VIII. Future Scenarios for Resettlement and Medical Treatment

The story of lead-poisoned Roma IDPs constitutes one of the most glaring examples of negligence and failure of the international authorities in Kosovo to address serious human rights violations of its most vulnerable population. Mandated and put in charge to facilitate returns and protect the minorities and displaced, none of the key international organizations, including UNMIK and UNHCR, have done enough to address the problem, which persists today.

During the first five years of camps in the north, little was done to address the lead contamination issue, and information about the health impact did not seem to be treated seriously enough. Due to these initial years of neglect, it became even more difficult to address the issue by the time some coordination actions started to take place under the umbrella of UNMIK, and involving the other key international institutions present in Kosovo. And by then the camps' inhabitants had become distrustful of the international authorities' efforts. More recently (as described in Chapter V)  the problem of the Roma IDP camps in the Mitrovica region has been under scrutiny by a variety of international organizations, NGOs and activists, who have made various recommendations. While the international actors in Kosovo who are largely focused on providing a long-term sustainable solution have paid limited attention to the medical treatment aspect, NGOs and activists have focused on medical evacuation coupled with immediate medical treatment. To date, the three main solutions that have been proposed are persisting with return to the Roma Mahalla, resettlement elsewhere in the north of Kosovo, and relocation to third countries.

Return to the Mahalla

The sustainable return of the Roma IDP camp residents to the Roma Mahalla has been for years pursued as the preferred option of UNMIK and other international actors in Kosovo. In the early years of negotiations, Roma leaders appeared more favorable to the idea of returning to their place of origin, despite their fears about living alongside the community that originally expelled them from the site in 1999.[223] Their level of enthusiasm dwindled in the months following the initial return in 2007, because of the difficulties encountered by the returnees.[224]

Despite these difficulties, the Mahalla remains the preferred option for international actors in Kosovo. Norwegian Church Aid, the key international NGO engaged with the Mahalla returnees, is constructing new housing blocks in the Mahalla (expected completion in autumn 2009), which would be able to host up to 24 families (around 125 individuals).[225] The United States Agency for International Development (USAID), through its implementing partner Mercy Corps, is currently developing a project for around 50 families of Osterode and Cesmin Lug to relocate "to the place of their choice," which includes the Mahalla for those who so choose (see also below).[226]

From the point of view of existing infrastructure, the return site of the Mahalla appears the most feasible location at present. It also offers a site away from the epicenter of lead contamination. But when Human Rights Watch interviewed Roma leaders and either formally interviewed or spoke informally to 28 residents of the Cesmin Lug, Osterode, and Leposavic camps in December 2008, most of them were reluctant to return to the Roma Mahalla. They said that they recognize the Mahalla is less lead-polluted but fear they would not be able to support themselves economically after they return.[227] Two displaced Roma told Human Rights Watch they would not rule out returning if further income generation projects were available, and if food aid was provided and access to schooling and medical facilities guaranteed.[228]

The fact that many of the previous Mahalla returnees did not qualify for social benefits in South Mitrovica (see Chapter VI) makes it important that any future Mahalla return initiatives ensure all returnees can access social welfare benefits. The Kosovo authorities should immediately address this issue, to demonstrate they are serious about their support for the return project.

The president of the Serbian National Council,[229] Dr. Milan Ivanovic (who is also the head of the hospital in north Mitrovica), told Human Rights Watch that considering the overcrowding in the north and scarcity of resources, in his personal opinion the best solution would be to close the camps and return people to the Mahalla, while ensuring that they can easily cross back to the north to access schools, jobs, and medical care.[230] Given that those who return to Roma Mahalla lose access to Serbian welfare benefits, and their continuing access to the hospital in north Mitrovica is an informal practice (see Chapter VI), making this solution work would require a commitment from the Serbian authorities to formally allow Roma Mahalla returnees to access medical facilities in the north if they so choose. It would also require a policy commitment from the Kosovo authorities to giving Mahalla residents full and facilitated access to welfare assistance.

