Kosovo: The physical and psychological consequences of war

  • International staff: 55
  • National staff: 152 Summer 1999 saw the beginning of the post-war period in Kosovo. With peace in June, hundreds of thousands of refugees who had sheltered in Albania, Macedonia and Montenegro returned en masse. MSF, which had an extensive presence in Kosovo prior to the war but withdrew when the bombing started, was also quick to come back, setting up medical aid points, rehabilitating health facilities, and providing mental health care to traumatized people. It soon became clear that, despite the peace agreement between NATO and Yugoslavia, tensions throughout the province remained high - especially in areas containing a substantial minority of either Kosovar Albanians, Kosovar Serbs, or Roma (Gypsies). Hoping for a sense of security with the presence of KFOR (the NATO-led military force charged with keeping the peace in Kosovo), many Kosovars from all ethnic groups have instead felt a growing insecurity. The interim civilian administration set up by the UN was also slow to get off the ground and often vague in its provisions for responsibilities like policing, adding to the sense of unease. In addition to providing medical aid and psychological support to people from all ethnic groups, MSF has worked over the last year to gather first-person accounts of inter-ethnic abuse and violence. MSF continues to call for increased protection for all Kosovars. In August 2000, the organization ceased activities in several minority enclaves in the north, as an act of protest and to draw attention to the deteriorating security situation for minority groups and vulnerable civilians in general. Meanwhile, MSF is offering aid to those in need in much of Kosovo. Since MSF re-entered the region in June 1999, it has been working in different areas: PejÃ?«/Pec (geographic names are given in Albanian and Serbian), Istog/Istok, Prizren, Gjakova/Djakovica, Skenderaj/Srbica, Vushtrri/Vucitrn, Gjilan/Gnjilane, Mitrovica and in many small villages, reaching a total population of 750,000 people. Activities have been many and varied. Direct medical care is given at hospitals, through mobile clinics or in small community "ambulantas," or clinics. Major hospitals in Prizren, Mitrovica, PejÃ?«/Pec and Gjakova/Djakovica have received either ongoing or short-term MSF support. Because of the mental trauma of the war and the high incidence of post-traumatic stress disorders (PTSDs), psychological care and training have been an important part of the work. Numerous mental health programs are currently in place in Kosovo, and include the support and training of Kosovar mental health professionals in dealing with PTSDs. In a place devastated by both civic violence and bombing, the reconstruction of infrastructure necessary for good health and good sanitation is critical. MSF gave technical advice and provided materials to help rebuild 800 roofs. In the aftermath of the war, access to clean water was impeded by dirty wells, sometimes containing human or animal cadavers. MSF worked with many communities to clean thousands of wells. Rehabilitation of several hospitals and many health clinics has also been an important part of MSF's work. From the onset of the war through September 1999, the organization also ran a clinic at the Cegrane refugee camp in Macedonia, home to 43,000 refugees at the peak of the crisis. MSF began working in Kosovo in 1993.