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By Sarah  Poole
Associate Editor

MSF Provides Aid to Kosovar Refugees

Doctors Without Borders/Medecins Sans Frontieres (MSF) is the world's largest independent international medical relief agency aiding victims of armed conflict, epidemics, natural and manmade 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 80 countries. Doctors Without Borders/Medecins Sans Frontieres has been providing medical aid throughout the former Yugoslavia since 1991. MSF's extensive projects throughout the region have ranged from emergency surgery, to rehabilitation of hospitals, to mental health care. MSF has worked in Kosovo province since 1993. Until the recent fighting began, MSF teams were responsible for supplying medicines to health clinics, upgrading water and sanitation systems and conducting a major vaccination campaign for children. When attacks on ethnic Albanian villages began occurring in the summer of 1998, the Kosovo medical team turned its attention to aiding tens of thousands of people who had been internally displaced within Kosovo, many of whom sought shelter in rugged forests throughout the winter. After NATO strikes began, Doctors Without Borders and the International Committee of the Red Cross were the last aid organizations to evacuate from Kosovo's capital, Pristina. The evacuation took place on March 30, 1999 when insecurity rose and the team could no longer gain access to villages under attack. As refugees began spilling out of Kosovo and into Macedonia, Albania and Montenegro, Doctors Without Borders prepared for a major emergency. Medical and nonmedical staff rushed to two neighboring countries and Montenegro, and on April 1, 1999, the organization sent its first cargo flights of emergency supplies, such as water pumps, sanitation equipment, medical supplies, emergency food, blankets, electric generators, tents and plastic sheeting to Macedonia and Albania. One MSF doctor, Martin Tekulve, described the scene in Macedonia on April 1: "It's really hard to describe. You can see in the eyes of the refugees.they are extremely overstressed, they are tired, afraid.Some people were able to grab a few things when they left Pristina.most had no time to take anything. They had to pass checkpoints on the way to Macedonia, where they were stripped of their belongings, so they have no passports or papers." There are 100 Doctors Without Borders international volunteers and many more local staff working on the refugee effort. Doctors Without Borders has now sent 22 cargo flights to the region. In Albania, Doctors Without Borders is working in several regions. In the northern village of Krume along the Kosovo border, Doctors Without Borders staff is providing direct medical care, supplying the local hospital and clinics with medical supplies, carrying out a measles and polio vaccination campaign and distributing hygiene supplies to refugee families. In Kukes, Doctors Without Borders is building latrines and supplying water to serve about 15,000 people. In Fier, in southern Albania, Doctors Without Borders, together with local health authorities, is working in several collective refugee centers, distributing medicines and baby foods and setting up water and sanitation systems. In Macedonia, Doctors Without Borders is providing medical care in several refugee camps. Medical teams report that people in the camps are exhausted, some having waited for six to eight days before crossing into Macedonia. Outside the refugee camps, people are waiting and searching for family members. In the chaos at the border, many families lost each other in the crowd. Twenty-two Doctors Without Borders international volunteers are working in a number of locations in Montenegro. They are seeing many refugees who are in very poor health, including those suffering from bullet wounds. MSF volunteers are distributing nutritional biscuits and blankets and providing water, sanitation and medical services at both entry points and refugee camps in Montenegro. Doctors Without Borders has completed an assessment of mental health needs in all of the settings where refugees are currently gathered (camps, host families and hospitals). Christina Moore, a Doctors Without Borders psychologist from Connecticut, is responding to individual requests for mental health assistance (provided with the help of a translator). A pilot project is being set up in Kukes to train medical, mental health, and community workers in identifying mental health problems and giving counseling. "In terms of treatment needs, the mental health of the refugees is a big issue of importance. A lot of what we are doing is psychological support. Many people that we see are not very sick but they have a huge need for attention - they need to talk to somebody," said MSF nurse Mary Lightfine, a 43-year-old American working in Brazda refugee camp. Chronic diseases are also a major problem for the refugees, according to MSF staff reports. ".there is really a large number of elderly people who have all sorts of chronic diseases which have been under ongoing treatment in Kosovo," said Christa Hook, a 56-year-old doctor from Edinburgh, Scotland. "When they were displaced, this treatment was stopped and they are now having a lot of problems with their diseases getting out of control, like high blood pressure, chronic lung disease, chronic heart disease. There are a lot of people who had major heart surgery and had their follow-up drugs stopped suddenly." ******************************* How to Become an MSF Field Volunteer All potential field volunteers must be interviewed by a human resources officer in one of the sections before they will be considered for a posting. Some sections organize regular information meetings for people who are interested in becoming an MSF volunteer. In general, it is an advantage to have some experience living or working in different cultural contexts. MSF operates with international teams, and a good command of English and/or French is useful, as is a second or third language, such as Spanish, Russian, Arabic, Chinese, Swahili or Portuguese. Whenever timing permits, a successful candidate is invited to take part in an introductory course and then goes on stand-by, awaiting the first suitable mission. There is no age limit for volunteers. However, applicants should have at least two years professional experience in their areas of specialization. Humanitarian work is professionally demanding, and MSF does not have positions available for students. The average mission period is six-12 months, although specialists, such as surgeons, may be sent for shorter missions of up to three months. An administrator is likely to stay in a capital city position for one year, and volunteers of all profiles sometimes extend their six-month missions before handing over to a replacement volunteer. Flexibility is a core value in MSF. In general, MSF is looking for health professionals, administrators and logistics staff. Of the medical professions, MSF recruits general practice doctors, nurses, surgeons, anesthesiologists and other specialists in such areas as tropical medicine, public health and epidemiology. In some projects, MSF also needs midwives and laboratory technicians. Non-medical volunteers look after the administration and logistics of the project. Administrators are responsible for management of project finances and may supervise locally recruited office staff. They are usually based in the capital, although in large project countries, administrators with bookkeeping functions sometimes work with teams in the field. Logisticians are responsible for the management of stocks, freight, vehicles, communication systems and building or water projects. MSF insures its volunteers for the period during which they are on mission. This includes coverage in case of medical evacuation, illness and death. MSF also pays all travel and living expenses associated with a volunteer's mission. A small stipend is paid to volunteers. This varies from section to section, according to the years of field experience that the volunteer has with humanitarian projects. Only in rare circumstances can missions be found for a couple in which both partners are qualified to work for MSF. To find out more about how to apply to become a field volunteer: In the US, contact: Doctors Without Borders/MSF, 6 East 39th Street, 8th Floor, New York, NY 10016; phone: 212-679-6800; fax: 212-679- 7016. If you are outside the US, please visit the website at for other offices worldwide.

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