Albania                                                                                                            

Potemkin Villages in Kosovo

UN officials and population-control zealots confidently predicted that refugees
from Kosovo would need contraceptive services. But a reporter on the scene found very
little interest in the family-planning services among the refugees themselves.

By Austin Ruse

A tiny stream of Kosovar refugees began crossing the Albanian border in the fall of 1998. They moved into hastily built refugee centers in the north of Albania. By the end of March this year, as Kosovars began running away from NATO bombing and Serbian atrocities, this small stream grew into a raging river. Pictures of hungry and frightened Kosovars filled the world’s newspapers and television sets, as the refugees fled from the increasing carnage. Most of these refugees left their homes in Kosovo with little more than the clothes on their backs.

Over one 60-day period, roughly 800,000 people crossed the border from Kosovo. Some went to Montenegro, some to Macedonia, but the overwhelming majority ran to their estranged ethnic Albanian cousins.

In those early days of the chaotic flood, the refugees caught the world flat-footed. The tents, food, and medicine on hand at the refugee camps was not nearly adequate; the charitable agencies were not ready. Then a massive relief operation started; agencies from dozens of different countries moved quickly to help the Kosovars.

One of the oddest responses to the crisis, however, came from the United Nations Population Fund (UNFPA), which announced on April 8 that, in cooperation with the world’s largest abortion provider, the International Planned Parenthood Federation, it was sending enough “reproductive health kits” to serve a population of 350,000 refugees for as long as six months. These “reproductive health kits” included the equipment needed for childbirth, the UNFPA announced. They also included contraceptives—including the abortifacient “emergency contraceptives”—and some “vacuum extraction” devices which the UNFPA insisted were intended for use only by medical personnel in “assisted deliveries.”

UNFPA’s response came at the very beginning of the refugee crisis, at a time when the refugee camps in Albania were in almost complete chaos. Indeed, in the early days of the emergency, one doctor was quoted by one Italian news agency as complaining that he had far too many contraceptives and not nearly enough basic medical supplies. At that point, the worldwide relief effort had not come close to meeting the basic needs of the refugees. Sometimes packed like cattle into trains, the refugees were scattered around camps up and down the Adriatic coast of Albania, many of which were still in the first stages of construction.

The Kosovars entered a country which had long been under the sway of aggressive population-control programs. After the fall in the early 1990s of one of the most oppressive Communist regimes in history, the Albanian birth rate had fallen to 2.44 children per woman. In the port city of Vlora, four hours south of the capital of Tirana, Georgio Fontana of the Italian relief agency AVSI reports that there are more abortions in the regional maternity hospital than live births. Indeed, the fertility rate has fallen so rapidly in Albania that there is talk in Tirana government circles of the possible need to initiate some sort of pro-natal policy.

In addition to the triple misfortune of being targeted by the Serbs, coming under the terrible NATO bombing campaign, and running for their lives, the refugees who came flooding out of Kosovo also came under the gaze of population-control agencies, who were quick to note that the Kosovar women have the highest fertility rate in Europe. So some human rights organizations and institutions devoted to pro-family work became concerned that these thousands of Kosovar refugees in Albania—who were in effect a captive population for the time being—would become the victims of an aggressive anti-natal campaign conducted by the Albanian government in concert with UNFPA, the US Agency for International Development, the International Planned Parenthood Federation, and other pro-abortion non-governmental organizations, such as the London-based Marie Stopes International, which had long been active in Albania.

For eight days in early June I traveled in Albania, looking for the truth behind the rhetoric.

Anarchy and corruption

The airport at Tirana had been taken over by NATO military commanders, so very few commercial flights were allowed in. Travel by car into Albania makes no sense. The roads are among the worst in Europe, and most highways are controlled by the night bandits who drive Mercedes-Benz sedans, wield Kalishnikov automatic rifles, and think nothing of murdering wayward travelers. Consequently, most relief workers come into Albania from Italy, on an overnight ferry that leaves from the port at Bari.

