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http://www.latimes.com/CNS_DAYS/990521/t000045600.html Friday, May 21, 1999 Relief Camps for Africans, Kosovars Worlds Apart Aid: Workers are struck by contrasts in food, shelter and health care. They cite culture, race as reasons. By T. CHRISTIAN MILLER, ANN M. SIMMONS, Times Staff Writers S KOPJE, Macedonia--When veteran refugee worker Lynne Miller arrived here from Africa earlier this month, she stepped into a different world. Miller had just spent three years monitoring food supplies at a remote refugee camp in Somalia, and one of her first crises in Macedonia was an urgent request from a medical team. A diabetic refugee had crossed the border. Could she provide a special diet? She couldn't believe what she was hearing, much less that she was able to fulfill the request. "In Africa, we don't have special food or diets. There are no diabetics in the camps," she said. "They just die." The outpouring of aid in recent weeks for ethnic Albanians ripped from their homes in Kosovo has stunned humanitarian groups, which continuously fight for dollars for refugees in Africa. For many of these workers, the response to the Balkan crisis has highlighted the enormous difference between the newly sprouted camps in Europe and existing facilities in Africa. And this difference, in turn, has raised uncomfortable questions about the reasons for it--a complex mix, according to humanitarian groups, of logistics, culture and race. While none of the camps compares to a permanent home and a stable life, refugee workers say, those in Africa and Europe are a world apart. Consider: * The Office of the U.N. High Commissioner for Refugees is spending about 11 cents a day per refugee in Africa. In the Balkans, the figure is $1.23, more than 11 times greater. * Some refugee camps in Africa have one doctor for every 100,000 refugees. In Macedonia, camps have as many as one doctor per 700 refugees--a ratio far better than that of many communities in Los Angeles. * Refugees at most camps in Albania, across the border from Kosovo, have readily available clean water. In Eritrea, on the Horn of Africa, families as large as 10 are given about 3 1/2 gallons of water to last three days, according to Mary Anne Fitzgerald, a Nairobi, Kenya-based spokeswoman for Refugees International. * The camps in Africa hold as many as 500,000 people. Up to 6,000 refugees there die each day from cholera and other public health diseases. In Macedonia, the largest camp holds 33,000 people. So far, there have been no deaths from public health emergencies such as an epidemic or starvation. The immense flow of aid to Europe has alarmed some aid agencies, which worry that the attention focused on the Balkans will cut into the food and supplies going to places such as Eritrea and Somalia. The most common explanation for the gap in resources is culture. U.N. officials and aid workers say they must give European refugees used to cappuccino and CNN a higher standard of living to maintain the refugees' sense of dignity and stability. Others offer a blunter assessment: They say wealthy donors in the developed world and the aid agencies they support feel more sympathy--and reach deeper into their pockets--for those with similar skin tones and backgrounds. Andrew Ross, a refugee worker who came from Africa to the Balkans last month, called the camps in Macedonia "far superior" to those in Africa. "What's the difference?" Ross asked. "There's white people here." Shelter and Supplies Better in Europe Nezir Gashi's life is by no means comfortable. His family of 13 lives in a 150-square-foot tent in Macedonia. Every day, Gashi or one of his four children stands in line four hours for food. They haven't had a hot meal in weeks. Water is a few hundred feet away at a communal spigot. Still, the meager shelter and supplies are far better than what is provided to refugees in Africa. Typically, African refugees sleep out in the open, or under makeshift shelters made from branches, leaves or mud or from plastic sheeting provided by an aid agency. They rarely have canvas tents or prefabricated housing. For example, most of the 300,000 or so Eritreans deported from Ethiopia back to Eritrea in early February make their homes under trees, in riverbeds or simply at roadsides without any kind of shelter, said Fitzgerald, who recently visited the refugees. They are stranded in a semiarid terrain, where the afternoons are blazing hot and the nights freezing cold, and there are 1,200 tents for about 16,000 families, Fitzgerald said. In other cases, African refugees get only a plastic sheet to cover a homemade shelter. Another major difference between refugee facilities in Africa and those in Europe is in the type of food supplied. World Food Program officials say both European and African refugees are getting about 2,100 calories a day of food rations. But for the Kosovo Albanians, those calories come in the form of tins of chicken pate, foil-wrapped cheeses, fresh oranges and milk. In some ready-made meals, there is even coffee and fruit tarts. Water is plentiful in most of the camps in the Balkans. At one camp in Macedonia, German officials have even installed a fully functioning sewage treatment system. That contrasts with Africa, where refugees are far less likely to get ready-made meals and have to make most of their food from scratch--a practice reflecting the simpler lifestyles of the area, say U.N. officials. Instead of meals, the refugees are given basic grains such as sorghum or wheat. "Here in Africa, we see