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Field Exchange Nov 1999: Challenges for humanitarian response in Kosovo

News and Press Release
Originally published
By Annalies Borrel, Rita Bhatia and Anna Young

This article looks at challenges in Kosovo with specific reference to delivering food assistance through local distribution mechanisms.Annalies Borrel is currently working as a consultant with UNHCR as Food and Nutrition Co-ordinator in Kosovo and Rita Bhatia, the UNHCR nutritionist from Geneva was on mission between June-August 1999 in Kosovo. Anna Young is working with 'Mercy Corps International as Project Manager for the 'Partnership Project'.

The tragic events leading to the expulsion of 800,000 Albanian Kosovars between March and June 1999 during the Nato air-campaign are well known. The speed at which the majority of refugees returned in the month following the signing of the Peace Agreement was just as remarkable. The initial UN assessment mission in May 1999, estimated that 600,000 people had remained within the province throughout the war. Of these, 50% had been internally displaced; half of this group had been on the move for more than one month, living mainly in the open in forests or mountains with little access to food or clean water and sanitation facilities. The testimony of refugees fleeing Kosovo reported that the Serbian forces had limited the access of the urban population to food.

Current population estimates indicate that the total population living in Kosovo is approximately 1,600,0001 with approximately 90% of Albanians having returned but with a simultaneous exodus of the majority of the Serbian population (75,000). The pre-war rural population accounted for 63% of the population with 37% being urban.2 There are an estimated 2,000 villages across 29 municipalities all of which have an urban centre. Despite efforts to provide protection for the remaining minority populations, their exodus continues. The need for the provision of food and non-food items to the entire population is acute as they work to rebuild their lives.

Currently over 200 humanitarian organisations are delivering emergency assistance in the form of food, medical care, shelter, water and sanitation, largely under the co-ordination of UNHCR. One of the main failings of the international community has been the failure to make maximum use of the parallel structures e.g. health and education structures, which had developed within the Kosovo-Albanian tradition of self-organisation. One of these structures was the Mother Theresa Society (MTS). This article highlights some of the challenges that both the local community-based MTS structure and the international community have faced in delivering emergency food aid and non-food items through an already existing 'assistance' mechanism.

Food assistance before the crisis

The Mother Theresa Society (MTS) was founded in 1991, as a "charitable and humanitarian society" in response to the change in strategy of the Yugoslav government towards Kosovo. Many Kosovar-Albanians (and other ethnic groups) no longer had access to state welfare and medical structures. MTS organised itself into 44 branch and 636 sub branch offices with the objective of providing welfare assistance3 to the poorest of those residing in Kosovo i.e. 'social cases'. Providing assistance for 50,000 'social cases' in February 1998, MTS was by far the largest local NGO. Other local organisations such as the Yugoslav Red Cross also provided assistance, although they were perceived to be targeting the Serbian population. At the time of the evacuation of humanitarian organisations prior to the Nato bombing in March 1999, MTS had become the principle vehicle for distributing humanitarian aid to war affected persons in Kosovo. Many of the estimated 4,000 - 6,000 activists4 were targeted by the Serb forces while others fled to Albania, Macedonia and elsewhere. With the cessation of fighting these activists returned and resumed their efforts with remarkable speed. MTS now serves a caseload of 1.1 million and takes charge of around 80% of food and non-food items. With the 1998 beneficiary caseload increasing twenty-two fold, the MTS network has been under ever increasing strain to continue to meet the needs of the beneficiaries as well as the reporting requirements of international donors and NGOs. MTS faces many challenges which, as expressed by MTS activists themselves and members of the Partnership Project, (a UNHCR funded project which aims to support MTS as they adapt to the new situation5), are summarised later in the article.

The current situation: assessment, delivery mechanisms and targeting of food aid (June 14th to September 1999)
During June and early July, under the co-ordination of UNHCR, eight international NGOs were identified to be the main implementing partners (IPs) of UNHCR and WFP for the distribution of food aid and non-food items. It was agreed that, for co-ordination purposes each of the IPs would be responsible for food distribution in each of the designated Areas of Responsibility (AORs). Food assistance would be delivered, where feasible, through a local distributing partner (DP)6. As part of the initial response in the first two months of the emergency, a blanket food distribution to a target population of approximately 1.7 million7 people throughout Kosovo was provided8. During August, 18.3 Metric Tonnes of food aid was distributed through the main food aid pipelines; 85% of the estimated food needs of 21.7 Metric Tonnes. During the early stages of the response in early July, a rapid Food Economy assessment was undertaken jointly by WFP and FAO, primarily to develop an analysis of medium-term food aid needs and to explore ways in which food aid could promote the normalisation and reconstruction of the Kosovo economy. In addition, a Food Security Survey, including an anthropometric survey, was undertaken by Action Against Hunger (AAH) during the month of July. Results of the survey indicated that the nutritional status of the under-five population had not deteriorated significantly since December 19989.

