Crime Moderate Risk Organised Criminal Groups Are Active Along Northern Areas Along the Border with Kosovo and in Skopje, but They Do Not Target Foreigners

Riskline / Country Report / 29 August 2021

NORTH MACEDONIA

Overall risk level

High Reconsider travel

Can be dangerous and may present unexpected security risks

Travel is possible, but there is a potential for disruptions Overview

Emergency Numbers

Medical 194

Upcoming Events

01 September 2021 - 02 September 2021 Medium risk: Entry requirements to be tightened from 1 September – Update Effective 1 September, all inbound travellers are required to present either a negative COVID-19 PCR test result no older than 72 hours prior to entry, proof of full vaccination against COVID-19 or proof of having recovered from COVID-19 within the previous 45 days; transit travellers who stay less than five hours are exempted. Macedonian citizens who arrive without these documents must quarantine for seven days upon entry.

Riskline / Country Report / 29 August 2021 / North Macedonia 2 Travel Advisories

Riskline / Country Report / 29 August 2021 / North Macedonia 3 Summary

North Macedonia is a High Risk destination: reconsider travel. High Risk locations can be dangerous and may present unexpected security risks. Travel is possible, but there is a potential for severe or widespread disruptions.

Covid-19 High Risk In August 2021, the country saw a sharp uptick in new COVID-19 cases due to the spread of the delta virus variant. A health pass system is in effect for some public venues.

Political Instability Medium Risk There are longstanding tensions and animosity between the country's ethnic Albanians and Macedonian nationalists, which remain despite the efforts of the European Union (EU) and pro-West Prime Minister Zoran Zaev to give ethnic Albanians more local power. Tensions in ties with Bulgaria are hindering negotiations for North Macedonia's EU membership.

Conflict Moderate Risk Following the brief 2001 civil war between ethnic Albanians and Macedonian government forces, political violence significantly decreased, but tensions remain.

Terrorism Moderate Risk The country is not at great risk of terror attacks as it is not a target nor a haven for known terror groups, but attacks by hardline Albanian nationalists are possible. Police and emergency response services are adequate.

Riskline / Country Report / 29 August 2021 / North Macedonia 4 Unrest Moderate Risk Protests over political and ethnic issues as well as football are common and can turn violent. Most rallies are limited to Skopje, Ohrid, Bitola, Kavadarci and Kičevo.

Crime Moderate Risk Organised criminal groups are active along northern areas along the border with Kosovo and in Skopje, but they do not target foreigners. Petty crime is common in market and tourist areas. Police services are generally reliable, yet hindered by a lack of resources and demands for bribes.

Natural and Environmental Moderate Risk The country is vulnerable to earthquakes and flash floods during heavy rainfall and the winter and spring season. The infrastructure in Skopje and the rest of the country is hardly adequate, but emergency response services are generally good, yet less so if natural disasters are very large or take place in remote areas.

Health and Medical Medium Risk Health facilities around the country suffer from chronic shortages of medicine and equipment. Mosquito- and tick-borne diseases, including West Nile virus, are present in the country.

Local Travel Moderate Risk Road travel is generally safe, but road conditions and driving habits can be poor in rural areas. Air travel is safe and public transport services, buses specifically, are good, excluding rail travel due to poor maintenance. Petty crime is a frequent problem on public transport.

Riskline / Country Report / 29 August 2021 / North Macedonia 5 Political Overview : Medium Risk

In May 2017, Social Democratic Union (SDSM) leader Zoran Zaev formed a new government in partnership with Albanian minority parties. Despite the creation of a new government, protests that began the previous year over the December 2016 election results continued, becoming increasingly nationalistic in tone as conservatives accused Zaev of selling the country out to foreign powers.

Since 2017, the opposition VMRO-DPMNE has led protests against Zaev’s government and plans to solve the name dispute with Greece by changing the country name to North Macedonia, which was ratified by Parliament in January 2019, paving the way for the country to join NATO. However, the failure of the European Union (EU) to commit to a firm timetable for North Macedonia's ascension process led to Zaev calling snap elections for April 2020. Due to the COVID-19 pandemic, the elections were delayed until July and saw sharply reduced turnout. After a month of talks, the SDSM formed a coalition with the Democratic Union for Integration (DUI) minority Albanian party on 18 August 2020 by agreeing to rotate Zaev out as prime minister before the next round of elections planned in 2024.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 6 Conflict : Moderate Risk

Civil War: In 2001, violence broke out between ethnic Albanians and Macedonian government forces. The conflict was low-intensity, with upwards of 70 deaths over the course of the year and over 100,000 people internally displaced. It ended in August 2001 with the signing of the Ohrid Framework Agreement between the government and representatives of the ethnic Albanian community. Most Albanian groups that once posed a serious threat, such as the National Liberation Army (NLA), have now disbanded. The Albanian National Army (ANA) opposed this disbanding and it, alongside other NLA factions, continue to demand greater autonomy or separatism for ethnic Albanians in North Macedonia.

Ethnic Tensions: The security situation in North Macedonia has stabilised since the brief civil war in 2001. Clashes involving ethnic Albanian militants and criminal gangs associated with them are now rare, though certain areas are still subject to violence, including areas north and to the west of Gostivar, Tetovo, Skopje, Kumanovo, and along the highways that link these cities. While attacks directed against travellers are unlikely, the possibility of being caught up in violence remains.

Amid a political crisis that began after the April 2014 general elections, a series of attacks targeting the government and security forces took place, with rejectionist factions of the NLA claiming several of them, including an attack on the government building in Skopje in October 2014, a successful weapons heist at a police base on the Kosovo border in April 2015 and grenade attacks targeting political party offices. These security incidents eventually culminated in May 2015, when police special forces fought a large body of ethnic Albanian militants in the northern city of Kumanovo over two days. Eight police officers and 14 gunmen were killed before order was restored; 30 people were ultimately arrested on terrorism charges over the clashes.

While no serious disturbances took place during the 2017 nationalist protests over the formation of a government with ethnic Albanian parties comparable to the deadly events of 2014-2015, unanticipated domestic or regional events have the potential to spark further violence involving ethnic Albanian militants who continue to dispute the post-2001 peace terms.

