The NATO attacks on Serbia began at the end of March 1999.

In the space of the three months, 430,000 ethnic Albanians fleeing ethnic cleansing in Kosovo had come and gone, placing enormous strains on an already insufficient health care infrastructure.

MSF first worked in Albania in 1981. Prior to the refugee crisis, MSF opened an emergency ward and an intensive care unit in the hospital in Fier, southern Albania.

Albania is one of the poorest coutries in the eastern European community and was stretched to capacity when the ethnic Abanian population of Kosovo fled Albania to escape the Serbian forces.

MSF has been in Albania the since 1991 with the first mission and, with the aftermath of the Kosovar conflict, the challenges facing the country are enormous. 

One of the issues if the sudden flood and then exodus of non-governmental organisations (NGOs) who appeared in the country and then left immediately afterards, following the refugees back to Kosovo. Foir many, it seemed as if Albania was being abandoned.

However many NGOs have indicated their intentions to stay in the country and assist in the redevelopment of the infrastructure and economy.

Coordination of the NGO efforts is being undertaken by the Emergency Management Group which has designed a list of sectors where the NGOs can place an emphasis in the immediate future. 

There has been a preliminary approval of a handful of projects where rehabilitation of the country shall begin. 

The remaining refugees in Albania are also under the EMG mandate. However with the flood of people initially arriving and the resettling after the peace, there has been some difficulty in getting an accurate figure on the number of Kosovars remaining in Albania.