They live in former hotels, motels and schools. MSF supports them on a daily basis and helps them with the process of finding better long-term solutions. From January 2006, a new NGO, Nexus, created by the local MSF staff will take over these activities.

Since 1999, more than 250,000 ethnic Serbs have fled Kosovo. Most of them were pushed out in retaliation for years of Serb domination. Others left in March 2004, when Kosovan Albanians staged riots; burning Serb houses, fields and churches.

In Pcinja district, in the south of Serbia, about 6,000 displaced people still live in collective centres. Since the Serbian government decided that the centres should be closed, MSF, through its' psycho-social programme, has been supporting families in the relocation process: moving back to Kosovo or settling in Serbia.

This support consists mainly of guiding people through the administrative maze. In the meantime, intensive work in the centres goes on every day. Our teams work in 15 of them, in the towns of Vranje, Vransjka Banja and Bujanovac. There are 260 families, or 900 people, living in these places.

Six years after the war, displaced Serbs still live in collective centres in appalling conditions

The collective centres are overcrowded, dirty and lack even basic privacy. Two or three generations often have to share a few square metres. In Vransjka Banja, the Vila Balkan Hotel is a metaphor of its inhabitants' lives. The plaster on the walls is peeling off year after year, water leaks eat away at the floor, maintenance is minimal and the rooms are tiny.

© Espen Rasmussen

It is in one of these minuscule rooms on the first floor that Aca's wife lived out the last six years of her life. She died recently and Aca now lives with his son, who is 40. The terrible event of the death diverts them for a while from their doubts about the next step in their lives. Will they move back to Prizren in Kosovo to rebuild their house? Will they settle in Serbia?

Dusica Peric, MSF social worker, explains that "people do not know where to seek help and are completely lost. They feel like they are evolving in a vacuum, that they have nowhere to go."

Like many displaced people, Aca has lost the ability to see himself in the future because of the burden of many constant doubts and fears. Ethnic violence in Kosovo, slow and exacting administration in Serbia: these are the seemingly insurmountable obstacles that, ironically, make the misery of collective centre the only stable option in sight.

From under his mattress, Aca pulls out a note from the doctor. This note illustrates a success of the MSF team: creating links between the region's health centres and the displaced population. A member of the MSF team helps him understand what is written on the note, and confirms that Dr Lilly, the MSF doctor, will drop by this week.

MSF also helps Aca with his request for a disability pension. He has a problem with his hip. The process is complex and the main challenge is to find written proof of his working life in Kosovo. Most of the archives have been moved or were destroyed after the war.

© Espen Rasmussen

In the collective centres, mental health care is almost non-existent.

Aca spends a lot of time in the MSF activity room, where he plays chess with companions in misfortune. The activity room also hosts a range of weekly workshops; from knitting to cooking classes, activities for mothers and their children and for adolescents. The educational games and activities give people the chance share some of their experiences on an informal basis outside the collective centres.

Addressing mental health issues is crucial for this highly vulnerable population. Unfortunately, that kind of support falls short of the enormous needs. For instance, psychiatric patients are often left to their own devices. People with lighter mental health problems like anxiety generally go unnoticed.

Jean-Yves Penoy, project coordinator in Vranje, highlights that "mental health services do exist in the region and displaced people are granted access to those. But in reality, coordination problems are a huge obstacle in terms of access. On a daily basis, MSF creates links between beneficiaries and local institutions."

In addition to that, in collaboration with the National Institute for Mental Health, MSF provides training to local doctors so that they can identify possible mental health problems among their patients.

Reconnecting people with institutions and society in general is the main goal for MSF in Southern Serbia – and for Nexus in the future.

Like Aca, thousands of people have been rejected by two societies, through violence or neglect, and are ignored by the rest of the world. For the forgotten people of the Balkans, every letter written on their behalf, every application lodged, and every bandage checked is vital proof that somebody cares.

* On 28th November 2005, Aca died of a stomach cancer.