Emory Report

July 12, 1999

 Volume 51, No. 35

The Kosovo Storm: an insider's view
Nursing student Susan Lomax spent a week in early May at a resettlement camp for Kosovar refugees flown in from Macedonia to Fort Dix, N.J. She was part of the Disaster Medical Assistance Team of the U.S. Public Health Service and kept a diary of her experiences, some of which is excerpted below. A second installment will run in the July 26 issue.

Sunday, May 2, 1999

Connie from the hospital called. Odd to hear her voice after nearly three years. The Disaster Medical Assistance Team (DMAT) has been contacted for volunteers to go to New Jersey and assist with the Kosovo refugees being resettled from camps in Macedonia. Could I make a commitment of at least seven days, am I available? I'm tired from a demanding semester. I need to sit in the sun. Talk to my family. Do nothing. Sleep in the dark for a change. But this is important, and I think I should do it. I hesitate a moment, then say I can go. Thanks, she says, she'll call back and let me know if I am actually needed.

After hanging up I immediately regret saying yes. I call home, warn my family I might not actually get there, despite having spent days trying to round up most of my sisters and their families to meet me at the farm where my parents live. They are disappointed, but I tell them I may not have to go. We leave it at that.

Monday, May 3

Connie calls back. They don't need me; thanks for offering. I am relieved, my plans are back on track and my mini-vacation springs up again on the horizon. I'd best get busy studying for theory.

Wednesday, May 5

I'm headed for an early night when Connie calls back. They may need me after all. Can I still go?

Friday, May 7

I check my messages: they want to put me on a plane leaving in 40 minutes and I am 50 minutes from home. I run home, grab the bag, hop [on] the train to the airport. We are delayed twice, then finally board the plane, which taxis out to the end of the runway and stops, killing the engines. No explanation is offered; they show a movie. Eventually we take off, two hours late. Only when we get to Philadelphia do we find out about the nearby tornado.

Fort Dix

Saturday, May 8

I wake up early, already edgy about the day. My traveling companions are waiting in the lobby, trying to snag transportation to breakfast. The others have been here two or three days, have their routines worked out. We're the newcomers, haven't a clue how things function.

The base is big, with large areas of softly rolling open land and equally large areas of forest. The major feature is an abundance of groundhogs, which we will find out over time. The buildings are brick, low-set, ugly. We roll past the largest and best-tended soccer fields I have ever seen.

The nurse in charge, Lissa, pins down our experience and comfort level, what areas we work in, checks for certifications. Her orientation for us is quick, to the point, concise. A plane arrived last Tuesday, the first. The refugees were in pretty good shape except for dehydration and some chronic illnesses, made worse by having to fly 14 hours in rough weather and then deplane at McGuire Air Force Base.

A Public Health Service nurse explains the protocols: All immigrants are being screened for TB, syphilis, HIVThere have been no vaccinations in Kosovo since the conflict broke out-active TB and polio exist. We are confused, write down everything we are told, understand little. The first families begin to straggle in. I am working with Betty, a Public Health Service nurse from Washington. I write; she injects.

At 1 p.m. my hand is cramping from writing, Betty's hands ache from shooting. Lunch is a quick, 25-minute run back to the same "dining facility." We eat so fast we get indigestion, then head back so others can go. In the afternoon I shoot, Betty writes.

Families are small, an uncle and two nephews, a mother and her three teen-age children. Or they're large, with elderly parents, two or three grown daughters and a couple of cousins. No children under age 4 the first day. Where are the babies? The children we see do not act like American children. They sit quietly on the folding chair, watch us silently. Our translator, an Albanian-American, tries to talk with them. They say little.

Most don't cry when we inject them. Some of them laugh nervously during the shots. We give them toys donated by the Red Cross after the injection. Some shake my hand as they leave.

We are cautious about these people. Our briefing says Muslim women are very modest, always chaste until marriage. Discussing intimate personal information is offensive. We have to ask each female of childbearing age if she is or could be pregnant before administering the MMR [mumps/measles vaccine].

Our translator is male. This is a problem. The few female translators are dragged about from room to room, always asking the same question. Are you or could you be? Always the answer is no. Occasionally the question brings a smile. Sometimes they say my husband is dead. Sometimes they say I don't know where my husband or fiancé is. Sometimes they look away, say no.

At the end of the long day another translator tells me that many of the pregnant women and very young infants are dead, didn't make it out through the mountains. Women who went into labor on the trek were left behind in order to preserve the safety of the group. The translator has been told of many women's bodies by the side of the road. Some bled to death, some were shot when found by opposing forces. No, they aren't pregnant.

We clean, straighten, pull up more vaccines, meet briefly. Tomorrow will be busier. We should be here early for a meeting, start immunizing at 8.

Sunday, May 9

The meeting makes sense today. We immunized almost 300 people on Saturday, gave 973 doses. There is much applause, this is the highest number yet. No bad for two people giving injections and two writing.

Lissa asks me if I would mind spending the day in the acute care area. I'm eager to get away from the immunizations, glad to go back to what I know best. The clinic as it exists is only five days old today.

No complicated interventions can take place here, but the ability to screen and treat on site prevents the local hospital from being overwhelmed. A few persons from each plane have ended up hospitalized on arrival; the rest are treated and then taken back through the immigration process, given alien numbers and identity cards. There is no plane today, so the acute care area is functioning as a small hospital.

It's Mother's Day. I call home, try to explain what is rapidly becoming unexplainable. People imagine, as I did, that "refugees" are a monolithic group of road-weary peasants living in tents. Some of them are exactly that. And some are schoolteachers, some are medical students, some are garage mechanics. Most speak only Albanian and whatever adjacent Balkan language is needed for commerce; the older educated people also speak some Russian, and the educated few between the ages of 16 and 25 speak remarkably good English.

They do come from an isolated, small country, but many of them know more about us than we do about them. They are Muslim, but they decorate eggs and celebrate with their neighbors for Orthodox Easter. They don't eat pork but raise pigs for commerce. They are extremely homogenous in appearance, beautiful when young, aging badly. Observant older men wear felt caps, older women wear scarves, young women wear MTV T-shirts and nail polish when they can get it.

Monday, May 10

The acute care area is up and running. The pharmacy is next door. In the course of the week I will watch a slim, funny woman from Seattle, Leah, spend her free time calling her foreign-born relatives to translate arcane instructions into Albanian (she doesn't speak it herself) and her days dispensing prescriptions. By tomorrow she will have hundreds of small labels printed out, saying everything from "take with food" to "for optic use only" in Albanian. By Wednesday she will have translated the instruction label for Nix, since our population has massive infestations of head lice.

Today's goal is to immunize and screen another 300 refugees. At 11 a.m. no one is in the clinic. We draw up extra vaccines, clean, organize, wonder where they are.

Everyone is down near the gym, waiting to see who is on this plane. Families and friends are standing five deep along the road, looking for loved ones. Of course they are. We should have known where they would be. Our staff comes back from the plane with a couple of unstable folks, both of whom have chest pain and suspect EKG tracings. We arrange transport, start lines, give aspirin.

We are investing substantial amounts of energy and resources to help this group of 1,000-odd refugees from Kosovo, and we are investing substantial amounts of energy and resources to kill their Serbian civilian neighbors. The difference, as nearly as I can tell, is the 250 kilometers that separate them. How insane. I traveled in Yugoslavia once. I know that I could never look at the population and tell Serb from Albanian. We are killing children who look just like the children in the Village.

--Susan Lomax

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