“Mine survivors are not a problem to be solved. They are individuals with hopes and dreams like all of us. They are assets with the capacity to be productive contributors to the social and economic development of their communities. The challenge is to provide the environment and opportunities that will enable mine survivors and other people with disabilities to reach their full potential to contribute to their communities and realize their dreams.”[81]
In 2005, Landmine Monitor identified new casualties from mines and explosive remnants of war in 58 countries, the same number as in Landmine Monitor Report 2005.[82 ] Landmine Monitor also registered mine/ERW casualties in seven of the nine non-state areas it covers, one less than reported last year.[83 ] Between January and June 2006, casualties were recorded in 48 countries and six areas.
Compared to last year’s Landmine Monitor Report, there are seven new countries with reported casualties: Chile, Honduras, Kenya, Moldova, Morocco, Namibia and Peru. There are also seven countries dropped from last year’s list because there have been no reported mine/ERW casualties since the end of 2004 in Belarus, Cyprus, Djibouti, Ecuador, Uzbekistan, Venezuela and Zambia.
Landmine Monitor has identified another 16 countries and one area with no new landmine casualties in 2005-2006, but with casualties (130 total) caused exclusively by unexploded ordnance: Bangladesh, Belarus, Bolivia, Côte d’Ivoire, Guatemala, Hungary, Kyrgyzstan, Latvia, Liberia, FYR Macedonia, Mongolia, Poland, Republic of Congo, Tunisia, Ukraine and Zambia, as well as Kosovo. In 11 of these, Landmine Monitor did not record casualties in 2004.
In 2005-2006, mine/ERW casualties were still occurring in every region of the world: in 17 countries and one area in sub-Saharan Africa, in 13 countries and one area in the Asia-Pacific region, in 12 countries and three areas in Europe and Central Asia, in 10 countries and two areas in the Middle East and North Africa, and in six countries in the Americas. Landmine Monitor found that 36 of the 65 countries and areas that suffered new mine casualties in 2005-2006 had not experienced any armed conflict during the research period. For all of the seven countries added to the casualty list in 2005-2006, the reason for inclusion was new casualties from previous conflicts, rather than the onset of a new conflict. However, expanded conflict in a number of countries accounted for most of the global increase in casualties in 2005, as explained below.
Bold: States Parties to the Mine Ban Treaty.
Italic: Areas not internationally recognized as independent states.
CAPITALS: new in 2005
Landmines continue to pose a significant, lasting and non-discriminatory threat. Landmine Monitor identified at least 7,328 new landmine/ERW casualties in calendar year 2005―721 (11 percent) more than in 2004 (6,607).[84 ] It is important to remember, however, that the 7,328 figure represents only the reported casualties and does not take into account the many casualties that are believed to go unreported.[85 ] In many countries, civilians are killed or injured in remote areas away from any form of assistance or means of communication; in some countries, casualties are not reported for military or political reasons. While acknowledging that it is not possible to know with absolute certainty, Landmine Monitor continues to estimate that there are between 15,000 and 20,000 new landmine/ERW casualties each year.[86]
The vast majority (81 percent) of new landmine casualties in 2005 were civilians, as in past years. The 2005 total included at least 1,518 children (21 percent) and 347 women (5 percent).[87 ] Nineteen percent of the reported casualties were identified as military personnel (1,404), a decrease from 25 percent (1,650) in 2004.[88]
The number of reported new mine/ERW casualties has dropped significantly in some heavily affected countries (notably Albania and Bosnia and Herzegovina), but continued to rise in some others (notably Colombia, Mozambique and Pakistan). The number of casualties remained fairly steady in most countries, including Afghanistan, Cambodia and Laos.
The global increase in casualties in 2005 was largely due to expanded conflict in a number of countries. In eight countries and one area experiencing conflict (Burma/Myanmar, Colombia, India, Iraq, Nepal, Pakistan, Somalia, Turkey; and Palestine) there was a combined increase in casualties totaling more than 950. Economic pressures and population movements contributed to increased casualties in countries like Lebanon, Mozambique, Syria and Uganda. In some cases, the higher number of reported casualties at least partly reflects better sources of information or improved media analysis (for example, in Algeria, Morocco, Nepal, Philippines and Russia). In a few cases, a single incident created a large increase in casualties, as in Eritrea and Yemen.
