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Balkans briefing 6. Picking up the pieces: reflections on the initial stages of the reconstruction of the health care system in Kosovo, July 1999
  1. Lindsey Davies
  1. NHS Executive Trent, Fulwood House, Old Fulwood Road, Sheffield S10 3TH
  1. Dr Davies (lindsey.davies{at}

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Kosovo came to the attention of the world's media in 1998 as details emerged of an apparently systematic attempt by the Serbian government to terrorise resident ethnic Albanians into leaving the region. This culminated in the flight of thousands of ethnic Albanians to refugee camps and other places of safety outside the region. The NATO bombardment in the spring of 1999 and the subsequent establishment of the United Nations Mission in Kosovo (UNMIK) as the civil administration encouraged many Albanians to return. Concurrently, many ethnic Serbs fled the country, frightened of reprisals.

I spent the month of July 1999 working for the WHO in Pristina, the regional capital, with a brief to develop a strategic framework for sustainable health service development in the region.

By the time that I arrived, the initial dramatic population flows had slowed and Kosovans were beginning to re-establish their lives and their society. This paper describes some of the challenges of this initial period and one of the approaches taken to meeting these. It is a personal view, based on my own recollection and the information available to me at the time.

Social and built environment

Kosovo has a population of approximately 2 million people distributed among six major population centres and many scattered rural villages. The landscape varies from remote mountainous areas to undulating lowland. Before the bombardment the economy had a mixed base of agriculture, industry and a limited amount of tourism. Much of the land is rich in mineral deposits and the industrial base included mineral extraction and processing. Housing is an unexceptional mixture of new and old, ranging from tiny traditional farmhouses to high rise apartment blocks. Bomb damage was restricted largely to strategic targets such as bridges, industrial complexes and communication centres. Many domestic, commercial and public sector premises had, however, been burned or …

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