May 17, 1999

High Rents, No Registration or Protection and Lack of Medical Care Among Worrying Findings of Survey

New York/Kukes, Albania, May 18, 1999 — Many Kosovar refugees in northern Albania are not receiving adequate international aid because they are housed in host families. They are fast running out of money to pay for food and shelter and have no access to basic medical care.

These are the findings of a survey among Kosovar refugees hosted by Albanian families, carried out by the international medical relief organization Doctors Without Borders/Médecins Sans Frontières (MSF) in late April.*

"What is often overlooked is that only 10%-15% of the Kosovar refugees in Kukes are sheltered in tented camps," says William Perea, MSF epidemiologist who led the survey. "They are much more difficult to access than refugees in camps, and as a result do not get the protection and assistance to which they are entitled as refugees."

None of the households interviewed had a registration card or any other document identifying them as refugees. Until all refugees are registered properly, distribution of aid and protection cannot be ensured. "That the majority of refugees are falling through the net is scandalous at a time when Albania is receiving unprecedented humanitarian, political, and media attention," says Perea. "UNHCR must register and protect these refugees as a matter of absolute priority."

The survey found that 61% of apartments or houses in Kukes were housing Kosovar refugees. Half of the Albanian families not hosting refugees had done so during the preceding month. The average number of Kosovar refugees per housing was 13. More than 60% of Kosovar households hosted in families were paying rent. (20% paid no rent and 18.5% were staying with relatives.) The average rent paid by families was $137 per month. Even when refugees receive food, they often need to buy additional baby food and hygiene items. Many are running out of money.

At the time of the survey, 20% of the refugees in the host families had not received food aid at all. Since then, distributions have been taking place. However, the vulnerability of this population remains a major concern.

Refugees are also vulnerable to abuse in the community such as organized crime, including extortion. In one refugee camp run by MSF, people have requested night-time security above anything else, including food and water.

A further indication of the vulnerability of the refugees is family makeup: over half of the refugee households were female, but the proportion of females was higher among the 15 to 54 age group. Each household had a high number of elderly relatives (8%), many with chronic diseases such as diabetes and cardiovascular disorders that require special medication and follow up. A third of families (34%) reported at least one member of the household absent (not in Kukes). Over 60% of absent family members are male, between 15 and 54 years old; 32% had joined the KLA.

Results also confirm serious human rights abuses in Kosovo. Over two-thirds (70%) of the Kosovar families reported being physically or verbally threatened by armed militias or military forces or terrorized by systematic acts of vandalism including burning and shelling of their villages; 6% were compulsorily sent in collective buses or escorted to the Albanian border by armed forces; 23% left because of fear of Serbian aggression; 43% of deaths occurred after the beginning of the NATO offensive; 56% of these deaths were explained by acts of violence by Serb police or military forces (out of 16, 7 were male adults and 2 were children under 10).

MSF is the world's largest independent international medical relief agency aiding victims of armed conflict, epidemics, and natural and man-made disasters, and others who lack health care due to geographic remoteness or ethnic marginalization. Each year the organization sends more than 2,000 doctors, nurses, other medical professionals, and logisticians to provide medical aid in more than 83 countries.

*The MSF/Epicentre survey was conducted between April 25 to 27, 1999, in Kukes, northern Albania among 195 houses or apartments. Two weeks after an initial survey was conducted, information about the problems refugees are facing, the makeup of their families and what they have been through is still representative. Detailed explanations concerning the causes of the "departure" from Kosovo were obtained from 197 families housed in families and tractor camps.

Note: To guarantee its independence and impartiality in the Kosovo crisis, MSF is not accepting funding from NATO member governments for any of its relief programs in the region.

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