Of the total recorded casualties, 39 percent (2,833) occurred in just three countries: Afghanistan, Cambodia and Colombia. Most (58 percent) of the recorded casualties occurred in 37 States Parties, and 42 percent occurred in 28 non-States Parties or areas not recognized by the UN. Of the casualties in States Parties, 87 percent were recorded in the 24 countries identified as having significant numbers of mine survivors (the “VA 24”). Analysis of the data shows that far less is known about casualties in non-States Parties.
In 2005, the most reported casualties occurred in Colombia - 1,110 (up from 882 in 2004), Cambodia - 875 (down from 898 in 2004), Afghanistan - 848 (down from 857 in 2004), Iraq - 363 (up from 261 in 2004) and Palestine - 363 (up from 187 in 2004).
In 2005, notable increases in casualties occurred in Colombia - up 228 to 1,110, Palestine - up 176 to 363, Somalia - up 174 to 276, Iraq - up 102 to 363, and Burma - up 99 to 231.[89]
In 2005, notable decreases in casualties were reported in Vietnam - down 126 to 112, Chechnya - down 70 to 24 (as recorded by UNICEF), Bosnia and Herzegovina - down 24 to 19, Albania - down 23 to 23 and Sri Lanka - down 18 to 38.[90 ] It also appears there was a significant reduction in casualties in Angola, but full-year data for 2005 was not available by mid-2006.
In 2005-2006, an increasing number of countries have seen intensified conflict resulting in both more civilian and more military (national and foreign) mine and ERW casualties. In Chad, there were 54 casualties from January to May 2006, compared to 35 in 2005 and 32 in 2004. In Colombia, there has been a constant increase in casualties, with 526 in the first five months of 2006, 1,110 in 2005, 882 in 2004, 734 in 2003 and 627 in 2002. In Pakistan, in the first five months of 2006 at least 344 mine/ERW casualties were reported in the media, compared to 214 in all of 2005.
Not only mine-affected countries have a problem with landmines. In 2005-2006, mine/ERW casualties also included nationals from 31 countries and one area (including nine mine-free countries) who were killed or injured while abroad engaged in military conflict, demining operations, peacekeeping or other activities. The mine-free countries were France, Kazakhstan, Netherlands, Portugal, Qatar, Romania, South Africa, United Kingdom and United States. The others were Armenia, Bangladesh, Egypt, Eritrea, Georgia, India, Iraq, Jordan, Kuwait, Mauritania, Moldova, Morocco, Peru, Philippines, Russia, South Korea, Sudan, Thailand, Tunisia, Turkey, Ukraine and Zimbabwe, as well as Palestine.
In 2005 and January-June 2006, mine accidents during clearance operations or in training exercises caused casualties in at least 29 countries and areas: Abkhazia, Afghanistan, Albania, Angola, Bosnia and Herzegovina, Cambodia, Chad, Chile, Croatia, Ethiopia, Georgia, Greece, Hungary, Iran, Kuwait, Lebanon, Liberia, Mozambique, Nicaragua, Peru, Serbia and Montenegro, Somaliland, Sri Lanka, Sudan, Taiwan, Tajikistan, Turkey, Vietnam and Yemen.
Improvised explosive devices are an increasing problem in many countries. Most IED incidents Landmine Monitor identified in 2005 and 2006 involved command-detonated or vehicle-born devices, and were therefore not included in Landmine Monitor’s casualty totals. Command-detonated devices were used extensively in Afghanistan, Iraq and India. But in some cases, IEDs exploded upon direct contact with a person, acting as de facto antipersonnel mines, and those casualties were included. However, identification of the type of IED (command-detonated or victim-activated) is often difficult, particularly when using media reports, which usually do not give enough detail on the circumstances of the explosion or accurate terminology for types of devices. In Algeria, victim-activated IEDs caused 46 of 51 casualties in 2005, the others being caused by antipersonnel mines and ERW. In Nepal, UNICEF found that from January-May 2006, 90 percent of civilian casualties were caused by IEDs, the majority of which were victim-activated.
