Death, disease belie spring in Kosovo

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By Fran Hesser
Special to CNN Interactive

GNJILANE, Kosovo (CNN) -- The arrival of warm weather has made Kosovo a much more pleasant place to live. But the veneer of spring does not disguise the death and disease that are still facts of daily life here.

Green fields have replaced the brown dinginess of winter. Instead of generator smoke, the fragrance of flowers is in the air. People have moved outdoors to sip coffee in front of cafes, but the bombs, the murders and the pollution are still here.

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One night last week a loud bang awakened us. We learned the next morning that a Gypsy house was bombed only two blocks from ours and a woman was injured. I tried to find the place to take photographs but so many of the houses in the "Roma" section have been bombed or burned that they all look alike -- shells of houses with collapsed roofs.

Two nights later, repetitive booms of illumination disturbed our sleep. Soldiers were firing rounds from Camp Montieth, one of two U.S. military bases outside Gnjilane.

They fire them when night patrols spot suspicious activity -- possibly gun or heroin smugglers at work.

Looking out our second story window, we could see the burst of star shells that light up the sky like fireworks and drift to earth on parachutes.

When the light fades, the gunners fire another round. We did not hear what provoked the incident. A day later we saw Albanian boys playing in the wind with one of the small parachutes.

This week, traveling to scattered Albanian and Serb villages, the degree of pollution struck me. It seems as if every car that has been in an accident or junked since the days of Henry Ford sits stripped and rusting along the roads. On the main streets of the larger towns we can hardly breathe because of auto exhaust fumes.

Just when I thought it could not get any worse, we discovered a new local custom -- burning tires to celebrate holidays. Coming back from supper the night before Kosovo Labor Day, May 1, we saw groups of youngsters piling used tires and igniting them with gasoline.

Huge plumes of black smoke soon filled the air of every village. As we drove into Gnjilane, it looked as if NATO planes had again struck with bombs. Thick smoke hung in the air everywhere.

Poor sanitation causes disease outbreak With garbage collection practically nonexistent in many areas, people strew trash across the countryside. In many towns, even where a semblance of trash collection has resumed, mountains of garbage are still piled on the outskirts. These are now thawed, and hungry scavengers tear them apart, a practice that could spread disease, such as the outbreak of tularemia just confirmed here.

Tularemia is a bacterial disease spread by host animals such as rats and rabbits. It is known in other parts of the world, including the United States, although few Americans nowadays have heard of it. In Montana, which I call home, many people recall relatives in years past sickened by the disease after eating rabbits children shot and brought home.

In Kosovo tularemia is new -- often unrecognized by local physicians -- although it is widespread elsewhere in the Balkans. Complicating diagnosis is the disease's symptomatic resemblance to mumps, another disease working its way through the school-age population.

Symptoms of tularemia include high fever, headaches, body aches, swollen glands, difficulty swallowing and a dry cough. The condition is treatable with antibiotics for those with access to medical care.

Streams in Kosovo, which make up the water supply of many small villages, are littered with trash, including dead animals and the rusting hulks of automobiles. I have seen people drive their cars or lead their animals into the streams to wash them, mindless of the people drinking from the same water downstream.

Survival, not cleanliness, has been the order of the day here since last year's war. In the Pec and Kjakovica regions of western Kosovo, which were heavily damaged in the war, many wells were polluted by the bodies of large animals thrown into them by Serbs as parting gifts when KFOR, the NATO-led peacekeeping force, arrived. After the war the well at the hospital here in Gnjilane was discovered filled with medical waste.

People are warned to boil their drinking water, and to neither eat nor even touch rabbits and rodents.

So far there have been no deaths among the 231 confirmed cases of tularemia. The suspected number of cases is 480. The outbreak has mobilized health officials, who have brought in German microbiologists to test blood samples. But it would take a massive international effort costing many millions of dollars to set up garbage collection and sanitary disposal methods here.

This is the first major outbreak of serious disease in Kosovo, despite the appalling sanitary conditions. Immediately after the war, when hundreds of thousands of ethnic Albanian refugees came back to their homeland, a typhoid epidemic was predicted but did not develop.

Conditions are improving Living conditions here have generally improved in recent weeks. The region's aging power plant has been repaired and most electrical service has been restored. The relentless noise and smoke from generators have ceased.

Food supplies are beginning to show more variety, as more fruits and vegetables are imported from regions farther south where the harvest of spring crops has begun. We can sometimes get a real salad in the restaurants, although the meat is still tough. And on pleasant evenings people sit outside cafes and sip coffee.

Those who are lucky enough to have family members living and working in other areas of Europe have money to spend on such amenities. But economic woes continue to plague many people.

A man stopped me on the street one morning and wanted to know if it was true the hospital was going to be painted. If so, he was interested in work. He told me, in almost perfect English, that he is a teacher who speaks six languages. He cannot find work in his profession and was delivering sand to a construction site, screening it by hand with a large sifter to get the rocks out. I had not heard about the hospital project, but I suggested he apply with some of the non-governmental organizations that need interpreters.

Our group uses several translators when we take health care to the mountain villages. The World Health Organization is urging medical groups such as ours to take health care to these areas, especially the Serb villages, which no longer have physicians. One day last week we went to Paralovo to hold a medical clinic for Serbs. It is a mountain village with spectacular scenery. Most of the people, who live in houses dispersed around the nearby countryside, have no transportation to get to larger towns for medical care. Most of their physicians have fled to Serbia in fear of their lives.

We had plenty of people show up for our clinic. The turnout was much less impressive at another room in the same remote school house where the Office of Stabilization and Cooperation in Europe was trying to take a census by registering people in advance of the elections in Kosovo next fall. The organization wants to identify everyone in Kosovo over age 16. It is a thankless task.

The Serbs, who are already registered in Belgrade, are refusing to participate. Authorities in Serbia have apparently told them to not allow themselves to be counted.

Fran Hesser is a free-lance writer from Montana who returned to Kosovo for three months to serve alongside her husband. He is a physician assistant in the International Medical Corps, a volunteer relief agency.