About MSA



    Our origins

    The dissolution of the former Yugoslavia was marred by a decade-long series of violent conflicts that ravaged the region from 1991 to 2001. The Socialist Federal Republic of Yugoslavia (SFRY) disintegrated during the 1990s, following the passing of Josip Broz Tito. Tensions escalated as Kosovo Albanians pushed for Kosovo to be recognized as a republic. In 1989 and 1990, the Serbian leadership orchestrated power shifts in Montenegro, Vojvodina, and Kosovo, consolidating control over half of Yugoslavia and securing 4 out of 8 votes in the Yugoslav presidency.

    These power maneuvers were followed by military interventions, notably in Slovenia and Croatia, which declared independence in 1991. The conflict intensified in Bosnia and Herzegovina, resulting in widespread civilian casualties. Subsequently, Bosnia and Herzegovina, along with Macedonia, also declared independence in 1991. Notably, the Republic of Macedonia achieved independence without military conflict but was plagued by heightened inter-ethnic tensions during its formation.

    Following the inception of the new state, there was a surge of enthusiasm and concerted efforts aimed at securing international recognition. This included endeavors to integrate various professional organizations, such as the physician anesthesiologists, into international associations. In the Yugoslav federation, the Yugoslav Association for Anaesthesiology, Reanimatology, and Intensive Care (JUARIL) operated at the federal level, with each republic hosting its own section of anesthesiologists under the Medical Associations.

    Regular congresses were held every three years, supplemented by annual intersectional meetings held in different republics. Noteworthy among these were the intersectional meetings organized by the Macedonian section of anesthesiologists in Bitola, Skopje, and the 4th JUARIL Congress in Ohrid. However, the dissolution of JUARIL became apparent with the conclusion of the 5th Congress in Belgrade in 1989. Subsequently, the atmosphere of impending conflict and disintegration overshadowed the final intersectional meeting in Neum (BiH), which saw diminished participation amidst the palpable sense of the state’s unraveling.


    The Transition and Formation

    On September 17, 1991, Macedonia formally declared its independence with the signing of the Declaration of Independence. This historic decision came after a successful referendum on September 8 of the same year, affirming the nation’s desire for sovereignty. With independence secured, the formation of the Macedonian army and the establishment of national institutions followed, marking a pivotal moment in the country’s history.

    Amidst these changes, organizational structures adapted to reflect the new reality. The former Association of Doctors of Macedonia (ZLM) underwent a transformation, evolving into the Macedonian Medical Association (MLD). This shift extended to its specialist sections, which transitioned into associations representing specific medical disciplines.

    In this vein, the Section of Anesthesiologists of Macedonia underwent a significant metamorphosis, emerging as the Association of Physicians for Anesthesia, Resuscitation, and Intensive Care (ZLARIL). This decision was formalized on June 19, 1993, during a meeting held in Kriva Palanka. With the renaming came the acceptance of new work regulations and the supplementation of the management board.

    The inaugural management board of ZLARIL comprised esteemed individuals, with Jordan Nojkov serving as president, Zlatko Shuplinovski as secretary, and Zvonko Krstevski as treasurer. Additionally, Marija Sholjakova, Violeta Miloshevska, Zlatko Petrov, and Velcho Stojchevski were appointed as members. Notably, Zvonko Krstevski contributed to the association’s identity by designing its logo, a symbol that endures to this day.


    International Affiliation

    In the ensuing years, our Association embarked on a concerted effort to gain admission to several esteemed international organizations, including the World Federation of Societies of Anesthesiologists (WFSA), the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), the European Society of Anaesthesiology (ESA), the European Academy of Anaesthesiology (EA), and the European Society of Regional Anaesthesia (ESRA).

    Our primary objective was to secure membership in the WFSA, particularly its European section, initially known as the European Regional Section (ERS), later renamed CENSA, and eventually, ESA in 1994. Our pursuit began with a letter from the last president and secretary of JUARIL from Croatia, Dr. Perushko and Dr. Shchap, informing us of JUARIL’s dissolution and advising us to seek admission to WFSA as an independent association.

    Subsequently, we submitted an application form to WFSA Secretary Dr. Saywan Lim on July 1, 1992, initiating our formal engagement. Building on this, I, alongside Dr. Lazar Shendov, engaged in discussions with WFSA President Dr. John Zorab during the 10th WFSA congress in The Hague, Netherlands, expressing our earnest desire for membership and outlining our association’s credentials.

    Dr. Zorab commended our initiative and pledged to facilitate further communication with the organization. On January 13, 1993, we received a letter from WFSA Secretary Dr. M.D. Vickers, acknowledging our efforts but highlighting the need for UN membership and recognition by the UK Foreign Office as prerequisites for admission.

    Our breakthrough came with Macedonia’s admission to the United Nations on April 8, 1993, clearing the path for our association’s membership aspirations. Subsequently, the WFSA Executive Committee conditionally approved our full membership until the General Assembly in 1996.

    Finally, during the 11th WFSA Congress from April 14-20, 1996, in Sydney, Australia, our perseverance paid off as ZLARIL was granted full membership at the General Assembly, marking a significant milestone in our international recognition and collaboration within the global anaesthesiology community.


