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Bringing health back to Kosovo

by Ron Osborn
After seeing his home torched by militiamen, Dr. Izer Sinani, 33, says he fled to the Kosovo mountains where, without tools or medicine, he cared for fellow ethnic Albanians in hiding. For nearly one year, in the most primitive and harrowing of conditions, the thin-framed and soft-spoken Sinani treated individuals suffering from the most extreme forms of trauma. Many of the estimated 65,000 Kosovars who spent the war in the hills faced exposure in sub-zero temperatures, and as the months wore on, starvation and malnutrition. Among them were villagers who fled their homes bearing the marks of terror-wounds from gunfire, beatings and landmines. Some of those he assisted, Sinani recalls, were brought to him without arms or legs.

Today, Sinani's most difficult patients are not victims of brutality or explosives, but, more typically, children like two-year-old Edona Aliu, whose father brought her to the Adventist Development and Relief Agency (ADRA) mobile clinic in the village of Rubove because of a persistent cough. Edona squirms in her father's arms as Sinani, armed with a tongue depressor in one hand and a flashlight in the other, valiantly attempts to look down her throat. At last he writes a prescription. Edona's father, Faruk, breaks into a wide grin. "It has been four years," he says. "We are very grateful."

He is referring to the fact that it has been four years since the two-room medical clinic in the farming community of Rubove (population about 2,000) was last open. For many villages it has been even longer. The people report that beginning in 1989, when harsh new laws in the region were introduced, not only Albanian culture and language were suppressed, but basic services including education and healthcare were systematically denied to ethnic Albanians. Clinics stopped receiving medical supplies; Albanian doctors and nurses in training were expelled from medical school; and doctors often disappeared into police stations, never to be seen or heard from again. Sinani says he was expelled without explanation from the government-controlled university in Pristina in 1990 after four years of medical study.

It is no wonder that primary healthcare in Kosovo is in a shambles. Many ethnic Albanians, particularly those living in rural areas, have not had a regular doctor's visit in years. Patients thus arrive at the ADRA clinic in a steady stream, either by tractor, horse-drawn cart, or on foot, with maladies ranging from diarrhea to diabetes. When the mobile clinic program began in July 1999, as many as 100 patients came daily. Their needs are usually basic by industrialized nations' health standards: a middle-aged woman is suffering from high blood pressure; a young boy has tonsillitis; an elderly man complains of sore teeth-highlighting the fact that there has been no dental care in Kosovo for nearly a decade.

Sinani, together with Dr. James Miyashiro, president of the Okinawan Medical Center, dispenses medicine from supplies donated by the International Medical Corps (IMC). More serious cases, such as a man losing his sight to cataracts, are given referral slips to take to Kosovo's main hospital in Pristina. In addition to the clinic in Rubove, ADRA operates mobile clinics in the villages of Shale, Banulla, Dobroje, and Lipina, all in the district of Lipjan. Together they served more than 2,500 individuals in their first month of operation.

The clinic program is funded by the ADRA regional office in Japan and the Japanese government, and is staffed primarily by volunteers from ADRA Japan working alongside Albanian health professionals, such as Sinani. Each team consists of two doctors and two nurses.

Although the clinics were established to provide primary healthcare in isolated regions, villagers often come to the ADRA clinics bearing more than just physical pain. After having his blood pressure taken, one man in Rubove worries that his well is poisoned. A woman, who has brought her niece to have her sore throat examined, suddenly bursts into an emotional appeal. "The one who killed my friend's father is still here," she says. "Every day we see him walking in the streets. How can we keep living like this?" For such problems the ADRA team has no pills or easy remedies to offer. They can only listen patiently and refer the villagers to the appropriate United Nations authorities in the nearby town of Ferazaj.

Work continues until late afternoon when it is time to load the boxes of medical supplies back into the mobile clinic's Toyota mini-van and head home. As the vehicle bounces along the pot-holed road, children who have just been treated stand outside their homes to wave goodbye. The ADRA team waves back but is largely silent.

Tomorrow they will visit another village, and the next day another, and another the day after that. The opening of the clinic in Rubove is a kind of victory, but for Sinani and his fellow aide workers, the battle to bring conditions of normality and health back to the people of Kosovo has barely begun.

ADRA continues to actively assist the ethnic Albanians and Serbians in Kosovo as they put their lives back together. ADRA's shelter, educational, water and sanitation, health and community service projects now surpass US$20 million in rehabilitation assistance for the returned refugees.

Ron Osborn was an ADRA volunteer from the U.S. serving in Kosovo for four months in late 1999.

Media Contact: Beth Schaefer, Media Relations Manager, ADRA Headquarters
Phone: (301) 680-6355
Fax: (301) 680-6370