Albania is an almost lawless land. It suffered under the most brutal Communist dictators in the world. For years Enver Hoxha ran his country as a sort of a slave colony. Aligned for many years with the Soviet Union, Hoxha split with the Soviets when he felt they were becoming too liberal, and became a client of the Chinese Communists. The beautiful Albanian landscape, with its majestic flat plains and rocky mountains, is dotted everywhere with cement bunkers shaped like mushrooms, from which soldiers spied on the Albanian people. These bunkers are crumbling and empty now, but they will remain with the Albanians, as reminders of the Hoxha regime, for decades to come.

One odd characteristic stands out as a sign of the country’s economic problems: hardly anyone in Albania wears eyeglasses. In fact, foreigners are readily identified by their eyeglasses. Since it is well established that a certain percentage of the people in any population will have vision problems of one sort of another, it is easy to conclude that many an Albanian driver cannot see clearly beyond the hood ornament on his Mercedes—a fact which does not seem to discourage the ubiquitous hell-bent-for-leather driving style.

When Hoxha died in 1985, after four decades in power, his Communist Party cronies took over. But they were toppled after a wave of civil unrest swept across the country in the early 1990s. Then a crude form of “democracy” came to the Albanian people, along with a cruder form of capitalism. A fraudulent financial enterprise—a pyramid scheme that affected almost every family in the country—thoroughly ruined the national economy. When the scheme collapsed, riots ensued, and the nascent “democratic” party lost power. Now a socialist government has the reins.

The cities are crowded and the buildings are all falling down. A photograph of downtown Tirana, taken at the height of the Hoxha era, shows a city almost completely devoid of automobiles; even in 1990, only 23 cars were on the streets in the town of Durres. Now the roads are completely jammed with vehicles. Most of these cars are Mercedes-Benz sedans, stolen by Albania youth gangs working in Germany and resold in giant open-air markets for between $4,000 and $20,000. Many young women of Albania are also engaged in illegal enterprises across international borders; they are smuggled into Italy to ply the prostitution trade in red-light districts in Rome and elsewhere. Albanians do not have a good reputation among the peoples of Europe.

For their part, the people of Albania have never been particularly cozy with their ethnic cousins in Kosovo. This tension may be attributable largely to jealousy. The image of Kosovars as peasants, which is accepted so widely in the West, is simply not accurate. Kosovo has had a strong middle class, and a strong dedication to both private property and freedom. Albanians, who have so little experience with either freedom or private property, have long resented their neighbors.

It was into this land, marked by a mix of lawlessness and hostility, that the Kosovars flooded in late March and early April.

Who invited them?

UNFPA makes it very clear that the group’s representatives never insert themselves into any country without an invitation. The UNFPA head of external communications, Sterling Scruggs, recently made this point in a published exchange with the editors of the Daily Oklahoman newspaper. Scruggs says UNFPA was invited into the refugee camps by the Albanian government. According to Scruggs, they were invited some time ago by President Milosovic to conduct a “needs assessment” in Kosovo. He indicated they will probably follow up this study with “regular programs” in the coming months.

There were three general reasons given for the UNFPA intervention into the Kosovar tragedy. The first, and by far the most potent from a political and emotional viewpoint, was rape. It was reported for weeks that “systematic rape” was being perpetrated by the Serbs against Kosovar women. Second, it was said the Kosovar women live in an overwhelmingly patriarchal society; they would surely want their “reproductive rights,” the family-planning lobby assured us, if only they knew about them, and if only their husbands allowed it. But Kosovar women were said to be shy, retiring, and powerless; they would need help. Third, it was whispered sexual promiscuity was common in the refugee camps, and therefore measures like sterilization and “emergency contraception” would be desperately needed.

