Echoes of Exile: The Unseen Cost of a Nobel Legacy
Bertila Bruka
The legacy of my hometown is that of the Nobel Peace Prize. Kukës, Albania, was the first city nominated for the Nobel Peace Prize in 2000. This honor was not for a monumental political achievement or a groundbreaking invention but for something far more profound—compassion. At the height of the Kosovo War in 1998-1999, Kukës became a sanctuary for more than 500,000 Kosovar Albanian refugees fleeing violence, ethnic cleansing, and unimaginable trauma.
This legacy is personal to me. My father, who served as the head of Kukës District Council during this critical period, played a vital role in the town's efforts to accommodate the influx of refugees. As a member of the emergency council, he worked alongside the United Nations and the Albanian government to provide housing, food, and education for displaced families. For many children, the classrooms of Kukës became a place of solace, offering structure amid the chaos. My father's work exemplified the quiet heroism of local leaders who transformed Kukës from a border town into a beacon of hope.
However, for many of those who crossed the border, the war did not end when the gunfire ceased. The trauma endured by refugees, carried on in their minds and bodies. The lasting effects of war on mental health are a legacy that is often overlooked. This paper examines the impact of the Kosovo War on the mental health of the region, focusing on the long-term psychological toll on those affected, drawing on historical context, personal narratives, and contemporary research.
To understand the mental health consequences of the Kosovo War, it is essential to first understand how the conflict unfolded. Kosovo's history of political and social strife stretches back decades. After World War II, Kosovo was incorporated into Yugoslavia as an autonomous province. Following the 1974 Yugoslav constitution, Kosovo experienced relative autonomy, allowing it to control its political institutions.
However, this autonomy was short-lived. In 1989, after the death of Yugoslav leader Josip Broz Tito, Serbian President Slobodan Milošević stripped Kosovo of its autonomy, centralizing power under Serbian rule. This shift was enforced by the presence of Serbian police forces and military control, setting the stage for a decade of oppression. Kosovo Albanians were subjected to police brutality, political repression, and loss of civil rights. By the late 1990s, tensions erupted into full-scale conflict.
The war officially began in 1998 with Serbian forces moving into Kosovo, targeting Kosovar Albanian villages, and committing mass atrocities. Villages like Račak became synonymous with horror after international media exposed the massacre of unarmed civilians. Reports of mass graves, systematic trafficking, and torture shook the world.
The United Nations' refusal to intervene in Kosovo created a moral and legal vacuum. Faced with evidence of ethnic cleansing and mounting civilian casualties, the United States and NATO launched a military campaign to halt the violence. Unlike previous conflicts, NATO's intervention did not have formal UN Security Council approval, as Russia and China signaled they would veto any resolution authorizing force. Instead, NATO justified its actions on humanitarian grounds, marking a shift toward the controversial principle of "humanitarian intervention."
A Cambridge University Press study explains that this logic was framed as an extension of the "Responsibility to Protect" principle. NATO claimed it had a moral obligation to prevent a humanitarian catastrophe. Instead of pursuing UN approval, the U.S. sought legitimacy from NATO as a regional security body. NATO's structure allowed it to act based on the consensus of its 19 member states (at the time) without requiring UN authorization (Cambridge University Press: The 1999 NATO Intervention, 2013). The U.S. argued that international norms should prioritize human rights over state sovereignty, especially in the face of ethnic cleansing. This set a controversial precedent, leading to debates on the legality of future interventions (like in Iraq in 2003).
While the intervention successfully ended Serbian aggression, it did not address the deeper trauma left in its wake. Refugees who fled to Albania, North Macedonia, and Montenegro carried with them the emotional scars of war. For many, returning to Kosovo did not mean peace—it meant confronting the memories of burned villages, mass graves, and lost family members.
In war, the greatest casualties are often those we do not see. Although war leaves behind shattered infrastructure and desolate landscapes, its most profound impact often lies in the psychological scars borne by those who endure it. The Kosovo War is no exception. Refugees and survivors experienced anxiety, post-traumatic stress disorder (PTSD), and depression. The displacement of 1.5 million Kosovars and the deaths of more than 13,000 people disrupted families and communities, creating long-term mental health crises.