Border Disputes: Prior to Kosovo’s declaration of independence, the Government of Kosovo stated before that they intended to question the location of their country’s

Riskline / Country Report / 29 August 2021 / North Macedonia 7 border with North Macedonia. They claim it was decided between Macedonia and the Former Yugoslavia in the late 1990s and bears no relation to the ethnic or geographic territory of Kosovo. However, since Kosovan independence in February 2008, relations between the two sides have improved. There is now a low risk of conflict regarding this border.

There are also deep-rooted tensions between Athens and Skopje over the use of the name “Macedonia”. Greece has traditionally believed that by allowing Skopje to use the name, the country would be enabled to make territorial claim over the northern Greek region of the same name. With Greece insisting that the country should have been known by a different name, the version ‘Former Yugoslav Republic of Macedonia (FYROM)’ was often used internationally on Greece’s request . A breakthrough happened on 17 June 2018, when Greek Prime Minister Alexis Tsipras and Macedonian Prime Minister Zoran Zaev agreed to rename FYROM as ‘Republic of Northern Macedonia’. The agreement, which would pave the way to Skopje's accession to the European Union (EU) and the NATO, was met with resistance from portions of the population in both countries. The deal was ratified by the Macedonian parliament in early July and a referendum to amend the constitution was set to be held in autumn 2018.

Riskline / Country Report / 29 August 2021 / North Macedonia 8 Terrorism

Domestic Terrorism: Domestic terrorism in North Macedonia is primarily motivated by ethnic nationalist grievances from hardline Albanian nationalists with prior experience fighting both Serbian and North Macedonian forces across the former Yugoslavia since the 1990s. The most serious incident in recent years involved a faction of the pro-Albanian National Liberation Army that clashed with security forces in Kumanovo in May 2015 [see Ethnic Tensions in the Conflict section]. Overall, however, attacks by Albanian nationalist groups have decreased sharply in recent years, while the core of the NLA has disbanded as part of the post-civil war peace process. The main threat now comes from organised criminal gangs, which are motivated primarily by financial concerns and settling scores. Although they do not normally target civilians, innocent people have been injured during improved explosive device (IED) attacks, such as a series of bombings in 2003 directed at police officers following a crackdown on organised crime.

Islamist Terrorism: Officials do not believe there is a significant threat posed by self- radicalised individuals inspired by ‘lone-wolf’ attacks in Western Europe. Nonetheless, a potential security threat comes from the approximately 146 nationals who have journeyed to Syria and Iraq to join terrorist organisations, including the Islamic State (IS) and al-Qaeda. While there is some risk that these individuals, some of whom also have combat experience from the Balkans conflicts of the 1990s, will plot and attempt to carry out attacks against the government. Multiple IS supporters have been detained since 2015 in Skopje, Kumanovo, Tetovo, Gostivar and Struga, but most of those arrested were detained on charges of membership in an illegal organisation or providing material support, rather than actively plotting attacks.

Response Preparedness: Emergency healthcare for mass casualty incidents is adequate in Skopje, where several hospitals have accident and emergency departments. However, outside Skopje, there are few emergency care beds available and hospital facilities are more rudimentary.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 9 Unrest : Moderate Risk

Sports-Related Riots: Football hooliganism occurs periodically in North Macedonia and is often linked to regional political and ethnic differences. In November 2006, Macedonian riot police fought with Russian fans during a match between the two countries in Skopje; it is thought that the violence was sparked by disagreements among fans over the status of Kosovo. It is advisable to consult local news sources to find out football match fixtures and avoid large groups of fans under the influence of alcohol.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 10 Crime : Moderate Risk

Organised Crime: Organised crime is a significant problem in North Macedonia and occasionally results in violent confrontations between members of rival organizations. Gangs are most prevalent in western North Macedonia. The threat to travellers is low, but there is a risk that bystanders may be caught up in confrontations between gangs. Since March 2006 there have been a number of small targeted bombings and shootings in central Skopje, mainly around the Cair and Bit Pazar areas. Maintain vigilance in all nightlife areas and avoid adult themed entertainment, as these are most often connected to organised crime.

Money laundering is a problem in North Macedonia, mostly due to the cash-based economy and weak law enforcement. Visitors are advised to only use official banks and money exchanges. Street currency exchanges may promise a better rate but often cheat foreign nationals. When approached by individuals that deal with currency on the street, visitors should politely refuse and walk away.

Credit Card Fraud: There have been a number of recent reports of credit card fraud. Victims are most often targeted when paying in restaurants or hotels. Members of staff will make a copy of the victim's card details and use them to make purchases online. Ensure that you always obtain a receipt after making a payment and that all transactions are done in front of you. Do not let cards out of your sight.

Incidences of card theft have also increased. Typically, victims are approached at Automated Teller Machines (ATMs) in urban areas and distracted by one individual while another approaches and steals the credit card. Visitors are advised to refuse unsolicited assistance while at an ATM and only use ATMs that are located in well-lit areas or inside malls and banks.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 11 Law

North Macedonia's legal system is based on civil law. The judiciary has been accused by international organisations of failing to provide fair trials due to corrupt police and government influences. Slow and inefficient legal processes mean that if you are a victim of crime the perpetrator may not be brought to justice.

Border Crossings: Aside from designated crossing points, border areas are considered military restricted zones where travel is forbidden without official permission.

Drugs and Alcohol: You must be 18 years or over to purchase alcohol, including beer, wine and spirits in North Macedonia. This law is not widely enforced, but the authorities take a dim view of public drunkenness and will arrest anyone deemed to be disorderly. The drink driving limit is 0.5 milligrams of alcohol per millilitre of blood. Although underfunded, police in North Macedonia place a high degree of importance on enforcing this law due to the high road accident rate. If caught you are likely to be arrested and given a large fine. Your car may also be temporarily seized. Persons under the influence of alcohol are also not permitted to travel in the front passenger seat of cars.

Enforcement of drugs laws is generally poor in North Macedonia, however foreign nations present an easy target for the police to make an example of. Possession, use, or trafficking of illegal drugs may result in lengthy jail sentences. There is no distinction between 'hard' and 'soft' drugs, but if caught with small amounts you may receive a large fine rather than imprisonment.

Traffic Infractions and Speeding: Speed limits are 50kph (31mph) in built up areas, 80kph (62mph) on rural roads and 120kph (74mph) on motorways. Despite having few resources, the police place traffic laws as a priority due to the high number of deaths on North Macedonian roads. Police enforce speed limits using radar checks and on- the-spot fines for speeding are usually high. Be aware that speed limits can be unpredictable and pay attention to signage.

