Landmine Monitor 2000
Landmine Casualties and Survivor Assistance
In the reporting period from March 1999 to May 2000, Landmine Monitor finds that there were new landmine and UXO victims in 71 countries.[16] Landmine Monitor researchers also registered mine casualties in nine areas not recognized internationally as states, but which suffer significantly from landmines and thus have received special scrutiny.[17]
In the time period covered by this report mine accidents occurred in:
Scale of the Problem
Trying to get a complete picture on new landmine casualties for the past year (incidence) is as difficult as trying to quantify the number of landmine survivors in the world over time (prevalence). Information remains difficult to collect and it is not possible to obtain a precise global total for mine victims in a single year. However, on the basis of information gathered for 1999-2000, it is clear that landmines pose a significant, lasting and non-discriminatory threat.
As shown in the chart above, in 1999-2000 mine accidents were still occurring in every region of the world: in 22 countries in sub-Saharan Africa, in 17 countries in Europe and Central Asia, in 15 countries in Asia and the Pacific, in 12 countries in the Middle East and North Africa, and in 5 countries in the Americas.
Moreover, there are landmine victims among people coming from mine-free countries – nationals sent abroad for military operations, peacekeeping, or demining operations. This would include victims from: Australia, Bangladesh, Belgium, Brazil, Canada, Costa Rica, Denmark, Egypt, Fiji, France, Germany, Italy, Kenya, Liberia, Lithuania, Malaysia, Moldova, Nepal, New Zealand, Nigeria, Norway, Pakistan, Russia, Spain, Turkey, USA, United Kingdom, Uruguay, Zimbabwe, Malawi, Senegal, Argentina, Belarus, Ukraine, and Uzbekistan.
While landmine accidents of course occurred during the armed conflicts being waged in 1999-2000, Landmine Monitor has found that a majority (39) of the 71 countries that suffered mine casualties in 1999-2000 had not experienced any active armed conflict during that time. In some cases the conflict has ended recently; in many other cases the conflict ended a decade or more ago. Civilian casualties during peacetime continue to account for a significant proportion of total landmine casualties.
Although in most instances casualty figures are sketchy and incomplete, a sampling of the findings from the Landmine Monitor Report 2000 country reports follows. It is important to note that not all these findings are for the same time period, and some include casualties only for certain regions of a country.
- In Albania, 136 casualties were recorded from June 1999 to July 2000;
- In Angola 1,004 casualties were officially recorded from mid-1998 to 2000;
- In Bosnia-Herzegovina, there were 94 casualties in 1999;
- In Burma there were an estimated 1,500 casualties in 1999;
- In Cambodia, 1,012 casualties were recorded in 1999;
- In Chechnya, there have been reports of hundreds of victims in 1999 and 2000;
- In Colombia, 63 victims were identified in 1999, and 35 in the first half of 2000;
- In Croatia, 51 mine casualties were reported in 1999;
- In Djibouti, 69 casualties were recorded between 1999 and early 2000;
- In Eritrea, 504 casualties were reported between 1994 and mid-1999;
- In Ethiopia, 100 deaths were reported from 1998 to1999;
- In Jammu and Kashmir [India], 835 civilian casualties were recorded in 1999;
- In Kosovo, 492 casualties were recorded between June 1999 and May 2000;
- In Laos, 102 casualties were reported in 1999;
- In Lebanon, there were 50 casualties in 1999 and at least 35 by June 2000;
- In Mozambique, 60 casualties were recorded in 1999;
- In Namibia, 89 casualties were reported in one region between December 1999 to mid-May 2000;
- In Pakistan, 405 victims were identified in Bajaur area;
- In the Philippines, 33 mine casualties were reported in year 2000;
- In Senegal, 59 mine casualties were registered in 1999;
- In Sudan, 51 casualities were found in Chukudum (1999 to May 2000);
- In Western Sahara, 42 casualties were reported from Nov. 1999 to March 2000.
Based on Landmine Monitor research, it would appear that casualty rates increased in 1999-2000 in a number of countries and areas, due to a new or expanded conflict: Albania, Angola, Burundi, DR Congo, Chechnya, Ethiopia, Eritrea, Kosovo, Lebanon, Namibia, and the Philippines.