An increasing number of casualties were attributed to people (mainly men and boys) engaging in the increasing scrap metal trade in many countries. In Vietnam, an impact survey in three provinces indicated that scrap metal collection, “bomb hunting,” and tampering accounted for at least 62 percent of casualties from 2001 to 2005. In Jordan, eight of nine casualties recorded through 18 April 2006 were from trading scrap metal. In Azerbaijan, an explosion in a metal workshop processing ordnance from former Soviet munition stores in Aghstafa killed three people and injured 23. On a positive note, in Cambodia stricter policing decreased the number of dealers selling hazardous material, resulting in fewer casualties in the first five months of 2006.
The number of new casualties each year is only a small indicator of the landmine problem, as the total number of landmine survivors having a right to assistance continues to increase. The exact number of mine survivors globally is unknown. Landmine Monitor has identified more than 264,000 mine survivors, the vast majority injured from the mid-1970s onwards. However, this figure of recorded survivors is only a starting point. It is reasonable to assume that, despite the increasing retroactive recording of survivors, a significant number of survivors have never been reported. Also, the number of recorded survivors does not include the many estimates of survivors in various countries. It does not include the new and more accurate estimate for the number of survivors in Afghanistan, of between 52,000 and 60,000, or the preliminary results of the disability database in Eritrea indicating that there are 84,000 known landmine survivors. Nor does it include longstanding estimates of 70,000 mine survivors in Angola, 30,000 in Mozambique, and 80,000 in Ukraine. While acknowledging that some country estimates may not be reliable, and that it is impossible to ascertain how many survivors are still living, a conservative estimate of survivors in the world today would be approximately 350,000 to 400,000, but could be well over 500,000.
Many countries with no new reported landmine casualties nevertheless have landmine survivors who continue to require assistance. Landmine Monitor has identified 122 countries with mine/ERW survivors, including 19 non-affected countries with nationals injured abroad in mine incidents and demining accidents. This means that almost two-thirds of the countries in the world are directly affected to some extent by the landmine/ERW problem and the issue of survivors.
At the First Review Conference in November-December 2004, States Parties acknowledged “the value and necessity of accurate and up-to-date data on the number of new landmine casualties, the total number of survivors and their specific needs, and the extent/lack of and quality of services that exist to address their needs....”[91 ] Nevertheless, comprehensive data on landmine/UXO casualties continues to be difficult to obtain, particularly in countries experiencing ongoing conflict, with minefields in remote areas, or with limited resources to monitor public health services. The sources used to identify new casualties include databases, government records, hospital records, media reports, surveys, assessments and interviews. The principal collectors of mine casualty data are mine action centers, the International Committee of the Red Cross, national Red Crescent and Red Cross societies, UNICEF, and some NGOs.
A number of mine-affected countries collect and store mine incident and casualty data using the Information Management System for Mine Action (IMSMA) or other databases. Often a lack of human and financial resources prevents prospective, proactive data collection and full operational use of databases.[92 ] IMSMA was primarily set up for humanitarian mine action purposes, making it less suitable for casualty data and survivor assistance planning. Additionally, many actors have indicated that other systems are more easily adaptable to local contexts, more user-friendly and can contain more relevant survivor assistance information for planning purposes.[93 ] Landmine impact surveys also give an indication of casualties in communities identified as mine-affected, but this does not indicate the number of mine survivors living outside these surveyed places, or nomadic or displaced populations. Even so, survivor assistance planners have told Landmine Monitor that LIS results have not been used to their full extent for planning purposes.
Of the 58 countries and seven areas reporting new mine casualties in 2005-2006, 40 countries and five areas reported using IMSMA or other comparable databases to record casualty data.[94 ] Of those, only nine countries and one area were able to provide Landmine Monitor with complete full year data, collected in all mine-affected regions. Even in countries with a functioning data collection system, it is likely that not all mine casualties are reported.
In some countries, significant decreases in reported new casualties would appear to be the result of a decrease in capacity to undertake comprehensive data collection, such as in Angola, Burundi and Rwanda. In other cases, conflicts (as in Burma and Iraq), instability and insecurity (as in Sudan), or political reasons (as in Colombia) impede data collection and information sharing.
In other mine-affected countries, there is no formal data collection mechanism. Only limited data on landmine/UXO casualties is collected from government ministries and agencies, international agencies, NGOs, hospitals, media reports, surveys, and country campaigns of the ICBL. In many countries, there is a strong likelihood not only of significant underreporting, but also of inaccurate or duplicated data.