Winter tyres must be fitted to your car between 15 November and 15 April annually. It is also compulsory that vehicles carry a warning triangle, first aid kit, high-visibility vest and set of replacement bulbs. It is illegal to use a mobile phone while driving. All

Riskline / Country Report / 29 August 2021 / North Macedonia 12 vehicles are required by law to use headlights during the day. On-the-spot fines are issued if caught violating any of the above laws. Ensure you are given a receipt by the police officer so that you can prove you have paid your fine if challenged at a later date. This also reduces the chances that the officer can pocket the fine for themselves. Police will impound vehicles that are parked illegally or running on worn tyres.

Importing and Exporting Goods: It is free to import 200 cigarettes, or 50 cigars, or 250 grams of smoking tobacco. For alcohol, two litres of wine, or one litre of spirits or strong liquors are allowed. Quantities larger than these are liable to taxation and must be declared. Any goods valued at EUR175 or greater must be declared.

Photography: Photographing any military and police infrastructure, personnel, or vehicles is strictly prohibited. If caught you will likely have your camera and film taken from you and be detained for questioning by police. Always check for “no photography” signage around any monuments or buildings before taking a picture.

Riskline / Country Report / 29 August 2021 / North Macedonia 13 Corruption

Travellers: In August 2009, North Macedonian authorities launched Operation Boomerang, aimed at tackling organised criminal groups working within the police force at North Macedonian border crossings. In under two weeks, up to 42 border police were detained at the Tabanovce crossing with Serbia on suspicion of soliciting and taking bribes. The policemen tended to demand money from foreign travellers entering and exiting the country. If marks refused to pay they were left waiting at the border crossing for no reason. At the end of each shift the officers allegedly divided the money taken in bribes, with each receiving up to EUR100 per day.

The police service is also highly corrupt and both travellers and residents may experience this first hand. Low level traffic officers often demand bribes in exchange for waiving fines related to minor offences. If offered the opportunity to pay a bribe, do not take it as it is illegal and may lead to more serious problems.

Residents: Administrative corruption is common in North Macedonia. Bribes are expected by many officials in exchange for giving an effective service. Bureaucratic government departments such as the tax and customs departments are particularly badly affected. Political corruption also affects democracy at the local and national level. Politicians are often linked to organised criminal gangs, who use corrupt practices to ensure their favoured candidate gets elected.

Business: North Macedonia has a problem with corporate corruption. This has affected many foreign firms doing business in the country. Both government and corporate tendering processes are rife with corrupt activities. Excessive and lengthy bureaucratic procedures provide an easy opportunity for officials to make money from bribes. Corruption has also prevented the emergence of effective property rights, leading to confiscation of property that was apparently legally obtained.

Riskline / Country Report / 29 August 2021 / North Macedonia 14 Security Services

The police force in North Macedonia has undergone extensive reforms in recent years with the aid of North Atlantic Treaty Organisation (NATO) and a number of European Union (EU) states. It is highly militarised in comparison with other regional police forces. Corruption is an ongoing problem with police in North Macedonia and it affects all areas of policing in the state. While funding is low, the force is able to provide a basic service. At times, language may be a barrier as not all police officers speak English.

Efficiency: Due to poor funding and endemic corruption, the police are unable to operate as efficiently as other European forces. Response times vary widely, with waiting times increasing outside Skopje. Convictions are not always assured as investigations can be curtailed by government or organised crime connections. Nevertheless, the force should be called in an emergency.

Professionalism: Officers are mostly professional in their behaviour towards travellers. However, the opportunity to gain money from a bribe often proves too hard to resist. Recent reports suggest it is very common for police officers to negotiate small payments from civilians in order to turn a blind eye or capture the perpetrators of a crime. At no time should you pay bribes to officers. Doing so is illegal, and recent reforms suggest that the government is starting to take the crime more seriously. In October 2008, 40 officers of varying ranks were suspended from the force on suspicion of involvement with organised crime.

Areas Active: The force is active across the country, but is severely limited in western North Macedonia, where organised crime gangs are most powerful.

Abuses/Miscarriages of Justice: There have been regular accusations of abuses against Albanians carried out by the North Macedonian police. Albanians are often harassed and there is evidence that false arrests occur. This problem has been most notable since the 2001 Albanian insurgency and it is thought the police force is determined to keep the Albanian community oppressed for fear of a repeat.

Funding: The North Macedonian police service has been aided by governments from around the developed world, but still lacks basic funding from the government.

Emergency Contact: The police service can be contacted by dialling 192. Additionally,

Riskline / Country Report / 29 August 2021 / North Macedonia 15 all emergency services can be contacted by dialling 112.

Riskline / Country Report / 29 August 2021 / North Macedonia 16 Natural Risks : Moderate Risk

The country is vulnerable to earthquakes and flash floods during heavy rainfall and the winter and spring season. The infrastructure in Skopje and the rest of the country is hardly adequate, but emergency response services are generally good, yet less so if natural disasters are very large or take place in remote areas.

Flooding

A flood is an overflow of water that submerges land that is usually dry. It is normally triggered by an extended period of heavy rainfall and can be exarcebated by poor drainage systems in the affected area.

The capital city of Skopje and surrounding villages – including Singelic, Stajkovci and Smilkovci – saw particularly horrendous flash flooding in August 2016 which left at least 21 people dead and scores of others injured. The severity of that storm is rare but, nonetheless, the deadly incident showed that the city is not capable of withstanding extreme weather.

If instructed of the possibility that flash-flooding may affect the area you are in, monitor local updates and move immediately to higher ground away from rivers, streams, creeks and storm drains. Though flash-flooding is commonly attributable to excess upstream precipitation, be aware that flooding can occur without typical warning signs of rain clouds or heavy rain. This is especially true near streams, drainage channels, canyons and other areas known to flood suddenly. If you happen across a flooded road in your car, turn around and drive in the opposite direction. When trapped on a flooded road, vacate your vehicle immediately and climb to higher ground.

