MSF in Albania/Macedonia
It is estimated that more than 355,000 refugees have entered Albania, with 45,000 new refugees arriving in Kukes in the past three days (April 17-19, 1999). Population demands are still pressing and MSF has begun the construction of two camps - one in Kukes and the second on Fier - to accommodate the current and new refugees.
Apart from the camps, MSF responsibilities also extend to the refugees in the collective centres and those housed with local families. In addition, MSF is involved in water and sanitation needs development, data collection, providing temporary shelter and collecting testimonies from the refugees. Project development can be broken down to four major geographical targets.
The North: Kukes and Krume - the border points where the refugees arrive.
The Northwest: Shkoder, near the border with Montenegro.
The South: Prefectures of Fier and Vlora
The Southeast: Korce
Kukes: WIth the influx of 45,000 refuges in 72 hours, all forms of accommodation in the area have been saturated. The Kukes area already has 100,000 refugees, mostly absorbed by host families. With the population saturation comes the additional worry that the border situation is quite tense. The new MSF camp is designed to hold 4,000 to 5,000 people. Even though it is not complete, there are already 2,000 refugees living there. The tents are organised, numbered and the occupants registered. Food distribution is being carried out GOAL, an Irish aid agency.
The MSF water bladders and taps are in place and functional. Blankets and plastic sheeting have been distributed by MSF. Latrines have been dug should be fully functional today. There is an MSF health post operating in the camp and volunteers have been recruited by Christina Moore for a peer counselling programme. The volunteers shall be receiving training before being sent into the field.
MSF is carrying out surveys of the camp and area to be sure health needs are being met and recording the make-up of family units. In the future, there is a measles vaccination campaign in the works with the Ministry of Health and UNICEF. MSF also has plans to improve the sanitary facilities of the makeshift camps and to give technical sanitation advice to the regional health authorities. NATO has announced it will build an emergency transit-camp for people who cannot be transported to the south of the country immediately, serving as a reception point with a medical post and the basic necessities. NATO will also provide trucks with the capacity to take 15,000 to 20,000 refugees per day to the south of the country.
The situation in Krume is very quiet, with no major security-problems. The refugees in the mosque and the chicken-farm collective centers want to stay in the region, but will move soon to a camp set up by NATO-countries (France or Germany) in Fazaj. MSF has set up a medical triage point in Krume and is carrying out consultations. There have been 322 to date. In addition, we are collecting data on human rights violations. MSF have put 12 water taps in place and is planning a mental health programme. Also in the plans is a reinforcement of the national health infrastructures and we shall be distributing basic health kits.
Shkoder: an MSF team is on standby in case of influx of refugees from Montenegro.
Fier and Vlora: Approximately 28,000 refugees are reported to have arrived in this area. 20,000 are hosted with families and 10,000 more are in the collective centres. The redistribution of refugees is becoming a daily event here. 600 refugees were taken down from Kukes to Fier on Sunday. There are plans that 1,500 transported each day, from today on, to Fier. There is a new MSF camp being constructed in Fier. It is a smaller camp with 50 to 100 tents and the expected population is 10,000 refugees. The camp should be ready for occupation in one week. In the meantime, there has been successful distribution of food, mattresses and eating utensils to the refugees.
Collective centres are also in the focus with MSF providing medical assistance, measles vaccination, reinforcement of the local health structures, epidemiological survey and preventative health measures are underway. Water and sanitation remains in the forefront, including ensuring the safe disposal of waste water. With local families taking in as many refugees as possible, MSF is offering support with medical care and the distribution of approximately 20,000 family parcels o the host families.
In Vlora, 13 MSF tents for refugees have been delivered to the monastery. The government is sending 30 more. 200 refugees are expected to arrive soon. In Berat, MSF has built showers in the textile factory-center, and a 15 cubic m. water tank has been supplied to the military base-center.