In 2005-2006, many countries made progress in the area of retrospective data collection by consolidating data sets, unifying separate data collection systems, reviewing existing records and revisiting survivors. In other countries, data collection was expanded to cover areas previously not monitored, or to include better statistics on less recent casualties. Additionally, many governments, NGOs, and other experts have identified better distribution of information and better integration into larger injury surveillance mechanisms as a priority area to improve; some countries tried to include more relevant survivor assistance information to enhance data for survivor assistance program planning purposes.
Collecting and sharing accurate information on the number of people assisted, and the people on waiting lists in relation to the total number of mine survivors and other people with disabilities, is crucial for planning purposes. Many facilities have been asked to report on how many people were assisted in the previous year, and how many were landmine survivors. Landmine Monitor was not always able to get this information and some facilities do not keep records on the cause of injury, as all people with disabilities are treated equally. Some facilities reported not having the capacity to record any form of data. In many cases, data is not collected in a systematic or centralized way so that it can be verified, aggregated and effectively analyzed for planning purposes. Some organizations do not count the number of beneficiaries, but count the number of sessions provided; others do not record the number of new patients, or do not include sufficient patient information to give an indication of the reach of the program, changes in patient profile, or changes in the scope of the problem. Improved information sharing would also reduce duplication of services and gaps in existing services, and improve referral systems. Nevertheless, while acknowledging that the data is far from complete, it does give an indication of where additional attention may be needed.
While there has been progress, existing programs are far from meeting the needs of landmine survivors. Survivors continue to face many of the same problems as in previous years. Survivors and other people with disabilities are still among the most impoverished groups in every society and often do not have access to some of the most basic needs: food security, clean water, adequate housing, a means to earn an income, affordable healthcare, rehabilitation, education or transportation services, let alone counseling services and equal rights. Additionally, many local and international NGOs report that a lack of funding, especially long-term funding, is limiting their operations and the sustainability of their programs.
The Mine Ban Treaty requires, in Article 6, Paragraph 3, that “Each State in a position to do so shall provide assistance for the care and rehabilitation, and social and economic reintegration, of mine victims....” Many mine survivors are benefiting from the increased attention given to the issue of victim assistance by States Parties and others. States Parties have agreed to promote a comprehensive integrated approach to victim assistance that rests on a three-tiered definition of a landmine victim. This means that a “mine victim” includes directly affected individuals, their families, and mine-affected communities. Consequently, victim assistance is viewed as a wide range of activities that benefit individuals, families and communities.[96 ]
Furthermore, States Parties have recognized that mine survivors are part of a larger community of people with injuries and disabilities, and that victim assistance efforts should not exclude this larger group because “the impetus provided by the Convention enhanced the well-being of not only landmine victims but also all other people with war-related injuries and people with disabilities.”[97 ] States Parties have also recognized that assistance to mine survivors must be considered in the broader context of development and underdevelopment. They have agreed that mine victim assistance should be integrated into poverty reduction strategies and long-term development plans to ensure sustainability and to avoid unnecessary segregation of survivors.
Landmine Monitor has found that in at least 49 of the 58 countries with new mine casualties in 2005-2006, and in six areas, one or more aspects of survivor assistance are reportedly inadequate to meet the needs of mine survivors and other people with disabilities. Landmine Monitor research indicated five main clusters of challenges impeding effective assistance in 2005-2006: accessibility, variety and efficiency of services provided, capacity, rights implementation, and financial resources.
The Mine Ban Treaty is the first multilateral disarmament treaty to call upon states to take responsibility in assisting victims of a particular type of weapon. In meetings of the Standing Committee on Victim Assistance and Socio-Economic Reintegration (SC-VA), governments, survivors, ICRC, ICBL and other NGOs work closely to advance victim assistance understanding and implementation. Since December 2005, Afghanistan and Switzerland have served as co-chairs of the SC-VA and Sudan and Austria have served as co-rapporteurs (they are expected to become co-chairs in September 2006).
