While some progress has been made in improving sources of drinking water, the vast majority of rural families, and some in the smaller cities, must rely on unprotected sources. Central sewage systems are found in only the largest cities.
Housing
Living quarters became increasingly overcrowded as population expanded at consistently high rates. Party First Secretary Enver Hoxha stated in December 1967 that the entire country, especially urban areas, was experiencing a housing crisis. Reports on housing construction indicated that the situation further deteriorated in the late 1960s because of the necessity to divert resources to even higher priorities, to the building of industry and procurement of food and clothing. War and natural catastrophes added to the burden. In World War II some 35,000 dwellings were destroyed. Earthquakes in November and December of 1967 demolished 3,500 homes. In April 1969, when 6,500 buildings were damaged or destroyed by earthquakes, additional thousands of homes had to be replaced or repaired.
Hoxha stated in late 1969 that 185,000 flats and houses had been built since World War II. The average annual rate of construction, as indicated by incomplete reports for the 1960s, was 6,000 private dwellings and 3,000 state-owned and cooperative apartment units. Total requirements were not stated, but with annual population growth at approximately 40,000 to 50,000 persons, and considering reports relating to crowded conditions, the critical condition was unresolved. Hoxha stated in late 1967 that the housing situation had reached the point where in some instances five persons were living in one room.
Most rural houses are of one or two rooms, with a hearth, and are of simple construction. They are small and sparsely furnished. Many are made of natural rock or stones. Urban houses and apartments are usually small and lack central heating. Kitchen and toilet facilities in apartments must be shared by three or four families.
Social Insurance
The social insurance program is administered by state organizations and covers medical care, compensation for incapacities, old-age pensions, family allowances, and rest and recreation. Social insurance was introduced in 1947. Several modifications were made later to the basic program. The law of 1953 provided a program closely resembling that of the Soviet Union, and for a number of years, following the Soviet example, trade unions administered a large number of social insurance activities. In 1965 the state assumed the administration of all phases except those for rest and recreation facilities.
The social insurance program, as provided for in the Council of Ministers decision of September 13, 1966, and effective January 1, 1967, included benefits for workers, employees, and others. Peasants in the collectives were not included in this law, but similar welfare benefits were provided from funds established by their organizations. The 1966 law continued the policy announced in 1964 that free medical care was provided to everyone. Drugs, such as penicillin and antibiotics, and vitamins prescribed during outpatient treatment had to be paid for by the user. Funds for social insurance payments came from the state budget. Contributions were paid by state institutions and enterprises that were in the role of employers.
Workers who became incapacitated and had over ten years of work credit received payments at the rate of 85 percent of the average wage for the last month worked; persons with less than ten years' service received 70 percent, except that temporary or seasonal workers were given less. When disability resulted directly from work, pay was given at the rate of 95 percent for most trades and 100 percent for persons working in mines. Compensation was less when incapacity resulted from an accident unrelated to work. Payments under these circumstances depended on age and years of work credit. Veterans who served in the Army of National Liberation before May 1944 and some of the Party elite were allowed an extra 10 percent when incapacitated ([see ch. 2], Historical Setting).
Pregnant women were given eighty-four days' leave under normal circumstances and 95 percent of their monthly wage if they had worked over five years. They received 75 percent if they had worked less than five years. Workers could remain at home for limited periods to care for the sick and receive 60 percent of their pay. When children under seven years of age were ill, the worker was permitted up to ten days' leave during a three-month period. A subsidy, a one-time payment, of 280 leks was provided for each child. Upon the death of a family head or his spouse, 300 leks were provided for funeral expenses.