Wounded, sick and pregnant refugees from Kosovo are staggering to hospital in the northern Albanian mountain town of Bajram Curri, only to find medical conditions worse than those they left behind in their besieged villages.
Agron Dula (22) was wounded in Kosovo three weeks ago, his leg splintered by a Serbian shell and his back peppered with shrapnel.
Surgeons at a battlefield clinic run by ethnic Albanian insurgents inside Kosovo treated the wounds and screwed external metal fixators to the young man's leg to help it heal.
But the wounds went septic and Agron Dula was forced to flee Kosovo strapped to the back of a mule as it climbed for 20 hours through the mountains into Albania.
When Mr Dula arrived at hospital in Bajram Curri, the main town in this part of northern Albania, he found a facility less able to care for him than the improvised clinic operating under wartime conditions in Kosovo had been.
"He needs another surgery to save the leg, but we haven't the ability to do the work here so we are trying to arrange a helicopter to transport him to Tirana," Mr Imri Vishi, a Kosovar Albanian surgeon working in Bajram Curri, explained.
"We have the staff but lack basic medicines and equipment. Even the surgery he received inside Kosovo would be impossible here."
Western aid workers say that while conditions at the hospital in Bajram Curri are worse than in some third-world countries of Africa and Asia, they are comparable to hospitals elsewhere in Albania.
Civil strife engulfed Albania in 1997 and observers fear a huge influx of refugees from Kosovo could destabilise the country once again by overtaxing its meagre resources.
Between 8,000 and 12,000 refugees have arrived in northern Albania from the southern Serbian province of Kosovo over the past two weeks as Serbian forces have intensified their crackdown on ethnic Albanian separatists, the UN reports.
"This is the poorest area in the poorest country in Europe, so it is no surprise to find conditions here worse than elsewhere in Europe," said one relief worker, who asked not to be named for fear of compromising his organisation's relations with the government.
"The short-term aid strategy is to provide medicines and some basic equipment like autoclaves to sterilise surgical instruments.
"The hospital needs substantial improvements that are beyond the capability of relief organisations during the current crisis."
One pregnant woman who fled Kosovo in recent days gave birth while hiking over the mountain.
A number of others have delivered their children in the hospital at Bajram Curri, where the resident gynaecologist, Ms Zylfie Hoxha, apologises for conditions.
"We are very poor and need everything you can think of. In the maternity section we work with our two hands and not much else," she said. "The autoclave is defective and of course we don't have an ultrasound machine. We lack medicines to treat complications in the women who have come from Kosovo, who arrived in very poor health. We don't even have proper disinfectant."
Despite the obstacles, Kosovare Tahiraj (20) lay beaming in her bed on Thursday after delivering a healthy daughter named Albana in honour of her place of birth.
"We left Kosovo on Saturday. I didn't ride a horse, I walked the entire way on my own two legs," the young woman said. "I wasn't afraid of anything. God gave us the strength to keep going."
Reuters reports from Zurich:
Switzerland will postpone the deportation of ethnic Albanian refugees to Yugoslavia because of the escalating conflict in the crisistorn province, the justice ministry said yesterday. The decision by the Justice Minister, Mr Arnold Koller, to stop deportations until the end of July came under domestic political pressure after he rejected parliamentary calls for a halt in repatriating ethnic Albanians.
Mr Koller's ministry said the move was in line with decisions by neighbouring Europeans, including Austria and most regional states in Germany, to stop returning a stream of Kosovo refugees.