THE HAGUE, Netherlands - Former Yugoslav President Slobodan Milosevic suffers from severe heart disease and dangerously high blood pressure and needs medical treatment and less work in court, the United Nations war crimes tribunal announced yesterday.
The finding that Milosevic runs a serious risk of a heart attack was announced at a hearing yesterday morning and is almost certain to change the pace and the shape of his war crimes trial, the most important such prosecution since Nazi and Japanese commanders were tried after World War II. The trial opened five months ago and, even at the current rate, could last three years.
Milosevic, who is 60, is conducting his defense in the trial, which opened with charges concerning the war he waged against Kosovo Albanians in 1998 and 1999. He is charged with genocide committed during the war in Bosnia, and it seems it could be many months, if not years, before he answers that accusation.
During his 13 years in power, Milosevic led the Serbs through four wars - in Slovenia, Croatia, Bosnia and Kosovo - that killed more than 200,000 people and drove more than a million from their homes.
The report of serious health problems came as the trial entered a fascinating new phase, with key members of the former Milosevic government - including the chief of the secret police - testifying about the inner workings of the secretive government as it repressed Albanians in Kosovo in 1998 and 1999.
Trial judges had ordered a thorough examination of Milosevic after he fell ill for the second time last month. They suspended proceedings for a third time a week ago, when Milosevic's high blood pressure rose sharply.
The presiding judge, Richard May, said yesterday that the medical report before the court described Milosevic "as a man with severe cardiovascular risk which demands careful future monitoring." He said it recommended treatment by a heart specialist and a reduction in Milosevic's workload. May said the court was ordering such treatment and would then decide how to proceed with the trial.
Yesterday, Milosevic's former secret police chief, Rade Markovic, appeared as a witness for the prosecution. Markovic was transferred here from his prison cell in Belgrade, where he is being held on murder charges in the killing of political opponents, and he is seen as a close Milosevic ally who may shed light on how atrocities in Kosovo were covered up.
Markovic, who ran the secret police for the last two years of Milosevic's rule, told the court that Interior Ministry and military officials reported in detail to Milosevic each day on their activities.
The witnesses from Milosevic's government who have testified in recent days have been a boon for the prosecution, with policemen and soldiers on active duty during the war giving sometimes shocking details about atrocities against ethnic Albanians.
But the mood among prosecutors and observers anxious to see Milosevic brought to justice has been far from upbeat. Rather, the confirmation of Milosevic's ill health has caused alarm. While it is not being said out loud, there is deep concern among court officials about the repercussions if Milosevic could no longer appear in court or suffered a heart attack.
Lawyers who work with Milosevic said his heart condition, though not well known, is not new. He has been hospitalized in Yugoslavia in the past for heart trouble and he was also taking medicine for high blood pressure while in detention.
"In Belgrade and here, he always says he is fine," said one lawyer, Zdenko Tomanovic, who sees Milosevic almost every day. "He takes medicine but he never complains and never wants extra care."
The medical report ordered by the court was prepared by two Dutch doctors from outside the prison who examined Milosevic.
At yesterday's hearing, the judges did not disclose any details from the report, but a lawyer who had seen it said Milosevic has a severe problem in his left artery and heart damage.
"This, together with the high blood pressure, puts him at high risk for a heart attack," the lawyer said, referring to the report. He said the doctors felt that the physical stress of Milosevic's illness and the stress of the trial have depressed his immune system, which has made him more prone to infections. Milosevic has had two long bouts of flu with high fever this year.