At the First Review Conference in November-December 2004, States Parties agreed on 11 concrete actions to encourage allocation of sufficient efforts and resources to facilitate the full rehabilitation, reintegration and participation of mine/UXO survivors and other people with disabilities. Within this framework, 24 States Parties were identified as having significant numbers of mine survivors, and the “the greatest responsibility to act, but also the greatest needs and expectations for assistance” in providing adequate services for the care, rehabilitation and reintegration of survivors.[98 ] Without neglecting other States Parties or states not party to the Mine Ban Treaty, these countries, the VA 24, are receiving more focused support for the period 2005-2009.
In early 2005, a questionnaire was developed to assist the VA 24 in developing a victim assistance action plan by answering four key questions: what is the situation in 2005 in each of the six main thematic areas of victim assistance;[99 ]what are the SMART (specific, measurable, achievable, relevant and time-bound) objectives to be attained in each of these areas by 2009;[100 ]what are the plans to achieve these objectives by 2009; and what means are available or required to implement these plans. In 2006, the SC-VA co-chairs acknowledged that “the questionnaire was not an end-product but rather an initial step in a long-term planning and implementation process.” Two regional workshops were organized in the Americas and in Africa to allow the relevant states to share experiences and develop their answers to the questionnaire.
At the Sixth Meeting of States Parties in Zagreb in November-December 2005, the VA 24 were to present information on the current status of survivor assistance and their objectives for the period to 2009, as a first step to turn objectives into concrete action plans. This information was included in a detailed annex to the Zagreb Progress Report that emerged from the Sixth Meeting of States Parties. However, the varying quality of responses and capacities to respond to the first two questions of the questionnaire made clear that the process could not proceed at the same pace for all 24 States Parties. Two countries did not submit a description of their current status nor objectives (Burundi and Chad). Several countries did not provide a complete overview of their status (Eritrea, Ethiopia, Guinea-Bissau, Mozambique, and Serbia and Montenegro). Several countries did not provide complete objectives (Colombia, Croatia, Mozambique, Nicaragua, and Serbia and Montenegro). Most countries did not provide SMART objectives (Angola, Bosnia and Herzegovina, Cambodia, Colombia, DR Congo, Ethiopia, Guinea-Bissau, Mozambique, Nicaragua, Peru, Senegal, Serbia and Montenegro, Sudan, Tajikistan and Thailand).
Nevertheless, the questionnaire was useful as a starting point to create some sense of national ownership, as a benchmark for progress and as an indication of priorities to be achieved. The ICBL has identified non-signatories to the treaty that could especially benefit from using the questionnaire, including Azerbaijan, Georgia, India, Iraq, Laos, Lebanon, Nepal, Pakistan, Sri Lanka and Vietnam.
With funding provided by Switzerland, the treaty’s Implementation Support Unit employed a Victim Assistance Specialist to provide support to the VA 24 in developing SMART objectives and action plans. This included country visits; one-on-one meetings with officials from relevant ministries to raise awareness and to stimulate interministerial coordination; communication with relevant international and other organizations regarding victim assistance efforts; and interministerial workshops to bring together relevant actors to discuss and consolidate objectives and plans.[101 ]
At the May 2006 SC-VA meeting, Chad presented some of its 2005-2009 objectives; Afghanistan, DR Congo, and Serbia and Montenegro presented refined objectives; Tajikistan presented revised objectives and a plan of action agreed by relevant ministries; Albania presented an improved plan of action and progress achieved as of May 2006. Nine other VA 24 countries made general progress statements. Only 10 delegations included a victim assistance specialist (Afghanistan, Albania, Angola, Colombia, DR Congo, Guinea-Bissau, Peru, Serbia and Montenegro, Sudan and Uganda)[102 ]and only three delegations included a survivor or person with a disability (Afghanistan, Croatia and Uganda). Eight countries did not engage in the process: Bosnia and Herzegovina, Burundi, Cambodia, El Salvador, Eritrea, Ethiopia, Mozambique and Senegal.
The ICBL’s Working Group on Victim Assistance (including mine survivors from various countries, national campaigns, Handicap International, Landmine Survivors Network and the Landmine Monitor thematic research coordinator on victim assistance) participated actively in the May 2006 SC-VA meeting. It presented a document aimed at increasing the level of knowledge on survivor assistance, Landmine Victim Assistance in 2005: Overview of the Situation in 24 States Parties, which was produced by Standing Tall Australia and Handicap International with funding from Australia. Survivors from El Salvador and Afghanistan made a statement urging States Parties to implement their victim assistance obligations and accurately represent the extent of the problem and the challenges faced rather than presenting a picture of a “survivor paradise.” The ICBL reaffirmed its commitment to provide a reality-check, to avoid the risk of the victim assistance efforts creating a “paper paradise.”
