It is estimated that more than 355,000 refugees have entered Albania, with 45,000 new refugees arriving in Kukes in the past three days (April 17-19, 1999). Population demands are still pressing and MSF has begun the construction of two camps - one in Kukes and the second on Fier - to accommodate the current and new refugees.

Apart from the camps, MSF responsibilities also extend to the refugees in the collective centres and those housed with local families. In addition, MSF is involved in water and sanitation needs development, data collection, providing temporary shelter and collecting testimonies from the refugees. Project development can be broken down to four major geographical targets:

1. The North: Kukes and Krume - the border points where the refugees arrive.  
2. The Northwest: Shkoder, near the border with Montenegro.  
3. The South: Prefectures of Fier and Vlora  
4. The Southeast: Korce      

The North  

Kukes

WIth the influx of 45,000 refuges in 72 hours, all forms  of accommodation in the area have been saturated. The Kukes area  already has 100,000 refugees, mostly absorbed by host families.  With the population saturation comes the additional worry that  the border situation is quite tense.  The new MSF camp is designed to hold 4,000 to 5,000 people.  Even though it is not complete, there are already 2,000 refugees  living there. The tents are organised, numbered and the  occupants registered.  Food distribution is being carried out GOAL, an Irish aid agency.

The MSF water bladders and taps are in place and functional. Blankets  and plastic sheeting have been distributed by MSF. Latrines have been dug  should be fully functional today. There is an MSF health post operating in the camp and volunteers have been recruited by Christina Moore for a peer counselling programme. The volunteers shall be receiving training before being sent into  the field.

MSF is carrying out surveys of the camp and area to be sure health  needs are being met and recording the make-up of family units. In the future, there is a measles vaccination campaign in the works  with the Ministry of Health and UNICEF.  MSF also has plans to improve the sanitary facilities of the  makeshift camps and to give technical sanitation advice to  the regional health authorities. NATO has announced it will build an emergency transit-camp for people  who cannot be transported to the south of the country immediately,  serving as a reception point with a medical post and the basic necessities. NATO will also provide trucks with the capacity to take 15,000 to 20,000 refugees per day to the south of the country.      

Krume  

The situation in Krume is very quiet, with no major security-problems.  The refugees in the mosque and the chicken-farm collective centers  want to stay in the region, but will move soon to a camp set up by  NATO-countries (France or Germany) in Fazaj.  MSF has set up a medical triage point in Krume and is carrying out  consultations. There have been 322 to date. In addition, we are  collecting data on human rights violations.  MSF have put 12 water taps in place and is planning  a mental health programme. Also in the plans is a reinforcement of  the national health infrastructures and we shall be distributing basic  health kits.      

Northwest

Shkoder

An MSF team is on standby in case of influx of refugees from Montenegro.

The South  

Fier and Vlora

Approximately 28,000 refugees are reported to have arrived in this  area. 20,000 are hosted with families and 10,000 more  are in the collective centres.  The redistribution of refugees is becoming a daily event here. 600  refugees were taken down from Kukes to Fier on Sunday. There are plans  that 1,500 transported each day, from today on, to Fier.  There is a new MSF camp being constructed in Fier. It is a smaller  camp with 50 to 100 tents and the expected population  is 10,000 refugees. The camp should be ready for occupation  in one week.  In the meantime, there has been successful distribution of food,  mattresses and eating utensils to the refugees.  

Collective centres are also in the focus with MSF providing  medical assistance, measles vaccination, reinforcement of the  local health structures,  epidemiological survey and preventative health measures are underway.  Water and sanitation remains in the forefront, including ensuring  the safe disposal of waste water.  With local families taking in as many refugees as possible,  MSF is offering support with medical care and the distribution  of approximately 20,000 family parcels o the host families.  

In Vlora, 13 MSF tents for refugees have been delivered  to the monastery. The government is sending 30 more.  200 refugees are expected to arrive soon.  In Berat, MSF has built showers in the textile factory-center,  and a 15 cubic m. water tank has been supplied to  the military base-center.      

