Konstruksion

Dr. Isufi decided to build a new clinic building. He built his old building on his parent’s property, in front of their home, in central Korca, near the city hall. It was small and seemed more slapped together than planned. He met with an architect and planned a modern, three story office building with plenty of room for his practice and room for his son to open his own dental practice, as well. The building would still fit on the property, in front of his house, although there would be no room for a garden or for off street parking for his son’s car. In late July, he moved as much of his gym equipment as he could into a storefront across the street and a few exam tables into another, smaller one down the block, and the demolition of his old building began.

A crew of men with picks, shovels and sledge hammers did this work by hand. They dug out the foundation and rerouted the plumbing. Footings for the steel reinforced concrete posts were constructed and a cement truck pulled up one day and filled up the forms and foundation. This took about a month. His mother, son, dog, other family and visitors have had to pick through the site to get access to the house in the rear of the lot.

Clinic continues in the temporary venue. It is not easy since the storefront is up six steep steps and most of the patients use canes, crutches, walkers or even wheelchairs. They are helped into the clinic by family members or even other patients. There are three tables in the back where, Shpresa (which means “hope”), his medical assistant, administers modality treatments and directs patients about. There is no changing room. There is a closet sized toilet which provides the only private space, and a boom box to provide background music. Isufi sees a few patients here and, when he needs more privacy, he walks about 50 feet down the block to a small storefront, behind a low iron fence where more equipment is stored and a few exam tables, a cabinet and an x-ray view box allow for his clinical evaluation and treatment.

In mid-August the work crew did not show for a few days, as the contractor has another project nearby and put the men to work there. Isufi was not happy and had to threaten to find another contractor to get the project going again. By mid-September the concrete floors and ceilings for the first two stories were completed and the masonry work for the walls was progressing quickly. Isufi and his son hope to move in by the end of October, although this seems a bit optimistic to me. The third floor will be left to the future to be completed as money allows.

This is typical in Albania. The country is filled with partially completed structures. It is largely a cash economy and only the biggest projects are financed. Almost all homes and smaller commercial buildings are built, like Isufi’s office, as the owner can afford construction. They may be partly occupied, giving the impression that squatters have taken over. This has some advantages, however. There was no mortgage crisis here and, in fact, like many developing countries in the world, the Albanian economy, although it slowed substantially, never went through the recent recession experienced in the US.

What is unusual in Isufi’s project is that he has financed this with savings from his work in Albania. He has not relied on remittances from his or family members work abroad. Many houses, including the one I lived in with my host family during pre-service training, are built with money earned by migratory work in Greece, Italy, or elsewhere in Europe or North America. In some cities, especially on the coast, like Saranda, Vlora or Durres, construction may be financed by laundered money from crime or corruption. These are often large projects that are mostly empty as there is no incentive in such a situation to meet a real estate demand or to sell in a low market to partially recover an investment. Sometimes work on these big projects halts when the contractors are forced to take payment in unsellable condos and are then unable to pay their workers.

None of this is relevant to Isufi’s new clinic. He wants to move in as soon as possible. His son wants to open his own practice rather than work for another dentist. He plans to marry next year as soon as his practice becomes established. Dental problems are very prevalent in Albania and he will certainly not lack patients.

Interestingly, Isufi’s building is behind the new Polyclinic building. This is mostly finished, but unoccupied. I have been told that this is because the grant that allowed the building to be constructed did not provide for furnishings. In any event, there are not many medical specialists in Korca. This may change since Albania is reorganizing its health care into regional centers with hospitals in smaller cities being turned into family practice clinics with concomitant development of specialty facilities in places like Korca. I don’t know whether Isufi’s building will be competing with the Polyclinic building or, if it is, it will be at an advantage or disadvantage.

Speaking of clinics, I recently traveled to Tirana to see the Peace Corps Medical Officer for follow-up on my mid-service medical evaluation, a dental exam and vision testing. As an older volunteer, I worry that they will find something and ship me out because it is less of a hassle to get rid of me than to try to treat some malady and keep me in the country. I saw this happen to a volunteer who had an episode of atrial fibrillation. I don’t know all the details of his case, but I did talk with him. I also know that such a case would not preclude him from returning to flight status after a few months, so it seems a bit strange to me that he could be fit to be a pilot but not a Peace Corps volunteer in Albania. Lucky for me, I am pretty healthy. I probably will pay for some extra cleanings (the PC only pays for one dental cleaning a year- not a good idea for an older person interested in keeping their teeth), but, otherwise, have few concerns. My eye glass prescription didn’t even change, although my lenses are pretty scratched up and could use replacement. This, apparently, has to be special ordered through Washington and is probably not worth the hassle.

Then, again, it is hard not to wonder how much real change working for two years makes in a place like Albania, or, probably for most places where there are PC volunteers. It is easy to get discouraged. I wonder how much protest I would put up. I am fortunate in that I get lots of positive feedback from my counterparts (although I am not so gullible to believe much of it) and I have a good support network here and at home. I heard that one of the older volunteers in the new group recently left. My group had a Program and Training Officer who took some special interest in the older volunteers. She hosted a brunch at her home in Tirana over 4th of July weekend my first year. She has since transferred to Africa and her replacement hasn’t arrived yet. 4th of July celebrations were a bit strange this year, anyway, with the party in Tirana not open to all volunteers and not observed until the following weekend. I don’t know how much support that volunteer had from her site mate or her service cohort or counterparts or if it would have made any difference. Six months into service is reputed to be a time of increased departures.

On Sunday afternoon, I hosted a small group of volunteers at my apartment for dinner. We made an eggplant stroganoff (made with yoghurt sauce instead of sour cream) served over noodles, salad, bread, and chocolate pound cake ala mode for dessert. The group included volunteers from my group, one from the new group and one from the prior group who opted to extend for a third year and move to Korca to work on a tourism project. We enjoyed our meal then joined the Sunday evening walkers for a pleasant stroll and a stop for coffee, then back home to watch a movie on my computer. I popped corn which we ate with salt and curry powder on it (don’t wince- you should try it) during the show. It was good to get together. It makes you feel a part of something, and calms the sense of isolation that is inevitable with a long service abroad.

I will be home for a visit in four months and have less than four months to go when I get back. Things are picking up at work as people have returned from August vacations. School has started. I have some new projects for this year. The weather has cooled a bit and I am enjoying my weekend hikes in the mountains again. I have short vacations planned in Turkey, Greece and Macedonia. I expect the time will pass quickly.