian, we discovered later that they spent an afternoon studying the presentations in our language, and one of them with severe difficulty in phonation gave us a book of poems written by her, with a beautiful dedication. In this context, was developed an interesting exchange of ideas and professional opinions that led the participation of psychologists and some patients to a conference organized by the Italian Development Cooperation on issues of de-institutionalization and integration, topic coherent with the service offered by the hospital. The interest shown by psychologists and patients is evidence of an opening to a new way of thinking for the process of assistance and unexplored possibilities of integration. The recruitment of the second clinical sample and the control group was difficult. Following the metaphor of the travel, we were on the unknown track in a path that was more devious than we imagined. Ended the contacts that we had, we did a search of the structure in which was possible to reach the sample and then we proposed our research to obtain the necessary permissions to get in the structures. At this level we found a lot of difficulties. For the control sample, the research was long and complicated because of bureaucratic problems often unsolvable. We requested the availability in six schools of Belgrade and, in five out of six, we were faced to a complex bureaucratic practices, that requests a lot of time and included an authorization request signed by the Serbian Ministry of Education. All these factors led us search for contacts outside of Belgrade. We went to Kragujevac, where, with the help of a psychologist that we met informally, we were able to recruit the second part of the control group in a state middle school. To find the group of children with epilepsy was really difficult. The hospital that gave us the availability to find the sample, after a three months postposition of the beginning of the tests, informed us about the inability to carry out the research because of coordination problems and internal frictions. The request we turned to others hospitals was unsuccessful because a research project such as ours is possible only with ministerial authorization, very difficult to obtain. So almost reached the end of our staying in Serbia, we were oriented in change the research plan for the lack of the main sample. In this situation very unpleasant and difficult we have been helped by a colleague, and really good friend of the Faculty of Special Education and Rehabilitation. In that time he was doing the internship as Somatoped in a neurological hospital for childhood and adolescence. Through its mediation, we received permission to continue the research by the director of the department. In that structure we observed the medical approach to neurological illness: our tutor was a physiotherapist and the other professionals were neurologists. Inside the hospital there were consulting rooms and EECG rooms, the services offered included monitoring inspection and rehabilitation sessions for neurological patients. There were two psychologists in the structure, with the function of counselor or therapist for who sees the need. The Basileus in his being a new project, even if fitted with precise regulations, was not tested on Serbian territory, or in a country that looks for the first time in the world of international academic exchanges. There were not connections between the structures, and many of the problems we encountered, were due to the lack of clear agreements . In these conditions we had to realize a network that in other contexts of exchange is already active and works following agreements between universities. Paradoxically it is precisely in this process which, after the end of our experience, we identify the best source of professional and human growth. In a situation of uncertainty and insecurity as the one just described, we was faced with the need to suspend any trial for a dive in problem solving process. From this need came our major achievements in academic and professional practice and at the same time the opportunity to better understand the complex world of Serbia. A country with a very difficult recent history which sees the opposition of a cumbersome and inflexible legal system, still in revision, with a wonderful population that makes its points of strength, welcome and hospitality. When the main risk was to be trapped in the bureaucratic net, the social net rescued us. We finished collecting data, staying in Belgrade for a part of the summer. We went home with the feeling of being richer. Of this wealth are certainly part the concepts of Neuropsychology acquired through an exam in the Faculty of Special Education and Rehabilitation; expertise on diagnostic testing, calibrated on Cerebral Palsy, in which we were trained in hospital, but specially all the emotions and feeling that we got on the field in contact with people, when we was under testing on a personal level, when we experienced something that is new and it's difficult, but can be solved "following the wind out of a ball whose wire unrolls between your hands "(cit. Giorgio Bettinelli).