‘Why are you leaving?’

Lynne Mastnak, a child psychiatrist, records the daily round in Kosovo before and since the bombing

1 January, Pristina. The UNHCR security officer rang early this morning to say that the main road through the area of Likovc, in Drenica, was now clear. We have been wanting to set up an emergency clinic there for the last two months, but it has been off-limits to all humanitarian aid workers since an International Committee of the Red Cross vehicle hit a mine, killing one doctor and seriously injuring another. Drenica was the poorest part of Kosovo long before the current wave of violence, and the region that suffered most from the weapons searches and arrests inflicted by the Serb police force on the predominantly Albanian population over the previous decade. It was here that the KLA first emerged a year ago, and here that some of the fiercest assaults were carried out by the Yugoslav military during the offensive of 1998.

My translator and I left at once, driving though the acrid wall of smog that has enveloped Pristina for the last week, up small winding dirt roads into the Drenica hills, past the upturned, mangled wreck of the ICRC vehicle. Almost every house in this area is in ruins. The torched houses have a peculiar ugliness. Each window has its thickened eyebrow of soot, the roof is missing and the chimney-pots on brick columns stand free above the eaves. Sadako Ogata said a few weeks ago that a humanitarian disaster had been averted. People are no longer shockingly visible camped out on mountain-sides. Instead they are tidied away in plastic benders in their skeleton homes or crammed in with neighbours, drinking contaminated water and dependent on hand-outs. Booby-traps are a hazard. A woman found one under her bed, a dog set another off in an orchard.

What is left of Likovc sprawls over three hilltops, the destruction outlined against a backdrop of snowcapped Albanian Alps. Only 15 of the 170 houses remain undamaged. The white school building and the cultural centre are gutted; the small clinic is a pile of rubble; teenagers are selling cheap biscuits, chewing-gum and cigarettes on upturned milk crates; and Dr E, who came back three weeks ago, has turned a shop into a temporary clinic. He is overwhelmed, however. He thought it would be helpful if one of our teams set up in a village a few kilometres away, where the clinic is still standing. We found a displaced family living in two of the rooms, the others had been wrecked by police occupants. We said we would bring plastic and wood for the windows, a couple of stoves for warmth and start next week.

For the rural population access to health care is difficult. It is not simply that many clinics have been destroyed or their doctors have fled. Every time I go into the field there seem to be more police. They have adapted to the conditions imposed by the October agreement between Milosevic and Holbrooke and travel in white vehicles, remarkably similar to those used by aid workers, and have mobile checkpoints. I saw 11 jump out of a van in one village recently, only to move on before any international verifiers arrived. So people are too frightened to move. They know that with identity cards from this region they risk interrogation and beating. And if they do get to a hospital, how to pay? Free health care is only available to those who are employed and have health cards. The vast majority of Albanians lost their jobs in the wave of dismissals that followed the removal of the province’s autonomy in 1989. Of the few people who were employed before the conflict, most have lost their papers in flight.

12 January. Every time I go through the Baice checkpoint it seems a little more entrenched. Last October there was just a single young man in KLA uniform with a kalashnikov. Then it was four men in a car, then a small wooden booth. Now it is a small wooden booth, plus stone cairn and red bollards, but we are waved through without problems. The clinic is packed. My colleague Mark and a local Albanian doctor come twice a week and see around a hundred and forty patients a day. Mark wanted me to visit a small boy called Illir who had been in Belgrade for three months with a badly injured leg, and had only just discovered that his father was dead.

