WKAROCSRIOMEVS ION A Population-Based Assessment of Human Rights Violations Against Kosovar Albanians A report by: Physicians for Human Rights Boston • Washington DC In conjunction with: Program on Forced Migration and Health, Center for Population and Family Health, The Joseph L. Mailman School of Public Health, Columbia University Copyright © August 1999 by Physicians for Human Rights All rights reserved Printed in the United States of America ISBN 1-879707-26-8 Library of Congress Catalog Card No. 99-075785 COVER INSET PHOTO: Glenn Ruga COVER AND REPORT DESIGN: Glenn Ruga/Visual Communications PHYSICIANS FOR HUMAN RIGHTS Physicians for Human Rights (PHR) mobilizes the health professions and enlists support from the general public to protect and promote the human rights of all people. PHR believes that human rights are essential preconditions for the health and well-being of all members of the human family. Since 1986, PHR members have worked to stop torture, disappearances, and political killings by governments and opposition groups; to improve health and sanitary conditions in prisons and detention centers; to investigate the physical and psychological consequences of violations of humanitarian law in internal and international conflicts; to defend medical neutrality and the right of civil- ians and combatants to receive medical care during times of war; to protect health professionals who are victims of violations of human rights; and to pre- vent medical complicity in torture and other abuses. As one of the original steering committee members of the International Cam- paign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize. PHR cur- rently serves as grassroots coordinator of the US Campaign to Ban Landmines. The President is Robert Lawrence, M.D, M.P.H.; Current Past President is Charles Clements, M.D.; Vice President is Holly J. Atkinson, M.D.; Current Past Vice President is Carola Eisenberg, M.D.. The Executive Director is Leonard S. Rubenstein, J.D.; Deputy Director is Susannah Sirkin; Director of Development is Mary Jo Adams, Advocacy Director is Holly Burkhalter; Director of Communications is Barbara Ayotte; Director of Campaigns is Gina Cummings; Director of Finance & Administration is Lori Maida; Senior Pro- gram Associate is Doug Ford; William Haglund, Ph.D., is Director of the Inter- national Forensic Program and Vincent Iacopino, M.D., Ph.D., is Senior Medical Consultant. Physicians for Human Rights Physicians for Human Rights 100 Boylston Street, Suite 702 110 Maryland Ave., Suite 511 Boston, MA 02116 Washington, DC 20002 Tel. (617) 695-0041 Tel. (202) 547-9881 Fax. (617) 695-0307 Fax. (202) 547-9050 Email: [email protected] Email:[email protected] www.phrusa.org Program on Forced Migration and Health Center for Population and Family Health The Joseph L. Mailman School of Public Health Columbia University The Program on Forced Migration and Health is part of the Center for Popula- tion and Family Health at the Joseph L. Mailman School of Public Health of Columbia University. The program was developed in response to the need for technically sound approaches to issues faced by health professionals providing humanitarian assistance in complex emergencies. The program has three main areas of activity: • Providing post-graduate training in public health, in preparation for careers in international humanitarian assistance • Offering short-term training for public health professionals currently working in the field • Conducting research into the relationship between public health and forced migration Program on Forced Migration and Health Center for Population and Family Health The Joseph L. Mailman School of Public Health of Columbia University 60 Haven Avenue, B-2 New York, NY 10032 Tel: 212-304-5221 Fax: 212-305-7024 Email: [email protected] Web: http://cpmcnet.columbia.edu/dept/sph/popfam/refugee v CONTENTS Acknowledgments viii Glossary x I. Executive Summary 1 Purpose of the Study 1 Summary of Findings 2 Summary of Methods 7 Recommendations 7 II. Political Background 11 III. Historical Background 17 Geography and Ethnic Composition of Kosovo 17 History 17 Recent Political Situation 22 Human Rights Violations before the Armed Conflict 23 Account of the Armed Conflict 25 Chronology of Key Events 26 Situation of Refugees and Displaced Persons 31 IV. Kosovar Refugee Survey 33 Methods 33 Survey Participant Characteristics 38 Forced Expulsions of Kosovar Refugees 38 Human Rights Abuses Observed by Kosovar Refugees 41 Human Rights Abuses by Serb Forces Experienced by 43 Respondents and Household Members Comments on Survey Findings 49 V. Case Testimonies on War Crimes in Kosovo 53 Methods 53 Forced Expulsions 54 Killings 59 Beatings 72 Beatings in Macedonia 76 Torture 77 Sexual