Earthquakes

An earthquake is the sudden, rapid shaking of the earth, caused by the breaking and shifting of subterranean rock as it releases strain that has accumulated over a long period. Initial mild shaking may worsen and become extremely violent within a matter of seconds. Additional earthquakes, called aftershocks, may follow the initial

Riskline / Country Report / 29 August 2021 / North Macedonia 17 earthquake.

Located across a highly active seismic zone, North Macedonia experiences frequent seismic activity. The capital, Skopje, is especially prone to earth tremors. Although mostly minor, the country has experienced severe earthquakes in the past, causing substantial property damage and human casualties. There have been no major earthquakes since the catastrophic 1963 Skopje earthquake.

When shaking begins, drop to the ground and take cover under, and hold on to, a sturdy piece of furniture, such as a heavy desk or table that can provide you with air space if the building collapses. If you're not near a strong piece of furniture, crouch down and protect your head and face in an inner corner of a building; only stand in a doorway if you know it is strongly supported. Stay away from windows or glass panels. Most deaths and injuries in an earthquake are caused by collapsing building materials and heavy falling objects. Stay indoors until the tremors stop and you are sure it is safe to exit. Avoid all areas in the vicinity of outer walls and doorways, as these are most prone to falling debris. In a high-rise building, the electricity may go out and the sprinkler systems may come on. Do not use the elevators. If the lights go out, avoid using candles, matches or lighters during or after the earthquake; if there is a gas leak, an explosion could result. If outdoors, move to an open space away from buildings, electric poles and street lights which are prone to collapse. Do not travel on roads and bridges which may have been damaged by the earthquake. Be prepared for secondary earth movements that follow the initial earthquake; some of these may be large enough to cause additional damage or bring down weakened structures.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 18 Health and Medical: Medium Risk

Overview

Health facilities around the country suffer from chronic shortages of medicine and equipment. Mosquito- and tick-borne diseases, including West Nile virus, are present in the country.

Before you travel

Consult your doctor or a healthcare provider who specialises in travel medicine at least six weeks before your departure. If you have a medical condition, you should also share your travel plans with your doctor.

Note: Requirements and recommendations for vaccines and other medicines are based on guidelines from the Centers for Disease Control and Prevention (CDC). Documentation requirements are based on World Health Organisation guidelines.

Outbreaks

Malaria

There is no risk of malaria transmission.

Riskline / Country Report / 29 August 2021 / North Macedonia 19 Yellow Fever

There is no risk of Yellow Fever infection.

Vaccine requirement: None

Vaccine recommendation: None

Vaccinations, Medicines and Documentation

Recommended for all travellers

Measles

Infants (6 through 11 months old): 1 dose of measles-mumps-rubella (MMR) vaccine before travel. This dose does not count as the first dose in the routine childhood vaccination series. People 12 months old or older, with no evidence of immunity or no written documentation of any doses: 2 doses of MMR vaccine before travel. The 2 doses must be given 28 days apart. People 12 months old or older who have written documentation of 1 dose and no other evidence of immunity: 1 additional dose before travel, at least 28 days after the previous dose.

Riskline / Country Report / 29 August 2021 / North Macedonia 20 Recommended for most travellers

Hepatitis A

CDC recommends this vaccine because you can get hepatitis A through contaminated food or water in North Macedonia, regardless of where you are eating or staying.

Recommended for some travellers

Hepatitis B

You can get hepatitis B through sexual contact, contaminated needles, and blood products, so CDC recommends this vaccine if you might have sex with a new partner, get a tattoo or piercing, or have any medical procedures.

Vaccinations, Medicines and Documentation

Required documentation

Yellow Fever entry requirement: No

Other entry requirements: None

Note: Documentation requirements are subject to change. Consult your destination embassy or consulate prior to departure for confirmation.

Riskline / Country Report / 29 August 2021 / North Macedonia 21 While you are there

Emergency Numbers

Medical: 194

Emergency services

Emergency medical services are extremely limited outside of major cities. North Macedonia is serviced with a nationwide ambulance service, but response times are known to be slow.

Evacuation

In the event of severe or life threatening injury or illness, medical evacuation may be required. Public health clinics are unlikely to be able to treat major medical complications, and in such cases, evacuation to a hospital or out of the country may be necessary.

Routine care

Private clinics are available in some major cities. Travellers are advised that when seeking care outside of metropolitan areas, or away from popular travel destinations, they are likely to encounter underfunded public health facilities with outdated equipment and a lack of trained specialists and multilingual staff.

Medicine

High quality prescription drugs are not widely available and can only be purchased at state pharmacies or, at higher prices, privately operated ones. Travellers are recommended to bring their own supply of medication, in particular insulin, due to restrictive laws governing legal in-country access to drugs by foreign nationals. While travellers are unlikely to experience any difficulties in entering the country with their own prescription medicine, it is advisable that all prescription drugs are kept in their original container noting the patient’s name.

Payment

Riskline / Country Report / 29 August 2021 / North Macedonia 22 Only North Macedonia citizens and legal residents in employment qualify for the free public healthcare system. All travellers will be expected to pay for services in full; upfront payment is expected for routine, non-emergency care and specialist visits, usually starting between MKD3080-6165. The European Health Insurance Card (EHIC) is not accepted in the country. A single doctor’s visit will typically be within the MKD615-925 range.

Ailments

Altitude Sickness

Parts of Macedonia have areas of elevation in excess of 2,500m (8,202 feet).

Altitude sickness is a pathological effect on humans caused by low partial pressure of oxygen at altitudes above 2,400 metres (8,000 feet). Typical symptoms resemble those caused by influenza, including headache, fatigue and dizziness; severe symptoms can include fever, persisting shortness of breath, loss of consciousness or haemorrhages. While preventative treatment and acclimatisation can prevent or lessen symptoms, the only effective treatment is to descend to lower altitudes.

Typhoid

Typhoid is a highly contagious bacterial infection, transmitted by the ingestion of food and water contaminated with infected faeces. Symptoms include a high temperature, a rash made up of small red spots, headaches, stomach pain and diarrhoea; serious complications, including internal bleeding and becoming comatose, are possible. While a typhoid vaccine is available, it does not guarantee immunity.

Riskline / Country Report / 29 August 2021 / North Macedonia 23 West Nile Virus

West Nile Virus is a viral infection transmitted by mosquitos. The majority of cases are asymptomatic; where symptoms occur they may include fever, diarrhoea, rash, vomiting and joint pain. In rare cases symptoms may include meningitis, encephalitis or coma. There is no treatment for West Nile Virus, beyond supportive hospital care and bed rest.

