Assistance and protection to Kosovo refugees in Albania

Over seven weeks since the beginning of the NATO offensive, the exodus
of 750,000 refugees from Kosovo in April and May 1999 has met with a
vast relief operation, involving humanitarian organisations, NATO
forces and Governments in a joint effort of unprecedented complexity

The vast majority of the refugees want to go home as soon as possible.
Clearly they can only do so
If some sort of a political or military solution is found to ensure
that they can return voluntarily and in safety. Currently there are
around 231,000 refugees in Macedonia, some 450,000 Albania (35,000
have crossed from Montenegro), 64,000 in Montenegro, 20,000 in Bosnia.

It is possible that at current rates of refugee crossings, within the
next six weeks the number of refugees in Albania could increase to
1.000.000. Albania is a fragile country that has not recovered from
the civil unrest of 97/98. It is often repeated that it is the
poorest country in Europe but the consequences of this statement are
never considered.

Although refugees are being moved onto third countries from Macedonia,
the international community, NATO countries in particular, still
expect Albania to cope with hundreds of thousands of refugees,
whereas Europe refuses to take in any significant amount of refugees.
With a Balkan winter beginning in September, weak infrastructure and
no provisions for medium term assistance, this is putting an
unrealistic burden on Albania and exposing the refugees to
unacceptable risks.


Refugee distribution and assistance

Since the beginning of this refugee crisis the distribution pattern of
refugees has stayed remarkably stable in spite of the focus on camps.

  • 50 to 60% are living with host families spread across the 12
    prefectures of Albania



  • 30 to 40% are in hundreds of collective centres (warehouses,
    abandoned factories, schools, unfinished buildings), new centres are
    appearing daily as others reach saturation



  • almost 15% of the refugee population are to be found in tents, or
    65.000 in total. The camps are increasing in size but so is the
    overall refugee population. The foreign military support is focused on
    the camps and transporting refugees from Kukes.



    There are approximately 93,000 refugees staying in Kukes (official
    figure of 16 May), many of the refugees are afraid to move South and
    want to wait in Kukes for other family members to arrive, also there
    are many refugees who have arrived by tractor and who do not want to
    leave their tractors behind.

    Roads are terrible and there is limited transport capacity to 'bus'
    the refugees to the South and the accommodation capacity to host
    refugees in the South is largely saturated. To accommodate the
    refugees who will be evacuated south, it is necessary to do extensive
    rehabilitation of the collective centres as most collective centres
    are in bad shape.

    Due to the dispersion of the refugees and the fact that support to
    families, camps and collective centres produce specific needs, the
    aid effort will have difficulty covering all the needs of the Kosovo

    A good illustration of this, came when we conducted a rapid household
    survey in Kukes, an area which has received a vast amount of aid since
    the beginning of the crisis. The survey of wild camps or tractor camps
    and hosting families was conducted on the 29th of April, and showed
    that 20% of the households had not received any food since arriving,
    73% had only received the food parcel once and only 52% had received
    soap. 24% of the households had received at least one blanket. Bread
    was the only food commodity received systematically by the families
    interviewed. At least 61% pay a monthly rent and the average rent
    paid is 250 Dm per month.


    The current refugee camps are not sustainable after September. The
    tents in the camps in Kukes are not winter tents and could not shelter
    refugees from a Balkan winter. NATO is building refugee camps in the
    mountainous region of Korce for a total capacity of between 35.000 and
    50.000. These camps cannot provide sustainable living conditions
    through the winter. The refugees will have to be relocated or the
    camps rebuilt well before September, the start of the cold weather.

    Only the refugees in host families (half of the current caseload of
    refugees) could be safe from the winter, but their housing conditions
    should be surveyed. MSF has come across many refugees living in
    out-houses, unfinished structures that are on private land (so
    considered as living with host families), that would need repair or
    rehabilitation for the winter. More to the point, many of the refugees
    staying with families are using their savings to pay for their
    accommodation and many are running out of money and will also be needing
    accommodation and assistance.

    Paradoxically as we enter the hot summer months, winterisation is of
    immediate concern. To make the existing camps places where people can
    survive the winter and to rehabilitate the collective centres,
    planning needs to be made now and work needs to start on a massive
    scale in early July at the latest.


    Refugees are by definition a vulnerable population and need to be
    protected. In the case of Albania, protection takes on a new meaning.
    The refugees here are vulnerable to organised crime. During the civil
    unrest of '97 it is reported that up to a million Kalashnikovs were
    looted from ministry of defense arsenals. The refugees themselves put
    security as their top preoccupation.

    For example at the Tobacco factory in Shkoder currently holding 4600
    refugees, we had to choose whether we were to supply hot meals or
    external lighting first. The refugees chose lighting as it increased
    their sense of security at night (fear of kidnapping by criminal gangs
    for prostitution networks in Europe etc). MSF is setting-up an
    incident report system for all the sites in which we are working.

    Health and water

    The refugees have arrived to Albania in relative good health. MSF has
    not come across malnutrition. Mortalilty is not alarming (less than
    0.5/10.000/day). Today the health situation can be considered under
    control, but we are expecting to see a decline in the coming months
    due to the cramped living conditions and poor hygiene.

    Further the water and sanitation facilities are barely sufficient to
    cope with the Albanian population. The system cannot cope with the
    increase in population without major immediate investment. Albania
    experienced a cholera outbreak as recently as 1994. MSF is building
    emergency water-sanitation facilities for collective centres and has a
    cholera preparedness programme.

    MSF is currently running relief programs in Albania, Macedonia and
    Montenegro. As a humanitarian organisation and to ensure that we
    remain independent from the parties in the conflict, MSF has taken the
    decision to not accept any funding from NATO member governments or
    from organisations they fund (UNHCR, ECHO etc). MSF is fundraising for
    private funds only in NATO countries.