Bosnia: West ignores Sarajevo's wounded: Medical evacuation procedures prevent patients from getting out - Russia seeks to prevent air strikes

EDHEM DEDOVIC has lost his left eye and most of the bone underneath. He needs massive plastic surgery to his face and reconstruction of the arm nerves, if he is not to look like a freak and lose the use of an arm.

Hit by a Bosnian Serb grenade on 30 May while playing outdoors, he is now at home. He can only envy Irma Hadzimuratovic, the desperately ill five-year-old airlifted to Britian on Monday for the treatment that could save her life.

Edhem is one of 41 patients approved for evacuation by the United Nations in Sarajevo, but who may never get the same chance as Irma. Some lie in the children's ward of the Kosevo hospital. Amer Nevesinjac, a 10-year-old boy has bandages over one eye. Shrapnel hit him when a Serbian shell exploded near his home. Without an operation he could go blind.

Ten-year-old Nazila Sisic may lose her leg, severely infected with shrapnel wounds. She does not know that her sister, whom the UN evacuated last month to a hospital in Belgium, has already died. Tiny, 7-day-old Deni was born with kidney and bowel complications. Without a proper diagnosis and treatment he could also die.

UN refugee officials in Sarajevo yesterday appealed to Western governments to open their hospitals to the desperately ill in the besieged Bosnian capital. 'We have 40 people just as desperate as Irma waiting to leave, and another 400 who are almost as ill,' said the UN refugee spokesman, Peter Kessler. 'We need complete package offers, which cover the cost of a hospital bed and medical treatment. We desperately need these offers.'

Refugee workers hope the stony hearts and tight purses of Western governments will be prised open by the plight of children like Irma. Little else has worked up till now. Last month the UN High Commissioner for Refugees, Sadako Ogata, made an impassioned plea in Geneva for hospital places and transportation to representatives of 43 governments. There was not one response.

The complicated procedure for medical evacuation seems designed to prevent patients from getting out. Without an offer from a foreign hospital, which covers all costs, the UN will not fly anyone out of Sarajevo, no matter how sick. Shrapnel wounds require a lot of plastic surgery to reconstruct bones and faces. Few foreign hospitals want to foot the bill.

Marijo Guberovic, 23, has leukaemia, and all the papers he needs from the UN to get out of Sarajevo. A hospital in Dusseldorf will carry out the bone marrow transplant that may save his life. But they will not accept him until he produces 350,000 German marks. His parents walk several miles daily to Kosevo hospital to bring him water and food. The run-down hospital supplies neither. 'Here they can only give me blood - nothing else is possible,' he says. 'I have all the papers I need but not the money. Every day I feel weaker.'

For patients under 16, the UN demand an assurance that accompanying relatives will also be supported. Unless governments waive visas, as John Major did with Irma, it is another time-wasting hurdle.

Marijo is frightened he will go the same way as Ramiz, 57, the father of two who was hit by a Serbian sniper in the chest in February. He was approved for evacuation by the panel in June. He died five days ago. Marijo's case has been taken up by a German charity. Children like Edhem and Deni have a chance - especially if foreign television cameras take up their plight. The media are less interested in Sarajevo's hundreds of desperately ill middle-aged.

No television cameras have encircled the bed of Suhra Coko, 35, run over by a French UN armoured vehicle on 26 July as she walked to Kosevo hospital to visit her husband. He is a paraplegic. The vehicle squashed her right leg. 'She needs a tissue graft, which we cannot do here, or her right leg will have to be amputated,' says Anadi Begic, a doctor.

A French soldier came once to the hospital and advised Mrs Coko to file for damages. He promised he would bring the forms. 'That was ages ago, but he never came,' she recalls sadly.

Salahudin Dizdarevic, the head of the children's ward at Kosevo, says regular fuel, not evacuation, is the answer to Sarajevo's worsening medical crisis. 'Over 80 per cent of these cases could be diagnosed and treated here if we just had electricity,' he says. 'It would be a lot easier and cheaper to get us a little diesel, than an aeroplane to take all these people out.'

Six tankers of diesel have been waiting to get into Sarajevo from the central Bosnian town of Zenica for weeks. But the UN will not escort them to the capital until Serbian forces besieging Sarajevo promise not to steal it.

'In the end the UN refugee workers are not the foot soldiers for Sarajevo's wounded,' said Mr Kessler. 'The city has been besieged for 16 months in a barbaric way. It is the siege which must be brought to a halt.'

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