Health care and safety in Albania

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Health care and safety in Albania
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The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer and trainee. Medical programs emphasize the preventive, rather than the curative approach to disease.

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk.

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See also:
Pre-Departure Checklist
Staging Timeline
The Health of the Volunteer The Safety of the Volunteer


The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer. Peace Corps medical programs emphasize the preventive, rather than the curative, approach to disease. Peace Corps/Albania maintains a clinic with a full-time medical officer who takes care of Volunteers’ primary healthcare needs. Some additional medical services, such as testing and basic treatment, are also available in Albania at local clinics and hospitals. If you become seriously ill, you will be transported either to an American-standard medical facility in the region or to the United States.

Contents

[edit] Health Issues in Albania

Good health results from good health maintenance. Major health problems among Volunteers in Albania are rare and often the result of Volunteers not taking preventive measures to stay healthy. Health problems in Albania are similar to those that exist in the United States, that is, colds, flu, diarrhea, skin infections, headaches, minor injuries, dental problems, STDs, adjustment problems, and alcohol abuse. These problems may be more frequent or compounded by life in Albania because of exposure to unfamiliar stresses.

[edit] Helping You Stay Healthy

The Peace Corps will provide you with all the necessary inoculations, medications, and information to stay healthy. Upon your arrival in Albania, you will receive a medical handbook. During pre-service training, you will receive a medical kit with supplies to take care of mild illnesses and first-aid needs.

During pre-service training, you will have access to basic medical supplies through the medical officer. However, you will be responsible for your initial supply of prescription drugs and any other specific medical supplies you require, as we will not order these items during pre-service training. Please bring at least a three-month supply of any prescription drugs you use since they may not be available in Albania and it may take several months for shipments to arrive.

You will have physical exams at mid-service and at the close of your service. If you develop a serious medical problem during your service, the medical officer in Albania will consult with the Office of Medical Services at Peace Corps headquarters in Washington, D.C. If your condition cannot be treated in Albania, you may be sent out of the country for further evaluation and care.

[edit] Maintaining Your Health

As a Volunteer, you must accept considerable responsibility for your own health. Proper precautions will significantly reduce your risk of serious illness or injury. The old adage, “An ounce of prevention is worth a pound of cure,” becomes extremely important in areas where diagnostic and treatment facilities are not up to the standards of the United States.

Many illnesses that afflict Volunteers worldwide are entirely preventable if proper food and water precautions are taken. Your medical officer will discuss specific standards for water and food preparation in Albania during pre-service training.

Abstinence is the only certain choice for preventing infection with HIV and other STDs. You are taking risks if you choose to be sexually active. To lessen risk, you should use a condom every time you have sex. Whether your partner is a host country citizen, a fellow Volunteer, or anyone else, do not assume this person is free of HIV/AIDS or other STDs. You will receive more information about this important issue throughout your training and service.

Volunteers are expected to adhere to an effective means of birth control to prevent an unplanned pregnancy. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the medical officer. It is critical to your health that you promptly report to the medical office for scheduled immunizations and that you let the medical office know immediately of significant illnesses and injuries.

[edit] Women’s Health Information

Pregnancy is treated in the same manner as other Volunteer health conditions that require medical attention, but also has programmatic ramifications. The Peace Corps is responsible for determining the medical risk and the availability of appropriate medical care if a pregnant Volunteer remains in Albania. Given the circumstances under which Volunteers live and work in Albania, it is unlikely that the Peace Corps’ medical and programmatic standards for continued service during pregnancy could be met.

[edit] Your Peace Corps Medical Kit

The Peace Corps medical officer will provide you with a kit that contains basic items necessary to prevent and treat illnesses that may occur during service. Kit items can be periodically restocked at the medical office and its contents are subject to change.

[edit] Medical Kit Contents

[edit] Before You Leave: A Medical Checklist

If there has been any change in your health—physical, mental, or dental—since you submitted your examination reports to the Peace Corps, you must immediately notify the Office of Medical Services. Failure to disclose new illnesses, injuries, allergies, or pregnancy can endanger your health and may jeopardize your eligibility to serve.

If your dental exam was done more than a year ago, or if your physical exam is more than two years old, contact the Office of Medical Services to find out whether you need to update your records. If your dentist or Peace Corps dental consultant has recommended that you undergo dental treatment or repair, you must complete that work and make sure your dentist sends requested confirmation reports or X-rays to the Office of Medical Services.