Many activists in the pro-natal camp look upon UNFPA as an all-powerful, all-seeing agency that can reach into almost any country and through money and force of will impose its ideology upon a population. What I found in Albania, where UNFPA has had a permanent office for many years, was that outside of its New York headquarters, UNFPA may be something of a paper tiger. Moreover, the great show made by UNFPA in providing “reproductive health kits” to last 350,000 people for upwards of six months was little more than public-relations posturing. Certainly the kits went somewhere, but at this point UNFPA has only a vague notion of where the kits actually went.

My mission in Kosovo was threefold. First, I intended to discover whether the three reasons given for UNFPA intervention were true. Second, I intended to investigate reports of human rights abuses related to the “reproductive health” intervention in refugee camps—that is, to discover whether women were receiving these services with full and informed consent. Third, I intended to find a “reproductive health kit.”

An “unmet need”

UNFPA claims repeatedly to be a completely non-ideological agency. Its spokesmen say that they merely follow the mandate of the Cairo Program of Action, a document written amidst great controversy at the International Conference on Population and Development in 1994. The Cairo Program of Action explicitly forbids the use of abortion as a method of family planning. To circumvent this ban, UNFPA uses a series of intermediaries: pro-abortion non-government organizations (NGOs) that receive financial and other material support from UNFPA. The chief exporters of their anti-natal message in Albania are Marie Stopes International, a London-based NGO that promotes and performs abortions all over the world, and the Albanian Family Planning Association. One of the pet phrases used by UNFPA in public pronouncements is that they are only trying to fill an “unmet need.” But what I found in their own private memos, and confirmed in interviews with their NGO partners, was that the Kosovar situation had created an “unmet need” only in the minds of UNFPA personnel. What I discovered was a sophisticated marketing apparatus, designed to create a desire for population-control services. This marketing effort was among the top priorities of UNFPA and its NGO partners.

Adrian Paravani runs the Marie Stopes office in downtown Tirana: a shiny three-story building behind a high wall near the US embassy downtown. Paravani is also program director of a business enterprise called Nesmark-CSMU, a German-backed marketer of reproductive-health supplies. Paravani was educated at New York University, where he took a master’s degree as a Fulbright Scholar. He spent a few years working at the US embassy, until most of the embassy’s operations were closed down after a series of riots a few years ago. Given such items on his resume, it is logical to assume that Paravani comes from one of Albania’s few elite families.

Nesmark employs four full-time salesmen, who scour the countryside selling a vast array of contraceptive gear to the 600 pharmacies in Albania. They provide condoms under the brand-name “For You,” oral pills, Depo-Provera, and various forms of “emergency contraception.” Paravani says that his firm is engaged in the “social marketing” of condoms—that they are trying to overcome prevailing attitudes, because condoms “are still viewed as a shameful thing.” Paravani claims that contraceptive use among Albanians is only 10 percent. That estimate is highly suspect, since in the span of just a few years the country’s fertility rate has dropped to 2.44 children per woman. Straining this reporter’s credulity still further, Paravani clamed that the rate of contraceptive use is around 30 percent among Kosovars—a population which, I would find, had hardly even heard of Paravani’s products.

Not all of his salesmen are successful in changing popular attitudes, however. There is still some fierce resistance to the “social marketing” message. Not long ago, a pharmacy owner wielding a Kalishnikov chased one of Paravani’s salesmen out of his store and down the street.
Paravani is eager to work his way into the refugee camps. He even offered to set up a tent in a new camp near the town of Fier, an enormous camp being erected by the Americans. Thus far, he has been unsuccessful.
An office in disarray
Across town, in a dirty, falling down building sits Valentina Leskaj, executive director of the Albanian Family Planning Association (AFPA) and president of the Albanian NGO Forum. Leskaj has fought the “reproductive health” battles in Albania from the very beginning. Founded in 1992 and associated with International Planned Parenthood Federation, AFPA agitated early on for the change in Albanian abortion laws. According to Leskaj, the total number of abortions in Albania rose from 30,000 per year before legalization to 37,000 per year after legalization. Still she contends that “liberalizing abortion laws prevents abortions.”