As of 12 July 2006, a total of 38 States Parties had submitted a voluntary Form J with their 2006 Article 7 reports to report on victim assistance activities or mine action funding. This included 22 mine-affected States Parties and 16 non-affected States Parties.[103]
Based on a variety of factors, Landmine Monitor perceives that in 2005-2006, the most progress has been made on victim assistance in Afghanistan, Albania, Eritrea, Guinea-Bissau, Tajikistan and Uganda. The least progress has been made in Angola, Burundi, Cambodia, Colombia, El Salvador, Ethiopia, Serbia and Montenegro, and Thailand.[104]
Each state with landmine survivors and other mine victims has the responsibility to ensure the well-being of this group as part of the larger population. In many mine/UXO affected countries this is done with the support of the international community, in implementing, advisory and funding roles. However, the ICBL urges states to see these services for what they are, temporary provisions until the national infrastructure can meet these needs. Therefore, close cooperation and coordination between national authorities, national and international partners, is necessary to ensure a better use of limited resources, prevent duplication of services, and decrease the gaps in services. States Parties and experts also prioritized this process as an area of work in 2006. This coordination responsibility ideally lies with the relevant line ministries in the form of interministerial committees or inter-sectoral task forces, which assess the needs and relevant existing activities, develop objectives and national plans and identify resources. The recent VA 24 process concerning the questionnaire has shown that dialogue within and between national and international stakeholders and government and non-governmental partners is flawed: objectives were sometimes written by one key player, an expatriate working in a mine action center, external consultants, or within one ministry, without consulting relevant colleagues, national and international NGOs, national campaigns or experts in the disability sector. In some countries, relevant actors were interviewed but were not able to provide input to the final result. In other countries, key assistance providers are not aware of the Nairobi Action Plan, other survivor assistance strategies or disability initiatives.
To be sustainable, survivor assistance programs must be integrated into the general national health and social network, whereby a feeling of national ownership, responsibility, accountability and gradual nationalization of programs both financially and in terms of implementation is stimulated. International organizations and NGOs can play an important role in the capacity-building of government officers and staff in several countries.
Action #38 of the Nairobi Action Plan that emerged from the First Review Conference states that States Parties need to “ensure the effective integration of mine victims in the work of the Convention.” At the national level, assessing the needs of survivors by consulting them directly is an important planning tool to increase efficiency of services. In 2005-2006, many survivors and their organizations continued to indicate that they were not included in planning and policy-making processes, and that they were not consulted on what they perceive as gaps. Only two mine survivors were part of government delegations at the Standing Committee meetings in May 2006. The ICBL delegation at the Sixth Meeting of States Parties included 23 survivors and at least 10 survivors were present at the Standing Committee meetings.
Victim assistance cannot be separated from a country’s health, social, economic, education and cultural policies and existing infrastructure and services. Assistance also needs to be seen within the larger context of a country’s development, reconstruction and mine action. In 2005-2006, a number of countries linked victim assistance programs to Poverty Reduction Strategy Papers, reconstruction efforts, development of the health sector, mine action coordination, millennium goals, and disability legislation. In 2006, the VA 24 were asked to provide information on how victim assistance plans were integrated into broader care, legislative, and policy frameworks.
As in past editions, Landmine Monitor Report 2006 provides information on the facilities that have been identified as assisting landmine survivors and other people with disabilities in mine-affected countries. It is not exhaustive, as information on the activities of some local and international NGOs and governmental agencies is sometimes difficult to obtain. Landmine Monitor would welcome more input from governmental agencies and NGOs on their survivor assistance activities for future editions of this report. Nevertheless, Landmine Monitor identified certain indications of the progress and problems faced in addressing the needs of mine survivors.
Emergency and continuing medical care includes first aid and management of injuries in the immediate aftermath of a landmine explosion, surgery, pain management, acute hospital care, and the ongoing medical care needed for the physical recovery of the mine survivor.