If you don’t want duplicate vaccinations, you should contact your physician’s office, obtain a copy of your immunization record, and bring it with you to Albania. Costs for any immunizations received prior to Peace Corps service cannot be reimbursed. The Peace Corps will provide all the immunizations necessary for your overseas assignment shortly after you arrive in Albania.

Bring at least a three-month supply of any prescription or over-the-counter medication you use on a regular basis, including birth control pills. Although the Peace Corps cannot reimburse you for this supply, we will order refills during your service. While awaiting shipment, which can take several months, you will be dependent on your own medication supply. The Peace Corps will not pay for herbal or non-prescribed medications, such as St. John’s wort, glucosamine, selenium, or antioxidant supplements. You are encouraged to bring copies of medical prescriptions signed by your physician. This is not a requirement, but they might come in handy if you are questioned in transit about carrying a large supply of prescription drugs.

If you wear eyeglasses, bring two pairs with you: a pair and a spare. If a pair breaks, the Peace Corps will replace it, using the information your doctor in the United States provided on the eyeglasses form during your examination. We discourage you from using contact lenses during your service to reduce your risk of developing a serious infection or other eye disease. You may not have appropriate water and sanitation at your site to support eye care with the use of contact lenses. The Peace Corps will not supply or replace contact lenses or associated solutions unless an ophthalmologist has recommended their use for a specific medical condition and the Peace Corps’ Office of Medical Services has given approval.

If you are eligible for Medicare, are over 50 years of age, or have a health condition that may restrict your future participation in healthcare plans, you may wish to consult an insurance specialist about unique coverage needs before your departure. The Peace Corps will provide all necessary healthcare from the time you leave for your pre-departure orientation until you complete your service. When you complete your service, you will be entitled to the post-service healthcare benefits described in the Peace Corps Volunteer Handbook. You may wish to consider keeping an existing health plan in effect during your service if you think age or preexisting conditions might prevent you from reenrolling in your current plan when you return home.

[edit] Safety and Security—Our Partnership

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk. Property thefts and burglaries are not uncommon. Incidents of physical and sexual assault do occur, although almost all Volunteers complete their two years of service without serious personal safety problems. In addition, more than 84 percent of Volunteers surveyed in the 2004 Peace Corps Volunteer Survey say they would join the Peace Corps again.

The Peace Corps approaches safety and security as a partnership with you. This Welcome Book contains sections on: Living Conditions and Volunteer Lifestyle; Peace Corps Training; and Your Health Care and Safety. All of these sections include important safety and security information.

The Peace Corps makes every effort to give Volunteers the tools they need to function in the safest and most secure way possible, because working to maximize the safety and security of Volunteers is our highest priority. Not only do we provide you with training and tools to prepare for the unexpected, but we teach you to identify and manage the risks you may encounter.

[edit] Factors that Contribute to Volunteer Risk

There are several factors that can heighten a Volunteer’s risk, many of which are within the Volunteer’s control.

Based on information gathered from incident reports worldwide in 2004, the following factors stand outas risk characteristics for assaults. Assaults consist of personal crimes committed against Volunteers, and do not include property crimes (such as vandalism or theft).

[edit] Summary Strategies to Reduce Risk

Before and during service, your training will address these areas of concern so that you can reduce the risks you face. For example, here are some strategies Volunteers employ:

Strategies to reduce the risk/impact of theft:

Strategies to reduce the risk/impact of burglary:

Strategies to reduce the risk/impact of assault:

[edit] Support from Staff

In March 2003, the Peace Corps created the Office of Safety and Security with its mission to “foster improved communication, coordination, oversight, and accountability of all Peace Corps’ safety and security efforts.” The new office is led by an Associate Director for Safety and Security who reports to the Peace Corps Director and includes the following divisions: Volunteer Safety and Overseas Security; Information and Personnel Security; Emergency Preparedness, Plans, Training and Exercise; and Crime Statistics and Analysis.

The major responsibilities of the Volunteer Safety and Overseas Security Division are to coordinate theoffice’s overseas operations and direct the Peace Corps’safety and security officers who are located in variousregions around the world that have Peace Corps programs. The safety and security officers conduct security assessments; review safety trainings; train trainers and managers; train Volunteer safety wardens, local guards, and staff; develop security incident response procedures; and provide crisis management support.

