LETTERS FROM STANKOVEC By Donna Behrendt Donna Behrendt volunteered as a nurse in a camp for displaced Kosovo Albanians in Macedonia.
******************************Tuesday, June 15, 1999
Hi everyone -
Where to start - this is truly an experience of a lifetime. Sorry I didn't phone but I have not had access to a telephone. I am sitting in the Internet Cafe in downtown Skopje, along with a dozen others who are writing e-mails, drinking my cappuccino. I arrived here two days ago and getting here was uneventful - picked up at the airport and taken to the International Medical Corps (IMC) office about 11:00 PM. People were still there working so you can see this is a dedicated bunch. I am working with a group of 30 ex-patriots (from all over the world, all speak English) and 70 Albanians, Kosovars, or Macedonians. It is a great group and in less than 48 hours I recognize most of them and know quite a bunch. Skopje is a lovely little city with big trees, quiet little back streets, outside cafes, and some pretty public buildings. From what I am hearing I probably will not see much more of the city as we work every day (I mean every day), and if the last two days are any example it is from 7:00 AM to 6:30 or 7:00 PM. When you can't work any more you take a day off. I've come here to work so I am not complaining, but it is not fun and games.
I am on such overload that it is hard to know where to start. I've been in the camps two days. I am at Stankovec II, which is about six miles out of Skopje and maybe 20 miles from the Kosovo border. It is a barbed wire-enclosed camp with guards at the gates and 20,000 people inside, all living in tents of every size from six to 100 to a tent. Wash is hanging on all the wire fences, there are sort of dirt roads going through the camp, and today mud was everywhere. The people are standing around looking very forlorn, many just sitting staring into space. The kids play but it is a miserable place to live. Let me tell you what I have been doing for the last two days and if you all are amazed you better believe that I am amazed. As you all know, nursing has been in my distant past, but one's memory is astonishing when it is needed . IMC has an area enclosed by a high metal fence with guards at each entrance and there are maybe ten tents in the enclosure. There is a tent for registration, one for seeing patients on an outpatient basis, a couple of pharmacies, a pediatric tent, an "in-patient hospital" (where I have been), storage tents, dental tent, etc., etc. Yesterday I kind of watched what was going on in the hospital and today I ran it. That is a bit of an exaggeration as there was a doctor there all day, but the nurse who was in charge was sick today so I had 18 people I was responsible for with everything from soup to nuts. The doctors I have been working with are super - both retired US docs who have a world of experience, could not have been nicer to me, and give the Kosovar patients the very best that the United States has to offer. All 18 people are lined up on cots one next to the other, and their stories would make your heart break. One very nice young student saw people being tortured. He was so distraught and would lie down for a few minutes then get up and pace around the tent and lie down again - did this over and over. One patient can't talk or feed himself now because he was beaten on the head but was an active 40-year-old a couple of weeks ago. This morning a young man was hallucinating, afraid that someone would kill him or that he would hurt his wife - crying and thrashing around.
The psychological after-effects of seeing the atrocities that most of these people have seen has left more than just a temporary mark. I heard a story today of the Serbs putting all the children in a building with the parents outside and they set the building afire. How, you think, could people do that and have any peace for the rest of their lives. So many people just lie in bed and stare. I have given out a bunch of little matchbox cars and for those of you who gave me some, your heart should swell with the happiness that one little car brings. You'd think it was the most elegant toy that ever was made and those little ones smile. There are other patients in the hospital with things like uncontrolled high blood pressure, one has a brain tumor, another an enlarged spleen, one with dehydration, etc. Their families bring them food and most are there all day to hold a hand or chat. Today I had two Kosovar nurses and we worked together - me teaching them some recording and organizational things. They are minimally trained but will be the main care-givers soon so we are trying to upgrade their skills. They do things like forget to give meds, don't pay attention to things out of line (a high blood pressure or glucose level), but the nurses have been working with them for several weeks now and they are getting better. There is no such thing as sterile (not true, as there are sterile needle packets) and we have a spigot of running water outside the tent where we wash forceps, oxygen masks, baby bottles, dishes and hands. It is like camping out while running a hospital, and everything is makeshift. My local nursing colleagues are teaching me Albanian and we are struggling with hand signals and a translator when they are around. After two days I can say that this is not only a life-changing experience but warm and caring while being horrifying and sad, all wrapped up together.
Yesterday it was in the 90s and baking in the tent - the heat will probably get to me as time passes. Today was rainy and quite OK but the yesterday experience has given me a taste of what is to come. I missed, by one day, the NATO forces going past the camp into Kosovo. Apparently all the refugees were lining the road cheering, touching the convoy trucks and crying. Everyone was quite touched and as we drive down the road people give us the peace sign or thumbs up. I am quite safe and am being careful. Skopje has not been unfriendly to me and I'm just going to say I am Canadian so don't worry. They asked if I wanted to go to Kosovo and I said no. Many of our organization are already in Kosovo getting things set up but it is still dangerous to be there and I am staying put for the time being. I may be getting involved in a Maternal and Child Health project but don't know yet. I'm living with two of the doctors in a very nice apartment with hot running water, a kitchen - I sleep on a pull-out bed in the living room and I am very comfortable during the little time I am there.