Southeast  

There are approximately 12,000 refugees in this area. Many of  them are either integrated in host families or are sheltered  in collective centres. The figures being provided are extremely  unreliable, but 3,000 refugees from Kukes were supposed to arrive last night. 900 are supposed to go a camp, run by the Greek  army, in the town of Pogradec. Another 600 are destined  for the flower factory in Korce. 850 more are for a  site called Lozhan and 100 in the socks factory in Korce.  The rest of the refugees will go to Erseke, in the Kolonia district. 

MSF is supplying first aid and further medical care for refugees in  flower factory. Blankets and drinking water will be distributed once  the material is available.  MSF has installed 12 latrines, warm water showers and organised rubbish  collection. A water container is set up at the latrines for hand washing.  A new Albanian MD has started in the clinic in the stadium. This clinic  is also open for refugees from the host families.  The team will work three days per week in a collective centre in  the district of Erseke and will open a clinic there soon.      

Macedonia  

General situation 

(UNHCR figures)  

• Camp population: 46,600  
• Families/communities: 80,600  
• Total: 127,200  

There are 40 expats working in Macedonia now, alongside 100  local staff. In Blace the Macedonian authorities are building a new transit camp,  directly behind the border. They say that it will have a capacity  of 5,000 refugees but seeing the site, our teams estimate a capacity of about 2,000. Late afternoon Tuesday, MSF was informed by UNHCR that a major influx of refugees would take place  during the night.  According to the UNHCR, 5,000 refugees crossed at Blace during  the night and early morning. Of these 5,000 refugees 920 stayed at  the new Blace site. The others were transported to Stankovic II and to Brazda.  

A health post was set up immediately  at the new site and work began on setting up sanitation facilities. A logistical and medical team have been  deployed. They have set up a tent for medical care and  stayed at the new Blace site the whole night. MSF will also try to get involved regarding health. MSF will push  to do sanitation services and requested Oxfam to cover water needs  who are looking into this. UNHCR is in not very clear with coordination of this camp. For the moment, MSF will remain operational at Blace site with one health post and a 24-hour presence. MSF shall also be in charge of sanitation. Camp activities are not an exclusive MSF domain. Responsibilities are divided amongst a group of NGOs, each one with specific areas of expertise and responsibilities.

NGO operations at the Blace Camp

At Blace, MSF is working with the following NGOs:

• Mercy Corps International - camp management  
• MSF - medical and sanitation  
• MDM - medical  
• ACF (Action contre la Faim) - food  
• Oxfam - water  
• Swiss Disaster Relief - tents  

Apart from the new site in Blace, the Macedonian authorities and UNHCR have decided to build a new site in Segrane, South of Tetovo.

This site will likely be much bigger than Blace and MSF will definitely get involved with medical aid. Sanitation may also be taken on, if no other agency does it. The ongoing issues of mental health with the refugees remains a  concern. Many of the refugees are  suffering from Post Traumatic Stress Disorder and there has been  a constant need from the refugees to talk about their ordeals in  order to put them into perspective. Although the massive influx of refugees always takes precedence,  from a logistical point of view, there are developments to bring  specific mental health strategies to the camps. The Brazda camp has been earmarked as a priority and work shall begin soon.  

At the Jazince border about 2,000 new refugees have crossed and  about 1,400 were directly transported to the Radusa, Bojane and  Nepostana camps. The rest of them stayed behind and are bring moved  later.  IMC (International Medical Corps) handles the medical  side at this border and also has enough blanket and plastic sheeting  for them. No MSF involvement required at this moment. We continue  monitoring.  The decision has been taken to check both borders on a daily basis  as there are a lot of rumours floating around regarding the possibility  of new arrivals.    

Brazda

There are 20 MSF expats currently working in Brazda. The extension for the Brazda camp has been cancelled. The 1000  refugees who where settled there are being moved  into the existing Brazda camp. MSF will remain in Radusa and shall keep a medical presence and  shall assist in the improvement of sanitation there. Other activities include working closely with UNICEF and the IMC to get involved in vaccination programs in the existing camps, especially Brazda which  is planned for next week. Refugee absorption capacity of existing camps in Macedonia is limited. Huge influxes will have to be settled in new refugee camps, which are still to be decided upon and built). UNHCR is negotiating with  the government to get these sites as soon as possible.