There are approximately 12,000 refugees in this area. Many of them are either integrated in host families or are sheltered in collective centres. The figures being provided are extremely unreliable, but 3,000 refugees from Kukes were supposed to arrive last night. 900 are supposed to go a camp, run by the Greek army, in the town of Pogradec. Another 600 are destined for the flower factory in Korce. 850 more are for a site called Lozhan and 100 in the socks factory in Korce. The rest of the refugees will go to Erseke, in the Kolonia district.
MSF is supplying first aid and further medical care for refugees in flower factory. Blankets and drinking water will be distributed once the material is available. MSF has installed 12 latrines, warm water showers and organised rubbish collection. A water container is set up at the latrines for hand washing. A new Albanian MD has started in the clinic in the stadium. This clinic is also open for refugees from the host families. The team will work three days per week in a collective centre in the district of Erseke and will open a clinic there soon.
Camp population: 46,600
There are 40 expats working in Macedonia now, alongside 100 local staff. In Blace the Macedonian authorities are building a new transit camp, directly behind the border. They say that it will have a capacity of 5,000 refugees but seeing the site, our teams estimate a capacity of about 2,000. Late afternoon Tuesday, MSF was informed by UNHCR that a major influx of refugees would take place during the night. According to the UNHCR, 5,000 refugees crossed at Blace during the night and early morning. Of these 5,000 refugees 920 stayed at the new Blace site. The others were transported to Stankovic II and to Brazda.
A health post was set up immediately at the new site and work began on setting up sanitation facilities. A logistical and medical team have been deployed. They have set up a tent for medical care and stayed at the new Blace site the whole night. MSF will also try to get involved regarding health. MSF will push to do sanitation services and requested Oxfam to cover water needs who are looking into this. UNHCR is in not very clear with coordination of this camp. For the moment, MSF will remain operational at Blace site with one health post and a 24-hour presence. MSF shall also be in charge of sanitation. Camp activities are not an exclusive MSF domain. Responsibilities are divided amongst a group of NGOs, each one with specific areas of expertise and responsibilities.
At Blace, MSF is working with the following NGOs. NGO operations at the Blace Camp Mercy Corps International - camp management MSF - medical and sanitation MDM - medical ACF (Action contre la Faim) - food Oxfam - water Swiss Disaster Relief - tents Apart from the new site in Blace, the Macedonian authorities and UNHCR have decided to build a new site in Segrane, South of Tetovo.
This site will likely be much bigger than Blace and MSF will definitely get involved with medical aid. Sanitation may also be taken on, if no other agency does it. The ongoing issues of mental health with the refugees remains a concern. Many of the refugees are suffering from Post Traumatic Stress Disorder and there has been a constant need from the refugees to talk about their ordeals in order to put them into perspective. Although the massive influx of refugees always takes precedence, from a logistical point of view, there are developments to bring specific mental health strategies to the camps. The Brazda camp has been earmarked as a priority and work shall begin soon.
At the Jazince border about 2,000 new refugees have crossed and about 1,400 were directly transported to the Radusa, Bojane and Nepostana camps. The rest of them stayed behind and are bring moved later. IMC (International Medical Corps) handles the medical side at this border and also has enough blanket and plastic sheeting for them. No MSF involvement required at this moment. We continue monitoring. The decision has been taken to check both borders on a daily basis as there are a lot of rumours floating around regarding the possibility of new arrivals.
Brazda: There are 20 MSF expats currently working in Brazda. The extension for the Brazda camp has been cancelled. The 1000 refugees who where settled there are being moved into the existing Brazda camp. MSF will remain in Radusa and shall keep a medical presence and shall assist in the improvement of sanitation there. Other activities include working closely with UNICEF and the IMC to get involved in vaccination programs in the existing camps, especially Brazda which is planned for next week. Refugee absorption capacity of existing camps in Macedonia is limited. Huge influxes will have to be settled in new refugee camps, which are still to be decided upon and built). UNHCR is negotiating with the government to get these sites as soon as possible.