In this reporting period, as in the past, emergency assistance was delayed in many instances because so many mine incidents occurred in remote, rural areas without adequate emergency transport and with facilities that could only provide first aid. The main obstacle impeding access to continuing medical care for many survivors is the lack of financial resources to afford services, exacerbated by lack of awareness, long distances, transport and accommodation costs, and documentation issues. Several mine-affected countries also have difficulties providing adequate assistance due to the lack of trained specialized staff, equipment and supplies.
Physical rehabilitation includes the provision of services for rehabilitation, physiotherapy and the supply of prosthetics/orthotics and assistive devices. Rehabilitation centers for the most part are located in urban areas far from patients who need them. For many people services are not affordable.
In Ethiopia, there are approximately 360,000 people in need of physical rehabilitation, yet in 2005 Landmine Monitor recorded only some 23,000 people receiving services, including 1,321 mine survivors. In Afghanistan, there are between 747,500 and 867,100 people with disabilities, including 52,000-60,000 mine survivors, while in 2005 Landmine Monitor recorded 113,340 people receiving physical rehabilitation, including at least 3,946 mine survivors. In North Korea, there are an estimated 64,000 amputees, yet in 2005 only 1,219 people were recorded as receiving rehabilitation services, including 10 mine survivors.
In 2005, ICRC supported prosthetics and orthotics training for 36 technicians from 10 countries and trained at least 51 more technicians in its national operations in three countries.
In 2005, ICRC assisted approximately 140,000 people in 72 projects in 18 countries, producing 20,543 prostheses and 25,914 orthoses, and providing 1,979 wheelchairs and 19,446 pairs of crutches. Fifty-two percent of prostheses produced were for mine survivors. ICRC-supported centers produced 5,097 prostheses (2,218 for mine survivors), 4,282 orthoses, 7,349 pairs of crutches and 190 wheelchairs in Africa; 10,388 prostheses (6,862 for survivors), 11,553 orthoses, 9,064 pairs of crutches and 1,567 wheelchairs in Asia; and 3,199 prostheses (1,066 for survivors), 6,974 orthoses and 541 pairs of crutches in the Middle East and North Africa in 2005.
In 2005, Handicap International-supported projects in 12 countries produced 3,300 prostheses, 5,150 orthoses, 6,885 pairs of crutches, 876 wheelchairs and 2,785 other mobility devices.
Psychological support and social reintegration includes activities that assist mine survivors and the families of those killed or injured to overcome the psychological trauma of a landmine explosion and promote their social well-being. These activities include community-based peer support groups, associations for the disabled, sporting and related activities, and professional counseling. This component of victim assistance remains the smallest and least appreciated, although several VA 24 countries indicated they will start assessing the needs in this field and develop support programs. In many countries, counseling is left to the family support network and there is a stigma attached to seeking professional psychological help. In some countries counseling is available through general war victim support, often targeting children. Social reintegration is hindered by the lack of understanding among the general population of the rights, needs and capacities of people with disabilities.
In 2005-2006, more organizations included sports activities in their programs, increasingly recognizing the value of sports both for health reasons and psychosocial reasons.
Inclusive education is becoming better known as a concept, but few countries have teachers trained in dealing with children with special needs.
Economic reintegration programs improve the economic status of mine survivors and other people with disabilities and raise awareness so that people with disabilities get equal chances at jobs and services. Economic reintegration includes education, vocational training, creation of employment opportunities, micro-credit schemes, and development of community infrastructure to reflect the local economic reality. For many mine survivors, taking up their roles as productive community members and working for their families’ well-being is the most important part of integral rehabilitation. However, they face challenges accessing employment opportunities and experience difficulties in maintaining a reasonable standard of living. The chances of socioeconomic reintegration are often further diminished by negative social perceptions, discrimination and stereotyping.
Where vocational training programs are available, they are not always geared towards people with disabilities, or free of charge. Training does not necessarily lead to employment and sustainable income: there is discrimination when accessing credit schemes or regular employment; training does not always meet market demand; and there is often insufficient follow-up for self-employed people. Moreover, it is important to open up economic reintegration programs to family members, and in particular to wives, widows and women alone. Women are often the primary care-giver, or become the principal income-earner, when their partner is killed or injured.
