ORGANIZATION OF STATE MEDICAL CARE/CATEGORIES OF CITIZENS/PROCEDURES FOR EACH CATEGORY/DOCUMENTS REQUIRED/RURAL HEALTH CONDITIONS TIRANA/LETAJ (NEAR KUKES)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00926A006800150001-2
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 7
• Document Creation Date: December 14, 2016
• Document Release Date: December 19, 2001
• Sequence Number: 1
• Publication Date: January 22, 1954
• Content Type: REPORT

DEC 1951
COUNTRY
SUBJECT
PLACE ACQUIRED
(BY SOURCE)
25:00ACQUIRED
(BY SOURCE)
DATE (OF INFO.)
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CONFIDENTIAL
CENTRAL INTELLIGENCE AGENCY
INFORMATION REPORT
Albania
Organization of state Medical Care/Cate ories o
Citizens/Procedures for Each Category/Documents
Required/Rural Health Condition
Tirana/Letaj (near F.Ukvc)
THIS DOCUMENT CONTAINS INFORMATION AFFECTING THE NATIONAL DEFENSE
OF THE UNITED STATES. WITHIN THE MEANING OF TITLE IS. SECTIONS 703
AND 794, OF THE U.S. CODE. AS AMENDED. BTS TRANSMISSION OR REVE-
LATION OF ITS CONTENTS TO OR RECEIPT BY AN UNAUTHORIkED PERSON IS
PR
THIS IS UNEVALUATED INFORMATION
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REPORT NO.
Organization of State Medical Care
First, a chart to show the organization of state medical care in Albania5 gee ne.yt
page7
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Legend For Chart
The Poliambulance is at the disposal of the citizens of
Tirana and of the- villages in the surrounding region. There
is no Poliambulanca in other regions.
The Spitali Pergjithshem Civil (Unified CiVilian. Hospital),
Aruga Bairam Curri, Tirana, is the only hospital which serves
the needs of the citizens of Tirana and of the Tirana region
and its villages. Similar civilian hospitals (obviously with
less -erlioai apparatw) exist in the capital of each region
ir Albania. Within each political region, the civilian hospital
acts also as the Poliambujamca.
There Is an Ambulamca in each of the thre raions of the city of
Tirana, They serve alsothe Tirana regi up and its villages,
Similar Ambulanca exist In other regions1. NO other medical
assistance or ambulame service exists in rural Albanian
villages.
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. Categories of Citizens
3. 'Regulat'ions governing medical treatment in Albania should be divided into four categories,
to apply. to:
(a) Persons NOT employed by state organizations (Government?s'field of labor') and who
will never get work because they are considered reactionaries (reaksionares). All
farmers are in this category.
(b) Persons who have been employed by state organizations and have been dismissed
because of reductions in peraonneleshaving thus the right to other Jobs: if and
when the Seksioni Kdadrit of the Party decides.
-(c) Persons within the:Government's field of labor who are actually working.
(d) Special cases.
2o
404should be e i
mphasized that throughout the whole of Albania no physician is authorzed
perform private treatment. This holds true also for those physicians employed by
a state institution, such as a plant or office enterprise.
Note: The following descriptions apply to Tirana, but the ba s4e eeeee -ee
procedures hold true elsewhere].
gATEG0RLIE1
5. 'For treatment of any minor ailment, such as a bruise or cut or minor sicknees. any
person may apply to the Ambulance of the raione in which he lives. The Ambulanda is
staffed by a medical attendant but not by a physician. The procedure is simple. Medical
attention and medication is given free of charge to anyone. The person applying for
such minor treatment need not produce his Letra Njoftimit (Identification Card). After
treatment is administered, the attendant requests only the name, surname and address
of the patient.