A systematic review of mental health in refugee populations conducted by researchers at Monash University, Australia, found that PTSD affected approximately 30% of refugees globally, while 31% experienced depression and 11% faced anxiety-related disorders. While the review included refugees from different global conflicts, these figures provide insight into the likely psychological burden borne by Kosovar refugees, many of whom were exposed to direct violence and forced displacement from their communities (The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis, 2020).
The same study found that the psychological effects of war extend beyond those directly exposed to violence, impacting the next generation. Children exposed to war-related trauma are at heightened risk for developing anxiety, depression, and behavioral issues, which can hinder their educational progress, social relationships, and family dynamics. These findings are directly applicable to Kosovo, where thousands of children were displaced to Albania, Macedonia, and other neighboring regions.
A study from the University of Utah found that generational trauma is also linked to increased household stress and economic instability, both of which were present in Kosovo during and after the war. Children growing up in refugee camps or makeshift housing often face interrupted education and limited access to mental health services, which can exacerbate the trauma experienced by their parents. These experiences have long-term consequences on children's ability to thrive in adulthood (The Mental Health Effects of War: Backed by Science, 2022).
One of the major barriers to addressing the mental health needs of war-affected populations is the lack of adequate mental health infrastructure. In Kosovo, like in many post-conflict regions, there was a scarcity of mental health professionals, counselors, and social workers available to assist refugees and survivors. Compounding the issue is the stigma surrounding mental health treatment in many post-war communities. In such cultural contexts, mental health is often seen as a private, personal issue rather than a medical one. This stigma deters individuals from seeking help, leaving many untreated for PTSD, anxiety, and depression.
While the Kosovo War ended in 1999, its psychological legacy endures. Ethnic tensions between Serbs and Kosovars remain unresolved. As recently as 2024, violence flared again when dozens of armed Serb gunmen stormed an Orthodox monastery in Kosovo, killing a Kosovar Albanian police officer. Events like this demonstrate how post-war trauma does not exist in isolation—it is constantly reignited by contemporary violence.
The mental health legacy of the Kosovo War reminds us that war never truly ends when the last gunshot is fired. Refugees, survivors, and aid workers continue to grapple with unresolved trauma. To address these challenges, Kosovo and other war-torn regions must confront the stigma around mental health and invest in long-term psychological support. As Sir Noel Malcolm, an English historian, observed, "It can never be said too often that questions of chronological priority in ancient history—who got there first—are simply irrelevant when deciding the rights and wrongs of present-day political situations." The real issue of war is the human cost—the refugees, children, and survivors whose suffering outlives the conflict itself. We owe it to them to recognize that mental health is as vital as physical health in recovery.
By reflecting on the legacy of Kukës and its role in one of Europe's most significant refugee crises, I am reminded that while war destroys, it also reveals humanity's capacity for compassion. We must now channel that compassion into mental health support for survivors, ensuring that the scars of war do not become permanent marks on the minds of future generations.
Citations:
Blackmore, Rebecca, et al., “The Prevalence of Mental Illness in Refugees and Asylum
Seekers: A Systematic Review and Meta-Analysis.” PLOS Medicine, Public Library of Science,
journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1003337. Accessed 4 Dec. 2024.
“The Mental Health Effects of War: Backed by Science.” University of Utah Health | University of
Utah Health, 19 Dec. 2022,
healthcare.utah.edu/hmhi/news/2022/03/mental-health-effects-of-war-backed-science.
Scharf, Michael P. “The 1999 NATO Intervention (Chapter 8): Customary International Law in
Times of Fundamental Change.” Cambridge Core, Cambridge University Press, 5 June
2013,
www.cambridge.org/core/books/abs/customary-international-law-in-times-of-fundamental
-change/1999-nato-intervention/8EC16E79A79083CC4CE5FDE926DC0AFA.
Images from the war:
Alone at the laid table, Ferdonije Qerkezi's 24-year wait for her family that disappeared in the Kosovo war: two of her sons were killed, while her husband and two other sons disappeared. Photo credits: Artan Korenica.
Comments
Post a Comment