Resettlement in the North

During our December 2008 research the substantial majority of Roma camps residents we spoke with expressed an interest in being permanently resettled in the Serb-majority areas north of the Ibar River (referred to here as the Mitrovica region, and encompassing part of Mitrovica municipality plus the municipalities of Zvecan, Leposavic, and Zubin Potok). They put forward greater economic opportunities, easy access to medical care (especially in the north Mitrovica hospital) and to local schools, as well as satisfactory security conditions as the main reasons for wanting to resettle there. When interviewed by Human Rights Watch, Skender Gusani, the camps' leader, stated that he has been in touch with the Serb-controlled municipal authorities in the north who, he claimed, would be willing to assign "a few suitable [lead safe] locations if they are officially asked."[231] Nevertheless, according to the information received by Human Rights Watch from the north Mitrovica authorities, there is at present no suitable land available for any such project, as land in the Mitrovica region is scarce and the small parcels of unused municipal land available are needed for "various infrastructural purposes, such as the sport stadium."[232]

According to Human Rights Watch's research, international and Kosovo authorities have yet to contact Serb-controlled municipal authorities in northern Kosovo to explore the possibility of allocating land there to construct houses for displaced Roma. This reflects in part reluctance by UNMIK and other international actors and the Kosovo authorities to engage with Serb-controlled municipal authorities, which retain strong ties to Belgrade and do not recognize Kosovo as independent.[233]

Some international NGOs have made contact with the Serb-controlled municipal authorities about allocating suitable land for the Roma. Norwegian Church Aid discussed the issue with municipal authorities in 2008. Reportedly, the location proposed by the municipal authorities was near the banks of the Ibar, in an area that sometimes floods.[234] Mercy Corps put forward an official request to the (north) Mitrovica municipality in January 2009, asking for potential land allocation for Roma IDPs, and they were waiting for a response at this writing.[235]

Human Rights Watch contacted various Serbian and Serb-controlled authorities to gauge their willingness to collaborate on closing the camps.A Serbian Ministry for Kosovo and Metohia representative stated that any decision to allocate land rests with the (Serb-controlled) municipal authorities in northern Kosovo, but confirmed that the ministry "would support eventual resettlement projects, even though the ministry would not be the one to conduct any such projects." Affirming that "the Serbian Constitution guarantees everybody the right to live wherever they want," he stated that the ministry would not obstruct any potential process leading to the stabilization of the Roma community.[236] President of the Serbian National Council Dr. Ivanovic expressed the view that, even though the council would not oppose the stabilization of the Roma IDPs in north Mitrovica, it does not see this as the ideal solution, as the territory already hosts large numbers of IDPs, "most [of whom] live in very dreadful conditions."[237] As noted above, Ivanovic sees return to the Mahalla, coupled with access to services and employment in the north, as the most viable option.

Ivanovic also stated the commitment of the Serbian authorities to the camps, including the "continuous free-of-charge hospital care" that has been provided "despite the ever decreasing budget for Kosovo and Metohia." He also stated that the Mitrovica hospital had planned to add a new facility to treat children for lead contamination, but claimed that UNMIK and WHO had failed to deliver on their promise to support the initiative.[238] Human Rights Watch enquired about this with UNMIK and WHO interlocutors but they had no knowledge of this issue.[239]

The stabilization of the Roma community in the Serbian majority areas broadly corresponds with the wishes of the majority of the Roma living in the camps. In order to arrange this solution, and ensure the immediate removal of the Roma from the contaminated camp sites, it would be necessary for whichever international agency leads the pursuit of resolving the Roma IDPs' situation (see below) to take the bold step of engaging officially with Serbian and Serb-controlled authorities and secure a suitable location for constructing new housing. Other donors would also need to be identified, in order to construct enough accommodation to relocate everybody at the same time into permanent housing. (The USAID/Mercy Corps project in development, mentioned above, would in the best-case scenario relocate at most 50 families, which is fewer than half of the families currently living in Osterode and Cesmin Lug).[240]

If the authorities in the north were to agree to assign a suitable piece of land and donors were to step in to ensure the necessary funding, it would still be a time-delayed solution. Refugees International suggested in 2005 that a good interim option would be to move camp residents to private rented accommodation in northern Mitrovica, and pay their rent and provide any other necessary support (medical treatment, food aid etc.) until their houses are constructed.[241]According to Mitrovica residents interviewed by Human Rights Watch, as of December 2008 the average monthly rent for a family house in north Mitrovica was €350, and the average time to construct a house was approximately one year.[242]

Human Rights Watch asked Skender Gusani for his views on the option to move to temporary privately rented accommodation pending relocation to new houses. He stated that his feeling is that "this option could be supported by the community, under the condition that this is not the only element of the assistance, but rather an interim step onto a satisfactory permanent solution, coupled with the medical treatment."[243]

Relocation to Third Countries

The idea of relocation to third countries has been put forward since the camps' early years, most notably by Paul Polansky, an American Roma rights activist based in Serbia. In his publication "UN-Leaded Blood," Polansky describes his efforts since 1999 to push all relevant policymakers in Kosovo and abroad to medically evacuate the camps.[244] Because of the persistent failure of the authorities in charge to secure a sustainable and timely alternative for the Roma IDPs in the camps, Polansky argues that the best solution would be to airlift them to a third country, such as the US.[245]

Most recently, he co-founded the Kosovo Medical Emergency Group (KMEG), a transnational grouping of human rights activists, scholars, and supporters committed to joint action leading to closure of all the camps and immediate provision of medical assistance to their inhabitants. In March 2009 the group published a demand to key international actors to close the camps immediately and evacuate all the families to a safe place "where they can be given proper medical treatment while their eventual resettlement is being organized, taking into account the wishes of the families and their best interests for security, health, work opportunities, and education."[246] KMEG's initial advocacy focus on third-country relocation was dropped in April 2009.[247]

Third-country relocation is deemed unrealistic by most international interlocutors Human Rights Watch spoke to in December 2008 and January 2009 in Kosovo and Brussels.[248] In the current climate, when large numbers of Kosovo Roma are being forcibly returned from Western Europe, in the words of one European Commission official, "there is no appetite in Europe for more asylum seekers from that region."[249] With EU policy trends going in the opposite direction, and with the EU, Kosovo's main donor, focused on exploring directing some of its current financial assistance to communities on the ground, there appears little will to explore any out-of-Kosovo solutions for the displaced Mitrovica Roma.[250]

Medical Treatment

The three scenarios described above focus on the resettlement of the Roma IDPs from the lead contaminated camps. However, resettlement alone is not going to solve the problem of lead contamination. Urgent medical treatment needs to be administered to those with particularly high lead levels, and the rest need to follow a calcium- and vitamin-rich diet, in order to neutralize lead using natural methods.

According to Dr. Jean Brown from the US Centers for Disease Control and Prevention, "chelation therapy is a straightforward and relatively inexpensive medical procedure. Chelation therapy and a better diet can be easily administered by a few trained medical staff members who receive some special training."[251]

In order for chelation therapy to work best, people undergoing the treatment should be moved away from the site of exposure to contamination. This calls into question the previously administered treatments in the contaminated camps, and highlights that evacuation of Osterode and Cesmin Lug camps is crucial. In practice it is difficult to ensure a 100 percent lead-free environment, especially in the Mitrovica area, but Osterode and Cesmin Lug, close to Trepca's lead-contaminated slag heaps, are among the locations least conducive to successful treatment; it only makes sense to administer chelation therapy in areas with a lesser degree of lead contamination[252]-that is, in locations further away from the Trepca complex.

It is also critically important that the population is systematically screened for elevated levels of lead in the blood. The failure to conduct systematic testing to date has made it impossible to develop an effective treatment program or to assess the impact of the treatment delivered.

Many other diseases the camp population suffers from, including kidney problems, high blood pressure, and respiratory problems, are aggravated by lead. Treatment for lead contamination and an improved diet should bring about an improvement in the overall health of the residents, provided people are evacuated from areas of high contamination. Wherever they are relocated, it will be important to provide on-site medical care and continued access to hospital services free of charge, and free access to medicine.

The Need for Leadership

In order to break the current stalemate there is a need for an entity or institution to assume leadership and responsibility of negotiating, coordinating, and implementing the urgent evacuation and medical treatment of the Roma IDPs, engaging the Roma and all other relevant authorities (including Serbian authorities, Serb-controlled municipal authorities, Kosovo institutions, international organizations, NGOs, and donors). This entity needs to have the political authority and technical capacity.

Even today, UNMIK has the strongest political mandate related to minority protection, including the displaced populations. In order to forge a durable solution for the residents of the camps, the UNMIK SRSG needs to make a decision to put the most suitable institution in charge of driving forward the process, to ensure the immediate relocation of the residents from Osterode and Cesmin Lug camps, the permanent closure of both camps, comprehensive medical treatment for lead contamination, and resettlement for the residents of the Leposavic camp.

An obvious candidate would be the United Nations Kosovo Team (UNKT), under the chairmanship of the UN Development Coordinator (UNDC). The team consists of 14 UN agencies, funds and programs active in Kosovo (including UNDP, UNICEF, UNHCR, WHO, WFP, IOM, OHCHR, UNIFEM, UN Habitat, UNEP, and UNOPS), which between them have mandates for interventions in the fields of health, women's rights, children's rights, and assistance to refugees and internally displaced persons.[253] The UN Kosovo Team possesses the necessary know-how, and could be acceptable to all parties to undertake a project to evacuate and close Osterode and Cesmin Lug as a priority, and the camp in Leposavic at a later stage.

With the UNDC playing a coordinating role, WHO taking a lead on medical treatment, UNHCR and UNDP negotiating a suitable short- and long-term solution for the physical evacuation and subsequent closure of the camps, and the other agencies providing adequate assistance to ensure economic sustainability of the project and any other services needed, the camps' closure would become a real possibility, after years of neglect and delays. Human Rights Watch spoke in February to the UN development coordinator who indicated that "he would not shy away from such a responsibility."[254]

UNKT would need to ensure that the authorities in Pristina and Belgrade, and Serb-controlled municipal authorities in Kosovo, are on board with the proposed solutions. If needed, they would need to ensure their financial support, or else find other interested donors. The European Commission appears to be interested in supporting financially feasible initiatives leading to camp closure.[255]

A key challenge of any initiative is to regain the trust of the Roma themselves. The organizations involved would need to move fast, in order to help people leave the camps and immediately provide medical treatment and material assistance.

In order to achieve the immediate closure of the camps, some kind of temporary solution, such as accommodating people in rented flats as discussed above, may be necessary. If this option is to be pursued, it will be a challenge to overcome the mistrust of the Roma community toward "temporary" solutions that become semi-permanent. One approach would be to develop a memorandum of understanding between the Roma beneficiaries and the leader of any such initiative, stating the maximum duration of the temporary solution, and obliging the implementing partners to deliver permanent housing in the prescribed timeframe and in a location acceptable to the Roma.

It may be the case that not everybody would like to move to the same long-term housing. There may be families unwilling to return to the Mahalla even if economic sustainability is ensured. In this case, it is important not to leave these people in the cold. There might not be one solution suitable for everybody, and the entities implementing the project might find it necessary to have more than one solution on offer. After spending years in shameful conditions and suffering from harmful lead exposure, the camp residents deserve to have their wishes taken into consideration.