Hepatitis (A, B, C, D and E)

Outbreaks of hepatitis A occur infrequently in Macedonia, but the risk to visitors is very low. The overall hepatitis B carrier rate in the general population is estimated to be between two and seven percent. Hepatitis C is present, but precise infection rates are not known. Sporadic and rare cases of hepatitis E are reported annually, but the risk to travellers is extremely low.

Hepatitis is inflammation of the liver. The three main variations (A, B and C) are caused by infections from parasites, bacteria or viruses, but are transmitted by different means.

Lyme disease

Foreign visitors intending to visit rural and forested areas are advised to undertake preventative measures to reduce the risk of tick-borne transmission.

Lyme disease is a bacterial infection transmitted by ticks and is most prevalent in rural areas. Early symptoms include fever, swollen lymph nodes, fatigue headaches

Riskline / Country Report / 29 August 2021 / North Macedonia 24 and a 'bullseye' shaped rash around the tick bite; later symptoms include arthritis, facial paralysis, memory loss, swollen joints, increased rashes and headaches and heart palpitations. In most cases Lyme disease can be treated with a course of antibiotics; a small number of cases may develop into Post-treatment Lyme Disease Syndrome (PTLDS), which may persist for a number of months.

Rabies

Most rabies in Macedonia is confined to animals, particularly bats.

Rabies is a serious viral infection, transmitted through close contact with saliva from infected animals (i.e. bites, scratches or licks on broken skin and mucous membranes). Travellers who suspect they may have come into contact with a rabies- infected animal should seek immediate emergency attention: post-exposure treatment has a high success rate if administered early. Late-stage rabies (when symptoms begin to occur) is untreatable and fatal.

Tick-borne Encephalitis (TBE)

Although rare in Macedonia, tick-borne encephalitis has been reported in forested regions.

Tick-borne encephalitis (TBE) is a viral infection usually transmitted through the bite of an infected tick. Typically the disease occurs in two stages. The first is a mild-flu like illness. The second is a potentially serious infection of the central nervous system (brain and spinal cord). TBE can at time be fatal in up to 20 percent of cases. Long-term neurological complications are common. Individuals are at increased risk if they visit areas where TBE is known to occur particularly in woodland or grassland. Travellers may reduce the risk of infection by avoiding risk areas and taking bite prevention measures.

Riskline / Country Report / 29 August 2021 / North Macedonia 25 Tuberculosis (TB)

The average annual incidence for TB is at least 25 cases per 100,000 people, indicating the disease is endemic, but the risk to travellers is low.

Tuberculosis is a bacterial infection transmitted via the coughing and sneezing of infected persons. Symptoms – which may take years to develop if a person has latent TB – include fever, night sweats, chest pain, coughing up blood, weight loss and fatigue. TB can be treated with a course of antibiotics; the length of treatment is significantly longer once the disease becomes active and is no longer latent.

Riskline / Country Report / 29 August 2021 / North Macedonia 26 Recent incidents

20 August 2021 - 21 August 2021 Moderate risk: EU approve COVID-19 certificates issued by North Macedonia, Turkey and Ukraine - Update The European Union (EU) approved COVID-19 certificates issued by North Macedonia, Turkey and Ukraine, and connected their certificates to the EU Digital COVID Certificate system, to facilitate safe travel from those countries to the EU, amid COVID-19. The three countries also accepted the certificate system for incoming travellers from the EU.

16 August 2021 - 17 August 2021 Moderate risk: Officials to introduce COVID-19 certificates for public spaces on 16 August Officials will require a COVID-19 vaccination certificate for entry to restaurants, cafes and venues where more than 30 people are present effective 16 August. The vaccine certificate will be available to those who have had at least one dose of a COVID-19 vaccine. Weddings and similar events inside enclosed spaces will be banned.

Riskline / Country Report / 29 August 2021 / North Macedonia 27 Covid-19: High Risk

Summary

In August 2021, the country saw a sharp uptick in new COVID-19 cases due to the spread of the delta virus variant. A health pass system is in effect for some public venues.

What is the current nationwide Policy?: Partial Measures

Policy starts: 15 June 2021 Policy ends: indef

Policy explanation:

While most non-essential venues and services are open, a COVID-19 health pass is required for access to hospitality establishments and large events.

Policy source: https://koronavirus.gov.mk/en/governments-measures

Last update: 26 August 2021

Infection

Infection Level: Extreme Infection rate: 538.33 cases per 100k in the last 14 days As of date: 22 August 2021 Hotspots:

Domestic Infection Map: https://covid19.who.int/region/euro/country/mk

Riskline / Country Report / 29 August 2021 / North Macedonia 28 International Travel

International Flights

Is there a ban on international commercial flights? No Through what date?

Flight Ban Explanation:

Skopje (SKP/LWSK) and Ohrid's St Paul Apostle (OHD/LWOH) airports are open to passenger flights. Travellers displaying COVID-19 symptoms will be denied boarding.

Last Update: 26 August 2021

Entry and Borders

Is there a ban on entry for any travellers? No Through what date?

Travellers from where are banned?

Land border: Open Maritime border:

Entry Rules Explanation:

The country's borders are open to travellers.

Entry Rules: Last Update:

Riskline / Country Report / 29 August 2021 / North Macedonia 29 Testing

Do travellers need to take a COVID-19 test No When? Is it mandatory or optional? Test Type: Minimum age requirement: Pre-travel test validity, in hours: After arrival test days:

Testing Explanation:

A COVID-19 test is not required for entry until 1 September.

Effective 1 September, arriving travellers must present proof of a negative test, recovery or vaccination against COVID-19. The test must be a PCR test result no older than 72 hours prior to entry or an antigen test no older than 48 hours. Transiting travellers whose stay does not exceed five hours are exempt.

Last Update: 26 August 2021

Health and Travel Documentations

Do arriving travellers need any health and/or travel documentation? No

Documentation Explanation:

Last Update: 17 August 2021

Tracing App

Riskline / Country Report / 29 August 2021 / North Macedonia 30 Do travellers need to use a contact tracing app after arriving? Recommended

Tracing App Explanation:

"StopKorona" (https://stop.koronavirus.gov.mk/en) is a voluntary mobile app for contact tracing available on Android and iOS devices.