Although abortion and other “reproductive health services” such as sterilization and contraception are broadly available in Albania, Leskaj is unhappy. She complains that there are still many barriers preventing her from reaching all Albanian women, and she has had little luck in penetrating the captive population of Kosovar refugees. She cites five reasons for her failure to reach the refugees:

•    Kosovar women do not have the right “mentality” to accept the AFPA services;
•    the refugees come from a “different culture,” which is “closed off” to the world;
•    it is difficult to “separate women from their families,” and arrange for “private consultations”;
•    transportation from the camps to the clinics is inadequate; and
•    some relief agencies run by religious groups—for the most part, Catholics—are not allowing the pro-abortion NGOs access to the refugees under their care.

Leskaj claims a close working relationship with UNFPA, and it shows. The walls of her small suite of offices are covered with posters supplied by UNFPA, including one proclaiming that “all young people of the world . . . have . . . rights as sexual beings. . . .” A stack of boxes with UNFPA stickers reaches almost to the ceiling. Leskaj also claims that her group was very active in a number of refugee centers, in and around the northern town of Skhodra, and especially in the southern port city of Vlora. Later I would learn that these claims were a mixture of wishful thinking and boasting, probably intended to shore up support among her donors.

In fact, UNFPA in Albania is mostly in disarray. Although the organization has long had an office in Tirana, during the busy past ten months that office has not had a director. Although the refugee crisis was easy enough to predict, UNFPA was caught unprepared. As the refugees poured over the border, UNFPA sent in a consultant to make an assessment of needs. In April, UNFPA released the recommendations of Dr. Manuel Carballo who appears to have been on the ground in Albania from April 6-13. After only a week, Carballo was quite certain that this new population of refugees needed UNFPA products and services. He wrote, “Although there were few hard data available on the demographic and social composition of the refugees, the profile of the Kosovo population before the crisis points to a relatively young population with a large proportion of people in their reproductive years.”

Carballo recommended the distribution of a broad range of the “reproductive health kits” that UNFPA chief Nafis Sadik unveiled on April 8. Actually there are eleven different “sub-kits” among these reproductive health kits, including a condom sub-kit, a post-rape sub-kit, an oral and injectible contraceptive sub-kit, a “management of complications of abortions” sub-kit, and a vacuum aspirator sub-kit. What drew the attention of many journalists at the time of the April 8 announcement from UNFPA was the sheer number of kits involved in the UNFPA contribution. But when UNFPA said that the kits would serve 350,000 people for six months, that did not mean that 350,000 different people would receive a kit. According to the UNFPA manual being used in the Kosovar refugee camps, each set of sub-kits is designed to serve a population of 10,000 people for a period of three months.

I arrived in Albania 60 days after Nafis Sadik’s announcement of the introduction of the “reproductive health kits” that were being sent into Albania. Seemingly not satisfied with the operation of her Albanian office, early in June, Sadik had sent in a senior specialist to direct UNFPA’s emergency effort. Dr. Roseanne Murphy, a tough-talking yet charming New Yorker, arrived in Tirana only a few days before me, in the second week in June. Murphy is something of an international trouble-shooter. She has served various UN agencies in emergency situations all over the world for nearly twenty years. She was at the Cambodian border in 1982. She was in Sudan from 1984 through 1986 when a million Ethiopians crossed the border; in Malawi and Mozambique from 1986 to 1987; Sudan again from 1987 to 1990; Hong Kong in 1990 and 1991; Eastern Europe from 1991 to 1996. While Murphy has done mostly straightforward relief work in refugee situations, she is a “reproductive rights” ideologue. When I told her that some Eastern European nations were considering plans to stimulate population growth, she sneered about “pro-natalists,” and said, “that is just the boys talking.”