If a trainee or Volunteer is the victim of a safety incident, Peace Corps staff is prepared to provide support. All Peace Corps posts have procedures in place to respond to incidents of crime committed against Volunteers. The first priority for all posts in the aftermath of an incident is to ensure that the Volunteer is safe and receiving medical treatment as needed. After assuring the safety of the Volunteer, Peace Corps staff provide support by reassessing the Volunteer’s work site and housing arrangements and making any adjustments, as needed. In some cases, the nature of the incident may necessitate a site or housing transfer. Peace Corps staff will also assist Volunteers with preserving their rights to pursue legal sanctions against the perpetrators of the crime. It is very important that Volunteers report incidents as they occur, not only to protect their peer Volunteers, but also to preserve the future right to prosecute. Should Volunteers decide later in the process that they want to proceed with the prosecution of their assailant, this option may no longer exist if the evidence of the event has not been preserved at the time of the incident.

The country-specific data chart below shows the incidence rates and the average number of incidents of the major types of safety incidents reported by Peace Corps Volunteers/ trainees in Albania as compared to all other Europe, Mediterranean and Asia (EMA) region programs as a whole, from 2000–2004. It is presented to you in a somewhat technical manner for statistical accuracy.

To fully appreciate the collected data below, an explanation of the graph is provided as follows:

The incidence rate for each type of crime is the number of crime events relative to the Volunteer/trainee population. It is expressed on the chart as a ratio of crime to Volunteer and trainee years (or V/T years, which is a measure of 12 full months of V/T service) to allow for a statistically valid way to compare crime data across countries. An “incident” is a specific offense, per Peace Corps’ classification of offenses, and may involve one or more Volunteer/trainee victims. For example, if two Volunteers are robbed at the same time and place, this is classified as one robbery incident.

The chart is separated into eight crime categories. These include vandalism (malicious defacement or damage of property); theft (taking without force or illegal entry); burglary (forcible entry of a residence); robbery (taking something by force); minor physical assault (attacking without a weapon with minor injuries); minor sexual assault (fondling, groping, etc.); aggravated assault (attacking with a weapon, and/or without a weapon when serious injury results); and rape (sexual intercourse without consent).

When anticipating Peace Corps Volunteer service, you should review all of the safety and security information provided to you, including the strategies to reduce risk. Throughout your training and Volunteer service, you will be expected to successfully complete all training competencies in a variety of areas including safety and security. Once in-country, use the tools and information shared with you to remain as safe and secure as possible.

[edit] What If You Become a Victim of a Violent Crime?

Few Peace Corps Volunteers are victims of violent crimes. The Peace Corps will give you information and training in how to be safe. But, just as in the U.S., crime happens, and Volunteers can become victims. When this happens, the investigative team of the Office of Inspector General (OIG) is charged with helping pursue prosecution of those who perpetrate a violent crime against a Volunteer. If you become a victim of a violent crime, the decision to prosecute or not to prosecute is entirely yours, and one of the tasks of the OIG is to make sure that you are fully informed of your options and help you through the process and procedures involved in going forward with prosecution should you wish to do so. If you decide to prosecute, we are here to assist you in every way we can.

Crimes that occur overseas, of course, are investigated and prosecuted by local authorities in local courts. Our role is to coordinate the investigation and evidence collection with the regional security officers (RSOs) at the U.S. embassy, local police, and local prosecutors and others to ensure that your rights are protected to the fullest extent possible under the laws of the country. OIG investigative staff has extensive experience in criminal investigation, in working sensitively with victims, and as advocates for victims. We also, may, in certain limited circumstances, arrange for the retention of a local lawyer to assist the local public prosecutor in making the case against the individual who perpetrated the violent crime.

If you do become a victim of a violent crime: first, make sure you are in a safe place and with people you trust; second, contact the country director or the Peace Corps medical officer. Immediate reporting is important to the preservation of evidence and the chances of apprehending the suspect. Country directors and medical officers are required to report all violent crimes to the Inspector General and the RSO. This information is protected from unauthorized further disclosure by the Privacy Act. Reporting the crime also helps prevent your further victimization and protects your fellow Volunteers.