IOS App: https://apps.apple.com/app/id1506362170 Andriod https://play.google.com/store/apps/details? App: id=mk.gov.koronavirus.stop Last 17 August 2021 Update:

Quarantine on Arrival

Who needs to quarantine on arrival Some travellers

Travellers from where need to quarantine? India

How many days is quarantine? 14 Is it self-quarantine or operated by the government? Self

Quarantine Explanation:

Travellers arriving from India must quarantine for 14 days.

Effective 1 September, Macedonian nationals who arrive without COVID-19 documentation must quarantine for seven days upon entry.

Quarantine Rules: https://vlada.mk/node/25374 Last Update: 2021-08-26

Riskline / Country Report / 29 August 2021 / North Macedonia 31 Exit

Is there a ban on exit for any travellers? No

Are there special requirements to exit the country? No

Exit Requirements Explanation:

Exit Requirements (URL): Last Update: 17 August 2021

Vaccination

Percent vaccinated with at least one dose: 32.376 as of 23 Aug 2021 Percent fully vaccinated: 24.17 as of 23 Aug 2021 Is vaccination mandatory for entry? No Are vaccinated travellers exempt from any policies or requirements? Qualified vaccines and timeline: Certificates accepted: EU Digital COVID Certificate

Explanation:

Travellers are permitted unrestricted entry, regardless of vaccination status.

Effective 1 September, all inbound travellers are required to present either a negative COVID-19 PCR test result no older than 72 hours prior to entry, proof of full vaccination against COVID-19 or proof of having recovered from COVID- 19 within the previous 45 days; transit travellers who stay less than five hours are exempted. Macedonian citizens who arrive without these documents must quarantine for seven days upon entry.

Riskline / Country Report / 29 August 2021 / North Macedonia 32 Source: https://koronavirus.gov.mk/en/governments-measures Last Update: 26 August 2021

Other International Travel Restrictions

Exit Requirements Explanation:

Last Update:

Domestic Situation

Areas on Lockdown

Last Update:

Areas under Curfew

Last Update: 17 August 2021

Domestic Travel

Domistic Travel Explanation:

Riskline / Country Report / 29 August 2021 / North Macedonia 33 Last Update: 17 August 2021

Other Domestic Restrictions

Gatherings of more than five persons in parks and other public places and areas is banned.

A COVID-19 vaccination certificate must be presented for entry to restaurants, cafes and other venues where more than 30 people are present. The vaccine certificate will be available to those who have had at least one dose of a COVID-19 vaccine. Weddings and similar events inside enclosed spaces will be banned.

Last Update: 17 August 2021

Resources

Government COVID Site: https://koronavirus.gov.mk/en/governments- measures

Health Dept COVID Site: https://zdravsko.gov.mk

Riskline / Country Report / 29 August 2021 / North Macedonia 34 Recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 35 Local Travel : Moderate Risk

Travel Safety

Air Travel and Airports: North Macedonia has two international airports; Skopje and Ohrid. International Airport Skopje (SKP/LWSK) is the main entry point for travellers to North Macedonia. It is located 20km (12.4 miles) from the city. Security at Skopje is good, with recent upgrades to infrastructure and technology used for screening. There have been no serious breaches in security in recent years. Queues for security are generally managed efficiently but can be long at busy times. During winter season, Skopje Airport is often closed due to fog, and flights to Skopje are often cancelled or diverted to Ohrid. Ohrid is a two and a half to three hour drive from Skopje, and the airline will provide transport to Skopje if your flight is diverted. Customs occasionally stop people while exiting the airport, and if so may ask you how much foreign currency you are taking into the country. While you are legally required to declare all foreign currency on arrival, the vast majority of people only make a declaration if they are bringing in a substantial amount of cash intended for business purposes. Customs tend to stop North Macedonians, rather than foreign nationals.

There is no public bus service linking Skopje Airport with the centre of the city. Officially licensed taxis are available from a rank outside the arrivals hall, but unlicensed operators are often more prominent. Do not use any taxi that is unmarked or fails to display an official taxi permit on the interior. Unlicensed drivers often overcharge foreign nationals. A typical ride into central Skopje should cost between MKD6,000 and MKD9,800. To reduce the chances of overcharging, you may wish to book a taxi in advance of your arrival. There are several car rental companies with offices at the airport, including local and international firms. Vehicles for hire are predominantly recent models that are well-maintained. Skopje is approximately a 20 minute drive from the airport.

North Macedonia's flag carrier, MAT, was liquidated in 2009 after continued operations at a loss. Plans by private investors to create a new national airline were tabled in October 2013, however as of one year later, no action had been taken. Skopje Airport, however, is a hub of low-cost Wizz Air; other regional and European airlines operate services to Skopje Airport.

Ohrid "St. Paul the Apostle" Airport (OHD/LWOH) is located 10km (six miles) west of

Riskline / Country Report / 29 August 2021 / North Macedonia 36 the city of Ohrid. The airport mostly operates in summer, as harsh winter weather frequently closes it. There are no bus services linking the airport to the city, but taxis are available after most landings. If your plane is scheduled to arrive early in the morning or late at night it is advisable to book a taxi in advance.

European Union (EU) and United States (US) citizens entering the country receive a three month visa stamp. Visitors who are not staying in a hotel must register with the police within three days of their arrival. It is a simple procedure and must be done together with the person you are staying with. There is no need to do this if you are staying at a hotel or guest house as it is done automatically.

Note: On 26 June 2010, North Macedonian authorities reached an agreement with leaders of Albania, Montenegro and Kosovo to establish a “free-movement” zone between their states as an indication of readiness for further European integration. The agreement will theoretically enable citizens of the four Balkan countries to travel across shared territorial borders without the need for visa registration.

Road Travel: The condition of roads varies, but compare favourably with other countries in the region. Some rural roads are poorly maintained and most roads are not lit at night. The highway linking Serbia to Greece that runs through Skopje is a dual carriageway and in very good condition. A four lane highway also links Skopje with Tetovo and Gostivar. Both are toll roads and tolls can be paid at the start of the road. Local drivers routinely ignore traffic regulations and speed limits, often causing accidents. The poor condition of many local vehicles means that headlights are not always visible at night, so drivers should exercise extra caution when driving in the dark.