The most important question for all the pro-abortionists marketing their services among the Kosovo refugees is how to crack the resistance they encounter in the camps. How can they persuade a seemingly uninterested audience of Kosovar women to accept their services? It is clear from Carballo’s recommendations, and from the presence of such a seasoned expert as Murphy, that UNFPA and its NGO allies have presumed a strong interest among the Kosovars for the full range of “reproductive health services.” Once again, they have banked on the existence of a giant “unmet need.”

Murphy is a devotee of the leftist labor agitator Saul Alinsky. “Find the clothesline or the water, because that is where you will find the women,” says Murphy, explaining a technique that might have come from an Alinsky manual:
And you line them up and tell them they can have one complaint, and none of them can be complaints about immigration. As a group you tell them they are to return sometime later with one complaint for all of them.

Murphy firmly believes that when she tries this tactic in the Kosovar camps, the subject of reproductive health will come up. She believes this because the Kosovars have such a high fertility rate. This cannot happen, she feels certain, without some kind of coercion by the husbands at the expense of the wives. Over the first few days after her arrival in Albania, Murphy took a whirlwind helicopter tour of the camps both north and south. She used her Alinsky technique in each camp. What were the results? Murphy concedes, “The Kosovar women aren’t talking.”

Happy families

All Albanian roads are bad. The ones in the north are the worst of all. Tirana has always held the north in special contempt. It is the stronghold of Albanian Catholicism. When Enver Hoxha outlawed religion in 1967, all the churches became movie theaters. The giant cathedral in the northern town of Skhodra was turned into a sports palace. Although Skhodra is less than 60 miles north of Tirana, the rotten roads mean that the trip takes nearly four hours. I went to Skhodra to look around the camps, and to find the influence of UNFPA, AFPA, and other anti-natal agencies and NGOs. I also went to find out whether the Kosovar women really felt an “unmet need”—whether they really hungered for UNFPA’s vision of reproductive rights.

What I found almost immediately was that, no matter what sort of statements their public-relations machinery generated, UNFPA and AFLA had no visible presence anywhere in the north. I also discovered that the Kosovar women were not the shy and retiring kind. And finally, I found out what UNFPA already knows: the Kosovars are not interested in the “reproductive health” services that lead to the kind of denuded families common in the industrialized west.

Over two days I made extended visits to four camps: the German Camp, the Austrian Camp, the “Big Nut” camp run by the Catholic group Caritas Albania, and a camp run by the local government called “The Tobacco Factory.” For the most part entrance into a camp is not easy. Visits are aggressively discouraged.

The first thing to understand about the refugee situation is that most of the world formed their images of the situation as the crisis unfolded. We saw pictures of burned-out buildings, of hungry and wounded people. That was in March and April. While it took a while for the camps to organize, by early June most of them were running like tops. This efficiency is due in no small measure to the dozens of public and private relief agencies buzzing around the country. With the exception of battered Mercedes-Benzes, the most visible vehicles these days are white off-road vehicles with a stenciled name across the side. The world of humanitarian agencies is here. Albania has never seen an invasion like this. These groups, together with the industrious Kosovars, have made most of the camps very livable.

In Skhodra I met with a few dozen Kosovars. I met them in their tents, in hospitals and along the roads. I found the Kosovars to be incredibly friendly and open. Given media accounts, and the briefings I received in Tirana, I expected deep reserve and emotional hurt, if not open hostility. Instead I found resolve, determination, and joy.

Starting a conversation with a group of Kosovars is as easy as smiling at them. A group of men and women beckoned me to their tent in the German camp. They wanted all the news from America. They love America. The US is viewed, more than NATO or any other country in the alliance, as the conquering hero of the Kosovar people. When I met with these refugees, the war had not yet ended. Still, they knew that it would, thanks to American bombs, and they were eager to return.

After a lengthy conversation about American intentions and American resolve, I steered the conversation to “reproductive health.” Kosovar women are eager to receive assistance with maternal health; that much is very clear. What is also clear is that they already know a fair amount about the full range of “reproductive health services.” Of course, they don’t know all the “right” language that currently dresses up the subject, but they certainly know the basics. The women tell me that some, but not many, of their big-city friends have IUDs. They tell me they are happy to have big families. They smile broadly when told that their fertility rate, the highest in Europe, is the talk of policy circles in the US.

