In June 1999, the Kosovo conflict came to an end. The armed forces of Yugoslavia, controlled by Serbian nationalist leader Slobodan Milosevic, finally gave up on their attempt to force the republic to stay within Belgrade's orbit. Kosovo's population (and especially the 1.5 million Kosovar Albanians who made up the overwhelming majority) welcomed the peace. But they faced an uncertain future.
The most pressing challenge involved public health. Months of war and ethnic cleansing had taken their toll on basic health care. The fledgling Balkan state found itself caring for the needs of 1 million displaced people, many of them returning from far-flung locations after fleeing the fighting. (The photo above shows a Kosovar woman fleeing into Albania with her baby in April 1999.) Public infrastructure was in dismal shape; many hospitals, clinics, and pharmacies lay in ruins. Healthcare workers were in scarce supply, the result of Serb efforts to purge locals from all administrative posts. Studies estimated that as many as 20 percent of the population suffered from post-traumatic stress. Non-war-related mortality rates spiked to two or three times the pre-war rate. The reason was simple: the collapse of the health care system meant that many chronic diseases went untreated.
A war-riven society cannot rebuild with people who are sick, displaced, and demoralized. The NATO-led alliance correspondingly placed health relief in the center of its nation-building effort. With donor backing, the UN Kosovo mission orchestrated large infusions of food, medicine, and shelter. This effort saved many lives that otherwise would have been lost to starvation, disease, or exposure. UN-compiled data show that the international health relief effort in the decade following the Kosovo peace accord have sharply lowered rates of tuberculosis and infant mortality, two health trends directly traceable to conditions of poverty and war.
While the reconciliation process in Kosovo still remains tenuous, there can be little question that the West's health-care assistance played a direct role in bolstering nascent democratic institutions and improving governance in the years since the war. Improved medical conditions allowed Kosovo communities to revive and stabilize. Health care can also help to build important political bridges. When he was crafting the political agreement that enabled Kosovo to declare independence, Martti Ahtisaari, the then-UN special envoy, was able to allay fears among Serbs within Kosovo by allowing them to establish aid links to Serbia for hospitals and schools.
It might come as something of a surprise, but there is another place in the world that could benefit dramatically from a comparable effort by the international community. Burma (Myanmar) is a nation similarly scarred by ethnic strife, authoritarian rule, and poverty. Yet in the course of the past year, Burma's leaders have announced plans to move the country toward democratic rule. They have followed up by easing control over the media, allowing opposition leader Aung San Suu Kyi to participate in a pending parliamentary election, and releasing political prisoners. These changes have led the United States to restore diplomatic relations, and have prompted others to lift sanctions or expand aid. The resulting window offers an opportunity that should not be missed. If the regime allows the unhindered delivery of health aid, such assistance can have an impact beyond that of merely helping people to overcome sickness. It can also boost support for reforms and reinforce the constituency for freedom.
There is much damage to repair. The previous military regime transformed Burma into a "barricade state," a country that shut down domestic political competition and shut out the international community. While defense spending consumes an estimated 25 percent of Burma's budget, the generals' appetite for weapons has left its people with health spending that amounts to just $2 per person per year. As a result, Burma today has some of the highest rates of HIV/AIDS, tuberculosis, and infant and child mortality in Southeast Asia. The UN Development Program gave Burma a ranking of 149 out of 187 countries on its human development index. Meanwhile, just as in Kosovo in 1999, refugees from Burma's internal conflicts are likely to start making their way home, a process that is already driving demands for additional food, shelter, and medicine.