Traffic congestion in Skopje and other larger towns can be heavy, with many drivers being frustrated and aggressive. If you are involved in an accident, call the authorities and do not remonstrate with the other driver.

The drink driving limit is 0.5 milligrams of alcohol per millilitre of blood. Police enforce this law strongly, and those caught over the limit will face large fines or licence suspension. Speed limits are 50kph (31mph) in urban areas, 80kph (49mph) in rural areas, 100kph (62mph) on dual carriageways and 120kph (74mph) on motorways. Police can stop you and fine you on the spot for speeding offences. Be sure to get a receipt for any fine you pay to prevent the officer taking it for him/herself. All vehicles are required by law to use headlights during the day. It is also a legal requirement to

Riskline / Country Report / 29 August 2021 / North Macedonia 37 carry a spare bulb set, warning triangle, first aid kit and high-visibility vest.

Public Transport

Boats/Ferries: Pleasure boats, water taxis, and other watercraft frequently operate on Lake Ohrid. During the summer there is a scheduled service to Sveti Naum. The quality of vessels operating on Lake Ohrid varies greatly. On 5 September 2009 a sightseeing boat carrying up to 74 passengers, well over safety capacity, sank in Lake Ohrid, killing at least 22 people. This was the worst boating accident in North Macedonian history. Never travel on a vessel that looks overloaded or poorly maintained.

Buses: International bus services link North Macedonia with Germany, Albania, Serbia, Bulgaria and Turkey. All services terminate at Skopje International Bus Station. The vehicles used on these routes tend to be modern and comfortable, but petty crime is a frequent problem. Always keep your bags close to you and use locks to prevent them from being opened easily. Valuables should be kept in hard to reach pockets, such as in a money belt.

Domestic long-distance bus services are efficient, reliable and widespread. Most towns are within easy reach by bus from Skopje or other large cities. For longer trips it is advisable to book well in advance, as some routes fill up very quickly. Fares are cheaper than rail travel and trips can often be faster. However, buses used for domestic routes vary widely in quality, with many being old and poorly maintained. Due to the risks inherent in road travel, accidents do occur periodically.

City bus networks operate in most large towns. Fares are very cheap: in the inner city, they are MKD20 and further out they are MKD15. Despite rarely arriving at their scheduled time, there are enough buses operating on each line that travellers rarely have to wait long. Busy periods can be very uncomfortable, as passengers are crammed in to the extent that nobody can move. Pick pocketing occurs often on the bus networks in cities, so always keep your valuables in a secure pocket.

Taxis: Taxis in North Macedonia are widely available in urban areas and offer an easy low cost transport option. A typical journey will cost between MKD40 and MKD80. Vehicles used by taxi companies are much newer in North Macedonia than elsewhere in the region and accidents are uncommon. To reduce the risk of overcharging, you should always ensure the driver has switched on the meter before you drive off. Unlicensed taxi drivers sometimes operate near public transport hubs. You should

Riskline / Country Report / 29 August 2021 / North Macedonia 38 never get into an unmarked private car, as these drivers often overcharge and are not regulated by the local authorities. Official licensed taxis will always carry a meter and will have a rooftop light or branding on their doors. All taxis should charge no more than MKD20 per kilometre, with MKD50 as a minimum fare.

Taxi drivers are generally happy to negotiate a price to take passengers to other towns in North Macedonia or neighbouring countries.

Trains: International trains run between Skopje and Belgrade in Serbia. Less frequent are services between Skopje and Thessaloniki in Greece. Both should be avoided if possible as the trains are aging and uncomfortable to travel in. Long delays can occur, although are infrequent.

Domestic rail services in North Macedonia are generally of a low standard. Rolling stock is outdated and petty crime is regular. Many journeys take longer by rail than by bus, so always check schedules before buying a ticket. Although serious accidents are rare due to the low speeds of North Macedonian trains, fatal accidents do occur. Level crossings in North Macedonia are not always clearly marked and may not have guard rails.

Vehicle Rental: Large international and smaller local car hire firms operate in North Macedonia. The majority use recent model cars that are well maintained. Car hire companies typically do not permit their cars to be driven into Bulgaria, so check with the hire company first if you wish to travel there. Before you drive off in a rental car, always check around the car for damage that may have been missed by hire company inspections. Bubbled tyre sidewalls are a common fault that can lead to blowouts at high speed.

There are no recent incidents

Riskline / Country Report / 29 August 2021 / North Macedonia 39 Country Hotspots

Regions: Tensions between ethnic Macedonian and ethnic Albanian communities exist across the country. Shootings and other acts of violence have taken place in the cities of Skopje, Tetovo, Kumanovo and Gostivar. There are sporadic reports of Albanian armed groups operating in the hills near Kosovo, particularly around the village of Tanusevci, but there have been no major episodes of violence reported since the end of the 2001 insurgency. There have also been a few shooting incidents linked to organised crime in the northwest of the country and in the Cair district of Skopje.

Apart from designated border crossings, the immediate border with Serbia is a military restricted zone and passing is possible only with police permission.

Riskline / Country Report / 29 August 2021 / North Macedonia 40 Safety

Beaches: The city of Ohrid, on Lake Ohrid, has many public and private beaches. Although small dangerous exist on rocky and pebbled beaches, water quality is considered good. It is recommended to always gain local information and insight as to the quality and swimming conditions on beaches in North Macedonia.

Beggars: Beggars, mainly Roma, are numerous in large urban centres around traffic lights and outdoor restaurants. They tend to target travellers and can be extremely insistent, however they are not a safety risk. Violence on the part of beggars is very rare. If approached you should be on your guard, as many are also pickpockets. Most will leave you alone if ignored.

Landmines and Unexploded Ordinance: The vast majority of the unexploded ordinance and mines left during the 2001 crisis and the months following it have been cleared. Nevertheless, there is a residual risk in rural areas in the northwest of the country towards the border with Kosovo. Areas most at risk are the Kumanovo and Tetovo rural areas, bordering Kosovo.

Police: Police lack resources to investigate crime effectively, but can be relied on in an emergency. The police emergency telephone number is 192.

Pollution: Air pollution in Skopje can become a problem in summer months. The city is located in a valley basin and is protected from the winds that could remove noxious gasses from the air. Travellers with existing respiratory problems should carry their medication with them at all times.

