[Congressional Record Volume 145, Number 134 (Wednesday, October 6, 1999)]
[Extensions of Remarks]
[Pages E2050-E2051]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


         UNITED NATIONS' POPULATION FUND (UNFPA) WORK IN KOSOVO

                                 ______
                                 

                          HON. JOSEPH CROWLEY

                              of new york

                    in the house of representatives

                       Wednesday, October 6, 1999

  Mr. CROWLEY. Mr. Speaker, I would like to call attention to the work 
UNFPA is doing in Kosovo. UNFPA is helping Kosovo rebuild from the war, 
improving medical care for men, women and children, making deliveries 
safer, and providing a full range of healthcare services. While the war 
is over, UNFPA is continuing its work to improve the quality of life 
and healthcare for Kosovar Albanians.
   Mr. Speaker, to answer critics who are questioning their work and 
commitment in Kosovo, I submit the following explanation of their work 
into the Congressional Record.

                         UNFPA's Work in Kosovo

       The United Nations Population Fund (UNFPA) is working in 
     Kosovo as part of the United Nations humanitarian and 
     development effort. The United Nations has set up a civil 
     administration in the province of Kosovo, under Security 
     Council Resolution 1244 (1999) of 10 June 1999. UNFPA is 
     working along with other United Nations agencies in Kosovo 
     and is a cooperative partner in the health sector under the 
     leadership of the World Health Organization (WHO). As in all 
     its programmes, UNFPA strictly adheres to internationally 
     agreed human rights conventions and standards and to the 
     Programme of Action of the International Conference on 
     Population and Development, held in Cairo in 1994.


                  unfpa's emergency relief operations

       When the refugee crisis in Kosovo began, UNFPA responded 
     quickly to ensure that those fleeing the province had access 
     to critical reproductive health services. The Office of the 
     United Nations High Commissioner for Refugees (UNHCR), the 
     lead United Nations agency responsible for refugees, formally 
     asked UNFPA to serve as co-ordinator for reproductive health 
     service. The Fund conducted a rapid needs assessment from 6 
     to 13 April 1999; sent materials, supplies and equipment for 
     safe delivery, safe blood transfusion, treatment of sexually 
     transmitted diseases, management of miscarriages, and 
     treatment for victims of sexual violence. Also, a total of 
     350,000 packets of sanitary towels and 14,000 pairs of 
     underwear were purchased for distribution during the crisis.
       In essence, UNFPA's major contribution to meeting the needs 
     of the Kosovo refugees was to supply emergency reproductive 
     health kits and other reproductive health equipment to 
     refugee camps in Albania and the former Yugoslav Republic of 
     Macedonia and to maternity hospitals throughout 
     Albania. UNFPA procured emergency reproductive health kits 
     to meet the needs of approximately 350,000 people for a 
     period of 3 to 6 months. In Albania, emergency 
     reproductive health kits were supplied to refugee camps in 
     Kukes, Korca and Elbasan and to a total of 10 hospitals 
     and maternity clinics. In addition, UNFPA facilitated the 
     donation of two ultrasound machines from a private company 
     to the Albanian Ministry of Health.
       UNFPA's emergency reproductive health supplies included:
       Individual clean delivery kits for use if medical 
     facilities are unavailable. The kit includes soap, plastic 
     sheeting, pictorial instructions and a razor blade to cut the 
     umbilical cord;
       Delivery equipment--for use by trained personnel to deal 
     with both normal and complicated deliveries, as well as 
     referral-level equipment to be used in hospitals to perform 
     Caesarean sections and to resuscitate mothers and babies;
       Sexually transmitted diseases (STD) kit--intended to 
     diagnose and treat STDs and explain how to prevent 
     contraction;
       Safe blood transfusion equipment;
       Then, in early May, UNFPA sent an expert on the treatment 
     of sexual violence and war trauma to assess the needs of 
     women victims of such violence. Interviews with them showed 
     that a considerable degree of sexual violence had occurred 
     and that there were urgent needs for the treatment and 
     counselling of women, their families and communities. UNFPA 
     set up a training programme for health and relief workers of 
     non-governmental organizations (NGOs) working with

[[Page E2051]]

     refugees and for international and national medical staff in 
     Albania and the former Yugoslav Republic of Macedonia.


                        Rehabilitation of Kosovo

       Following the cessation of hostilities and the return of 
     refugees to Kosovo, UNFPA, along with other United Nations 
     agencies, quickly established an office in Pristina, the 
     capital of the province. As part of the civil administration 
     authorized by the United Nations Security Council, UNFPA is a 
     member of the Joint Civil Commission on Health, which is 
     responsible for developing health policy and which includes 
     representatives from the United Nations and from all of the 
     communities in Kosovo. UNFPA heads the Reproductive Health 
     Policy Task Force of the Joint Civil Commission and the 
     Reproductive Health Coordination Committee, which includes 
     representatives of all the United Nations bodies, NGOs and 
     bilateral aid agencies working in reproductive health. The 
     Policy Task Force has worked with the Kosovo Institute of 
     Public Health, a local organization, to draw up a 
     Reproductive Health Policy, which will guide the work of 
     all organizations as they undertake the rehabilitation of 
     the province.


