Harriet Epstein in Kosovo

Although the March 1999 NATO bombing campaign was successful in stopping much of the bloodshed in Kosovo, a province of the former Republic of Yugoslavia, ethnic violence and retribution killings were still common in the winter of 2000. No one was safe. Not even the children. "Ethnic Albanian secondary school students were among those targeted by the Serbian militias," remembered Harriet Epstein, MPH '81, who traveled to Kosovo after the war. "One of the kids I saw, he and his friend were stopped. They asked how old the friend was. He said fifteen. They shot the friend anyway."

Epstein began working internationally in 1996 after finishing her doctorate in social policy and social welfare at Brandeis University. She will soon go to Albania to continue her work of helping children in resource-poor settings.

When Epstein arrived in the Kosovar capital Pristina three years ago, she was working under the auspices of the International Rescue Committee, which provides assistance to refugees, displaced persons and others fleeing persecution and violent conflict. From there, she traveled to the towns of Prizren and Gjilane to work with high school students. She said that her education at HSPH reinforced her technical skills in child health, education and welfare assessment, and allowed her to look at the situation in Kosovo in terms of populations.

"One of the things you do in a disaster area is a pretty quick assessment of needs," she said. "This large group of young people between the ages of 13 to 18, who had seen a lot of conflict, was at risk for a variety of problems. The public health training says basically, 'Here are my skills. Where are the health risks, and where can we provide services and support to lessen bad outcomes?"

The new Children's Resource Center in Pristina, Kosovo, built and funded by World Vision. The center is for children with disabilities and their families. Epstein wrote the proposal that led to its funding.

Epstein counseled students, faculty and staff at the 11 schools she visited on a one-on-one basis and in groups. She also did consulting and training with school personnel. The goal was to engage students and teachers, some of whom had witnessed massacres and all of whom had experienced the turmoil of violent conflict. Another priority was assessing who was in need of more intensive psychological care, she said. Often just listening to the children was the most important thing she could do.

"A lot of it was about the kids just having someone to talk to," she explained. "It was important to affirm that the experience the children had undergone was not a good thing and that you are there to bear witness and say, 'This is a terrible thing that has happened. Let's figure out how to go ahead."

Epstein encouraged Kosovars to set up their own organizations and resources to aid traumatized children. In Prizren, for instance, a group of women sought Epstein out. The group, including a lawyer, several teachers and housewives, wanted to be counselors, but they did not have the training. They met with Epstein for nearly two months, brainstorming about activities they might organize for an area of the city most devastated by ethnically motivated violence. Drawing on American history, Epstein told them the story of Jane Addams, the Chicago activist who co-founded Hull House near the turn of the 20th century in the midst of one of the city's most desperate slums. She described how a settlement house could be a place where children could play after school, where mothers could meet and socialize, and where literacy and job skills could be taught. The Kosovar women were immediately energized.

"Within two to three weeks after that, the women registered as a local non-governmental organization," Epstein recalled. "I referred them to the United Nations High Commissioner for Refugees, and they received some funding and rented a house across from an elementary school in the section of the town that had the highest number of people massacred." The settlement house was called Shpresa (Albanian for "hope"). Within a few weeks, more than 200 young children were registered.

"I couldn't believe the progress that was made in so short a time," said Epstein. "The women had the skills to engage the kids in activities, and there was a safe place to go after school."

Epstein returned to the U.S. in June 2000. Six months later, she went back to Kosovo, this time under the auspices of Doctors of the World. She helped establish community residences for children with disabilities and developed a successful proposal for World Vision for the recently constructed Children's Resource Center in Pristina. There, parents of all ethnic backgrounds can learn skills to care for their disabled children at home and in their communities.

Since then, she's been to Bosnia and has worked with Chechen refugees.

When Epstein came to HSPH in 1980, she was a psychologist for the child community services division of the Massachusetts Mental Health Center. During her year at Harvard, she wrote a proposal for a mental health and social service system based in the Boston Public Schools. The proposal, which was approved and funded by the state legislature, opened the schools to external clinical services such as individual and group psychotherapy, as well as mental health consultation and training programs. The care was initially free of charge. The system still exists, with services supplied by a larger network of agencies and providers.

"Instead of children coming to the clinics," said Epstein, "the clinics came to the schools."

In August Epstein leaves for Duress, Albania. Working with the British charity Hope and Homes for Children and the Albanian government she will transition 39 children under the age of five from institutionalized care into the community. The plans call for the development of a continuum of services including foster care, adoption, and emergency services. She will also look to develop respite services-short-term training programs and support services--to help the families of the impoverished region get through difficult times without abandoning their babies, a problem in poor or war-torn regions.

"When parents are desperate they have been known to sell a child, even into prostitution," said Epstein. "The child is seen as not starving, and the money helps keep the rest of the family alive. We've seen this throughout the world. Extreme poverty does bad things to people and makes people do bad things."

Though the borders and languages may change, Epstein said that the overarching theme of her work remains the same.

"What I've done in the towns I've worked with is all the same," she said. "It's all related to children in need of services in communities. It's about helping families to take care of their children and developing resources to support them."

--Paul Massari