The conversations were very much the same in every camp I visited in Skhodra. I repeatedly investigated the three reasons given for the UNFPA policy: systematic rape, timid Kosovar women, and promiscuity in the camps. On the question of rape, a UNFPA investigator reported in early May that there is no real evidence of systematic rape of Kosovar women. It is conceded that rape occurred, but not necessarily as a part of Serbian state policy. Indeed, the alleged policy of systematic rape was not one of the charges brought against the Serb President Milosevic and his generals at the UN war-crimes tribunal. Knowing Kosovar women would not talk freely with me on this topic, I spoke instead with more than a dozen aid workers, none of whom had uncovered evidence that Serbian forces had used rape as a systematic aspect of policy. Even Valentina Leskaj, head of the Albanian Family Planning Association, said the Western media and international agencies were “obsessed” with the question of rape.

Many aid officials agreed that a Kosovar woman who had been raped would not want to keep a Serb baby, and would opt for abortion. Yet I visited the camps roughly two months after most of the women had crossed the border—roughly the time when women who had been raped during their flight would realize that they were pregnant. Still the abortion rate among Kosovar women was miniscule. In what is arguably the finest hospital in all of Albania, a warren of spotless, air-conditioned tents built by the Austrian army, only three abortions had been performed, and no sterilizations. Down the road only a few miles, Dr. Namik Kamberi, vice-chief of obstetrics at Skhodra Maternity Hospital, said there had been only a few Kosovar abortions and no sterilizations. A Peruvian national serving as head doctor at the Big Nut camp in downtown Skhodra said she had never been asked by a Kosovar woman for either an abortion or sterilization.

No shrinking violets

Were the Kosovar women too shy to ask for their “reproductive rights”? Was their society too patriarchal? Put simply, the answer to that question is No. The Kosovar women are outspoken and strong. Frequently they interrupt or talk over the men. Aside from their great friendliness, the most impressive thing about a Kosovar woman is her handshake: a brief and very firm two pumps accompanied by strong eye contact. These are not the sort of trod-upon weak women who would be too afraid to ask for what they want. They have more in common with the type of woman one imagines running the families and homes on the American frontier.

The simple fact that explains attitudes regarding reproduction in the refugee camps is this: The Kosovars love pregnancy, and they love children. This attitude was best summed up by Kim Lemka, an American nurse working for the Northwest Medical Team. Lemka has assisted at deliveries in refugee camps all over the world. She said she has never seen anything like the Kosovars. Lemka reports:

When you tell a Kosovar woman she is pregnant, it is like her whole world has been made. And it does not matter how many children she already has. And everyone with her, outside in the hallway, are just as excited as she is.

And is there any truth to the rumor about rampant promiscuity in the refugee camps? Was there an urgent need for contraceptives and “morning after” pills on that account? It seemed unlikely. First, one must keep in mind that the camps are formed in row upon row of nothing but canvas tents. There is no privacy for regular marital relations, let alone any extra-marital hanky-panky. When asked about promiscuity, Lemka could only repeat one word: “No, no, no, no, no.” Barbara Molinario, a young Italian woman assisting at the Don Bosco camp in Tirana laughed aloud when asked the same question. She observed that the Kosovars are a very conservative people. While young Albanian women parade down the streets dressed in mini-skirts and very high heels, Kosovar women wear long skirts and demonstrate a highly evolved sense of modesty.

Even though these reasons given for UNFPA intervention did not hold true, neither did the suspicion of pro-lifers that the camps were being flooded with contraceptives while they were still lacking in essentials like food. I found significant supplies of contraceptives. And I did find many camps wanting in basic medical supplies. The Northwest Medical Team, for example, was waiting desperately for one of the basic delivery kits promised by the UNFPA. But in fact those “reproductive health kits” which had generated so much attention were very hard to find.