6. "If a person needs dental care or more serious medical treatment, he may apply to the
Poliambulanca. The Poliambulanca in Tirana has all sorts of medical departments and
'Xray apparatus, In the one at Tirana there is a chief physician and physicians in charge
of each medical department. A person applying at the Poliambuianca for treatment is
givensby the porter (portier) at the door a white ticket bearing a number for the
department concerned. The numbers run in series. When his number is called, the person
must produce his personal Identification Card (Leter-Niojftimitrft the Sekretari
(each physician has one). All personal data is 17-77e1T-EZ-Uom the Identificatien Carde
After medication, payment is made at the Sekretari. In 1952 the charge for pulling
a tooth was 30 lek; the charge for a filling was e00 lek; any medical visit cost
100 lek. if a person needs medicine, the physician issues a medical prescription on
paper that bears the Poliambulanca letterhead. Prescriptions may be filled at one of
the three Farmacias in Tirana:
No. 1 ee Br. Bajram Curri
No. 2 --eRr. 28 Na idor
No. 3-- Er. Bajram Currt
The prescriptions must be paid for. (I do not know any prices of medicines.) Neither
streptomycin nor penicillin are prescribed by physielana. If a patient needs one of
those anttbiotics, 4nd If he can afford. it, the physician makes the injection directly
at the Pollambplatoriam, I do not, know the exact ,ost of these antibiotics, but they
are fantastic?something like 5000 lek ftor an injectiongT77. If the physician feels
the person needs hoSpfttalizatiorl he,t issued a RaportjAjku. (Medical Report) for
the hospital.
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e ereen need; heepitalization, he -an pply directly to the haeei_ei. Re mnee
? for ihe Dokter, ;ioje Yeuty ahysieian, determinee whether neeae hoenitalizatoe,
? hoepitalIzaITon Tiepenae upon availability of vaeanries Priority i5 given to
eereone in Categories kb) and (c) /Tee belew7 A person with a Eatert-Mjeka from e
eliambulanea must report to the SekseonilTformacionit at the heepital, Priority
L'or hotpitalization holds true in-EI7-se7a7-in the oneabove he has lowest priority.
e person succeeds in obtaining hoopitalizatien, he must make a deposit of 1000 lc*
and. muel present his Identification Card, from which personal data is copiel. Final
payment le made when the patient Is discharged Prom the hospital.
if a person is In urgent heed of hospitalization (e.g, if he is at his home), he can
call an Lmbulance Ndihma e_Lhpjete. These are red autoambulancee, American make,
'ahere are only two in Tirana: One at the Poliambulanea and one at the Opitali
eerjithshem Civil (Urfied Civilian Hoe)ital)- These ambulances also pick up persons
. . . _
:eriouely injured Ir traffic accidents. Hospitalization is given, regardless of
ehether the patient can afford it. But, when the time comes for discharge, if he
nannPt afford the payment (even if his case was due to a traffic accident), he is
net discharged. He is sent to court, tried and sentenced to payment of his hospital
bills. If he still cannot afford, payment he is sentenced to compulsory work for a
eertain number of 6ays (based on the length of his hospital confinement and on the
medieinee issued him) In a atate enterpriee This means hard work, The judge
determines the length of the sentence
,:aTaaWiEY (b)
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12. The alete-eiguri4 (:ocial ineuranee alira is the only document 'reeled t a stute
employee to cover hie medical eare. There are no permanent Social Insurance identity
Cards. The issue of the slip Ic a simple proeedure. It does not require the pre. entutien
of earticular documents. The state employee (worker or salaried executive) goes to
the personnel section (C,eksionit Personalit) of his enterprise and fills in himself a
form asking his personal data, The form is handed to an employee of the personnel
eeetion who stamps it and sees that it Is seIgned The signature must be that of the
director (of a plant) or the kryetar of the :institution)--not the chief of the
personnel section. Each Flete-Sigurimi bears a number in the upper left hand corner
underneath the heading. That number is the number of the plant or institution
concerned. For example. the Ministry of Education uses the number 64. The Flete?
