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### Viewing cable 03THEHAGUE2835, ICTY: AN INSIDE LOOK INTO MILOSEVIC'S HEALTH AND

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
03THEHAGUE2835 | 2003-11-12 16:04 | 2011-01-18 00:12 | SECRET//NOFORN | Embassy The Hague

`

    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

    SIPDIS

    NOFORN

    DEPARTMENT FOR S/WCI - PROSPER/RICHARD, EUR/SCE -
    GREGORIAN/MITCHELL, L/EUR - LAHNE, INR/WCAD -
    SEIDENSTRICKER/MORIN

    E.O. 12958: DECL: 1.6 FIVE YEARS AFTER CLOSURE OF ICTY
    TA...

    ",
    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

    SIPDIS

    NOFORN

    DEPARTMENT FOR S/WCI - PROSPER/RICHARD, EUR/SCE -
    GREGORIAN/MITCHELL, L/EUR - LAHNE, INR/WCAD -
    SEIDENSTRICKER/MORIN

    E.O. 12958: DECL: 1.6 FIVE YEARS AFTER CLOSURE OF ICTY
    TAGS: PREL PHUM BK HR SR NL ICTY
    SUBJECT: ICTY: AN INSIDE LOOK INTO MILOSEVIC'S HEALTH AND
    SUPPORT NETWORK

    REF: THE HAGUE 2568

    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
    improve.

    ¶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
    Belgrade.

    ---------------
    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
    medications.

    ¶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
    health.

    -----------------------------------
    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.
    SOBEL

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