Where are the kits?

In every camp I visited in Skhodra, I asked about the presence of AFPA and UNFPA. I could not find them anywhere in the camps around Skhodra. And still I had not encountered a single “reproductive health kit.”

Hearing that most of the kits went to Vlora in the far south, I returned to Tirana, then drove another four hours south to this pretty coastal town on the warm Ionian Sea. Vlora is like a town right out of the American “wild west.” It was the seat of most of the ruinous pyramid schemes of a few years ago, and I am told that most Vloran men carry weapons. I was in Vlora for only 23 hours. It was in Vlora where at last I found the footprints of UNFPA, and a full-time office for AFPA. And I found more than footprints.

One of the major claims by UNFPA is that the “manual vacuum aspirator” is only used for assisted deliveries. (UNFPA repeatedly insists upon this position because they are forbidden by the Cairo Program of Action from using abortion as a method of family planning.) I discovered otherwise. In the Vlora office of AFPA, office manager Gilberta Bano reported that two American doctors had just given an all-day seminar for local midwives and medical personnel on performing abortions with the “manual vacuum aspirators.” Did the doctors mention any other use for the devices, I asked? Bano said they had not. I pressed the question: are there any other uses for these devices? Bano again said No. Later Dr. Maria Borij, head of maternity services at the Vlora hospital, confirmed that the manual vacuum aspirator was used only for abortions. When pressed whether there was no other use, she insisted there was none.

Borij also informed me that in her large regional hospital, only twelve Kosovar refugees had received abortions since the beginning of the crisis more than two months earlier, and that no sterilizations had been performed. She informed me the most recent Kosovar abortion had been performed that morning, that the patient was still present in the hospital. Borij led me to her.
The young woman was recuperating in a dirty bed in a small and smelly room with peeling paint falling from the walls. She was wearing her own clothes and had been there most of the morning. Through my translator she identified herself as coming from a small village, and said she had been in the refugee camps for several weeks. Her pregnancy was not the result of rape. She said she had six other children and suffered from a lung condition. She said she had not been informed of any possible medical complications related to abortion. Nor had she been informed that abortion could harm future pregnancies. It should be noted that she was prepared for her abortion not by an NGO representative or by any UN agency, but by a local midwife. And the abortion was performed by a doctor of the Albanian state. Still, her case was one that lacked even basic informed consent.
It was also in Vlora that I discovered the only part of a “reproductive health kit” that I saw in the entire country. It turned out to have been a heavy and expensive item: one which included the “manual vacuum aspirator.” Oddly, this one had not even been unpacked. It had also been delivered to the wrong address.

At the very least, independent auditors should take a careful look at what happened to all those “reproductive health kits.” Even as I left Albania, UNFPA had only a very rough idea where their packages had all gone.

It is clear that UNFPA and the Albanian Family Planning Association engaged in at least a little public-relations fluffery regarding their intervention into the Kosovar refugee crisis. Each agency exaggerated where they were and what they were doing. However, both agencies are engaged in an aggressive campaign to drum up popular support for their products and services, in this case struggling to convince the Kosovars that they should accept a very Western concept of “reproductive rights,” and thus stop reproducing at such a high rate.

Returning to Tirana, I met again with Dr. Roseanne Murphy, the new head of UNFPA relief efforts in Albania. Although she admitted that the refugee women showed little interest in a “broad range of reproductive health services,” she was certain they could be convinced. And she promised one thing. “I will fly the flag of UNFPA in all seven regions of Kosovo.” What is certain is that as this refugee population returns north to their burned-out homes, all the world’s relief operations will follow them there —including some agencies peddling IUDs, “emergency contraception,” and “manual vacuum aspirators.”

Austin Ruse traveled to the Albanian camps for the Population Research Institute, a non-partisan think-tank located in Virginia.

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