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ARCHIVE 2004

URC Comes to Albania

Over the past six months, URC has developed a growing presence in Albania. In September, URC was awarded the Improving Primary Health Care in Albania Project. Program Development Associate Kamden Hoffmann spent four weeks in Albania, working with Dr. Victor Boguslavsky, Chief of Party for URC's new project, to help hire local staff and set up the office.

Peggy Cook, URC staff on the Partners for Health Reformplus Project, joined PHRplus Albania in August 2003 as Site Implementation Manager. Peggy supervises a team of about 10 people and manages the local office in Berat in addition to providing technical assistance and training for the project. The PHRplus Albania project gives technical assistance to support the Government of Albania to implement health reform. The project's objective is to demonstrate a modest cost and sustainable Primary Health Care delivery model for replication in Albania.

Since Albania is a country unfamiliar to most of us, we asked Kamden and Peggy for their impressions. Peggy included with her report, correspondence sent by her husband, Scott Pierson, to friends and family. Scott's narrative was so colorful and interesting, we thought we would share it with you along with those of Kamden and Peggy:

Kamden's Impressions:

Tirana, Albania Photo by Kamden Hoffmann

Albania is a unique country in Southeastern Europe bordering the Adriatic Sea and Ionian Sea and situated between Greece, Serbia, and Macedonia. With approximately 3.1 million people in an area slightly smaller than the state of Maryland, a majority of the population is situated in Tirana, the capital.

Project office set-up is always challenging, and can be even more so in a situation when one is new to a country. Tirana is quite a busy place, but small enough that after about a month, I was able to get around easily. Street names are not commonly used, and many people use landmarks to decipher where an office, apartment, or store is located.

Old castle in Kruja ( a town near Tirana). Photo by Kamden Hoffmann

I found people in Tirana to be extremely open and warm. Although language was a barrier at times, a lot of communication can be shared through body language and signs. Albanians are more than willing to help a foreigner find their way when gone astray! The food is a wonderful blend of Italian, Greek, Turkish, and traditional Albanian, creating numerous dishes to please any type of appetite. Lots of roast lamb with onions, garlic, and yoghurt—really delicious!

Tirana is located in a valley, and due to a temperature inversion, it can sometimes seem quite dusty and polluted. The excess of diesel-run cars, limited public transportation, and ever-changing street rules can make transportation difficult. The traffic can cause serious delays, but people seem to view such inconveniences as an inevitable part of urban life.

Tirana's stadium, near the University, popular for soccer games. Photo by Kamden Hoffmann

Coffee, espresso, and cappuccino are extremely popular, and people are known to have a "second office" at a coffee shop to discuss issues outside the office. Numerous encounters took place over coffee, giving Victor an opportunity to explain some of the main objectives of the new project to Government officials, other USAID cooperating agencies, and relevant stakeholders. The Ministry of Health was very welcoming, and USAID has a good relationship with them. As a USAID contractor, URC was received well.

Overall, Albania is a country that few foreigners are familiar with or perhaps understand; yet the land and people have so much beauty and kindness to offer. The country is currently in transition from a Communist society to a more democratic and open market society. There are still many relics signifying previous Communist influences. Therefore, the future holds a great deal for the people as well as promise for expansion in social, economic, health, political, and other arenas. It is often said that foreigners find Albania inadvertently, but then, the warmth of the people and splendor of the natural surroundings continue to draw them to return for a retreat.

For more information, view the Improving Primary Health Care Project in Albania site page or contact Project Coordinator Marjola Hotchkiss at mhotchkiss@urc-chs.com.

and from Peggy Cook:

We are enjoying Berat, and have had opportunities to visit lots of areas in Albania—Saranda, Girokaster, Shkodra, Kruja. Berat is unique in that we have not met other native English speakers. There is very little begging, although the country is poor. And shopkeepers give us the same prices as native Albanians—something very different from the other countries where we have been. We have been very warmly welcomed. Everyone in Berat knows us, I think. We feel supported and very safe—something that may not have been true a while back. Every word of Albanian that I learn helps a lot, because only one or two of the people working in the four health centers speak any English.