Community-based rehabilitation (CBR) and outreach programs are designed to supplement facility-based rehabilitation in order to improve service delivery, provide equal opportunities and protect human rights for a larger group of people with disabilities who have limited access to services due to high costs, uneven distribution of services and small numbers of rehabilitation staff. CBR integrates actions for all domains of survivor assistance with survivors’ and disabled people’s participation using realistic and sustainable resources. CBR programs and outreach workers aim at empowering people with disabilities and integrating them into society, via development of disabled people’s organizations, increased community decision-making and accountability; skills training in self-care principles; needs-based programming; and identifying local skills and technologies. CBR also plays a role in improving coordination with and referral to other services, which are unavailable in the community and of which the community might be unaware.
States Parties have recognized the need for legislation and actions “that promote effective treatment, care and protection of all disabled citizens.”[105 ] Landmine survivor assistance, as with assistance for all people with disabilities, is more than just a medical and rehabilitation issue; it is also a human rights issue. Landmine Monitor has identified over 50 mine-affected countries or areas with legislation or measures explicitly protecting the rights of people with disabilities; in other countries people with disabilities are protected by common law. However, in many instances these laws are not fully implemented or enforced.
Negotiations on the draft text of the Comprehensive and Integral Convention on Protection and Promotion of Human Rights and Dignity of People with Disabilities were scheduled to be completed in August 2006. In December 2005, the General Assembly of the UN adopted a resolution calling upon states to participate constructively to have the text ready for submission at the 61st session of the UN General Assembly starting in September 2006. The adoption and implementation of the Convention would require inclusion of disability issues into mainstream policy agendas, commitment of resources, awareness-raising, capacity-building, comprehensive data collection, implementation of services and programs, and establishment of an independent monitoring body.
From 28 August to 3 September 2005, Raising the Voices East Africa, in Kampala, Uganda provided advocacy training to 10 participants from Eritrea, Rwanda, Sudan and Uganda. In May 2006 in Geneva, Landmine Survivors Network initiated its Widening the Voices training program for graduates of its Raising the Voices program aimed at improving their advocacy skills so they can engage at local, regional and international levels, and helping them implement sustainable initiatives for survivors and other people with disabilities.
[81] Sheree Bailey, Victim Assistance Specialist, GICHD, “Developing SMART objectives and a national plan of action – the role of inter-ministerial coordination,” Standing Committee on Victim Assistance and Socio-Economic Reintegration, Geneva, 9 May 2006.
[82] For the purposes of Landmine Monitor research, casualties include the individuals killed or injured as a result of an incident involving antipersonnel mines, antivehicle mines, improvised explosive devices (IEDs), cluster munitions and other unexploded ordnance (UXO). When it was clear that a device was command-detonated, these incidents were excluded. In the cases of Iraq and Afghanistan, all casualties identified as IED casualties were excluded from the totals as they appeared to be command-detonated incidents. From the information available in many countries, it is not always possible to determine with certainty the type of weapon that caused the incident. Where this level of detail is available, information is included in the country report.
[83] These include Abkhazia, Chechnya, Nagorno-Karabakh, Palestine, Somaliland, Taiwan and Western Sahara.
[84] Landmine Monitor reported 6,521 casualties for the year 2004 in Landmine Monitor Report 2005, but due to the ongoing nature of data collection, additional casualties occurring in 2004 have been registered in several countries, including Colombia, DR Congo and Sudan.
[85] Moreover, even the number of reported new casualties should be viewed as a minimum, as many heavily mine-affected countries were not able to provide statistics for the full year or for the whole country. Some reports refer to several people killed or injured without giving a specific figure; these reports and any with “estimates” are not included in the total.
[86] There are some indications that this estimate should be revised and reduced, but at this point there is insufficient country data on which to base a new estimate.
[87] The figures for mine casualties involving women and children should also be viewed as a minimum; the gender and age of casualties is often not identified; the gender and age of 2,450 casualties unknown.
[88] In mine-affected countries where the media is the main source of information, reported casualties are predominantly military. In Colombia, for example, where a data collection mechanism has been established and the country is experiencing armed conflict, 69 percent of 1,110 recorded casualties in 2005 were military personnel. Reported mine/UXO casualties in Colombia account for 15 percent of casualties recorded by Landmine Monitor in 2005. Therefore, the high percentage of military casualties in Colombia impacts on the overall global percentage of military to civilian casualties. In contrast, in Cambodia, a country