    Professional Development and Engagement

    The benefits of our association’s admission to the World Organization of Anesthesiologists were manifold. We gained access to comprehensive notifications of professional events via letters and received approximately 50 copies of the newsletter “World Anesthesia” annually for distribution among our members. In response to a request from the journal’s editor in 1999, I authored a “profile” of our association, detailing the history of our country, the evolution of anesthesiology, specialization methods and programs, commonly utilized anesthesiological techniques, and the landscape of surgical healthcare networks. A slightly modified version of this text was subsequently published in the newsletter of the European Academy of Anesthesiology the following year. These endeavors represented incremental yet meaningful steps in our nation’s quest for international recognition and integration.

    Furthermore, during this period, we were regularly invited to attend meetings of the presidents of European anesthesiology societies, typically held in conjunction with the annual gatherings of the German Society of Anesthesiology (AGAI). Our members actively participated in these events, presenting their papers at all major scientific meetings, including world congresses in Sydney (1996), Montreal (2000), Paris (2004), Cape Town (2008), and European congresses in Jerusalem, Frankfurt, Lisbon, Florence, Bermingen, among others. These engagements not only facilitated knowledge exchange but also underscored our association’s growing prominence within the global anesthesiology community.

    The period following our nation’s independence was characterized by a remarkable sense of enthusiasm and proactive engagement. We welcomed numerous officials from Western countries, particularly in the healthcare sector, signaling a phase of robust international interaction. Additionally, vital aid in the form of equipment and medicines poured in from various countries and organizations, fortifying our healthcare infrastructure.

    During this time, our Association played a pivotal role in fostering the professional growth of our members. We achieved this through the organization of a multitude of meetings, symposiums, and seminars, reflecting our commitment to continuous learning and development. Notably, within the first four years of independence, we convened a total of 20 meetings, underscoring our dedication to advancing the field of anesthesiology.

    Among these gatherings was the landmark 1st Congress of Anesthesiologists of Macedonia, a testament to our collective efforts and aspirations. While many of these meetings were tailored for our members, we also facilitated joint sessions with other medical specialties, promoting interdisciplinary collaboration on crucial topics such as therapy with blood substitutes, thromboprophylaxis, intrahospital infections, and the rational use of antibiotics, among others.


    Social Cohesion and legacy

    Two notable symposia deserve mention: one focusing on pain treatment and the other on cardiopulmonary resuscitation (CPR). These events aimed to engage a wider audience of medical professionals and were held within the framework of the “Medicine” fair event. It’s worth highlighting the significant role played by anesthesiologists in educating doctors on CPR, a responsibility we have shouldered since the 1980s.

    Furthermore, we commemorated two solemn occasions during this period: the ceremonial inauguration of a new department for intensive treatment at the Clinic of Anaesthesiology, Reanimation, and Intensive Care, and the celebration of the 30-year anniversary of the anesthesiology service in Bitola. These events served as poignant reminders of our progress and commitment to excellence in healthcare delivery.

    Overall, the initial years after independence were marked by a dynamic and forward-thinking approach, characterized by proactive engagement, professional development, and meaningful contributions to the advancement of healthcare in Macedonia.

    The organization of the 1st Congress of Anesthesiologists of Macedonia in May 1995 stands as a pinnacle of our professional endeavors. Hosting such a significant event with international participation posed a considerable challenge, one that we can proudly affirm we met with flying colors, as attested by the resounding praise from attendees and the broader medical community.

    With 160 anesthesiologists actively contributing to healthcare in Macedonia at that time, the congress received an impressive turnout of scholarly submissions. A total of 130 papers were presented by domestic authors, complemented by sixty contributions from esteemed colleagues hailing from Bulgaria, S.R. Yugoslavia, Slovenia, Denmark, Germany, France, and Japan. This diverse array of perspectives enriched the academic discourse and solidified the congress’s reputation as a forum for global exchange and collaboration.

    In addition to the scholarly program, the congress featured five accompanying symposia, further enhancing the depth and breadth of discussions. The lively social atmosphere added an extra dimension to the event, fostering camaraderie and networking opportunities among participants.

    Even in hindsight, it’s evident that the scale of the congress surpassed previous Yugoslav gatherings, setting a new standard for professionalism and excellence. Its legacy endures, serving as a benchmark for countless professional congresses that followed, both nationally and internationally.

    The success of this Congress set a high standard for subsequent events. Over the years, six more congresses followed, each maintaining an exemplary level of professionalism. The presidents of these congress committees, including Violeta Milosheva, Mirjana Shosholcheva, Jasmina Nancheva, Biljana Shirgovska, and Maja Mojsova, have upheld our commitment to excellence. Today, under the leadership of Vesna Durnev, our current president, we continue to elevate the standards of anesthesiology in North Macedonia and beyond.

    The professional gatherings organized by our Association were not just about academic discussions; they also fostered a strong sense of community and camaraderie among colleagues. These meetings played a crucial role in strengthening personal bonds and enhancing professional networking.

    They were hosted in various cities and tourist destinations across Macedonia, providing opportunities for colleagues from different regions to come together and exchange ideas. Colleagues from rural areas actively participated in presenting their professional papers, contributing diverse perspectives to the discussions.

    Organized bus trips facilitated high attendance rates, with members traveling together to attend these meetings. Besides professional matters, members shared personal milestones such as completing specializations, obtaining master’s or doctorate degrees, or retiring from their careers.

    Moreover, these gatherings served as a vital source of information about upcoming international professional events, serving as a precursor to today’s online platforms. The meetings concluded with joint lunches and, often, musical programs, fostering a relaxed and enjoyable atmosphere for networking and socializing.

    In summary, these events were not just about professional development; they also played a crucial role in building a sense of unity and solidarity among anesthesiologists in Macedonia.