However, in a number of other heavily mine-affected countries, it appears that the casualty rate is declining, in some cases quite substantially: Afghanistan, Bosnia-Herzegovina, Cambodia, Croatia, Mozambique, Senegal, and Uganda.
- In Afghanistan, the casualty rate is now between 5 to 10 every day, down from 10 to 12 in 1998 and a significant decrease from 20 to 24 in 1993.
- In Bosnia-Herzegovina, 94 were casualties recorded in 1999, down from 149 in 1998, 286 in 1997 and 625 in 1996.
- In Cambodia, the Landmine Monitor registered 1,012 casualties in 1999, a decrease from 1,715 in 1998 and 3,046 in 1996.
- In Croatia, 51 casualties were reported in 1999, down from 77 in 1998.
- In Mozambique, 60 casualties were recorded in 1999 down from 133 casualties in 1998.
- In Senegal, 59 mine casualties were registered in 1999, down from 195 in 1998.
- In Uganda, in Kasese district, where ADF rebels are most active, casualties declined from 17 in 1997, to 28 in 1998, to only one in 1999.
Casualty rates appear to have fallen in other countries as well, but specific data is not available. The reasons for these reductions could be many, including achievement of a cease-fire or peace agreement, or a decline in armed combat. But it is notable that in several of these countries, major mine action programs have been underway. The increased removal of mines from the ground and the increased mine awareness education appears to be having a real impact.
In addition to the 71 states and nine areas with a casualties incidence in 1999-2000, Landmine Monitor has found that more than 30 other countries have a prevalence of victims. Prevalence is where victims were registered in 1998 or before, even if no information on casualties in 1999-2000 is available; in other words, these countries have survivors but no new casualties reported. Combining the incidence and prevalence shows that more than half of the countries of the world are affected by the landmine epidemic and the survivors issue.
States and Victim Assistance
The Mine Ban Treaty requires, in Article 6.3, 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 and for mine awareness programs.”
Donors to mine victim assistance in 1999 include U.S., UK, Norway, Germany, Canada, Japan, Sweden, Netherlands, Australia, Italy, Denmark, Switzerland, Finland, France, Belgium, Ireland and Austria. Others who have contributed to international programs and funds that include victim assistance are Czech Republic, Liechtenstein, Mauritius, New Zealand, Poland, Portugal, Qatar, Slovakia, Slovenia, South Africa and Spain.
Most of the countries that allocate funds for mine action do not specify the amount that is provided for victim assistance. The policy of many countries is to consider victim assistance as an integrated part of humanitarian mine action. The aid, which might have come from different ministries (Foreign Affairs, Development, etc.), may be given directly to the affected countries, to multilateral organizations, to NGOs, or to the agency responsible for development.
Components of Victim Assistance
The principal actors in victim assistance generally agree that victim assistance includes the following components:[18]
- Pre-hospital Care (First Aid and management of injuries);
- Hospital Care (medical care, surgery, pain management);
- Rehabilitation (Physiotherapy, Prosthetic appliances and assistive devices, Psychological support);
- Social and economic Reintegration (Associations, skills and vocational training, income generating projects, sports);
- Disability policy and practice (Education and public awareness and disability laws);
- Health and Social Welfare Surveillance and Research capacities (Data collection, processing, analysis, and reporting).
Capacities of affected States to provide assistance to landmine victims
States differ in their capacities to meet the needs of landmine victims. One tool used to measure the socio-economic health of states is the Human Development Index.[19] Only five out of the 71 countries that reported landmine incidents in 1999 scored high on the HDI scale, and those are countries that are minimally affected by mines. Nearly every mine-affected country in Africa scored low on the HDI scale. Mine-affected countries in other regions score low and medium on the HDI scale. The challenges of providing assistance to landmine victims are obviously greater for less developed countries with a large number of casualties, such as Cambodia, Afghanistan or Angola, than for countries higher on the HDI scale with fewer casualties.
