UNHCR reports that one year after ethnic violence and hostility drove 900,000 ethnic Albanians from the Serbian province of Kosovo, at least 70,000 Kosovo refugees are still living outside of Kosovo. Most who took refuge in Albania and Macedonia during the conflict returned home within weeks of the June 9 peace agreement. However, many who fled to eastern Europe are still reluctant to return despite assistance offers from governments due to insecurity.
UNHCR estimates that some 14,000 Kosovar Albanians are still living with host families in Macedonia. By the end of March, they will lose their refugee status and Macedonian authorities will no longer assist in their repatriation. Bosnia still shelters 5,800 Kosovars, Croatia 3,000 and Slovenia 1,100.
In an effort to improve cross-border economic issues, particularly between Skopje and Pristina, UNMIK and the Government of Macedonia recently signed a joint program of enhanced cross-border cooperation. To support this program, the European Union (EU) is providing 5 million euros (approximately USD 5 million) through the European Agency for Reconstruction for improvements to the Hani I Elezit/Blace border crossing between Kosovo and Macedonia. This financial assistance, as well as EU technical assistance, will be applied towards projects to improve customs and administration procedures at the border.
According to UNHCR in Gjilan (Serbian: Gnjilane), a small influx of internally displaced persons (IDPs) continues to arrive in Kosovo on a daily basis from Serbia.
UNHCR reports that the ethnic Albanians who leave villages along the border on the Presevo (Albanian: Presheva) side tend to settle in small villages directly across the border in Kosovo. These IDPs are typically absorbed by host families and are difficult to track or quantify.
Ethnic Albanians from the larger cities of Bujanovac (Albanian: Bujanovc), Presevo, and Medvedja (Albanian: Medvegja) typically enter Kosovo and settle in cities and towns such as Gjilan, Kamenica, Viti (Serbian: Vitina), and Prishtina.
According to UNHCR, many of the people use a regular commercial bus service from Presevo to Gjilan and from Presevo directly to Prishtina.
Some of the schools in the Gjilan area have started three shifts (instead of the normal two) to accommodate the additional school-aged children coming from southeastern Serbia.
UNHCR is keeping the temporary community shelter (TCS) facilities in Kamenica and Viti open, but unoccupied, should further influxes from southeastern Serbia occur.
The International Rescue Committee (IRC), which manages temporary community shelters in the municipalities of Gjilan, Viti, and Kamenica, reported that as of mid-March TCS in the area could accommodate 300 more people before being filled to capacity.
According to the American Refugee Committee (ARC), all of the spaces are currently filled in its USAID/OFDA-funded host family support program, and there is a waiting list of 30-40 families (currently accommodated in the TCS facilities). ARC is working to identify additional host families and will work with the UNHCR/Gjilan field office to establish a minimum number of unoccupied rooms as a contingency to deal with any new influxes of people.
The TCS reception center (at the Gjilan sports center) can also accommodate an additional 500 people on a short-term basis.
The International Committee of the Red Cross (ICRC) has arranged to provide three meals per day to IDP families living in the reception center until they are placed in host families.
The World Health Organization (WHO) and UNMIK are planning the development of a primary health care system in Kosovo, which will require infrastructural, educational, financial, and technical reforms over the next three to five years. The development of a primary health care system in Kosovo will redirect a focus onto family medicine delivered by family health teams to specific populations, requiring the development of larger family health centers serving a defined population.
Sites for family health centers, with ambulantas primarily serving this function, are now being identified. Donors and NGOs will focus their rehabilitation efforts on these sites. However, the family health center structure has not yet replaced the former parallel system run by The Mother Teresa Society because some of the old structures are still operating while new sites are being reconstructed and prepared for use.
Agencies working in the health sector report that Kosovar patients often seek primary care at health houses, rather than the more appropriate location - ambulantas, due to the perception that they will receive more thorough or extensive care at a health house. This trend may cause an overloading of the already over-extended health house resources.
Training of doctors to be general practitioners remains a considerable task in Kosovo. One reason for the lack of general practitioners is that the practice of medicine in Kosovo is very specialist-oriented and the route to respect and success has been through the specialties.
The creation of the new health structure directly affects the issue of access to adequate health care for minorities. Minorities may have limited access to health care if their village does not have an ambulanta and the nearest family health center is in a neighboring ethnic Albanian village. If a minority community does have an ambulanta, there remains the problem of safe access to secondary and tertiary health care in the hospitals. Short-term mobile clinics are assisting minority populations throughout Kosovo.
Approximately 50 ambulances operate throughout Kosovo. International donors fund most of these ambulance services, although a few communities have purchased their own vehicles. Approximately 50-55 ambulances are required to provide adequate coverage in Kosovo. Although many of these ambulances are operational at this time, little if any continued donor funding is expected, thus jeopardizing the long-term sustainability of some EMS programs.
WHO reports that improved emergency care practices have cut the death rate in half among ventilated and non-ventilated patients admitted to Prishtina University hospital from July 1999 to November 1999, despite similarity in illnesses among the patients during this period of time. The Prishtina Hospital medical director credits Medecins du Monde's work with emergency care doctors for this improvement.
A group of Kosovar doctors is developing strategies to reduce infant mortality, following their participation in a four-day WHO training course on essential newborn care and breastfeeding. These strategies include promoting increased thermal protection to decrease the risk of hypothermia, nurse training in resuscitation of asphytic infants, and initiation of breastfeeding immediately after birth.
Safety and Security
According to KFOR, landmines remain a major concern in Kosovo. Mine-related incidents increased during February, including one where a bus traveling from Mitrovica to Zvecan ran over a landmine that had been laid on the road. KFOR expects that the number of mine strikes could increase as the weather improves and more people are outdoors. In certain cases, people have moved landmines to the road shoulder for disposal by removal experts. KFOR is strongly discouraging such activity, particularly in expectation of the spring farming season when shifting soil may reveal additional landmines.
UNMIK reports that the majority of the landmine action teams are available for deployment for the 2000 de-mining season. Teams include mechanical equipment and mine detection dogs. Mine awareness teams have been operational throughout the winter period, in conjunction with minefield marking and maintenance teams.
The U.S. Government (USG) has provided more than $533 million in response to the Kosovo crisis since March 1998.
USAID/BHR: $ 276,893,000
FFP: $ 131,200,000
DOS/Population, Refugees and Migration: $209,036,475