Contributor: Irene Taylor

Kosovo villagers standing around a disabled boy.

Mercy Corps' Healthy Community Initiatives in Kosovo is working to improve the health of Kosovars through strengthening health knowledge and advocacy skills at village level and strengthening the ability of the Municipalities - four in northern and central Kosovo - to provide good quality care that is responsive to the needs of people. Mercy Corps is also involved in teaching nurses about community health, helping develop good teamwork between doctors and nurses and re-equipping health centers with basic equipment.

Working with municipal officials and community members, we undertake small and large projects to enhance health. These include the building of new health centers, water and sewerage systems and environmental improvements. The groups in these villages are known as Community Health Advocacy Groups (CHAGs). Generally, only the women participate in the beginning and some men join later to assist with the projects.

Angelina is an important member of the CHAG in a village called Ranoc in Kline Municipality in central Kosovo. When she was 22 years old, she was cooking with her child two-year-old Arian besides her, when people burst into her house and gave the family five minutes to get out 'with their lives.' She is from a minority Catholic village in Central Kosovo. Like many others in the area her family possessions were ransacked, stolen or burnt. A period of sadness, fear and confusion followed. She remembers Mercy Corps bringing food and assistance to them and what it felt like to know that people from the outside world knew of their plight and cared.

The family is now back in the village trying to put their lives back together. There are eight family members in the house. Angelina's brother-in-law is mentally disabled and only Angelina's husband has a job. They live on 15 euros a day which provides food only. Like most Kosovar families, they are a very close, loving family.

I asked Angelina how she knew about the Health Program. She tells me that her and some of the other women kept seeing Mercy Corps vehicles passing through the village, they asked the men what was happening and no one was sure. They became very excited when they heard that their area had been chosen for help but found that Mercy Corps educators were working with women in another part of the village. They found the educators and helped to create another group.

In Kosovar society, it is the mother's responsibility to pass on education about reproduction to their girls. Her mother had already had eight children with seven surviving and she knew very little herself. Through the health education sessions the women discovered they could take control over their lives in a way they had never imagined. Mercy Corps provided information about mother and child health, family violence, basic illnesses, diet and how to use the environment to create a healthy lifestyle. The trained women then became community health contacts to spread this knowledge to others.

Angelina became the teacher. Her confidence increased. She learned that breastfeeding was best for a healthy child and unlike her first child, she breastfed Gjok and says she feels like a "good mother" for doing this and giving her child a good start in life. She now tells all the women how important this is. All the women say that education about AIDS and other sexually transmitted illnesses have really been interesting to them. They had heard about such things and had no idea how they were transmitted.

Angelina's group was so enthusiastic they wanted to go on to the next stage and learn about advocacy and ways to bring greater changes into their lives. The rest of the village stopped joking about what the women were up to. They learned about how civil society works, how and why they are important as participants in it, how to decide what is needed in the village to improve health and how to include others in the decision-making. They gained the confidence to present their project to the Municipal Minister for Health and other high level people and argue when necessary. The rest of the village started to get involved.

The group is now working closely with Mercy Corps and the Municipality to undertake a very large project to build a road from the main highway to their village. This will provide access to the health center and school.

Angelina says that her greatest dream is to finish school. Like many others, she only experienced school in an informal way at a village house, done in secrecy with great risk by dedicated neighbors. As her knowledge has developed she realizes that she is limited without this education. They will be dependent on outsiders unless they can comfortably deal with information and present it to others. This knowledge would give them great power to change their lives.

She also says the group feels comfortable now to go and negotiate with the Municipality for other things in the future. However, when we talked about how she saw the future there was some despondency. Lack of basic needs like stable water and electricity supplies, the high crime rate and pervasive influence of the Balkan mafia and fear about the returnees coming back to the village next door. She said she was not sure she could face them without fear and anger.

Angelina says, "I don't know the words to explain what Mercy Corps has given to me. My life has changed and I have changed and that is a good thing."

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Raisa with Mercy Corps Health Program Manager, Kosovo, Irene Taylor. Photo: Mercy Corps Kosovo

Raisa was not like the other children in the village. As other children played and ran around, Raisa was always sitting on the steps of her house alone or by the time she caught up to the others, they had run off somewhere else. Even eating was exhausting. When I first saw her I was shocked at her poor physical condition but really touched by her capacity to accept, go on smiling and to use the small amount of energy she had to give me a big hug.

I found out about Raisa when I was approached by two UN International Police Officers who had been involved in the training of a Bosniak Kosovar police recruit in Peja in Northern Kosovo. Frank is with the German Border Police and is working on cases involving trafficked women. Allan is with the Northern Ireland Constabulary and has seen his fair share of death and destruction in his own country. He is now involved in training police recruits. As they had got to know Raisa's father they heard about the plight of his daughter, Raisa. She was dying a little day-by-day because the required treatment is not available in Kosovo.