Disability laws and policies in countries reporting accidents
Officially recognized disability laws and policy are essential for establishing equal opportunities for disabled people. Landmine victims living in States with such laws in place can hope to receive better assistance that those living in States without such laws. Unfortunately, only 32 out of 71 countries reporting an incident in 1999-2000 have explicit policies and/or legislation on disability. Countries without specific legislation on disability (especially relatively new States) may include articles in their Constitution which protect the disabled against discrimination in various arenas, a first step towards recognizing disability issues. Finally, some States use common laws with specific amendments to guarantee equal opportunities. Even where policies and legislation exist, they are often implemented slowly and with difficulty. Clearly, the legislative and policy aspects of victim assistance require much development.
In Africa, the countries with a clear national policy on disability are Uganda and Namibia. South Africa, Uganda, and Mozambique have national disability laws. Kenya, Rwanda, and Senegal are in the process of elaborating new laws. Tanzania has a national coordination body on disability. Half of the countries in Africa however have no laws or specific policies regarding disabled people.
In the Asia-Pacific region, half the affected countries have disability laws. In Cambodia, the government is making efforts to assure legal protection to the disabled. Cambodia, Pakistan, and the Philippines have a coordination body on disability.
In Europe, Bosnia & Herzegovina, Croatia, Yugoslavia, and Estonia have disability laws. Bosnia & Herzegovina, Croatia and Cyprus have a national coordination body on disability.
In the Middle East and North Africa, Egypt, Jordan, and Iraq have laws which directly address disability issues; Israel, Palestine, and Yemen are elaborating existing laws and policies. None of the countries in this region has a coordination committee on disability.
In the CIS, most of the countries have disability laws, but only Belarus and Ukraine have coordination bodies on disability. As everywhere in the former Soviet Union, the implementation of the laws remains considerably dependent on the economic capacities of the public administration. In Chechnya, it is likely that legal protection for disabled people has been disrupted to at least the same degree that general health and social welfare have been disrupted.
Health and Social Capacities
A thorough understanding of States’ efforts in the field of victim assistance would require the consideration of a wide range of indicators over a long period of time beginning with emergency medical care and continuing until the social and economic reintegration of the victim is complete and secure. Some useful indicators would include victim profiles set against the backdrop of population demographics for each country and over time, medical and social needs that arise as a result of the accident, and the accessibility of services from a logistical and financial perspective. Although such in-depth data is not available for all of the countries, some observations can be made.
Pre-hospital Care (Emergency medical treatment)
The Landmine Monitor has information regarding the existence of pre-hospital care services in eleven of the 71 countries and nine mine-affected areas. Djibouti, Eritrea, Chile, Colombia, Nicaragua, Thailand, Belarus, Albania, Azerbaijan, Israel, and Syria, as well as the Golan Heights, are mentioned as having first aid services with variable physical and geographical access. Sparse information is available regarding the financial access to those services.
In a dozen other countries and areas with landmine incidents such services appear to be non-existent. This situation may be particularly dramatic where the presumption of casualties is high, as in the Democratic Republic of Congo or in Chechnya.
There is no information from the remaining countries regarding pre-hospital care. However, it should be stated that emergency care is particularly difficult to provide in heavily mined areas and evacuation to health centers is often problematic.
Hospital Care (medical care, surgery, pain management)
The information collected by Landmine Monitor regarding hospital care confirms some trends which have already been underlined by various actors in victim assistance:
- geographical access: most of the medical services are in urban centers whereas the rural areas are usually the most polluted by mines;
- financial access: the economic situation of affected countries is an obstacle for adequate care of landmine victims;
- political and military constraints are another significant obstacle;
- International Organizations and NGOs working near the affected zones and supporting the urban public services can help improve accessibility.
In 1999, all the governments in Africa provided medical care, mainly in the biggest cities. In the rural areas, medical services often lacked personnel, equipment, and medicines. Military health services usually have better equipment (Angola, Burundi, Niger, Senegal, Uganda) and sometimes care for civilians as well. In about half the affected countries, hospital care is the patient's financial responsibility. Victims without geographic or financial access to hospital services may turn to traditional medicines. NGOs in Africa made a significant difference by adding to and improving government services in 1999.
