Cablegate: Icty: An Inside Look Into Milosevic's Health And

Published: Wed 12 Nov 2003 04:04 PM
This record is a partial extract of the original cable. The full text of the original cable is not available.
12055,11/12/2003 16:26,03THEHAGUE2835,"Embassy The Hague",SECRET//NOFORN,03THEHAGUE2568,"This record is a partial extract of the original cable. The full text of the original cable is not available.
","S E C R E T SECTION 01 OF 05 THE HAGUE 002835
Classified By: Legal Counselor Clifton M. Johnson per reasons 1.5(b)-(d
1. (S/NF) Summary: The head of the detention unit of the
International Criminal Tribunal for the former Yugoslavia
(ICTY) provided Embassy legal officers and USG physician with
details of Slobodan Milosevic's health status, daily regimen,
legal and financial network, frame of mind, and contacts
outside the Tribunal. Among many revealing details, this
official -- who sees and speaks with Milosevic more regularly
and closely than nearly anybody else -- provided information
indicating that Milosevic's heart condition, while manageable
on a day-to-day basis, is serious and not readily controlled
by medication. At the same time the official discounted
reports that Milosevic suffers from diabetes or, at least at
present, depression. The official described a confident,
engaged Milosevic who with his wife's assistance ably manages
a web of legal and political contacts. Through his Belgrade
legal advisers that rotate through the Hague he exercises
control over Social Party of Serbia (SPS) activities and
coordinates legal strategy with the amici curiae, friends of
the court. Meanwhile, the accused's financial situation is
precarious, necessitating a recent hat-passing exercise by
the SPS in order to generate funds to pay household staff and
the travel of his lawyers. End Summary.
2. (S/NF) Tim McFadden an experienced Irish prison warden and
head of the ICTY's detention facility in Scheveningen,
provided embassy legal officers and USG physician an
unprecedented overview of Slobodan Milosevic's life and
activities since coming to trail. McFadden, whom one ICTY
Registry official described as ""the best of the best,"" is in
a unique position not only to describe Milosevic's detention,
as he sees the defendant and interacts with him on a daily
basis, but also to assess him on a relative basis to other
ICTY detainees. Moreover, McFadden is privy to the contents
of Milosevic's monitored telephone conversations and visits
as well as the reports of the physicians that have examined
him. McFadden has had long experience in managing tough
prisoners, as he managed a number of UK prisons holding Irish
Republican Army detainees; another Registry official
described ICTY detainees as ""pussycats"" compared to McFadden
charges in the UK. Throughout the one-hour discussion,
McFadden gave the impression of being fully and personally
aware of all of the details of Milosevic's detention, though
he noted that Milosevic remains a private man who does not
generally share his thoughts.
Associates and Frame of Mind
3. (S/NF) McFadden firmly rejected reports that Milosevic was
suffering from depression noting that the accused has given
""no indication that he would be anything but defiant to the
process"" of his prosecution and that he demonstrates only a
""limited inclination toward depression."" He noted that
Milosevic's inability to see his son, daughter,
daughter-in-law, wife and grandson, especially the latter
two, causes him substantial unhappiness. On the other hand,
McFadden said that Milosevic ""has a job that distracts and
preoccupies so that he is not apparently inclined to
depression."" He calls his wife, Mirjana Markovic, every
morning, continuing what McFadden described as an
""extraordinary relationship""; Milosevic could manipulate a
nation, he said, but struggled to manage his wife who, on the
contrary, seemed to exert just such a pull on him. McFadden
referred to a broad range of emotions and approaches that
Mira Markovic deployed to goad or cajole Milosevic to take
particular actions. When he failed to heed her advice, she
was not beyond telling him that bad outcomes could have been
avoided had he listened to her. Markovic served as a source
of information, comfort, motivation, and strategy for
Milosevic and he relied heavily on her guidance. When
Markovic pressed Milosevic to do something he did not want to
do, Milosevic rarely pushed back directly but simply never
acted on the particular entreaty. McFadden referred back to
the relationship a number of times in the discussion as the
central one in Milosevic's life. McFadden made clear that
Milosevic's blood pressure spike in September (ref) caused
serious alarm at the Tribunal, driving registry officers to
consider ways in which to reduce his stress and, as one
contact had previously said, ""make him happy."" McFadden even
described his proposal that the Registry find a way to bring
Markovic to The Hague from Russia with some immunity from
arrest (which the Deputy Registrar noted was not feasible),
because McFadden believed so strongly that getting the two
together could help keep down Milosevic's stress and perhaps
his blood pressure. He added, however, that even that was a
risk because ""she can be a very volatile person.""
4. (S/NF) In the absence of his wife, Milosevic himself has
had to coordinate the various groups providing him with legal
and other assistance, previously her domain. It appears that
her absence has left a substantial hole in his ability to
organize the various entities purporting to assist him. He
tries to maintain what McFadden called ""functional contacts""
with the SPS and the Freedom (Sloboda) Association, but ""the
Belgrade crowd doesn't get on with the internationals,"" a
relationship that Markovic used to manage and coordinate.