Assault 80 vi Separation and Disappearance 82 Shootings 85 Looting and Destruction of Property 86 Landmines 90 Other Human Rights Violations 91 Human Shields 91 Forced Labor 92 VI. Violations of Medical Neutrality 93 Introduction 93 Definition of Medical Neutrality 95 Abuses of Kosovar Albanian Health Professionals 97 Killing of Physicians 99 Threats and Hunting of Medical Workers 100 Forced Expulsion/Lack of Freedom of Movement 102 Torture and Beatings 104 Abuses Against Kosovar Albanian Patients 105 Military Use of Hospitals 108 Health Facility Destruction and Looting 110 VII. Application of Relevant International Law 113 Human Rights Law 113 International Humanitarian Law 113 VIII. Psychological Trauma and Recovery 117 IX. Appendices 119 APPENDIX A: List of Surveyed Refugee Camps and 119 Collective Centers APPENDIX B: PHR/Columbia Survey Instrument 120 APPENDIX C: Reports of Mosques Destroyed by Serb Forces 127 APPENDIX D: Reports of Schools Destroyed by Serb Forces 129 APPENDIX E: Reports of Medical Facilities Destroyed 132 by Serb Forces APPENDIX F: Reports of Landmines Laid By Serb Forces 134 vii ACKNOWLEDGMENTS This report was written by Vincent Iacopino, M.D., Ph.D., Senior Medical Consultant to Physicians for Human Rights (PHR); Martina W. Frank, M.P.H., Staff Associate, Program on Forced Migration and Health, Center for Popula- tion and Family Health, The Joseph L. Mailman School of Public Health, Columbia University, New York, NY; Allen S. Keller, M.D., Director, Belle- vue/NYU Program for Survivors of Torture, Center for Health and Human Rights, New York University School of Medicine, New York, NY; Sheri L. Fink, M.D., Ph.D., Fellow, Human Rights Center,University of California, Berkeley, CA; Daniel J. Pallin, M.D., M.P.H., Resident in preventive medicine, New York City Department of Health & Columbia University; Ronald Wald- man, M.D., M.P.H, Director, Program on Forced Migration and Health, Center for Population and Family Health, The Joseph L. Mailman School of Public Health, Columbia University, New York, NY; Doug Ford, J.D., Senior Program Associate, Physicians for Human Rights, Boston, MA; Holly Burkhalter, Advo- cacy Director, Physicians for Human Rights, Washington, DC; Barbara Ayotte, Director of Communications, Physicians for Human Rights, Boston, MA; Alli- son Cohen, Program Coordinator, Physicians for Human Rights, Boston, MA; Ruth A. Barron, M.D., Clinical Instructor, Harvard Medical School, Boston, MA; Jennifer Leaning, M.D., Assistant Professor, Harvard Medical School, Boston, MA; and Mary Ellen Keough,M.P.H., Director, Antemortem Database Project, Bosnia Projects of Physicians for Human Rights. The report was prepared for production by Dr. Iacopino and Ms. Ayotte. The report is based on research undertaken by the PHR/Columbia team between April 1,1999 and May 3,1999. We are grateful to Linda Cushman, Ph.D., Associate Clinical Professor of Public Health, Center for Population and Family Health, The Joseph L. Mailman School of Public Health, Columbia University, New York, NY; Heidi Bauer, M.D., M.P.H., Research Specialist, University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, and Roger Vaughan, Dr.P.H., Assistant Professor of Clinical Public Health, Center for Population and Family Health, The Joseph L. Mailman School of Public Health, Columbia University, New York, NY for their assistance in the design of the survey instrument and data analysis. Patricia Dawson, Linda Federico-O’Murchu, Aaron Foeste, Shannon Light- ner, Carol McMahon, Martine Nokes, Jordana Sander, and Elias Wolfberg pro- vided invaluable research and data entry assistance. The report was reviewed by Leonard Rubenstein, J.D., Executive Director of Physicians for Human Rights, Susannah Sirkin, M.Ed., Deputy Director of viii Physicians for Human Rights and H. Jack Geiger, M.D., M.P.H., City Univer- sity of New York Medical School, Department of Community Health and Social Medicine. The law chapter was reviewed by Gregg Bloche, M.D., J.D. and Alicia Ely Yamin, J.D., M.P.H., members of the board of directors of Physi- cians for Human Rights. This research was supported by grants from the Blaustein Foundation, the Open Society Institute, the John Merck Fund, the Ford Foundation, and the Edna McConnell Clark Foundation. The authors would like to extend sincere gratitude to Luan Jaha, M.D., for all of his tireless efforts on behalf of Physicians for Human Rights over the past year. His unique insight into the health care system of Kosovo and his commit- ment to human rights investigative work have been invaluable. We also thank the research interviewers who assisted in data collection: Sebiha Ahmeti, Alban Bakija, Vedat Beshiri, Hasan Bishlimi, Vulnet Dulatahi, Learta Gunga, Lulzim Hasani,