In the Americas, medical services are reported for Chile. In Colombia, Ecuador, Nicaragua, and Peru, only the urban centers, typically far from mined areas, benefit from medical infrastructures.
For the Asia-Pacific region, medical services for landmine victims are located far from the mined areas. In about half the affected countries, medical services are the patient's financial responsibility. NGOs in the Asia-Pacific region made a significant contribution to public services in 1999.
In the affected countries of the former Soviet Union as well as in Central Europe, modern health care services are located in the urban centers. In the majority of cases, there is no information about the hospital fees. Again, Chechnya seems to face the worst situation since the medical infrastructures have been destroyed.
In the Middle East and North Africa, there are medical services in all countries. In Iraq, the international embargo places the same obstacles to health care for landmine victims as it does for the general population.
Rehabilitation (physiotherapy, prosthetics and assistive devices, psychological support)
Government rehabilitation services usually have long waiting lists and require payment both of which landmine victims can ill afford. NGOs have been of great assistance in providing free or subsidized prosthetics in a timely manner. Psychological support is rarely a component of government services. For many countries, services are also concentrated in the capitals or in urban areas, whereas mine-affected areas are in remote places. Community Based Rehabilitation programs (CBR) can provide a partial remedy to this situation, providing assistance to victims in the villages. It should be noted as well that rehabilitation services are often quite good for military victims but not for civilians. This is the case in the Middle East, Africa, and the Americas.
In Africa, each of the affected countries has rehabilitation services for landmine victims with the exception of Somalia for which no information is available. However, these services are scarce and almost impossible to reach for most victims, especially in Angola, Djibouti, Eritrea, Sierra Leone, and in Casamance. Prostheses are provided free of charge in Burundi, Eritrea, and Mozambique, and at a subsidized cost in Kenya, Rwanda, and Uganda. Many NGOs and private groups provide prostheses free of charge. Countries that do not produce prostheses locally, e.g. Djibouti, have to import them at high prices. Psychological support is given in Namibia and Sierra Leone. Community Based Rehabilitation programs exist in Mozambique, Uganda, and Zimbabwe.
In Central and South America, rehabilitation services are generally provided by States. An exception is Honduras. Costa Rica and Nicaragua provide psychological support to victims and Colombia provides it to disabled soldiers. Services are concentrated in the regions’ capitals or in major cities. In Costa Rica, rehabilitation services are free for the most part. In Colombia, it is difficult to get prostheses as well as subsequent adjustments to prostheses. CBR programs are expanding only in Nicaragua.
In the Asia-Pacific region, governments provide rehabilitation services, except in Laos. Often however, these services are inadequate and require substantial help from NGOs, especially in Afghanistan, Burma, Cambodia, and Sri Lanka. In Cambodia, all services are free of charge thanks to the numerous NGOs. Victims pay for their own rehabilitation in Pakistan, Thailand, and Vietnam. The governments of Afghanistan, China, and Vietnam are implementing CBR programs.
In Europe, all countries for which data is available have rehabilitation services. Services are only in the capitals for Albania and the Federal Republic of Yugoslavia; services are provided at no cost to Albanians through the ICRC and to Yugoslavians through the government. Victims in Bosnia & Herzegovina have to pay for their own rehabilitation, although services are generally accessible. Needy Croatians receive some rehabilitation services at no cost, but for proper care Croatians have to travel to Slovenia. CBR programs and NGO’s are very active in rural areas.
In the Russian Federation and in the CIS, excluding Chechnya, rehabilitation services are available in all countries. Azerbaijan has services only in the capital. In Abkhazia and Azerbaijan, services are provided by the government in cooperation with the ICRC. However, in the Russian Federation, governments appear to leave rehabilitation to NGOs. Prostheses are well distributed and free in the whole of Belarus; however, Ukrainian victims must wait a long time for a prosthesis. Abkhazia covers all victims’ expenses related to rehabilitation; Azerbaijan only provides free wheelchairs. Finally, psychological support is given to children in Georgia and to all Abkhazians although not on a regular basis. Chechen rehabilitation services have collapsed.