Love to my family,miss you - I'm taking lots of pictures. Wish you all could have this experience.
Fondly, Donna
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Thursday, June 17, 1999
Hi from Macedonia,
Another couple of days under my belt, and I'm getting the lay of the land around here. Today we put in an 11-hour day and I hated to leave when I did. All was quiet - keeping busy but not frantic - until about 4:00 and then we got a call to go out to the tents to pick up a sick person. Dr. Herbert and I went out in this old German ambulance and picked up first someone with gall stones, then someone with dangerously high blood pressure, then someone had severe chest pain, and it goes on and on. At one tent I took off my shoes before going in and when we hauled this lady out on a stretcher I couldn't find my shoes anywhere. Some little boy was off clomping away in my shoes. His father was sorely displeased! You work under such marginal conditions, such as today we had one person on oxygen and when a second person needed it we had to decide who needed it most and stopped the first person. Then not having a second set up we used the same mask for the second guy - you just cringe.
Dr. Steve and I went out to one tent and there were 30 people in the tent with foam mattresses butted one against the other. People's clothes and personal effects were neatly folded in the one foot at the head of the bed. A newborn baby was being rocked in a hammock and little kids were everywhere. It was very hot in the tent. Several women were cooking on little one-burner camp stoves and sitting on the floor feeding their family.
The bedlam in the hospital is hard to describe. The helicopters beat overhead and it feels like something out of MASH. There is a turnover of patients and three or four go home every day and an equal number arrive. There are tons of family members milling around and then the Kosovar nurses and doctors plus relief workers checking patients out for evacuation. We have many people on the list for evacuation to another country - a woman in her 30s with MS and a very nice man with a brain tumor. The man wanted to be evacuated with his wife, three small children, mother and brother but I don't think they will take all of them. The French are taking this guy next week and I hope he makes it.
One man, named Gemail, is about 45 and always smiling. He was hit over the head by the police and is brain-damaged. He was evacuated to Germany today. He has no family and needed total care. The local nurses fed him but otherwise didn't pay much attention to him. One of the nurses and I bathed him this morning, washed his mattress and put a clean sheet on and I went out and bought him a T-shirt (we've run out of clothes). About two hours after the clean-up the Germans came and took him. We cheered when he left as we both knew he will be cared for. When we gave him a bath all we could find was a galvanized pail for water and two socks for wash clothes. A pillowcase served as a towel and we had a few handiwipes. Oh yes - we used shampoo in the water. When Gemail left we had another man almost immediately take that bed, and the Albanian nurses wanted to use the same sheets as we had "changed them today".
This experience really makes you examine what medicine is all about - how do you heal people and help them go on with their lives. We have no fancy equipment and yet no one has died in that hospital yet. That will come, I'm sure, but healing is caring and loving ---and two super docs. The old lady that I found in the tent where I "lost" my shoes had one son die two years ago in the war and then two more died in the last month. As a mother one wonders how anyone deals with that. On a lesser scale I had a talk with a young man who is a medical student. His father was a professor at the University in Pristina, Kosovo, until he was fired for not signing a paper that he would unfailingly support the Serbian regime. This guy lives in Pristina and hasn't been back but someone saw his apartment and people have stolen his TV, all his music, his computer, etc., etc. He expressed just being thankful that his family was all alive. Every day I hear stories like that.
On a lighter note there is lots of laughing. A joke that I have now heard from two Kosovars is, "Do you know what Clinton's doorbell sounds like? CLING TONG." We all were kidding today about whether we were getting time and a half or double time for our overtime hours - 1 1/2 x 0 or 2 x 0. This doctor was dancing down the aisle on the way to the "bathroom" (san-o-let) and he had everyone in the room smiling.
There are two groups of ex-pats - the older ones of which I include myself, and the kids just out of medical school. Even though our group has done mostly administrative stuff, it is amazing how living teaches you things. When you don't have resources you learn quickly. An example is early this afternoon while things were slow, the four of us (two docs and two nurses) were sitting around eating peaches and discussing the 70 drugs that are available and how to make the best drug decision with a limited selection.
Just to let you know, I have not seen a newspaper since I arrived, have no idea what is going on in the world and almost nothing about what is going on in Kosovo. It is like being in the eye of the storm. Our local translators tell us a bit and I try and watch TV and figure out what is going on by the pictures but this is an island unto itself. It is 9:00 and I'm about ready for bed so I'm signing out from the Internet Cafe in Skopje, Macedonia.
Love to everyone, Donna