Grim examines a boy who developed a yeast infection after being treated with antibiotics for an infected scratch. “Kids in the states wouldn’t develop this,” says Grim, “but his immune system was compromised due to starvation and stress.” |
On June 9, eleven weeks after NATO began raining bombs on Yugoslavia, Slobodan Milosevic agreed to withdraw Serb forces from Kosovo. By then, more than 850,000 Kosovars had fled the region. A few refugees managed to immigrate to other countries; the vast majority are housed with host families or in refugee camps in Macedonia, Albania, and Montenegro.
The refugees’ future is still uncertain, and the obstacles to their safe return are many. Kosovars going home face land mines, booby traps, and poisoned wells. Many have no homes to return to. More than 50 percent of the homes in Kosovo are reportedly destroyed. Food is scarce. The Kosovars are likely to remain in refugee camps months after nato finalizes a peacekeeping agreement. Says Laura Guimond of Mercy Corps International, “The camps aren’t going away anytime soon.”
The problems surrounding Kosovo are by no means unique. Around the world, the estimated number of refugees and people displaced within their home countries has risen from 10 million in 1980 to 50 million today. Many refugees never return home. They stay in refugee camps, often for years.
Pamela Grim, an American emergency physician, volunteered her services at a Macedonian refugee camp during the thick of the war. This is her journal.
{5/6/99} Managers of Senokos Camp, a refugee shelter in northern Macedonia, have been notified that 4,000 to 5,000 Kosovars are to arrive. Doctors of the World, the organization that provides medical care in the camp, has called for physician volunteers, so I find myself in their headquarters in New York City, signing an insurance policy for, among other things, kidnapping, ransom, and extortion.
{5/8/99} I arrive at the headquarters of Doctors of the World emergency relief project in Skopje, the capital of Macedonia. The dominant architecture is pseudo-Soviet, cement Gothic. Senokos Camp is about an hour’s drive away, near the Macedonian-Kosovar border.
I am introduced around the office. Doctors of the World had been in Pristina, Kosovo, for six years, long before the town was in the nightly news. The staff had been evacuated two days before the bombing began in March. In the kitchen I meet the cook, an elderly Kosovar who has been here a month. As she serves me potatoes and Turkish coffee, she tries to explain something. But she speaks no English. She seats herself abruptly, takes off her glasses, glares around the room, and starts to cry.
My welcome to the war.
Later that evening, we head off to Senokos Camp. It is just dusk when we arrive. The guard waves us through the chicken- and barbed-wire fence that surrounds row upon row of tents. The medical clinic is a small complex of three tents joined by an awning.
Their future uncertain, Kosovars arriving from the border wait to be checked into the camp. |
I am told she was bitten by a horse two weeks ago, just before the Serbs cleared Pristina. The family fled; the bite went unattended. While they waited a week at the Macedonian border, the girl’s wound festered and eventually turned gangrenous. Finally, the family came to this camp, where an orthopedic surgeon, also a Kosovar refugee, saw the wound and dressed it. As I unwrap the dressing, the orthopedic surgeon silently materializes beside me. “It was an open fracture,” he tells me in gruff English. “Very bad, very bad.”
He was separated from his fiancée and does not know if
she is alive or dead
We unveil the wound. The index finger is broken; it cants off at an odd angle. Two large wounds on either side of the finger had obviously extended to the bone. Each laceration involved half the finger, at least, but if they were once infected, they are now quite clean. The red angry flesh I see is actually good, healing tissue.In the United States, a surgeon would have put the bone back into place and secured it with a metal pin. In the transit camp, however, the best the orthopedist can do is splint the wound and dress it.
“Fantastic,” I say looking up, “this wound looks great.” The orthopedic surgeon smiles. I’m not sure how he did it, but he saved this child’s hand.
{5/9/99} Several of the doctors working in the camp are Kosovars who fled when the war began. The doctor in charge of the camp health facilities, Visar Nushi, fled Pristina a few days after the bombing started. He was separated from his fiancée and does not know if she is alive or dead. He does not know if his parents are alive or dead. His sister—with his two nephews—has also disappeared. Still, Visar puts in 14-hour days, organizing the camp, hiring and scheduling the doctors, arranging the supplies, fighting with local health authorities. He works from 8 a.m. to 10 or 11 at night. He has done this for six weeks without a day off.
Senokos Camp in Macedonia has more than 700 tents—each housing 10 to 15 people. The camp’s tents, kitchens, clinics, and day care centers cover about 14 city blocks. |
The married women tend to remain in the tents, out of public sight, as is traditional in Islamic societies. The girls, though, parade back and forth, hair nicely combed, heads held high, jeans tight, T-shirts short enough to reveal their young bellies. They walk with their girlfriends or lead their small brothers and sisters by the hand or sometimes even walk with their boyfriends. They are the scandalous next generation.
Senokos Camp is about 30 miles from Skopje, Macedonia. |
We are starting to experience similar problems. Today a doctor treats a refugee with two teeth knocked out by another refugee. There was no disagreement; they didn’t even know each other. The assailant had just walked up to this man and kicked him twice in the face.
As I fuss with paperwork, Drew Fuller, an American internist, sees the first patient of the day. A 32-year-old woman has been brought in by her husband. She is accompanied by their 4-year-old son. The mother sits on the stretcher, looks around cautiously, and then stares up at Drew. She says something in Albanian.
“She has a headache,” the translator explains.
Drew gives her a minute to continue, but the woman says nothing.
“How long has she had it?”
The woman just stares off into the distance. Then she covers her face with her hands. Her shoulders start to shake; she is weeping noiselessly.
“What’s the matter?” Drew says. The translator prods the woman verbally. She says something from behind her hands.
The translator frowns. “She says she just found out her mother and her father were massacred in Kosovo. They are dead.”
The woman weeps. Beside her, her son stares up into the woman’s face, confused. He is too young to understand what grief really is. His hand reaches up to his mother, and he starts sobbing in sympathy.
BBC News: Kosovo
International Committee of the Red Cross: Balkan conflict
Kosovo Crisis Update from the UNHCR
Doctors of the World