We went round to the house to find one of the two small rooms packed with people – some twenty members of the extended family – waiting for me. The easiest way to begin in these situations is to get the children to help me draw a family tree on a big piece of paper. It is a common enough psychiatric practice at home, but here it’s invaluable: the children are immediately engaged, everyone gets a chance to introduce themselves while I get an approximate sense of who belongs to who. Most significantly, it allows the family to name and identify the dead in a natural way, and say as much about what happened as they want to. Illir’s sister Laura explained that their father and two sisters, aged 8 and 13, were killed by shells as he tried to load the family onto a tractor. She herself was wounded and watched her little sister die on the way to the doctor. Illir was too badly injured to know what was happening. Now he is very angry. When I asked if he wanted to explain what happened to him, he started to cry and an uncle rushed across and begged him to stop. It would do no harm, I suggested, if he could cry for a bit. After a time he started to rage, not so much about his dead father but about how dangerous everything was now, how hundreds and thousands had been made homeless and how many had been killed. ‘And they will lay mines and they will shell us again and they will kill old ladies and children and they do not care, and who will look after us now? There is no one and we will never be safe.’ He went on in this vein, curled up hot and sweaty with my arms round him on one side and his uncle’s on the other, Bini translating in a low murmur as the others pressed up close, half of them crying as well.

14 January. Another NGO asked me to assess Faton, a 14-year-old. He and his father, 20-year-old brother and two uncles were taken by the police, stripped naked and badly beaten. Then, because his father pleaded for his life, Faton was allowed to escape. He wandered in the woods for two days until he found his way home. Meanwhile the police had rounded up his female relatives. ‘They put a gun in my mouth and said give us weapons,’ his mother told me. ‘I said: “I don’t have any so kill me if you want.” Then they told me to go and look for my husband, whom they had killed. We had heard the shots.’ What she found first were the piles of clothes, then the cut and beaten bodies – her eldest son’s eyes had been gouged out. When Faton came home he clung without speaking to his mother for two weeks. Now, some three months later, the family are still displaced and live in one room. Faton is frightened all the time, jumpy, and unable to sleep. His head is full of images of the police. I teach him muscular relaxation. At least it makes him and the family laugh. I also teach him ways to keep the thoughts at bay, promising to visit again and practise with him. It is one thing to treat children when the source of distress is irrational, or has to do with some event that is properly in the past; quite another when the object of fear remains visible from the bottom of the garden, fully armed with a machine-gun and knife.

Driving home, I saw some small boys playing ice hockey on a frozen stream, skating on foot-skis. But the landscape is mapped by the horrors of my patients’ stories: the iron-works that figure in 16-year-old Dardan’s nightmares because he saw five men thrown into the furnace when he was imprisoned there; the red brick farm where Arlinda’s invalid father was executed with all the men of his village; the small wooded valley where Simon’s mother, aunt, grandmother and three young cousins are buried, having been killed, along with 16 others.

18 January. It is three days since the massacre at Recak. International Medical Corps suggested I go out with them to do some kind of psycho-social assessment of the displaced families in the neighbouring villages. We set off in a convoy of four vehicles carrying food, blankets and plastic. The roads were narrow and twisting, with deep ruts in the frozen snow. We encountered small groups of people everywhere, some in outdoor clothes, some less adequately dressed, none with any idea of which way to go. We were not sure either, as by this point we could hear shelling, although where it was coming from was unclear. We told them which village we were headed for and suggested they come and pick up food and blankets there. Petrovac, three kilometres from Recak, was half-destroyed, and seemingly deserted, except for six women and girls weeping and completely bewildered in the middle of the street. Apparently there were more people sheltering in one of the houses and a woman in labour in another. The IMC field co-ordinator decided to split the convoy, leaving me to find the other villagers and the Médecins du Monde obstetric team to attend to the woman in labour, while he took two cars to assess the next village.

The women and children led me to a house where twenty or thirty women, children and babies and one very old man were sitting in a single room, terrified, listening to the sound of shelling, which was now quite close and frequent. ‘It’s been going on intermittently for three days,’ the owner of the house said. ‘Most people are in the mountains but these are too old or weak to travel, so I said they could come here, but we’ve had nothing to eat, and what everyone wants is to leave.’ A plump woman in a leather coat burst into tears: her cousin had been killed in Recak, please would I take her away?

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