However, the food security assessments confirmed that the crisis had a significant impact on the food security situation of a large proportion of the population living in Kosovo. Production of winter wheat (planted in October and harvested in June/July) was most severely affected in the northwestern municipalities and less severely affected in the southeast of the province. The rural population had been severely affected by loss of harvest of vegetables, beans and maize since the massive population displacement (March-April) prevented the planting of these crops. Furthermore, the looting and slaughter of livestock particularly cattle, was significant. On this basis it was estimated that in those rural areas most severely affected, 80% of food aid needs would need to be met through food aid. In the towns where little infrastructural damage had taken place, such as Pristina and Prizren, it was anticipated that the urban trade and business sector would recover rapidly10. In the urban areas where more significant damage has occurred, the percentage of population requiring food assistance will most likely remain quite high i.e. 65%11.

The findings from the Food Economy assessment estimated that approximately 900,000 people (an estimated 53% of the population) should be targeted for food aid assistance from mid-September through the winter. Food assistance would be geographically targeted according to two main factors, crop production and infrastructural damage. However, with over 1.3 million people registered to receive food aid by the end of August, the question remained as to "how the food aid would be targeted?" An exhaustive process to define beneficiary selection criteria for targeting at community level was carried out. Four categories of beneficiaries (see box) were defined and ranked in order of priority.

Although the process of defining eligibility criteria had been participatory in nature, it is widely accepted that the criteria were not entirely satisfactory. The main areas for concern were:

  • The number of beneficiary numbers from the 'bottom-up' community based targeting exercise would be greater than the 'top-down' 900,000 figure
  • The selection criteria appeared to focus too much on structural damage rather than 'access to food' and other food security factors
  • A strategy for implementing the selection criteria, based on the following principles, was proposed by WFP:
    • The ceiling figure of 900,000 beneficiaries would still be respected
    • A compromise figure, between the geographical and community-based targeting systems, would be used (by taking the average and applying an adjustment factor) as the final figure for targeting in each area
    • The order of priorities would be respected i.e. those falling in Category I would receive before Category II etc.
    • The system needed to be understood by all players and needed to be applied immediately without further information collection and analysis.
  • There were still some outstanding concerns:
    • Where food was inadequate to address the needs of all categories, some of the most vulnerable with respect to access to food, would not receive assistance i.e. those in Category III and IV.
    • The obligation to adhere strictly to the order of priorities and not share rations was not necessarily the usual (acceptable) practice of the community.
    • The top down geographical targeting was not based on accurate population data and had most likely under-estimated the significant rural to urban displacement.
    • The appropriateness of the selection criteria for the non-Albanian populations had not been adequately considered.
    • The categories, as outlined in the criteria, could not realistically capture the significant knowledge and skills that were so fundamental to the community-based distribution system.
    • In this context, a task group was set up to monitor the implementation of the selection criteria. The purpose of the task group was not to identify whether or not the NGOs and food distribution system partners were failing to rigorously apply the targeting criteria, but rather to better understand how the targeting process was being implemented in practice, to identify problems and to use the opportunity to learn from the community-based system12.
Selection Criteria for the Distribution of Humanitarian Food Aid in Kosovo

1. Families without shelter whose houses have been badly or totally destroyed.

2. Internally displaced families (IDP) - people who are unable to return to their homes due to the emergency situation and are currently living with a host family or in a community centre and do not have access to food. Families hosting IDPs are eligible to receive a ration.

3. Persons who are permanently unable to generate an income and have no access to other financial support nor to food, such as the elderly and handicapped

4. Social cases such as single parent households, families with low socio-economic status and households whose members are unemployed.

Challenges facing local distribution partners such as MTS

Strains on the voluntary ethos of the network

MTS activists worked for 9 years without monetary compensation for their work. During 1991 to 1998, engagements with the society and associated work commitments were limited to a few hours a week. By the autumn of 1998 activists at the branch were working full time coordinating between sub-branches, headquarters and the plethora of NGOs establishing themselves in Kosovo. Furthermore, since the return to Kosovo the vast increase in commodity distribution has meant that community level activists at the sub-branch level are also working full time. A short-term solution has been found by compensating a select number of activists at all the levels of the society. In the future when workloads decrease, MTS will need to return to a volunteer network, streamline its personnel or develop other projects to sustain itself.

Large number of agencies operating in Kosovo

At the time of writing there are more than 200 hundred agencies operating in Kosovo, many of them providing relief supplies to the Kosovar population. This has inevitably led to a lack of coordination not only among international agencies, but specifically among the local distributing partners, such as MTS who are often not informed about deliveries to their network. This inevitably has undermined the independence and strength of a localised community-based organisation. Given the reality that local agencies will continue their work when international agencies begin to significantly reduce their presence, more attention should be paid to the negative implications of the international community failing to fully recognise and respect local structures.

