Ground Troops

From its South Minneapolis headquarters, the American Refugee Committee sorts out the logistics of relief

"No, we've been around for about 20 years," the receptionist tells a caller. "Right. You can send a check. Yes. Just specify Kosovo in the memo." No sooner has the receiver hit the cradle than the phone rings again. The small lobby, and the mazelike offices behind it, are as busy as a politician's "war room" on Election Day. But this space on 24th and Nicollet is more of a reaction-to-the-war room: It serves as the headquarters for the American Refugee Committee, an international relief organization with a budget of $18 million and some 1,000 employees around the globe. Their latest engagement is in Kosovo, where 420,000 people are estimated to have been displaced in the past three weeks.

Karen Johnson Elshazly, ARC's director of international programs, is on the phone to Macedonia, where's it's now ten p.m. She's negotiating how to get money to the group's staffer in the country's capital, Skopje, since the cash he carried in from Minneapolis is down to $200. Wiring funds requires a local bank account, and to get a bank account ARC must register with the Macedonian government--a complex process that could take weeks. "I think we've found an organization that we could wire money through," Elshazly says. "But it's not all set up yet."

Elshazly, age 48, is an art teacher by training and in her early 20s worked in publishing. One day, she says, "I had this burning desire to have a job that meant something. I had just bought a house and a new car, so I got a grocery-store job to keep going while I was looking. I would go around to employment agencies, and I would give this speech, how I wanted a job that's meaningful to somebody.

"I got a call from an employment counselor--it had nothing to with his job, but he'd met a guy at a DFL fundraiser and thought of me. It was Stan Breen, our first director here at ARC. I met him the next day--a Thursday--and started on Friday. We had $700 in the bank. It was really hand-to-mouth, but a great opportunity." The year was 1979; the American Refugee Committee had been started a year earlier in Chicago by community leaders who were helping refugees from Vietnam, Laos, and Cambodia settle in the United States. Its headquarters were moved to Minneapolis because Breen lived here.

"We had a big warehouse in Minneapolis where we gave out donated goods to arriving refugees," Elshazly recalls. "But families were telling us that their family members couldn't get over, that they were on medical hold [in a refugee camp] for a year. So we said maybe we should send a medical team to Thailand." Within a year she had put together three groups of doctors and nurses, and traveled along with one of them; since then, similar medical strike forces have traveled to Bosnia, Croatia, Guinea, Rwanda, Somalia, Sudan, and Uganda.

Unlike many Americans--and some international aid groups--Elshazly and her colleagues did not come to the Kosovo crisis unprepared. They began casting a worried eye on the region years ago and spent part of an emergency fund to establish a one-person office there in 1998; last summer, the group's director flew to Macedonia to meet with government officials. At the time, says Elshazly, the country's leaders did not want to contemplate scenarios involving more than 60,000 refugees, all of whom were to be "absorbed" into private Macedonian homes. Since the beginning of NATO air strikes against Yugoslavia, some 120,000 people are thought to have entered Macedonia from Kosovo, and many have been placed in impromptu refugee camps set up by NATO forces. An estimated 300,000 more have crossed into Albania, where the committee is not active.

But those border camps, Elshazly explains, are not open to just any aid organization: "It can become political. The German troops set up a camp and turned it over to a German agency, the Turks did the same, so did the Greeks. Many [relief] groups ended up having little or no assignment."

ARC, she says, chose to stick with its original plan to serve an estimated 77,000 refugees doubled up with Macedonian families--in part because, even as other refugees are sent to more permanent facilities elsewhere in Europe, "these people are remaining there." Within the next few months, the group hopes to have a total of six medical teams operating in Macedonia.

Contrary to public perception--and the assumptions of doctors who have been calling ARC offering their services--those teams will not consist of white-coated volunteers flown in from the U.S. Whenever possible, Elshazly notes, ARC seeks to function as an extension of the local health care system; in some countries, such as Thailand, that has meant cooperating with local healers to set up traditional-medicine centers dispensing herbal remedies. In Macedonia it means supporting the country's network of clinics, or ambulantas.

Elshazly says the first priority for ARC's nurses and doctors will be to identify and treat people with chronic conditions such as heart trouble, and to help immunize children to prevent outbreaks of diseases like measles. But they will also seek to address what may be the most common, and least obvious health problem among refugees: depression and other mental-health troubles. "Our [American] approach--seeking professional help from a stranger--doesn't work in other countries. We couldn't ask refugees about rape or talk about mental-health services with them. So we take an activity-based approach. In a refugee situation, it's usually women and children, so sometimes we put them to work to sort hygiene kits or do rug weaving. We just provide the venue, and then we see that contact within a group allows people to be heard, to be believed, not to be judged."

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