Children's well-being after the war in Kosovo: survey in 2000

Abstract

Aim: To assess special health and psychosocial needs of Albanian children in Kosovo shortly after the dramatic ethnic conflict in this part of former Yugoslavia in 1999.

Methods: The survey included representative samples of school-age children (n=813), parents (n=41), and teachers (n=31) from six public schools in Prishtina and surrounding area. The measuring instruments included a standardized inventory of children's coping behavior in stressful situations (Ryan-Wegner Coping Style Inventory, SCSI), and survey questionnaires for children, parents, and school teachers, which were also used in a parallel study in Bosnia and Herzegovina (Sarajevo) on comparable survey samples. The study was accomplished in April 2000, ie, only a few months after the crisis in Kosovo.

Results: At the time of the survey, many children in Prishtina and surrounding area lived in unhealthy and dangerous physical environment. There were frequent lack of electricity (74%), lack of safe drinking water (68%), garbage on the streets (63%), and firearms, explosive devices, and mine fields in close environment (45%). Many of them showed signs and symptoms of ill health, including frequent headaches (60%), stomach ache (41%), frequent high fever (32%), and sleeplessness (18%). Most of them felt unsafe on the streets (61%). Many of them had rather unhealthy eating habits, such as not having breakfast regularly (16%) or not having a morning snack (60%). Three major groups of stressors were identified as having impact on children's health and psychosocial well-being in Kosovo, as follows: 1) lack of cultural and social security resources at home and in the community at large (20% of common variance explained); 2) poor physical and mental health conditions (14% of common variance); and 3) school-related stressors (11% of common variance). Similarly, parents and teachers also lived and worked under stressful life conditions. Many parents feared the impact of traumatic war experiences on children's health (54%), and school teachers noticed high rates of children's learning and behavioral disorders (84%). Factor analysis of the SCSI proved the hypothesis that in stressful situations children tend to use two major coping strategies: either active, ie, object-focused coping (13% of variance explained) or passive, ie, self-focused coping (10% of variance explained), the later being more typical for younger children. The pattern of stressors and coping behaviors were similar to stressors impacting physical and mental health of children in Sarajevo, although there were a number of culture-specific differences.

Conclusion: Environmental, educational, and social conditions must be respected in assessing impact of war and conflict on children. Promotion of solidarity, tolerance, and mutual support among children from different ethnic and cultural backgrounds should be encouraged.