Re-establishing after the conflict

During the evacuation it was uncertain whether or not MTS as an institution would survive events. Upon return, the network re-established itself with remarkable speed in many areas of Kosovo. The capacity to re-establish so rapidly is one of many indicators of the strength of the network, especially considering the tragic personal crises many of the activists were facing themselves. The Red Cross has also re-established itself.

Donor accountability

There is an obvious need for a large degree of accountability in situations where commodities are delivered as humanitarian aid. MTS has a highly developed system of distribution logs and ration cards, which was refined in 1998 and continued after the bombing. The challenge now lies in collating this information, since the large majority of the entries are being carried out manually. The process of establishing a computer database is a gradual one. However, MTS is working hard to meet the requirements of the donor community which is based on a mutual understanding of the importance of record keeping.

Accountability to local community

Inevitable delays in pipeline deliveries which lead to irregular distributions, are often blamed on MTS who themselves, are often ill informed as to the broader picture of the mechanisms of large scale aid delivery. Additionally, when NGOs deliver directly to one village (often luxury 'one off' commodities such as toys, food parcels etc.) without informing MTS, other villages perceive MTS to be favouring certain areas. In contrast, an MTS sub-branch or branch would try to allocate commodities between villages according to those most in need. WFP, UNHCR and the IPs have partially addressed this issue by attempting to increase coordination and mutual support and establishing targeting criteria jointly.


Given the current undetermined status of Kosovo, national bodies are under political pressure to align themselves with potential political parties. This is perhaps particularly relevant to MTS since the network delivers such a substantial amount of commodities. Inevitably, the commodities lend authority to those controlling them. MTS headquarters has clearly stated that the network will remain politically non-aligned. However, at the community level this issue at times, can lead to some tension between the self-elected civil administration, political groups and MTS. In most cases this has been resolved through negotiation and a general acceptance that MTS is the most qualified and experienced network to handle the commodities.

Relationship between international and local agencies

The relationship between international and local agencies is often (as elsewhere in the world) one of uneasy interdependence. Without the cooperation of local distribution partners, the humanitarian relief effort would be severely hindered. Local distribution partners are on the other hand frequently dependent on international agencies for resources. However, often there is mutual distrust with international agencies doubting figures given and the decisions taken by distribution partners and the distribution partners lacking confidence in the international community to access and deliver sufficient commodities in a timely manner.

Addressing the needs of multi-ethnic groups

In some areas where atrocities had been carried out specifically against MTS activists, it remains difficult13 for MTS to provide welfare assistance to non-Albanian communities, specifically the Serbian populations. In some cases, non-Albanian ethnic groups have refused to accept assistance from the MTS network. For many of the MTS activists, the individual loss and trauma suffered as a result of the war has been enormous and will inevitably affect their ability to support all communities in the immediate future.

Challenges facing the international community

The opportunity to work with local distributing partners, such as MTS, from the outset of the emergency, was a relatively unique one. It did however present certain challenges

Systems and protocols

In the beginning, there was some reluctance by the international organisations, particularly by those who had not worked in Kosovo prior to the crisis, to consider the local MTS as an integral part of the overall food distribution system. Different agencies had their own protocols, monitoring systems, forms etc. and were keen to implement their own systems, which in some situations conflicted with that of the local community-based distribution system.

Local staff recruitment

The national staff members who were employed by the international agencies did not have suitable experience. They were often young individuals, well educated, spoke English and were recruited from the urban areas14 rather than from local rural communities. This sometimes gave rise to difficulties between the usually much older, more experienced local volunteers who were working with MTS.

International staff skills

The international staff, employed by the agencies for the distribution, did not necessarily demonstrate the skills required for the type of approach that was considered so important in developing a constructive relationship with the local community-based distribution system.

Monitoring role

An important component of the international agencies' role was that of monitoring. This created a number of challenges. Firstly, a code of conduct was necessary to ensure that the monitoring was carried out using a discrete, respectful and constructive approach. Secondly, rather than carrying out the distributions themselves, the agencies were expected to focus on issues of monitoring at the household level, such as; coverage, access to the ration, food use, vulnerability factors and the community perception of nutritional vulnerability. The need to develop monitoring skills, procedures and means to use the monitoring information was relevant to all agencies.

Measuring 'nutritional vulnerability'

The community-based targeting system did not always accord with international agency perceptions of nutritional vulnerability. The system relied on community knowledge of vulnerability which was sensitive to detail and changes, and captured a number of complex factors affecting nutritional vulnerability - a concept that international agencies could not necessarily 'measure' quantitatively.