We feel very lucky to be living in the office building with a generator. Even when there is power, it is often so weak it won't run the heating units. In general I'm very spoiled by having Scott do all the complicated things like transferring money and setting up bank accounts. He does the shopping, which provides him with a break from his computer work. He enjoys the interactions with the people, although his communication is mostly charades. An example of the hospitality here is that one night a little store on our street didn't have bread. The shopkeeper locked up and took Scott to her house, where (in addition to getting some bread from her kitchen) he found himself drinking Raki (the homemade brandy/liquor of the region) and developing a friendship (communication by mostly charades again) with the husband. The work is very challenging, but I'm pleased with the progress we are making.

For more on PHRplus Albania, visit http://www.phrplus.org/countries_alb.html.

and from Scott Pierson:

Apollonia, an "antiquity site" located an hour or so from Berat.

We have been in Berat, Albania for a little over a month now and have pretty much settled in. We have a very nice apartment with plenty of room for my office and a spare bed for guests. It is in the same building as Peggy's work so she can get to her office in the morning in about 60 seconds. This is mostly a good arrangement but is sometimes a bit too close to the office. However, all of the office staff leave PROMPTLY at 5pm and do not darken the door ever over the weekend so really it isn't too weird for Peggy to be living "at the office". There is a big whole house generator that keeps us supplied with electricity all day. This is important because the power is off in our neighborhood from noon to 5pm everyday and then at other odd times as the electric company so desires.

The town is pretty small…40,000 maybe. There are a couple of very old parts of town with some buildings dating back to the 1500's and earlier. These are picturesque but the rest of the town consists of unremarkable concrete two- or three-story buildings. Mostly we buy our food and household things from small shops or street vendors in the neighborhood. There are some "fancier" newer stores in the center of town. Every night from about 6pm to 8pm most of the town goes out walking up and down the main street which is blocked from traffic for this purpose (it is called the "Xhiro", pronounced "giro"). We go do this most nights.

The monetary system here in Berat is a bit odd. The unit of money is the Leke, pronounced "Lek". The exchange rate is currently around 120 leke to the dollar so you are usually talking about hundreds or thousands of lekes when you buy something. Apparently over 50 years ago the government reissued the currency and changed the values by a factor of 10. Everyone had to turn in their old currency and get new currency. So, 1000 old leke became 100 new leke, etc. Now, this was 50 years ago, but the folks in our neighborhood have been slow to adjust. So when they say something costs 1000 leke, they mean OLD leke and you need to give them 100 leke in the new currency (keep in mind there is no old currency in existence, it is all the new stuff for the past 50+ years). Then for some reason they also have the custom of referring to something that costs 50 leke sometimes as 500 and sometimes as 5 (but in our neighborhood they would never refer to the cost as 50). Now, downtown in the fancier stores they seem to mostly use the new leke numbers so the prices they quote actually match the numbers on the money.

The saving grace to this confusing pricing system is that everyone here is scrupulously honest. So, if you make a mistake and give them a 1000 leke note when you only needed to give them a 100 leke note they will not take advantage of you. We also find that the street vendors do not give us prices, as obvious foreigners, that are higher than they give other people.

There is no haggling over the prices, either. This feels very good and civilized and very different from the experience we have had with street vendors everywhere else we have lived.

We are not as obviously foreigners here as we were in Malawi but we certainly stick out when we open our mouths. Some of the young kids can speak pretty reasonable English but very few people over 25 can. And our Spanish is pretty useless. We have been in Berat for a month now and have yet to encounter another native English speaking person. We have heard that there are some other Americans in town working on some type of oil drilling project but we have not seen (or rather "heard" them yet). Peggy takes Albanian language lessons from a young woman who works in the local school system teaching English. Her English is pretty good but she told Peggy that talking to her has been the first time she has ever had an extended conversation with anybody whose first language is English. This is mainly the result of the fact that Albania has been completely isolated from the rest of the world until 12 or 13 years ago. For the 50 years prior to that, pretty much nobody came into or went out of Albania.

Peggy, of course, is intensely focused on learning Albanian, studying language books, listening to audio tapes, taking lessons. Although she has learned repeatedly that pointing to things on menus and asking the waiter how you pronounce this or that is going to inevitably result in ordering whatever that is, she just can't help doing it. We are both learning that even though Spanish is a foreign language and Albanian is a foreign language, despite what you might think, it doesn't help to speak Spanish to an Albanian. And, I am getting very good at charades.

Well, enough for now. Attached is a picture taken at Apollonia, an "antiquity site" an hour or so from Berat [photo above].

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