-
aigurimi is printed on white paper. Eaeh btate enterprise has its own heading on
similar forms. The document does not bear any registration number in the outgoing mail,
The following is a copy of a sample aoeial Insurance Slip. It is printed on white
eaner, about 5 3/4 ins by 8 1/4 ins. It states that worker (name and surname to be
filled in), born one (date) at (place), son of (father's name), working at(name of
department, etc.) is to be given a medical examination, and for that purpose the
?resent document is being issued. Following is only a sample, for the City People's
Board:
KOMITETI EKS.K.F. UTETIT Tirane-195..
(Sigurimi Showier)
(number) FLETE-3IGURIMI
Nepunesi X............ dt, lindjes......
lindun ne.....i bin i .......nepunes prane ketij
Dikasteri, kalon ne viziten mjeksore per te ellen i leshohet fleta
e sigurimit ahognor.
PER KOMITETIN EKZ.K.P. QTYETIT
KRYETARI
P.Sh. stra e bardhe me shtumpe (
e vkefshme prane Poliambulances signature
stamp
13, '"The employee, after filling In the FJetenaigurimi, informs his direct supervisor
(section chief etc.) that he if, going to the doctor. He goes then to the
Poliambulanca (in Tirana, the Komitet Ekz.a,P. aartatit-Tiranes, Bl. Shqipria e Re
The porter there hands him a white ticket bearing a number (for priority order).
alien his number is called the person enters the office and hands his Flete-Olgurimi
(social Insurance Clip) to the eeeretary of the doctor who is to treat him (i.e.
specialist in his ailment). The bearer of the Flete-Sigurimi (if it has been assued in
his name) is not requested to identify himself with the Leter-Njoftimit regular
citizen's Identification Card), The secretary enters in the registry--but without
putting a registration number on the Flete-aigurimi--the data shown on the Flete-
aigurimi, i.e. name of institution, number of institution, information given concerning
bearer. The person then has his medical visit. After the visit the doctor writes on
the back of the Flete-Siguriml his personal notes: date of examination, diagnosis
and number of days the man In entitled to rest because of sick nese. The doctor signs
the slip and stamps it with tho stamp of the Poliambulanea. This completes the
medical visit. The worker ret1Prms to the :)eyconnel section of his institution and
surrenders there the Flete.r1irli. Then he can go home and rot. for the period
of day-, authorized by the dortor The medical visit was naturally free of charge.
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14. "If the doctor decides during the visit that the worker needs medical treatment, he
writes his prescription on a Report - Mjeku Perte Sigurim (Medical Report for Sick
Persons). The prescription form bears the stamp and signature of the doctor of the
Poliambulanca. It must be taken to any one of the three pharmacies in Tirana
gee Paragraph 67. The medicines prescribed are issued free of charge.
15. "If the doctor decides that the werker needs hospitalization, he then issues a
Rapert Mjeku (Medical Report)- cSeeaeeees in Category (a), Paragraph 6.7 He writes
on the backof the person's Flete-SigurfRi the f ct that he does need hoipitalization.
The person goes to the hospital, hands over the medical report and social insurance
slip and is hospitalized. The hospital takes care of informingthe personnel section
of the state institution or enterprise where the person works, When the person is
:discharged from the hospital, he receives back his FletesSigurimi, on the back of which
is written the period of hospitalization. NO fees are charged for this hospitalization.
The worker must then present the Flete-Sigurimi to the Sigurimi Shognor (Social Insurance
Office) of the Ministry of Health, Blv. Sh. e Re, Tirana, where he receives a payment
of wages based on days hospitalized,. 50 report to this office is the procedure for a
citizen of TiranaTe:
16. "Following are the social insurance regulations for the payment of sickness benefits.
During the first seven days of sickness the worker of a State enteeprise, plant or
institution receives his full pay (100%). Thereafter, payment during sickness and
hospitalization proceeds thus:
:(a) For an employment period of less than two years: 25% of monthly wage. Previous
employment periods are not considered,
(b) For an employment period of two to five years: 50% of monthly wage.
(c) For period of employment over five years: 75% of monthly salary.