Using a 'capacity-building' approach

The professional capacity of the local distribution system varied from one area to the next. In most cases it was necessary for agencies to take a 'capacity-building' approach to food distributions. While under enormous pressure to 'get the job done', it was certainly challenging for agencies to provide the necessary support and not undermine other capacity building activities provided by the partnership project.

Identifying alternative distribution partners

Where the MTS distribution system was not working e.g. in some non-Albanian 'enclaves', the agencies needed either to identify an alternative partner or carry out the distribution themselves. In cases where an alternative partner was deemed appropriate e.g. Orthodox Church or local village committee, significantly more time and resources needed to be allocated to training and building systems for accountability etc.

Co-ordination with KFOR

The distribution systems established in Kosovo involved a number of different agencies working in close partnership, namely UNHCR, WFP, an Implementing Partner (international) and a Distribution Partner (local). In addition, KFOR, the UN Peace keeping Mission for Kosovo, was yet another element to take into consideration in the distribution system. The extensive network of KFOR personnel in villages, with their enthusiasm to provide food and other humanitarian assistance to the population, sometimes created misunderstandings and confusion among the partners. While their presence was recognised as important in identifying gaps in aid provision these well-intentioned efforts were often cause for misunderstandings.

Joint planning and information sharing

Information flow from MTS headquarters to the extensive number of sub-branches has at times, been very slow. This undermined the ability of agencies to co-ordinate shared planning and take timely action. Given the obvious differences in resources that the international and local agencies were working with, this limitation was understandable. Despite these constraints, agencies recognised that it was important to continue to make efforts to facilitate and carry out joint planning.


Despite the difficulties and constraints experienced by both the international agencies and distribution partners, the relief effort in Kosovo has demonstrated that it is possible to work with local partners from the outset of an emergency. In these contexts however, there is still a need for 'emergency food distribution agencies' to develop a 'community-approach' to food distributions with a focus beyond 'logistical relief'.

The need to target food aid to those who most need it is a legitimate one. The Food Economy approach is one method that is based on a sound analysis and can provide a framework for identifying geographic differences in food needs. Community-managed targeting is undoubtedly, in many situations, an effective way of reaching the most vulnerable. This case study has shown that where both targeting mechanisms are applied, the process of reconciling them can be challenging. The process needs to be managed carefully and sensitively otherwise it may be the cause of grave misunderstandings and possibly even create conflict at the community level.

The international community and local distribution partners must now together, assess the effectiveness of the targeting process. Adequate resources, skills and time must be allocated to monitoring the impact of the implementation of the selection criteria. Mechanisms such as: establishing a task group, the development of monitoring skills and activities in each of the agencies and adopting a learning approach with local distribution partners, are fundamental to this next stage.

The full implications for a community-based network such as MTS of the presence of, and interaction with such a large international community in a crisis situation, still has to be realised. A follow-up evaluation of the impact of the relief effort on local NGOs, such as MTS, will be important in enhancing understanding and the future role of a community-based approach to emergency food relief provision.


1 UNHCR/KFOR, September 1999
2 It is likely that there has been a shift towards urban displacement due to dramatic destruction in the rural areas, increased employment opportunities and access to food.
3 MTS also had a medical sector providing parallel primary health care throughout Kosovo. This will not be discussed in this article.
4 Community 'contact' persons
5 The Partnership Project has been funded for a year now in recognition of the demands placed upon the MTS society. It aims to support the society by providing financial and material resources to the network in conjunction with training and technical support.
6 In most, but not all situations, the DP is MTS.
7 With the objective to reach 80% of the population.
8 The monthly food basket, which aimed to provide 2,300kcal, was made up of wheat flour, beans oil, sugar and canned meat. Due to logistical constraints, this complete food basket was rarely fully provided during the early stages of the emergency.
9 In December 1998, global malnutrition was 2.0% and in June 1999 was 3.1% (-2 z-score weight for height) among under fives (Action Against Hunger Nutrition Surveys).

10 Prior to the war, when Albanian employment in the formal sector was restricted resulting in the urban (and to a lesser extent) rural Kosovar Albanian economy being fuelled by remittances from abroad, Mother Theresa Society was assisting 30% of the population.
11 Mark Lawrence, Food Economy Assessment of Kosovo Province, July 1999.
12 This process is currently under way with the aim to make any changes to the criteria by the end of October.
13 In many situations MTS is delivering assistance to non-Albanian populations.
14 Furthermore, these well-educated persons were often employed as interpreters, drivers and monitors - removing them from potential positions in rebuilding their own structures.

For more information contact: Annalies Borrel, 829 Courtenay Drive NE, Atlanta, GA 3036, USA. email: