
This 68-page report tells the story of a decade of failure by the UN and others to provide adequate housing and medical treatment for the Roma, and the devastating consequences for the health of those in the camps.
A decade ago, the Roma living in the Mitrovica region in northern Kosovo comprised one of the most vibrant and distinctive communities in the former Yugoslavia. Their neighborhood, known as the Roma Mahalla, comprised around 750 houses, with an estimated 8,000 inhabitants. In the wake of the 1999 conflict, during which ethnic Albanians had suffered mass expulsions and killings at the hands of Serbian forces, there was a wave of retaliatory violence against minorities at the start of international rule in Kosovo in June 1999. The targets of this violence included the Roma, Ashkali, and Egyptians (RAE), whom the Albanian perpetrators saw as “Serb collaborators.”
Fearing repression, the Roma Mahalla dwellers fled their homes, crossing the Ibar River to the north Mitrovica region, which remained under Serb control. Albanian crowds subsequently entered the Mahalla, looting the houses and then burning the whole settlement to the ground. The forces of the international peacekeepers (KFOR) who were stationed in Mitrovica at the time did not intervene to stop the pillage and arson.
The Office of the UN High Commissioner for Refugees (UNHCR) provided assistance to the Roma internally displaced persons (IDPs), distributing food and organizing makeshift camps in Cesmin Lug and Zitkovac, to which many of the IDPs moved in October 1999. These camps were supposed to be a temporary solution until Roma houses in the Mahalla were reconstructed. Other IDPs spontaneously occupied abandoned army barracks at Kablare (next to the Cesmin Lug camp) and Leposavic, a town 45 kilometers from Mitrovica.
With the exception of Leposavic, all the IDP camps created were in the vicinity of the Trepca complex, a mine for lead and other heavy metals. The entire region has for years been known for environmental pollution caused by the mining industry. Cesmin Lug and Kablare were located right next to toxic slag heaps of lead-contaminated soil.
The living conditions in the camps were very difficult from the beginning. IDPs lived in small shacks made of wood, in wooden barracks, or in metal containers. They had no access to running water, only a few hours of electricity per day, a poor diet, and could not maintain adequate personal hygiene. At the same time, the proximity of the camps to Trepca and especially the slag heaps of leaded soil exposed them to lead contamination by air, water, and soil (especially when the wind blew from the direction of the slag heaps, or when children played in that area and brought contaminated dirt back into their houses).
The proximity of Trepca and the poor living conditions in IDP camps indicated a clear likelihood of lead exposure. UNMIK, the UN body that was the effective civil authority in Kosovo from 1999 to 2008, commissioned a report in November 2000 to provide recommendations on how to assess risk and means of mitigation. The report recommended comprehensive epidemiological studies, periodic environmental sampling, and robust medical monitoring and medical treatment for those in need. However, it concluded that the costs of any such strategy exceeded the financial capacities of UNMIK. During the period 2000-04, no further steps were taken to address the issue of contamination in the region.
In 2004 information about the deteriorating health of the IDPs in the camps began to emerge from local and international Roma rights activists. They started to bring to light cases of children with black gums, and with lead-related symptoms such as anxiety, concentration and learning difficulties, headaches, disorientation, convulsions, and high blood pressure.
Prompted by the alarming NGO reports, the World Health Organization (WHO) conducted an assessment of the situation in the camps in the summer of 2004, producing an internal report to UNMIK on how to manage the risks and recommending finding a more suitable location for the IDPs and to close the existing camps. WHO also initiated blood testing on children from the camps, which demonstrated unacceptably high lead levels.
In April 2005 UNMIK established a task force (comprising UNHCR, WHO, the Organization for Security and Co-operation in Europe Mission in Kosovo, and the NATO-led KFOR peacekeeping force) to develop a framework for the relocation of IDPs from the camps. The task force came up with the idea of moving the IDPs temporarily to the KFOR-donated barracks in its former military camp known as Osterode, before returning them to the reconstructed Roma Mahalla. The Osterode camp was determined to be more “lead safe,” despite also being located next to the toxic slag heaps.
While offering better living conditions than the other camps, this solution did not move the IDPs from the center of contamination. In the spring of 2006 the inhabitants of Zitkovac and Kablare camps moved to Osterode, but the people in Cesmin Lug largely refused to relocate there, not seeing the point of moving to a location just 150 meters away.
Simultaneously, international donors funded the reconstruction of individual houses and blocks of flats on the site of the Roma Mahalla, which resulted in a group return of 450 IDPs from all the camps (as well as some other locations in Serbia and Montenegro), facilitated by the task force in June 2007. After an initial period of receiving assistance, the returnees found themselves unable to support their families. Most were not given assistance by the Kosovo welfare system, but they had to de-register in the north and lost access to the Serbian assistance they had been receiving. This, coupled with difficulties with finding jobs in south Mitrovica, made the returnees disillusioned with living in the Mahalla, which in turn discouraged other potential returnees. Many Mahalla returnees subsequently left, moving either back to the north or to various locations in Serbia or Western Europe, and leaving behind the reconstructed houses, some of which were subsequently looted.
During the period 2004-06 at least three rounds of testing of blood samples from children, (usually around 50 children each time) were conducted under WHO’s auspices. The test results are not publicly available, but according to WHO lead levels decreased over that period, especially for people in the Mahalla and the Osterode camp. The Roma continued to complain about lack of transparency in the process, an allegation denied by all international actors involved in it. In 2006 WHO organized two rounds of oral chelation therapy (medical treatment aiming to bind and remove heavy metals) on around 40 children from Osterode.
In 2007 UNMIK decided to discontinue further blood testing and therapy. Reportedly, WHO recommended this as it was under the impression that all camps’ inhabitants would be moved back to the Mahalla, where the contamination level is lower.
Roma leaders requested the Serbian Public Health Institute in Mitrovica (which had previously been conducting the testing under the auspices of WHO) to continue monitoring children’s lead levels, and the institute carried out two more rounds of blood testing, most recently in April 2008. The results showed continuing high levels of lead contamination (lower than before, but still exceeding acceptable or moderate levels) in children coming from all the camps as well as the Mahalla.
Efforts to seek justice and compensation for health damage caused by prolonged exposure to lead contamination have yet to produce results. A criminal complaint filed with the Kosovo prosecutor in September 2005 against unknown perpetrators alleging criminal neglect resulting in prolonged exposure to a highly toxic environment did not result in an investigation. A complaint filed by the international NGO the European Roma Rights Center (ERRC) in February 2006 with the European Court of Human Rights on behalf of Roma IDPs was ruled inadmissible on the ground that the court lacked jurisdiction over UNMIK-administered Kosovo. A claim filed in July 2008 with the Human Rights Advisory Panel in Kosovo (a semi-independent body created by UNMIK to deal with human rights complaints against it) was deemed admissible on June 5, 2009, but at this writing the Panel had yet to rule on the merits.
In May 2008 UNMIK handed over the management of the Cesmin Lug and Osterode camps to the Kosovo Ministry of Communities and Returns, which hired and funded a local NGO to run the camps.
The years of continuous failure of UNMIK and its international partners to find a durable solution for the inhabitants of the camps constitute multiple human rights violations, including of the right to life; the prohibition of cruel, inhuman and degrading treatment; the right to health, including medical treatment; the right to a healthy environment; and the right to adequate housing. This failure is the subject of growing international criticism, including from UN human rights bodies and experts.
To remedy these violations, it is vital that UNMIK and its international partners work with authorities in Kosovo, including in Serb-controlled municipalities, and with the leaders of the camps to urgently close the remaining camps, and move their residents to an acceptable location. It is also crucial that medical monitoring and treatment for all IDPs resume without delay. Roma IDPs should also be compensated for the health and other damages incurred.
In June 2009 displaced Roma will have spent a decade in lead-contaminated camps. The complex political reality in Kosovo and especially in the tense Mitrovica region does not change the fact that during a decade of international presence in Kosovo very little has been done to address appalling conditions in the Roma camps and especially the issue of lead contamination. For children and others living in the camps the consequences have been disastrous-not just ill-health but possible irreversible intellectual impairment. The Mitrovica Roma cannot afford to wait any longer.
Methodology
A Human Rights Watch researcher travelled to Kosovo in late November and the beginning of December 2008 to document the current situation in the Roma IDP camps of Cesmin Lug, Osterode, and Leposavic, as well as the return site in the Roma Mahalla.
Human Rights Watch interviewed the most prominent leaders in each of the camps, six other RAE community activists, and 40 members of the RAE community living there, 10 of whom were women. Most of the persons interviewed were ethnic Roma, while a few interlocutors described themselves as Ashkali (see Chapter IV, “Background,” for more information on ethnic self-identification).
Interviews were conducted in Serbian, Romani, and Albanian, through interpreters hired by Human Rights Watch. Interviews were conducted individually except in the Leposavic camp, where persons were interviewed in a group and in the presence of the camp leader. All individuals were offered anonymity, and the majority of individuals preferred not to give their names to us. Individuals were told that the information they provided would be used in a report prepared by Human Rights Watch and were told that they were free to decline to answer any questions or to end the interview at any time. Nobody we approached declined an interview, although parents spoken to preferred to talk about the conditions of their children, rather than letting Human Rights Watch interview children themselves. No money was paid for any of the interviews.
Human Rights Watch conducted in-person interviews with 10 national and 21 international officials, from the Kosovo Ministry of Returns and Communities, Office of the Prime Minister of Kosovo, Ombudsperson Institution, the United Nations Mission in Kosovo (UNMIK), the Office of the UN High Commissioner for Refugees (UNHCR), the United Nations Development Programme (UNDP), the World Health Organization (WHO), the European Union Rule of Law Mission in Kosovo (EULEX), the International Civilian Office (ICO), the Organization for Security and Co-operation in Europe (OSCE) Mission in Kosovo, and the NATO-led Kosovo peacekeeping force (KFOR). We also interviewed representatives from the following NGOs: the Roma and Ashkali Documentation Center, Mercy Corps, the Danish Refugee Council, Norwegian Church Aid, and Movimiento por la Paz.
Further interviews were carried out by phone and email in January-February 2009, including with WHO, the United Nations Children’s Fund (UNICEF), the United States Centers for Disease Control and Prevention (CDC), the Kosovo Ministry of Health, the Kosovo Ministry of Environment, the Serbian Ministry for Kosovo and Metohia, and Serb-controlled municipal authorities in north Mitrovica. We also conducted follow up with civil society groups including Romano Them/Chachipe and the Kosovo Medical Emergency Group (a network of concerned activists including NGOs and academics).
Most international officials working in Kosovo interviewed for this report requested that we withhold their names, even when commenting on uncontroversial matters.
Human Rights Watch encountered significant challenges while conducting research on past efforts to provide medical treatment to displaced persons living in areas of lead contamination. The results of the blood testing done under the auspices of WHO in 2004-06 are not publicly available. Neither are the results of blood testing conducted by the Mitrovica Institute of Public Health in Mitrovica in 2008. Human Rights Watch was provided with a summary of the results of both sets of testing, but was denied access to detailed information about the results.
There is no publicly available detailed information on the past instances of chelation therapy administration, and Human Rights Watch was unable to obtain such information despite repeated requests to relevant agencies. Human Rights Watch relied on verbal statements of camp residents, local medical practitioners involved in the camps, and international officials working on the issue while compiling the medical history section in Chapter IV of this report.
In an effort to fully assess the impact of lead on the health of displaced persons resident in camps in north Mitrovica and the effectiveness of past efforts to provide testing and treatment for lead contamination in the camps, Human Rights Watch sought the opinions of independent medical experts in Europe and the United States. But because of the lack of statistical data available, the experts contacted were reluctant to comment on the approach taken by the international community to the medical problems in the camps. The information provided here on the symptoms, effects, and treatment of lead contamination is based on reviews of medical journals analyzing studies of lead contamination.