KASINDO, Bosnia (Reuters) - ``Something is going on here which was not happening before,'' says a doctor at a remote and decrepit hospital in what is called Serb Sarajevo.

Slavko Zdrale, director of the Kasindo hospital at the Serb-controlled outskirts of the Bosnian capital, says the health of Bosnian Serbs has been significantly threatened by depleted uranium (DU).

``We have exact indicators according to which the number of cancer patients has increased at least 2.5 times in this area compared to the war period and the first two years after the war,'' Zdrale said.

He was referring to a period between 1992 and 1997, during which four cases of leukemia were registered at the hospital.

Over the past three years, 18 people, including a 4-year-old child, have died from the disease, Zdrale said.

NATO has been criticized for using armor-piercing shells in the Balkans, which some ailing soldiers and anti-nuclear campaigners say have caused cancer.

The alliance and the United States, whose aircraft fired some 40,000 DU shells during the 1999 air raids against Yugoslavia and earlier in Bosnia in 1994-95, deny there is any link between the use of DU-ammunition and cancer.

Zdrale disagrees.

``Our analyzes indicate that there is a causal link to the use of munitions containing depleted uranium,'' he said.

Post-war Bosnia is divided into the Serb republic and the Muslim-Croat federation.

The hospital in Kasindo has become a major center providing medical care for up to 100,000 people from central and eastern parts of the Serb republic since the 1992-95 war ended.

According to Zdrale, an increased number of cancer patients have been observed in these areas which include sites hit during the NATO air attacks on Bosnian Serb military positions.

His claim is based on the rise of at least 2.5 times in the number of cancer patients, most of whom come from areas hit by the DU-munition, and on the fact that many of them are younger people.

``We are concerned about the toxic effect. The metals are in the ground, water and food are now affected by toxic dust,'' he added.

But Zdrale said that the hospital staff were cautious about the data, bearing in mind a high level of migration and imprecise figures on the area's population.

MUSLIM DOCTORS CAUTIOUS

In Sarajevo, doctors seem reluctant to link the illness to the use of DU munitions even though figures presented by the main clinic have shown a significant increase in the number of cancer patients in recent years.

However, Ismet Gavrankapetanovic, the head of the bone surgery clinic of the Sarajevo University medical center, said his team had noticed an increase in the number of cancer patients, particularly children, two years ago.

``I did not know what were the reasons for this. We could only express our suspicions,'' Gavrankapetanovic said.

But even without depleted uranium there were enough factors that could account for the rise of cancer in Sarajevo and elsewhere in Bosnia, he said.

``If 2 million grenades fell on Sarajevo during its siege, there must have been heavy metals there, including uranium.'' Heavy metals are genotoxic, causing mutation of the DNA that might create conditions conducive to cancer,'' he added.

Among other factors that might have contributed to a deteriorating health situation, Gavrankapetanovic mentioned poor nutrition during the city's 43-month siege by Bosnian Serb forces as well as daily stress, fear, lack of water and electricity and the use of medicine well past its shelf life.

Gavrankapetanovic said that separate figures from different parts of Bosnia would be no more than ``speculation'' until a recognized state institution for cancer research began to compile data for the whole country.

``I absolutely oppose any abuse of this information for political or any purposes other than the treatment of patients,'' he said. ``In order to conduct real statistical analysis, you have to have a state institute for cancer. It is an essential. I think Bosnia is the only country in the world without it.''

Health is among those sectors that are exclusively under control of Bosnia's two separate entity governments, and there is no state-level health policy.

Even though Serb and Muslim doctors differ in their views of causes which may have led to the increase in cancer across the country, they agree that it is there.

Zdrale said that cases of leukemia and cancer of the digestive organs were most frequent in the whole range of what he called an ``eruption'' of different types of cancer.

Both he and Gavrankapetanovic agreed on the need for Western assistance in order to diagnose the illness at an early stage.

``We are not able to conduct such tests nor do we have equipment for it,'' Zdrale said.

   One of the problems with DU is that is might support a kinetic microfission of the U-235 residual in the DU.   One thing that was noticed with enriched penetrators is that they burn hotter, and the only way this can happen is from a nuclear effect.

   The suspicion then becomes that fission and fission products like Sr-90 may also be a factor in DU use, and the bone seeking Sr-90 is a strong association to triggering leukemia and this adds to the bone surface seeking effect of DU and free radical flow to bone marrow.