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Department of Public Information . News and Media Division . New York

14 April 1999

The immediate health needs and psychological trauma of children were the focus of the United Nations Children's Fund (UNICEF) at the moment, its Executive Director, Carol Bellamy, told correspondents at a Headquarters press briefing this morning, following her recent visit with Kosovo refugees in Albania.

Ms. Bellamy said that she had travelled on Saturday morning to Tirana and spent the day there. On Sunday, she had gone to Kukes, and then had left Albania on Monday. Although UNICEF had activities in the former Yugoslav Republic of Macedonia, she had not travelled there. There was currently no staff in Kosovo, but there was still some local staff in Belgrade. There was also an office in Montenegro.

While in Tirana, she had visited with officials, including the President, Prime Minister, Foreign Minister, and Ministers of Health, Education, Labour and Social Development, she said. She had also visited a camp set up in Tirana, that had received some of the earliest refugees. While there, she had seen a tent that had been set up, where kids could come and where volunteers would work with them, with minimal supplies, such as paper, crayons and putty. In Kukes, she had visited an area where many had camped out, largely living out of the back of long wagons. She had also visited a few health posts established in some locations, had helped kick off an immunization campaign, and had met with local officials.

The Office of the United Nations High Commissioner for Refugees (UNHCR) was the lead agency, and their focus at the moment was on shelter and registration, she said. While in Kukes, she had met with UNHCR representatives there, High Commissioner for Refugees Sadako Ogata's Special Envoy, and representatives of the World Food Programme (WFP), World Health Organization (WHO) and the International Monetary Fund (IMF).

UNICEF's focus had generally been on emergency health intervention, she continued. While it had already had some supplies stocked, no one had anticipated the scale of the "ocean of people" who had come out of Kosovo. Basic health supplies included emergency health kits, a single one of which was aimed at serving about 10,000 people for a three-month period. Basic essential drugs such as antibiotics, medicines and oral rehydration salts were among the items provided.

The agency had also focused on water, and had distributed five tons of chlorine for disinfecting water by last week, as well as water tanks, she added. Children's blankets and clothing were also part of the overall kinds of supplies being provided. The UNICEF had also identified doctors and nurses among the refugees, who were given medicine and minimal, simple health equipment.

Among her observations was that the general health conditions of the people and children were not terrible, she said. Nevertheless, they were vulnerable. The later refugees were in less healthy conditions than the earlier ones. There had been no major outbreaks of diseases, but there had been some cases of measles identified. Thus, with the WHO and the Albanian Ministry of Health, UNICEF had started an immunization programme, largely focused on polio and measles to avoid an outbreak.

Further, the refugees were living outside and conditions were deteriorating, she added. Those coming over now had generally been out in the "elements" longer and so their health conditions were not as good as those of the people who had come over earlier.

A major problem with unaccompanied children, or children separated from their families, had not yet been identified, she said. However, it had been more of a problem in the former Yugoslav Republic of Macedonia. To date, in conjunction with the International Committee of the Red Cross (ICRC), UNICEF had identified more than 100 children, who had been separated from their parents. There were a number of ways of trying to reunite them. Polaroid cameras and pictures could be useful if there was a place where everybody could look at them. The current concern was to avoid further separations.

Another concern was the psychological impact on children of what had happened, she said. The most immediate response was trying to identify, within the refugees themselves, some teachers or community workers. Also, a couple of months ago, UNICEF had completed training about 30 Albanians in psychosocial trauma, and several of them had been sent to Kukes. They were trying to use simple engagement techniques with the children, including play and games. Clear signs of the psychological impact could be seen, including children being extremely quiet or being hyperactive.

She said that over 300,000 Kosovo refugees had flooded into Albania, which was the poorest country in the region. In addition, one of the reasons for the immunization programme was that immunization coverage in Kosovo was far lower than immunization coverage in Albania. Hence, they were trying to avoid the outbreak of diseases.

The implications for the already over-stretched, sometimes non-existent, health and education systems were quite shocking, she continued. How long host families in Albania would be able to provide assistance for the refugees was unclear. The hope was that they would be able to return home soon. The UNICEF had doubled its staff in both Albania and the former Yugoslav Republic of Macedonia, and was prepared to go back into Belgrade to respond to children there, as soon as it could. The same was true for Kosovo, where contingency plans had already been put together with the UNHCR and the WFP.

Regarding criticism of the slowness of the United Nations agencies in doing anything on the Albanian border, Ms. Bellamy said that there had been an almost immediate response by the United Nations agencies when the crisis had started, but the response had been inadequate, because nobody had anticipated the scale and the speed at which it had happened. Unlike other events, UNICEF actually had stock located there and so were able to respond immediately, although inadequately.

While she was in the area, she continued, there had been a recognition that things, while not in order, were much more under control than they had been the week before, on the humanitarian side. While there were valid complaints that the response had been inadequate in the beginning, it was now closer to being adequate.

With regard to the focus of the immunization campaign, she said that cholera was also of great concern in addition to polio and measles. Chlorine, water testing kits and some water tanks had been provided, and more were on the way.

In response to a question on UNICEF's small staff remaining in Belgrade, she said that currently there was very little they could do. She heard from them through e-mail, and they were still trying to do some things, but the conditions did not permit them to do much. The UNICEF was in the process of developing contingency plans for returning, and seeking visas for international staff to go back in, when the security situation allowed them to do so. While it was UNICEF's intention to go back in, there was nothing they could do at the moment.

She added that she had not, in New York, received any requests from the Yugoslav authorities for help, but her staff in Belgrade had received miscellaneous requests for help. It was hard to tell if they were official requests by the Government, but they had been getting calls for humanitarian help.

Elaborating on how UNICEF was preparing to cope with the psychological trauma, she said that the first thing it was doing was to try, in areas with large refugee concentration, to identify teachers and community workers within the adults and involve them in play with the children. It was an effort to bring in a simple way, some amount of normalcy into what was a totally abnormal situation.

In the medium term, the agency hoped, to the extent that camps were set up, to begin some informal schooling. One of the materials UNICEF provided, which had been used in Bosnia and Rwanda, was "school in a box/bag", which included booklets and pencils. The hope for the long term was that the refugees would be able to return to their country, and that the Albanians, Macedonians and Montenegrins would be able to restore some normalcy in their lives.

Asked if UNICEF would be doing any more training programmes in the psycho-social field, she said that there had been a training scheduled for Albania for next month which they now hoped to do by next week. Additional staff with expertise in the area were also being added.

Responding to a question on whether she knew what was happening to the people inside Kosovo, she said that she had heard what everyone else had heard. Nobody knew where the people were, and there were clearly a number of people still in Kosovo. One could only assume that a number of people had fled into the forests and their physical conditions were deteriorating.

In response to a question on the agency's method of operation, she said that neither UNICEF nor any other United Nations agency was able to function in Belgrade at the moment. They were prepared to do so as soon as security allowed them to do so. If UNICEF had access to Kosovo tomorrow, it would go there tomorrow. Contingency plans had been set up and they were ready to go in and provide humanitarian assistance when it was possible to do so.

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