They asked if Mercy Corps could help. I felt really frustrated when I started to explore options and discovered there was no help for her. After meeting Raisa and examining her medical file it was apparent that without lifesaving surgery, Raisa was in serious trouble. The surgery she needed was complex, expensive and could only be done in an advanced hospital with a specialized heart surgery unit. The parents had no passports or money.

Raisa has a congenital deformity resulting in an extra vessel leading to the heart. This means that the blood cannot flow properly and her heart is under constant strain. Her heart is three times larger than it should be. It had been detected at birth and she had been sent to the Children's Hospital in Belgrade but they could only give drugs for the symptoms, suggesting that Raisa would have to go to another part of the world if she was to survive. The troubles and the war came.

For those of us who believe in miracles, regardless of our religious or spiritual beliefs, there is no explanation needed for what happened next. I got on the Internet, entered surgical assistance for children in Kosovo, the first entry was for an organization in Switzerland especially working to help Kosovar children receive life saving surgery. I immediately wrote to them and the response was that they had limited funds left for Kosovo but if I forwarded the medical files to them, they would have their heart surgeon review the case.

The rest is history. Raisa had the lifesaving surgery in Geneva two days ago, performed by one of Switzerland's best heart surgeons and it has been a success. All medical expenses were covered by the hospital and the surgeon performed the surgery for no fee. Frank and Allan turned the UNMIK system upside down getting the visas and wouldn't take no for an answer. I ensured we had Raisa in the best possible physical condition prior to the surgery and worked closely with the surgeon to achieve this. All Raisa's friends at the police station and Mercy Corps donated money for the tickets for Raisa and her mother and the Bosniak community in Geneva provided for all the family support needs in Geneva. I know some of you were praying for her and thinking of her as well.

Raisa will be in intensive care for at least four days and will have months of rehabilitation but the signs are excellent that she will have the full life she has never enjoyed and completely deserves. Her ongoing care will be supervised by us on her return. Her 8th birthday party promises to be a big event.

Courage needs witnesses and Raisa's courage was witnessed and a diverse group of people from all over the world came together, wouldn't take no for an answer and changed not only Raisa's life but that of her family and friends. I don't think you can ever understand all the effects of such things. All of humanity is touched when compassion and kindness replace destruction and hopelessness. Everyone in the Mercy Corps family participates in this wonderful story because we are interconnected and I hope you all feel as inspired by Raisa's story as I do. I just wanted to share it with you all and thank you for providing the support and inspiration that enables us here in Kosovo to reach out to people on your behalf.

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Tina and Mercyana. Photo: Mercy Corps Kosovo

Tina is Albanian. She met her Albanian Kosovar husband Ishmet during her nursing training in Albania and they moved back to his family home in Istog in northern Kosovo. It was a painful time for Tina. She left the family she loved, moved into a culture that was very different and discovered what it was like to be an "outsider."

Ishmet had worked for Mercy Corps before in our tuberculosis program. When we were looking for a translator in our health program he told Tina she should apply. Jane Ohuma, our Clinical Educator from Kenya, soon saw Tina's potential and she is now the Deputy Clinical Educator of our Health Program with responsibility for the development of the other local nursing staff of Mercy Corps, playing an important role in our planning.

We were all very excited when we heard that Tina was expecting a baby. We all joked that it would be great for clinical training purposes and Jane and I would be delivering the baby! One day in May we received a terrible phone call. Tina's mother and sister had been involved in a tragic accident in Albania. Her mother was dead and her sister was seriously injured and not expected to live. Tina's world fell apart. All she had talked about was seeing her new child in her mother's arms. We feared for Tina and the baby.

When Tina returned from the funeral, her sister's life was still at risk but Tina bravely continued on, not wanting to let us down. Fortunately, her sister has now recovered.

On July 30, we got the call from the local Health House. Tina was in labor and being cared for by the local midwife. Jane Ohuma, our midwife, went to provide support and Besa Vuthaj, the Deputy of the Health Program, joined them. As the labor progressed, complications arose. No doctor was available and Jane fortunately had the skill and experience to take over the delivery and safely deliver the baby. Early the next day little Mercyana came into the world, surrounded by Tina's surrogate family from Mercy Corps. I am sure her mother was there with her, experiencing the joy of new life, new beginnings and she continues to watch over them.

Tina's sense of being loved and supported by us, she says, has enabled her to gain a new vision for the future. She wants to be part of the development of nursing as a profession in Kosovo.

"I want to help nurses believe in themselves, feel pride in the great job they do and to contribute to the community with a sense of purpose and care rather than as a job," she says.

She says that she will fight for the education of nurses to make all this possible. She believes that only with education will health services improve for Kosovars.

Her experience and training with Mercy Corps put her clearly on the path towards achieving this goal. Mercy Corps is training nurses in community health and providing follow-up, on-the-job support and training for nurses across four municipalities in northern Kosovo. Tina tells the nurses she works with during this training that Mercy Corps believes in them and tells her own personal story of development through our program. She is now inspiring other nurses to share in her vision.

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