In conjunction with the RSO, the OIG does a preliminary investigation of all violent crimes against Volunteers regardless of whether the crime has been reported to local authorities or of the decision you may ultimately make to prosecute. If you are a victim of a crime, our staff will work with you through final disposition of the case. OIG staff is available 24 hours-a-day, 7 days-a-week. We may be contacted through our 24-hour violent crime hotline via telephone at 202.692.2911, or by e-mail at [email protected]

[edit] Security Issues in Albania

When it comes to your safety and security in the Peace Corps, you must be willing to adapt your behavior and lifestyle to minimize the potential for being a target of crime. As with anywhere in the world, crime exists in Albania. You can reduce your risk by avoiding situations that make you feel uncomfortable and by taking precautions. Crime at the village or town level is less frequent than in the larger cities; people know each other and generally will not steal from their neighbors. Buses and bus stations in larger towns are favorite work sites for pickpockets. Using your cellphone in public can also put you at risk to be pickpocketed. Fortunately, violent crime is relatively rare. The most frequent threats to your security will be harassment and pick pocketing, especially during travel. If you follow a few simple guidelines, you will reduce most risks.

[edit] Staying Safe: Don’t Be a Target for Crime

You must be prepared to take primary responsibility for your own safety. Only you can make yourself less of a target, ensure that your living arrangement is secure, and develop relations in your community that will make you an unlikely victim of crime. In coming to Albania, do what you would do if you moved to an unknown city in the United States. Be cautious, check things out, ask questions, learn about your neighborhood, know where the more risky locations are, use common sense, and be aware. You can reduce your vulnerability to crime by integrating into your community, learning the Albanian language, acting responsibly, and abiding by Peace Corps’ policies and procedures. Serving safely and effectively in Albania will require you to accept many restrictions on your current lifestyle. One example is that you will have to inform Peace Corps in advance each time before leaving your site.

Volunteers always attract a lot of attention, but usually receive far more negative attention in larger towns, where they are anonymous, than in smaller towns, where family, friends, and colleagues look out for them. While gestures and exclamations from strangers may be fairly common on the street, these behaviors can be reduced if you dress appropriately, avoid eye contact, and do not respond to unwanted attention.

Carry valuables close to your body or under your clothing. Undergarment money pouches, the kind that hang around your neck and stay hidden, work well. Do not keep money or valuables in outside pockets of backpacks, in coat pockets, or in fanny packs. Keep track of your belongings at all times. Be wary of overly friendly strangers, particularly near bus stations. Avoid places that make you uncomfortable and make inquiries before you wander off alone. Women need to take extra precautions; it is not advisable for them to walk alone after dark. Finally, be very careful in drinking alcohol. The most common factors in injuries and security incidents involving Volunteers worldwide are alcohol consumption and being out late at night.

[edit] Preparing for the Unexpected: Safety Training and Volunteer Support in Albania

The Peace Corps’ approach to safety is a five-pronged plan to help you stay safe during training and your two-years of service. The plan encompasses information sharing, Volunteer training, site selection criteria, a detailed emergency action plan, and protocols for addressing safety and security incidents.

Peace Corps/Albania will keep you apprised of any issues that may impact your safety through information sharing. Regular updates will be provided by the country director, safety and security coordinator, and medical officer through telephone and mail contacts. In the event of a critical situation or emergency, Volunteers will be contacted through the emergency communication network.

Volunteer training includes sessions to prepare you for specific safety and security issues in Albania. This training will help you adopt a culturally appropriate lifestyle and exercise judgment that promotes safety and reduces risk in your home, at work, and while traveling. Safety training is offered throughout your two-year service and is integrated into the language, community skills, health, and other components of training.

Certain site selection criteria are used to determine safe housing for you before you arrive. The Peace Corps staff works closely with host communities and counterpart agencies to help prepare them for your arrival and to establish expectations of their respective roles in supporting you. Each site is inspected before your arrival to ensure placement in appropriate, safe, and secure housing and work sites. Site selection is based in part on any relevant site history; access to medical, postal, and other essential services; availability of communications, transportation, and markets; suitable living arrangements; and other Volunteer support needs.

You will also learn about Peace Corps/Albania’s detailed emergency action plan, which is implemented in the event of civil or political unrest or a natural disaster. When you arrive at your site, you will complete and submit a site locator form with your address, contact information, and a map to your house. If there is a security threat, Volunteers in Albania will gather at predetermined locations until the situation is resolved or the Peace Corps decides to evacuate.

Finally, for the Peace Corps to be fully responsive to the needs of all Volunteers, it is imperative that you immediately report any security incident to the Peace Corps safety and security coordinator or medical officer. The Peace Corps has established protocols for addressing safety and security incidents in a timely and appropriate manner, and it collects and evaluates safety and security data to track trends and develop strategies to minimize risks to future Volunteers.

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