                         UNFPA's Priority Areas

       The main concern of the United Nations in the area of 
     health is to help reestablish the public health system in the 
     province in order to meet the health needs of all the people 
     of Kosovo. The overall needs throughout the province are 
     overwhelming, and most of the health infrastructure has not 
     been properly maintained; much of it was destroyed or removed 
     during the recent hostilities. Equipment in hospitals is 
     either obsolete and/or broken, including such basic equipment 
     as washing machines and incubators for premature babies. Many 
     health facilities have been left in decay, with broken 
     windows, useless heating systems, and little or no 
     functioning equipment.
       The maternity, obstetric and gynecological clinic in 
     Pristina delivers some 30 to 40 babies per day; it is on 
     target to deliver 12,000 babies in the coming year, which 
     would give it the largest number of deliveries of any 
     hospital in Europe. It is achieving this with one broken-down 
     washing machine and a shortage of sheets, gowns, incubators 
     and ultrasound machines. On particular busy days, it does not 
     have enough cribs in which to put the newborns, even when 
     they are doubled up. Many of the deliveries are premature, 
     born to women who suffered great trauma and stress during the 
     hostilities. The World Health Organization (WHO) estimates 
     that almost 50 percent of premature infants born in the 
     Pristina Hospital do not survive. Other problems related to 
     the effects of the hostilities are a higher-than-normal 
     incidence of miscarriages and still births, both of which put 
     the lives of mothers at risk. Conditions are equally poor, if 
     not worse, in maternities and health centres outside 
     Pristina. In light of the above, it is essential to upgrade 
     the equipment of the maternity at the Pristina Hospital and 
     in other regions of Kosovo, as a critical first step in 
     safeguarding maternal and child health within the overall 
     context of the rehabilitation of the health system of Kosovo.
       UNFPA is playing a key role in the area of reproductive 
     health by helping to assess reproductive health conditions 
     and needs; by supplying urgently needed equipment, materials, 
     and medicines for hospitals, primary health facilities and 
     mobile clinics; by providing training and support for health 
     staff; and by supporting health information and education 
     programmes. UNFPA has begun work with its other partners in 
     Kosovo in drawing up a standard reproductive health-training 
     curriculum for health workers in the province. It is designed 
     to raise their awareness of reproductive health needs and to 
     provide basic and refresher training in basic reproductive 
     health skills.
       The issue of sexual and other violence against women in 
     Kosovo is a very serious issue. UNFPA has sent an expert on 
     sexual violence to the province to report on ways in which 
     the health system and health workers in Kosovo can address 
     these issues in a culturally sensitive manner. Another 
     component of UNFPA's strategy in the area of health, 
     education and community services focuses on mental health, 
     particularly the mental health of women. Violations of human 
     rights and human dignity have been used as a systematic way 
     of conducting war and have left profound scars that may not 
     disappear. Victims of torture or violence, be it physical, 
     sexual or psychological continue to suffer from significant 
     trauma. To provide counselling and to prevent ostracism and 
     exclusion of the victims from their own communities, UNFPA 
     will continue to help strengthen local community capacity to 
     provide care and support to women and men in distress.
       There is an urgent need in Kosovo for demographic and 
     health status of Kosovo since the return of the refugees in 
     June this year. Given the new situation, all prior census and 
     other data--if they can be found--are obsolete. All relief 
     organizations working in the province are looking for such 
     information to use in their operations. To that end, UNFPA 
     and the International Organization for Migration (IOM) 
     jointly organized a preliminary mission to assess the 
     feasibility of a cluster sample population survey in Kosovo. 
     The two organizations have developed a proposal for a survey 
     of about 9,500 households. The results of the survey will be 
     made available to all interested agencies and to the public.
       Therefore, as priority measures for emergency relief and 
     rehabilitation in Kosovo, UNFPA is preparing to undertake 
     three crucial projects in the short term: upgrade the 
     equipment of the maternity/OB-GYN department of Pristina 
     hospital, and to provide basic equipment and supplies to 
     maternities and ``birthing centers'' elsewhere in the 
     province; strengthen local capacity to identify members of 
     the community who need psycho-social support and to provide 
     care and support to these women and men; and undertake an 
     urgently needed demographic, socio-economic and reproductive 
     health survey of the province.

     

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