In the Middle East and North Africa, rehabilitation services are available for all victims, with the exception of the Golan Heights and a restriction for the Western Sahara where services are limited. In Egypt, services are especially poor in the mined areas. There is a charge for prostheses. Military victims have better services than civilians. Access to services is especially limited in the Western Sahara but is improving in Yemen. The government provides free services for all victims in Israel and Kuwait; services are free for the neediest in Syria. Lebanon no longer subsidizes rehabilitation and compensation for Palestine victims is irregular.
Social and economic Reintegration (associations, skills and vocational training, income generating projects, peer counseling, sports)
Socio-economic reintegration activities are not often implemented in mine-affected countries. Where there are such activities, they are usually implemented in urban areas while the affected population is located in rural areas. NGO’s implement most of the activities; governments tend to limit their financial commitment to pensions.
In Africa, socio-economic reintegration activities for landmine victims were reported in twelve countries (Angola, Eritrea, Kenya, Mauritania, Mozambique, Namibia, Rwanda, Senegal, Tanzania, Uganda, Zimbabwe, and Burundi). There are no projects in Djibouti. Reintegration activities seem to be geographically accessible only in Kenya and Namibia. Generally, services are concentrated in the capital, far from the affected population of the rural areas. Existing reintegration activities are generally free, in so far as they are mostly provided by international organizations and NGOs. Allowances and benefits are provided by governments in Angola, Djibouti, Mauritania, Mozambique, and Rwanda, while pensions and grants are offered in Eritrea and Namibia.
In the Americas, only El Salvador is reported to have implemented free socio-economic reintegration activities for landmine victims. Colombia certainly lacks this kind of service. Grants or benefits are provided by the governments in El Salvador, Honduras, Nicaragua, and Chile; pensions are allocated in Costa Rica and in Colombia, in the latter only to military personnel.
In the Asia-Pacific region, most countries have socio-economic reintegration activities for landmine victims implemented by governments with the assistance of NGOs. These countries are Afghanistan, Burma, Cambodia, India, the Republic of Korea, Nepal, Pakistan, Sri Lanka, and Thailand. Such activities are not carried out in the Philippines. The importance of reintegration activities seems to be understood in the Asia-Pacific countries more than in other regions. Allowances, benefits, or pensions are given by governments in Nepal, Sri Lanka, Pakistan, Cambodia, China, and the Republic of Korea where the beneficiaries are mainly soldiers.
In Europe, these countries have implemented socio-economic reintegration activities: Albania, Bosnia & Herzegovina, and Croatia. The Federal Republic of Yugoslavia, Albania, Cyprus, and Estonia proceed mainly through the allowance of benefits and pensions.
In the countries of the former Soviet Union, socio-economic reintegration activities are very weak. Only the Russian Federation has implemented these activities for landmine victims. No efforts towards socio-economic reintegration were reported in Abkhasia, Azerbaijan, Belarus, or Chechnya. Russia, Azerbaijan, and Kyrgyzstan provide pensions.
In the Middle East and North Africa, Jordan, the Golan Heights, Kuwait, Syria, and Israel have implemented socio-economic reintegration activities for landmine victims. Geographical access is problematic in Jordan and the Golan Heights. Most of the time, these services are provided free by governments. Benefits and pensions are allocated in Yemen, Egypt, Israel, and Kuwait.
The Intersessional Standing Committee of Experts
One of the most important outcomes of the First Meeting of State Parties to the Mine Ban Treaty held in Maputo, Mozambique in May 1999 was the establishment of the Intersessional Standing Committee of Experts on Victim Assistance, Socio-Economic Reintegration and Mine Awareness (ISCE-VA). Intersessional work has been open to participation by governments, international organizations, and non-governmental organizations. The ISCE-VA was co-chaired by Mexico and Switzerland, with the help of co-rapporteurs, Japan and Nicaragua (who will become co-chairs in September 2000). Over 160 people attended the ISCE meetings on victim assistance, including representatives from at least 43 countries, nine international and regional organizations, 22 NGOs and thirteen other institutions.