people who have walked naked, without a thread on their back, who don't have a grain of rice," said Nina Galbe, a Nairobi-based spokeswoman for the International Committee of the Red Cross. "With all due respect to the horrors the people of Kosovo have suffered, they are dressed in their winter clothes; the babies are kept in their blankets. They are not malnourished." Beyond such basics as shelter and food, the differences become even more stark. The camps in the Balkans have mobile phones that refugees can use. There are soccer fields, basketball courts and pingpong tables. One camp has a children's center with two theaters showing films like "The Neverending Story." At Stankovac, the third-largest camp in the Balkans, hot showers, communal kitchens and street lighting are planned. Such extras are nonexistent in Africa, according to those who have worked in both areas. "Compared to the refugee camps in Africa, Stankovac is a five-star hotel," said Marion Droz, a Red Cross field worker who also worked during the Rwandan crisis earlier this decade. Provisions Based on Living Standards The primary explanation for the stark contrasts, according to U.N. and aid groups, is the difference between the backgrounds of the refugees on the two continents. In Africa, where many refugees eke out an existence in seminomadic tribes, the bare provisions of shelter and health care offered by the refugee camps are a step up in life for many. But in Europe, where many of the refugees from Kosovo, a southern province of Serbia, the main Yugoslav republic, had two cars, a city apartment and their own business, a night in a canvas tent with cold food is misery. "You've got to maintain people's dignity," said Bob Allen, a camp manager who has worked in both Africa and Europe for the relief agency CARE. "The life in Africa is far more simple. To maintain the dignity and lifestyle of Europeans is far more difficult." Another issue is that Yugoslavia is in Europe's backyard. Albania is a ferry trip from Italy. Two of the Macedonian camps are just off the main highway that leads north from Athens to such European capitals as Vienna and Berlin. The crisis is far more immediate and tangible. People can directly see and feel the impacts of the refugee crisis, and they respond accordingly, aid workers say. "This is the middle of Europe. It's so close to home," said Paula Ghedini, a spokeswoman for the U.N. refugee agency who has worked in Africa and the Balkans. "This is not so foreign." Still, many wonder whether such distinctions are valid. While some extras are just that, shelter, food and water should be the same everywhere, they say. "I don't know if [the help] should be different," said Lindsey Davies, spokeswoman for the World Food Program, a U.N. agency. "People are people all over the world." Ross, a CARE worker who came to the Balkans from Sierra Leone, said race plays a big role. It's easier for Europeans and Americans to identify with the Kosovo refugees they see on television than with those in remote parts of Africa, he said. "I may be cynical, but personally I think people see the television and say, 'It's just a bunch of blacks over there,' " he said. The media--and people's response to coverage--also play a big role in determining the conditions during a particular refugee crisis. In Macedonia alone, there are more than 1,000 reporters, according to government figures. The steady television presence attracts scores of charities, for which the media visibility is free advertising to raise money. "You can't walk in the camps here for tripping over the television cables," said Miller, the food worker. As a result, eight to 10 charities labor in some camps, dividing the work of running the facilities into highly specialized areas. In the medical field, for instance, the large number of volunteer groups has created a mini-HMO system, with primary-care doctors from some humanitarian groups referring refugees to specialist clinics run by other groups that offer sites for dentistry, minor surgery and gynecology. "I'm always asking, why are these things not a problem for my Somalis?" said Miller, the World Food Program worker. Pledges to Africa Not Keeping Pace All the attention focused on the Balkans has frightened refugee officials and charity groups in Africa, who fear that the continent's already meager resources will be further drained by the Balkan crisis. For instance, the World Food Program has a fund-raising goal this year of $98.5 million for the area around Africa's Great Lakes--Rwanda, Burundi, Tanzania, Uganda--where long-simmering, though often ignored, conflicts have created hundreds of thousands of refugees. So far, the food agency has received 22% of that amount. In Liberia, the situation is even worse. The agency made an appeal for $71.6 million. It received $500,000. That compares with the situation around Kosovo, for which the agency has requested $97.4 million and received more than 70% of that amount already, with a "large number of commitments" now under negotiation, Davies said. "Africa is just being eclipsed by this," said Fitzgerald of Refugees International. Refugees in Eritrea "are just being ignored for the large part because of Kosovo," she said. "Everybody is focused on Kosovo, because it's a serious situation, and because of peer pressure." Miller reported from Skopje and Simmons from Nairobi. Times staff writers Elizabeth Shogren and Marc Lacey in Macedonia contributed to this report. Copyright (c) 1999 Los Angeles Times. 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