This report provides a daily update for the regions of Albania, Macedonia and Montenegro.

MSF has operations throughout the districts with repsonsibilities ranging from developing ongoing water and sanitation needs to constructing new camps to meet the demands of the refugee influx.

Part of the ongoing dilemma for humanitarian aid providers is the constantly changing demands placed upon them. Accounts are that there can be a flood of thousands of refugees each day for days and then only a few hundred appear on the following day.

News reports there are thousands of refugees caught in the 'no man's land' and still more are fleeing Kosovo for the borders. Over 100 MSF expats are working in Albania, Macedonia and Montenegro and over 588 tonnes of supplies have been flown into the region.

Albania

Kukes

With almost 30,000 refugges crossing into Kukes over the weekend, the existing reception capacity in Kukes is now completely overloaded.

People are forced to stay outside the camp in bad conditions, due to the lack of available space. One solution is to try and transport the refugees further inland and authorities are trying to relocate people using cars and buses.

MSF remains active with camp construction as well as a health post functioning in the camp. As has been the case from the beginning, there has been a demand for mental health care and the programme is ongoing.

The camp construction started on Saturday and is designed to hold 4,000 to 5,000 people. By the end of Sunday afternoon, 2,000 people were staying in the 100 tents put up so far. The Italian and French armies are both setting camps to try to cope with the new influx.

Poor weather has been very detrimental. All camps, MSF included, are suffering from wet weather. The camps are very muddy but, fortunately, an abnormal amount of diseases is not seen yet. Security is an issue and a fence is being set up.

Korce

Aid workers are bracing themselves for an influx of 40,000 refugees. MSF is prepping for the influx and continues with medical consultations in the sports stadium. As always, providing water and sanitation remains a constant activity.

Fier

MSF has been given permission to construct a camp at Fier but the size shall be about 50 to 100 tents to prevent it from becoming an alternative for the collective centers

Shkoder

This is a new locale for MSF and the group remains on stand-by there for a possible influx of refugees from Montenegro. 

The Southwest: Fier, Vlora, Berat

This district has already absorbed about 28,000 refugees and most have been taken in by host families. MSF is targetting the collective centres and assisting local families.

Collective centres present unique problems. Centres are mostly buildings (factories, schools, buildings), versus tent camps, and the buildings have been adapted for use by the local refugees. It means the population is scattered far wider, presenting certain logistical problems for support.

Currently there are In Fier, there are currently 2,397 refugees in eight buildings. In Vlora, there are currently 2,900 refugees in three buildings.

In Berat, there are currently 1,650 refugees in two buildings. Another 300 are at a military base but it has the capacity for 2,500. 

Macedonia

Brazda camp

As mentioned in previous reports there are two MSF clinics operating in Brazda with over 1,000 consultations a day in total. The hours of the clinic are flexible, operating longer hours when more refugees arrive. One has reported to have operated for a 24 hour shift to meet the demands. The refugee population, according to the UNHCR is approximately 25,000 people.

Radusa Camp

Population: 1,200 - 1,400 - according to the Macedonian Institute of Health.

General Situation

The Bulgarian army will provide medical aid in Radusa camp. The army doctors have set up a sort of policlinic with ten doctors, eight nurses and a pharmacist. MSF will remain in the camp for the coming days to monitor the water and sanitation, protection and mental health sitaution.

From Monday, April 19th, onwards the Bulgarian army will also start to distribute hot meals for the refugees in Radusa. They have brought five kitchens to prepare the meals. So far the refugees had no access to hot meals. In contradiction to earlier sitreps, Radusa camp will most probably not be moved by UNHCR, because of other camps being overcrowded right now.

Mental health

MSF is hoping to set up a support system for the camps and the outlying communities. More info later this week.

Skopje and surrounding Districts

Plans are being made to support El Hilal (israeli NGO) in Skopje where there are approximately 40,000 refugees among host families (source El Hilal).

MSF Activities

Assessment in the district continues and concrete plans will be made asap to support the existing medical structure in the areas mostly affected by refugee influx. Support can be given through mobile clinics, support MoH and or local NGO. More info soon.

Emergency preparedness

A contingency plan has been set up to provide medical aid for 50,000 new arrivals and to non-medical supplies for 10,000 people. It is expected that more refugees want to cross the border. It is unclear how long the border will remain open.

Montenegro

During the past two days, 200 displaced people arrived from Kosovo in Rozaje, Montenegro. This is a trickle when compared with the more than 3,000 people who have arrived daily over the past few days.

Rozaje

Tension is rising very seriously in Rozaje between the Federal Forces, which is Serbian, and the Montenegrin forces. Belgrade announced publicly that the Montenegrin vice prime Minister should be arrested. A number of federal reservists along with militias are now around Rozaje.

MSF Activities

Due to increased tensions, the team will not move too far from Rozaj. They will continue their work in Cristal and Dakor displaced camps providing medical, logistical and water and sanitation.

General Situation

Team reports a general feeling of fear among the population in Rozaje.

MSF position

As a consequence of the deteriorating situation, a number of displaced people are willing to leave Rozaje. But it is still very expensive and unsafe for them. There is a huge problem with the protection and the safety of these refugees. The team is particularly concerned by the fate of the people whose passports were destroyed by the Serbian soldiers.

UNHCR is, for the moment, still not ensuring its role. Only one protection officer is on the field and not based in Rozaje. In a meeting planned tomorrow in Geneva, MSF will push for the voluntary displacement of these displaced people to another safer place, such as Ulcinje or Albania, under the supervision of UNHCR and protection of the Montenegrin authorities.

Ulcinje

There are some problems with local authorities in Ulcinje with the willingness to have more refugees arrive. There is a need to check on the local availability of space. There is still no information on the number of people going to Albania in the future.

MSF Activities

In Ulcinje, the team is still trying to improve the living conditions in the Neptune camp where there are more than 1,000 people.

Plave

Exploratory mission planned for Plave is on stand-by because of insecurity. Team planning to go to Tuzi, the passage point to Albania.

MSF Supplies

A new full charter is to leave Bordeaux to go to Croatia on Wednesday loaded with milk and beans.