Previously, Markovic would keep him up to date on wrangling
within the SPS and tell him who he needed to call to patch up
feuds, solve conflicts, or provide political guidance to.
Meanwhile, Milosevic's financial position has worsened
considerably since the spring (i.e., soon after the
assassination of Zoran Djindjic). Milosevic fell five months
in arrear in paying his Belgrade household staff and was
unable for a period to pay the air tickets of his rotating
Belgrade advisers. Ultimately, the condition worsened to
such a degree that the SPS was forced to ""to pass the hat"" to
raise money on his behalf. The Registry believes his
financial problems will worsen. In an interesting sidenote,
McFadden said that his Belgrade contacts organized, and the
Registry consented to, an evaluation of Milosevic's medical
records by a group of physicians partial to him. The group
concluded, following the review about 19 months ago, that his
medical treatment (described below) met the requisite
standard of care.
5. (S/NF) In the process of discussing Milosevic's contacts,
McFadden illuminated the nature of the relationship among the
so-called legal associates (Serb lawyers who have no
courtroom privileges but enjoy privileged communications with
the defendant), the amici and Milosevic. McFadden said that
Milosevic believes that ""he is surrounded by fools"" both
inside and out of the courtroom, though he added in an aside
that this was a problem of his own making, as he had
surrounded himself with ""fools"" throughout his career out of
a fear of being challenged by more competent and intelligent
advisors. Milosevic most relishes the opportunity to examine
senior level witnesses of his level and is disdainful of the
lower level officials and witnesses paraded before him by the
prosecution. The two associates who have spent much of the
trial in the trial chamber's public gallery (Zdenko Tomanovic
and Dragoslav Ognjanovic) are, in McFadden's view, ""messenger
boys"" to (unnamed) associates in Belgrade. McFadden knew
little of Branko Rakic, the Belgrade lawyer/law professor
recently added as Milosevic's third legal associate, but his
initial impression was that he was contributing a more
methodical, ""legal and logical"" approach to Milosevic's
defense and cross-examination preparations. As a result,
McFadden expected Milosevic's organization of his defense to
6. (S/NF) In contrast to his courtroom disdain of the amici,
McFadden said that Milosevic is in fact ""fond"" of them.
Moreover, his public distancing of them actually masks the
fact that his legal associates regularly liaise with the
amici to discuss and coordinate defense strategy and
questioning of witnesses. (Comment. Milosevic's adept and
hereto unknown coordination with the amici is a striking
demonstration of his abilities and methods. By using his
Belgrade advisers to liaise with the amici in secret he is
able to maintain the optically favorable appearance of a
single man defending himself against an unfair and powerful
international process. At the same time, he takes full
advantage of the legal resources the amici offer and ensures
that key technical legal points in his defense are covered so
that he can focus on tending to the more political aspects of
his defense. The fact that senior prosecutors on the
Milosevic team are wholly unaware of this cooperation (as
were we) underscores Milosevic's ability to work effectively
behind the scenes, through third parties, and leave few
fingerprints. End comment). The Registrar noted that, as
helpful as the amici might be to Milosevic now, he does not
expect the amici to continue in their current role during the
defense case. Their departure would be a significant blow to
Milosevic's defense unless he finally decides to accept legal
counsel or is at least able to beef up his legal support from
Physical Health
7.(S/NF) McFadden noted that Milosevic's medical records from
the former Yugoslavia indicated a long history of
hypertension (high blood pressure) that was difficult to
control especially when Milosevic was stressed or excessively
fatigued. He said that during the past summer a number of
things happened that put Milosevic under increased stress and
caused excessive fatigue, including the build up of stress
from court appearances and trial preparations, his wife's
legal problems that caused her to flee to Russia, the need
for Milosevic to give increased time and attention to
disputes and problems within the SPS Party (that would have
formerly been handled in part by his wife), financial
difficulties, and his gradual loss of attention from media.
All of these factors appear to have contributed to the
increase in Milosevic's blood pressure. Physicians
consistently found Milosevic had a diastolic blood pressure
above 120 mm mercury (normal should be below 90 mm mercury).
Despite treatment with high doses of six medications his
blood pressure remained dangerously elevated until the trial
schedule was reduced to three days a week. (Note. The only
information we have about his medications is that he was near
the maximum dose of beta blockers and was also taking a
medication that has to be stopped intermittently because of
dangerous side effects. End note). Milosevic is now on four
8. (S/NF) A reduced trial schedule had been recommended by
Dutch physicians (including Dutch cardiologist, Dr. Paul Van
Dykman) last year but was rejected by the Court until
Milosevic's blood pressure could not be controlled with
standard medications. His long history of hypertension has
caused mild heart damage (identified by Serb physicians
before he was apprehended and transferred to The Hague) but
physicians have seen no evidence of a heart attack, stroke,
or kidney damage. Three exercise EKGs have been normal and
Milosevic will continue to have an exercise EKG twice a year
according to McFadden. The last hypertensive episode ended
about 6 weeks ago.