Protests: Demonstrations and protests can occur in larger cities and should be avoided as they may turn violent. In 2018, protests have been held near the Parliament in Skopje to oppose an agreement on 17 June between Greek Prime Minister Alexis Tsipras and Macedonian Prime Minister Zoran Zaev to rename FYROM as "North Macedonia" and that would pave the way to the country’s accession to EU and NATO. Consult local media sources for information regarding planned protests.

Water Safety: Tap water may not be safe for drinking. Always use bottled water for cooking or consumption which is available across the country.

Riskline / Country Report / 29 August 2021 / North Macedonia 41 Culture

Political Sensitivities: Immediately after North Macedonia’s independence in 1991, Greece objected to the country’s constitutional name, Republic of Macedonia, and delayed international recognition of the country. The country was eventually internationally recognised as the Former Yugoslav Republic of Macedonia (FYROM). Successive Macedonian governments have pushed for international recognition of the country under the constitutional name, but Greece has vetoed these attempts, viewing Macedonia as a Hellenic name. A breakthrough in bilateral negotiations was reached on 17 June 2018 with an agreement between Greek Prime Minister Alexis Tsipras and Macedonian Prime Minister Zoran Zaev to rename FYROM as "North Macedonia". The agreement was met with fierce resistance in both country and was expected to undergo a referendum in autumn 2018 before entering into force. Travellers may prefer referring to North Macedonia as ‘Macedonia’ when in the country.

Political differences between the the country’s ethnic Macedonian majority and ethnic Albanian minority remain high, though are not likely to return to armed conflict as occurred during the 2001 national emergency. During that time, anti-Western sentiment flared up among some North Macedonians based on the perception that Western countries were favouring the Albanians, a view that has never gone away and now regained salience in light of the ongoing political deadlock between conservative and liberal party coalitions over the status of the Albanian language - which is not an official language - and political representation of ethnic Albanians.

It is better not to offer opinions about interethnic relations to prevent confrontations. Macedonians and Albanians generally live in separate areas of the major cities. Outside the capital, most Albanians live in the west of the country.

Religious Sensitivities: Roughly two-thirds of the country in North Macedonia is predominantly Orthodox Christian, while just under a third is predominantly Muslim ethnic Albanians. Always behave with sensitivity at religious sites to avoid confrontation and dress modestly.

Riskline / Country Report / 29 August 2021 / North Macedonia 42 Specific Traveller Advice

Female Travellers Local Customs and Laws: There are no local customs or laws that a female traveller should take into consideration in North Macedonia. Dress according to the country’s culture, especially when visiting places of cultural and religious importance. Familiarise yourself with your destination prior to travel, and be respectful and mindful of any possible cultural sensitivities, which may include dress, behaviour and topics of discussions.

Safety: There are minimal safety concerns female travellers should take into consideration in North Macedonia. Sexual assault and rape do occur; however, visitors to the country are not likely to face an additional risk as most perpetrators of assault are known to their victim. While isolated incidents of street harassment and assault are reported in large cities, it is not a widespread or rampant concern. Emergency services and police outside major cities are unlikely to respond effectively if cases of sexual assault or rape are reported. Consider consulting your home consulate/embassy for legal advice and ensure you receive a copy of the police report. Exercise personal safety awareness if walking alone at night. Stick to main, well-lit streets and avoid walking through desolate areas or unfamiliar neighbourhoods. Refrain from wearing headphones while walking in the evening.

Health and Wellness: Women have access to some specialised gynaecological and reproductive health services, medicines and products in North Macedonia. Medical facilities outside major cities often lack adequate resources to provide specialised care. Facilities that provide specialised care are concentrated in Skopje. A full range of feminine hygiene products is available. Emergency contraceptives are sold behind the counter at pharmacies and can be purchased from a pharmacist without a prescription. Prescription contraceptives may not be readily available as access to high-quality medication is limited outside major cities. Abortions can be performed during the first 12 weeks of pregnancy and for health and for socioeconomic reasons up to 22 weeks. Consider bringing an adequate supply of oral contraceptive pills, which may not be available locally. Visitors in need of specialised care are advised to consult private facilities in Skopje.

LGBT+

Riskline / Country Report / 29 August 2021 / North Macedonia 43 Homosexuality is legal in North Macedonia. There are no legal protections for LGBT+ persons in the country. An anti-discrimination law which had prohibited discrimination on the basis of sexual orientation, gender identity and other grounds was repealed by a court ruling in May 2020. Same-sex marriage is illegal. LGBT+ activity and persons are not socially accepted, with the exception of limited areas of the capital Skopje. Despite the legal status of LGBT+ rights, social conservatism may be prevalent in some parts of the country. Travellers may prefer to be discreet about sexual orientation and avoid excessive public displays of affection in areas where attitudes towards the LGBT+ community are unknown or generally not accepted. Use caution in conversations about sexuality or LGBT+ issues with strangers or recent acquaintances. Consider booking hotel rooms with two separate beds. Transgender travellers may wish to consider having their passport and identification changed to reflect their new gender before travelling.

Technology & Communication Risk Travellers are unlikely to face risks related to information and communication technology (ICT) in North Macedonia.

Internet access and social media have no restrictions. While there are laws prohibiting hate speech, which includes the expression of racial, ethnic, or religious intolerance, this is unlikely to affect travellers.

There are no concerns related to device searches or sensitive technology. Device searches and inspections at the border are unlikely. There are no restrictions in relation to bringing or operating sensitive equipment, which may include photo cameras, satellite phones, drones, and other GPS systems, in the country.

State or criminal penetration of private data is unlikely. Historically, the state has implemented pervasive state surveillance of ICT networks in the country, but this is unlikely to affect travellers following the institution of reforms after nationwide protests erupted in 2015 over the illegal wiretapping of some 20,000 politicians, activists, reporters and businesspeople organised by then-Prime Minister Nikola Gruevski’s government.

Travellers should exercise basic ICT safety precautions. However, travellers should note that ICT laws and practices are subject to change on short notice, and travellers are recommended to confirm the legality/appropriateness of their specific ICT needs prior to departure.

Riskline / Country Report / 29 August 2021 / North Macedonia 44 Legal notice

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Riskline / Country Report / 29 August 2021 / North Macedonia 45