The ISCE emphasized the need: to promote an exchange of experiences; to support a wider and more integrated scope of landmine victim assistance; to facilitate the practical use of planning tools at the country level; to share information on resource allocation at the donor, country, and operational agency levels; to formulate methodology and systems for the evaluation of programs.
Important work was accomplished during two intersessional meetings, held in September 1999 and March 2000, in Geneva, Switzerland. Following the first meeting five network groups were established to address the following issues: information and data collection, victim assistance reporting, portfolio of victim assistance programs, strategic approach to guidelines, and donor coordination. Mine awareness was added as a sixth group for the second ISCE meeting.
One result of the ICSE-VA process was clarification of a broad definition of “landmine victim.” Another result was much discussion that victim assistance needs to be integrated into the larger development perspectives such as humanitarian assistance, post-conflict reconstruction, and public health strategies. Victim assistance was also considered in the context of disability issues. A key question is how to meet the specific needs of landmine victims without setting them apart from larger groups such as victims of violence and trauma as well as people with other disabilities.
Plans for a portfolio composed of one-page descriptions of victim assistance programs from around the world were elaborated. The portfolio is intended to facilitate the sharing of information, promote transparency among actors, and highlight funding gaps.
Various guidelines and tools related to victim assistance and mine awareness were collected and presented. Donor coordination was approached through the key issues of concerted efforts, identification of gaps, and reporting mechanisms.
For affected countries, national coordination bodies were seen as necessary to bring together all actors of victim assistance, to facilitate communication, strategic planning and to coordinate policies and practices. All the actors expressed the need for improvement of mine information systems especially in the field of evaluation.
Victim assistance reporting was taken up as a specific topic for the SCE-VA because there is no explicit requirement in the Mine Ban Treaty for countries to report their contributions to victim assistance. Consultations resulted in a draft proposal regarding a voluntary reporting mechanism with a format similar to other aspects of mine action (Article 7 of the Treaty). The exact method of reporting will continue to be discussed, but all interested parties agreed to continue to work towards an efficient and effective means to monitor the implementation of Article 6.3 of the Mine Ban Treaty.
The objective of the information and data collection on Victim Assistance was restated: to deliver baseline data and to quantify the impact on public health and reintegration systems, on human and socioeconomic development, and on the daily life of people and communities. All the actors have expressed the need for the improvement of mine information systems, especially in the field of evaluation (indicators).
A significant result of the first year of the ISCE process was to engage the whole range of actors to continue to work on effective implementation of the Mine Ban Treaty, and to promote quality in victim assistance and mine awareness programs. It was recommended that future work should focus on the rationalization of the roles of the major interlocutors in victim assistance. The ISCE-VA will also continue to focus on identification of gaps in terms of financial, technical, and other resources needed, and to measure progress toward implementation to the Treaty provisions. To increase the efficiency of the ISCE process, it was proposed to merge future work into two types of activities: the implementation of key recommendations and action points from the first year of intersessional work, and analysis of several new themes.
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[16] Landmine Monitor researchers definitively registered mine casualties in 55 countries and one area. In another 16 countries and eight areas, casualties were not formally reported, but evidence points to the strong likelihood of new victims, based on the scope of the landmine problem and previous reports of victims in 1998 and earlier years in those countries.
[17] These include Abkhazia, Chechnya, Golan Heights, Iraqi Kurdistan, Kosovo, Nagorny-Karabakh, Palestine, Somaliland, and Western Sahara.
[18] Beside the core of health and social capacities and activities, a wide interpretation of assistance may also include socioeconomic development in former mined zones, repatriation and resettlement of refugees and internally displaced persons into mine-cleared zones, legal assistance, and other social and economic measures for mine (and UXO) affected communities.
[19] The Human Development Index reflects a country's level of health, education, and income. The UNDP calculates the Index using three measures: life expectancy at birth, adult literacy and schooling levels, and the Gross Domestic Product per inhabitant. Countries are assigned to three groups according to the HDI: .8 or higher indicates high human development, between .5 and .79 indicates medium human development, and under .5 indicates low human development.