9. (S/NF) McFadden reports that Milosevic's hypertensive
episodes have not correlated with adverse events at the trial
or with the appearance of certain witnesses. They have seen
no evidence that he is using his blood pressure problems as
an issue to slow or otherwise affect the trial. Moreover,
Milsoevic understands that he has potentially lethal health
problems and is a compliant patient. The only two physician
recommendations he has refused are (1) to take sedatives
recommended by his doctors to lower his blood pressure and
(2) to undergo invasive procedures to look for underlying
causes of his hypertension and evidence of end organ damage
in the brain. He is allowed to cook for himself, which
limits control of his diet, but he nevertheless appears to be
following a salt restricted diet.
10. (S/NF) In contrast to previous reports that Milsoevic has
diabetes, McFadden stated that there is no evidence in his
medical records for this diagnosis and all of his blood
sugars have been normal. Milosevic,s cholesterol and other
lipids have been normal. His weight has been stable since he
lost 12 pounds when he was first brought to The Hague. He
has not been observed to smoke much; in a recent conversation
with McFadden, he claimed not to have smoked in four days and
to have no desire to do so. His only request, McFadden said,
is for a glass of red wine, but alcohol is strictly forbidden
in the detention unit.
11. (S/NF) Milosevic is said by McFadden to have a nearly
photographic memory, saying that he has ""never met a man with
his memory."" He said that a ""very important"" detainee, whom
he would not identify, warned McFadden early in Milosevic's
detention that Milosevic has a very good memory that would
""come back to bite""; with a laugh, McFadden said it had.
McFadden has seen no evidence of any deterioration in
Milosevic's memory or other mental capacities. He remains,
McFadden said, as ""narcissistic a person"" as when he arrived
in The Hague. On the other hand, unlike other detainees who
constantly complain, Milosevic is cooperative and always
accepts McFadden's decisions, often responding, ""at least I
asked."" In general, moreover, Milosevic believes strongly in
his own powers and thinks that he is ""winning"" in the
courtroom, an attitude that reinforces his currently stable
Daily Regimen and Prison Activities
12. (S/NF) Milosevic's routine varies depending on whether
court is in session. Thus, on the three days of court
proceedings per week, a typical day begins around 0700 with a
wake-up call; after he gets ready, he calls his wife around
0730 and leaves for court by 0800. The court sessions run
from 0900 to approximately 1400, with two twenty minute
breaks. After court, he returns to the detention center,
where he has a meal and is allowed one hour of outdoor
exercise (McFadden noted that he will walk for a full hour,
""sun, rain or hail""). Following the hour of exercise, he
meets with legal advisors, reads the court transcripts, and
otherwise prepares for the next court appearance. In the
evening, he will typically read a book (he is an avid reader,
especially of ""rubbish"" and potboiler thrillers like Grisham,
and he prefers to read in the original English). On days
when he is not in court, he may sleep later, sometimes until
0930 or 1000, have additional exercise time, attend
""creativity class,"" visit with his legal associates, have an
afternoon nap, listen to Sinatra discs, and perhaps watch one
of the DVD's that a privileged visitor (i.e. most likely his
Belgrade lawyers) have smuggled in to him.
13. (S/NF) Milosevic has access to a laptop computer but is
not allowed on the Internet and cannot use E-mail. His
access to the outside world is via phone calls or visits. He
is allocated 75 euros per month for phone use, but can make
an unlimited number of calls beyond that as long as he pays
for the calls -- something he has consistently been able to
do. He is allowed an unlimited number of free calls to
recognized legal associates on a special detention unit
phone. All of his phone calls and visits, except those with
the recognized legal associates, are monitored.
14. (S/NF) Within the detention community, Milosevic is well
liked and respected by other prisoners. Many of them take
care to monitor his health and encourage him to watch his own
diet, McFadden said. He has refused to see a psychiatrist
individually but does participate in the group sessions with
the other prisoners on his floor, which are monitored by the
detention unit. The psychiatrist who conducts these sessions
tells McFadden that she has seen no evidence that he is
depressed or has any other significant clinical problem.
15. (S/NF) Comment: Slobodan Milosevic's health surely puts
him, in McFadden's words, at ""higher risk of accident"" than
similarly situated persons of his age who do not suffer
hypertension. Yet his health seems to have stabilized for
the time being, particularly since the trial chamber's
decision to go to three days per week. Whether Milosevic can
maintain such a schedule will be tested when the defense case
begins (perhaps not before September 2004). Some in the
Registry and in the Office of the Prosecutor speculate that
the courtroom schedule will be further reduced to one day a
week in order to allow Milosevic two days of defense
preparation and, as the doctors have ordered, four days of
rest. The end of the trial seems ever more distant when put
in this light. Even with his health stabilized, the impact
of the move to the defense phase will cause further pressures
of a financial and legal nature which could in turn trigger a
downturn in his health. For now, however, Milosevic remains
comfortably on top of his game. End comment.
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