I am certain that sickness benefits continue to be paid for as long as two or three
years if necessary,
17. "Whenever a worker needs urgent medical attention (or if he has a fever, for instance,
and cannot get to the Poliambulanca himself), he, or his relatives, may phone the
Poliambulanca and report the case, It must be stressed to the Poliambulanca that the
sick person is in the Government's field of employ and thus carries insurance. A
doctor will come immediately, even at night) if the case is serious, The document
procedures for medical care and hospitalization, if necessary, are as above ffera-
graphs 11-157. The doctor himself calls for an ambulance if transportation to the
hospital is urgent, All expenses are borne by the Sigurimi Shognor.
_8. "If a worker just needs minor treatment he reports to the Ambulance) which handles him
the same asazi other citizen. Ambulance treatment is free of charge to any citizen
and does not require documentation.
-9. "The Flete-Sigurimi (Social Insurance Slip) entitles to the same rights and medical
treatment--except for wage payments?any relative of the worker who lives with him
in the same house, i.e. in a family nucleus: even a sister- or brother-in-law if In the
family unit. This holds true also for Category (b), if the bearer of a Motivacion-Pune
has a relative in the same house who gets the Sigurimi Shag:nor. The procedure is simple.
The worker has obtained from his place of employment the usual FletesSigurimi bearing
his name, This slip is taken by the sick relative to the Poliambulanca. The same
documentation is required as would be for the worker, except the relative must identify
himself with his Leter-Niojftimit (Identification Card37-from which all personal data
is copied. it the bearer of the Flete-Sigurimi is the person to whom it was actually
issued no Identification Card is requ1red7. The relative's relationship to the worker,
whose name is on the slip, is written on the back of the slip. The relative's name and
surname are also written there. Thereafter the procedures are the same, and the
relative is entitled to free medical care, hospitalization and medicines.
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20. This is th category for special cases--the privileged castgof the Communist regime:
(a) Members of the Kuvendit Popullor (Peoples Parliament)
(b) Members and candidates of the Komiteti *ndor Partis Punes Sh ris (C t 1.
Committee of the Albanian Labor q p , en ra
(c) Ministers and vice- inisters.
(d) Directors of plants, institutions a'nd cooperatives.
(e) Members of Institutes of science! (writers and poets).
21. "These privileged persons get special, medical attention and single rooms in hospital.
A personal doctor is assigned only to them if they are sick. (I know nothing further
about the medical treatment of persons in this Category).
Medical Conditions in Rural Areas
22. ttThesanind,al-coriditions in rural Albania are terrible.
23. "There is no doctor in any Albanian village. The nearest medical. aid will he an
ambulance in the nearest town (localityg). This ambulance will be in the charge of
an, infermler-primitiv--a medical attendant who has had a six-months? accelerated
medical course. Thus, there are the following ambulance in the Kukes region: at Bicaj,
Kale e Dudes, Krume, Shishtevec and Far.
24, "No farmer gets social insurance'benefits, Thus he has no right to free medical
care beyond that extended.' at the ambulance to any citizen.
25. "There are no Poliambulancel, In the capital city of each region there is one hospital,
which act also as a Poliambulanca. Thus there are civilian hospitals in the following
cities:
Elbasan Korce
Pogradec Permet
Lushnje Beret
Gjinokaster Vlona
Sarande Durres
Rimara TePelene
Fier Kavaje
Shkoder Kruej
Shijake Peshkopi
Puke Lesh
Kukes Tirana
Each hospital has only one ambulance, which must handle all calls for traffic accidents,
first aid and emergency eases. Since the roads and communications in Albania are
terrible, the Kukes ambulance, for instance, can only get to the town of Bicaj; the
other roads in that area are not good for ears, only horses.
26. "I know that in the Kukes region any farmer who needed medical care at the civilian
hospital in Kukes ? to pay for the visit in the same way as described for Category (a)
above,ffaragraphs 5-87. He is not hospitalized until he h s paid a deposit of 1000 lek.
If he cannot fford payment nobody cares for him. It is his own business. Due to this
Virtual lack of medic 1 attention, to malnutrition, to poor hygiene about 50% of the
people in the region of Kukes have TB."
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