Rebuilding Hope in Post-conflict Regions: Telemedicine in Kosovo - Ethical Engineering for International Development and Environmental Sustainability - page 271

(WHO 2005 : 2). Studies from both developed and developing countries show that
developing and implementing medical informatics or e-health is becoming a crucial
part in providing patient-friendly access to effi cient, effective health-care services.
Information technology and the Internet access are crucial to this development and
implementation (Harteloh 2003 ; Chiasson and Davidson 2004 ; Gonzalez et al.
2006 ; Chiasson et al. 2007 ; Blaya et al. 2010 ; Chen et al. 2013 ; Sultan et al. 2014 ).
Systems engineers have an important role to play in setting up sustainable health
systems which can provide for health services in post-confl ict regions. A sustainable
health system contributes to the stability of the region and helps reduce the likelihood
of a return to confl ict. In spite of this the systems engineering literature has largely
overlooked post-confl ict regions as a particular context with special features.
Developing and implementing large-scale, technologically enabled infrastructures
such as health services is notoriously diffi cult, even in stable regions. Post-confl ict
regions are extreme situations with many additional complicating features for large-
scale technology projects. What are the features of a successful advanced technology
project aimed at providing important medical services?
The primary contribution of this study is to set out factors present in the case
organisation which have received little attention previously and which were impor-
tant in the successful implementation of a large-scale telemedicine system in the
Balkans. The study shows that the post-confl ict context loads additional factors into
an already complicated systems development process. Particularly important factors
include the relationship between the technology project and underlying human pro-
cesses at work. This has implications for our understanding of the dynamics of sys-
tems development generally and in post-confl ict, developing regions in particular.

2 Confl ict in Kosovo

The signifi cance of Kosovo in the expression of the Serbian identity can be traced
back to the Battle of Kosovo in 1389. In this battle Serbian forces were beaten by
Turkish forces, on a battlefi eld which lies just 5 km north of the Kosovo capital
Pristina. This battle and the myths and legends that surround it are at the heart of
Serbian identity. During the centuries which followed, Kosovo came under Serbian
rule, the Ottoman Empire and later became part of the new state of Yugoslavia after
World War I (Wilson 2009 ).
Albanians began to move into Kosovo in large numbers in the fi fteenth century,
and by the late seventeenth century, with increasing Ottoman Empire activities,
many Serbs had left the region and relocated north to Belgrade, now the current
capital of Serbia. During this time the population of Kosovo was very low, and many
Albanians resettled the region.
The early nineteenth century saw the beginning of a stronger Serbian presence in
Kosovo, and at the end of the fi rst Balkan war in 1912, Serbia were in control of the
region. This led to much anti-Serbian feeling in Kosovo from the now majority
Albanian community.