Caring for ethnic Albanians in Macedonia's refugee camps

Abstract

THE LANCET • Vol 353 • May 15, 1999 1701 Giota Koutsoukou is haunted by the memory of a 7-year-old boy. When I visited Macedonia in mid-April, 1999, the nurse had spent 5 days working in hellish circumstances treating refugees from Kosovo who were violently forced to leave their homes by Serbian police only to be kept waiting in a no-man’s land at the Macedonian border. About 45 000 traumatised people spent as long as a week interned in a freezing, muddy makeshift camp known as Blace with little food, water, or shelter and no proper sanitation. Koutsoukou tended to hundreds of people suffering from exhaustion, bruises inflicted by Serbian and/or Macedonian police, convulsions, hysteria, frostbite, and respiratory infections. People with diabetes went into shock from a lack of insulin. Others emerged needing to have stitches removed or dressings changed from previous operations. Dozens died. But it is the 7-year-old who dwells in Koutsoukou’s thoughts. “The 7-year-old was just hysterical. It was incredible”, says Koutsoukou, who works for Medecins Sans Frontieres. “It was an adult hysteria, and children just aren’t supposed to get that hysterical. I was shocked. The people were shocked. These people just couldn’t understand what was happening to them.” The ethnic Albanians who comprise the overwhelming majority of the population in the Serbian province of Kosovo are the victims of the worst ethnic cleansing in Europe since World War II. The Kosovo Liberation Army has been fighting for the province’s independence for over a year. The Yugoslav authorities have attempted to eradicate the rebels by burning villages and massacring civilians in its quest to keep Kosovo within Serbia. (Serbia and Montenegro are the two remaining republics in Yugoslavia.) About 800 000 Kosovars had been displaced within the province. But when NATO began bombing Yugoslavia in late March, the country began a systematic expulsion of ethnic Albanians which has created a humanitarian nightmare. More than 6 0 0 000 have fled into Macedonia, Montenegro, and Albania, catching humanitarian relief organisations by surprise. And there is little rest for the overworked aid agencies as refugees continue to flee. The situation is the worst in Albania, Europe’s poorest country, which is hosting more than 350 000 refugees. A combination of the vast number of refugees, poor infrastructure, and mountainous terrain has made delivering aid very d i f f i c u l t . The situation is better in Macedonia, which is hosting about 120 000 refugees. But reports that another 50 000 people could be heading for the Macedonian border are causing a panic in overcrowded refugee camps. Doctors say is nothing short of a miracle that the camps have escaped epidemics but now staff are concerned that their luck could run out. Brazda, the largest camp in