Action points based on findings

• Dedicate resources to implementation of socioeconomic inclusion and psychosocial support programs; create sustainability and decrease dependence on international cooperation.
• Ensure there is an active coordination mechanism for victim assistance that includes all relevant bodies working on disability issues.
• Increase awareness of Law 763 on the rights of persons with disabilities and dedicate resources to its implementation and enforcement.
• Effectively implement the law on Assistance to Ex-Combatants for Peace, Unity and National Reconciliation.
• As a State Party to the Mine Ban Treaty, report on progress and challenges on victim assistance activities before national and international audiences. 

Victim assistance commitments

The Republic of Nicaragua is responsible for a significant number of landmine survivors and survivors of other explosive remnants of war (ERW) who are in need. Nicaragua has made commitments to provide victim assistance through the Mine Ban Treaty, Protocol V of the Convention on Conventional Weapons, and is also a State Party to the Convention on Cluster Munitions.

Nicaragua ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 7 December 2007.

Casualties Overview

There were no mine/ERW casualties identified in 2015 in Nicaragua.[1] In 2014, no casualties were reported, while in 2013, one civilian ERW casualty occurred when a man was injured in October in the department of Leon.[2] This was consistent with recent low annual casualty figures following the completion of antipersonnel mine clearance in 2010.[3] The last reported landmine casualty occurred in 2010.[4]

When last reported in March 2014, 1,303 mine/ERW casualties (92 killed, 1,211 injured) had been recorded in Nicaragua, including 42 deminers (five killed, 37 injured).[5]

Victim Assistance

There were at least 1,205 mine/ERW survivors in Nicaragua as of May 2015.[6]

Victim assistance in 2015

Between 2002 and 2013, all registered mine survivors in Nicaragua had received support from the Organization of American States (OAS), with international funding to access physical rehabilitation and/or economic inclusion assistance. However, these services could not be provided in 2014 and 2015 as the OAS did not receive new funds.[7]

The Nicaraguan Demining Commission’s (Comisión Nacional de Desminado, CND) Sub-Commission for Medical Assistance and Rehabilitation of Mine Survivors is the victim assistance coordination mechanism and the Ministry of Health is the focal point. Both have been largely inactive in recent years.[8]

Global assistance to mine/ERW survivors and their families remains underfunded and inaccessible, especially since major international organizations can no longer carry out operations in the country.

Assessing victim assistance needs

Until 2013, the OAS had been the main organization delivering services to mine/ERW victims in Nicaragua and has provided services to all registered mine survivors. As of May 2016, the OAS remained the focal point of the Information Management System for Mine Action (IMSMA), a database that handles information on demining, mine risk education, and victim assistance. However, the OAS ceased its activities in 2014 due to a lack of funding and closed its office in Nicaragua at the end of March 2016.[9]

The program “A Voice for All” (“Todos con voz”), led by the Ministry of Health, holds a registry of all the country’s municipalities in which it monitors persons with disabilities, although no specific attention is paid to mine/ERW survivors.[10]

In 2014, the Nicaraguan Federation of Associations of Persons with Disabilities (Federación Nicaragüense de Asociaciones de Personas con Discapacidad, FECONORI) led a survey on the barriers met by persons with disabilities in accessing education and employment. The conclusions were used in the planning of activities of organizations of persons with disabilities for 2015–2017.[11]

Victim assistance coordination

In 2015, coordination meetings on disability-related issues were held between the Ministry of Health and representatives of persons with disabilities in the government-based Cabinet of Persons with Disabilities, through the “A Voice for All” program. Coordination efforts were also made by the country’s three federations of persons with disabilities (FECONORI, FEMUCADI, and FENOFADIS).[12] THE ICRC Special Fund for the Disabled (SFD) also held regular coordination meetings with the Ministry of Health through the program, which led to the signature of a framework agreement for 2015–2019. These coordination efforts also resulted in the hiring of a new technical professional in the public rehabilitation center in La Trinidad city, new scholarships for two rehabilitation centers, needs assessment and budget elaboration for peripheral areas that lacked government support, and regular coordination with Integral Health Assistance Local System (Sistema Local de Atención Integral en Salud, SILAIS) directions.[13]

Nicaragua did not provide updates on progress or challenges in victim assistance at the Mine Ban Treaty Fourteenth Meeting of States Parties in Geneva in December 2015, at the Convention on Cluster Munitions First Review Conference in Geneva in September 2015, or at the Mine Ban Treaty Third Review Conference in Maputo in June 2014. Nicaragua’s most recent Mine Ban Treaty Article 7 report (for calendar year 2012) included no information on casualties or victim assistance.[14] In its most recent Convention on Cluster Munitions Article 7 report (also for calendar year 2015), Nicaragua indicated that Form H on victim assistance was not applicable.[15]

Service accessibility and effectiveness

In 2015 and into 2016, through the “A Voice for All” program, the Ministry of Health continued to carry out home visits for persons with disabilities and in a situation of vulnerability, especially in remote areas, to provide basic medical care, mobility devices, and refer patients to regional hospitals as needed.[16]

Between 2002 and the end of 2013, all registered mine/ERW survivors had received support from the OAS to access physical rehabilitation and/or economic reintegration assistance. Starting in 2011, OAS support to mine victims was limited to physical rehabilitation; economic reintegration assistance was no longer available.[17] The OAS received no financial support for victim assistance activities in 2014 and 2015 and therefore could not provide assistance to mine/ERW survivors.[18]

In general, mine/ERW survivors have access to the same services as other persons with disabilities, however, there is no specific mechanism to ensure they actually benefit from these services.[19] Furthermore, many persons with disabilities, including ex-combatants and mine/ERW survivors, still lack medical insurance and struggle to earn a decent living.[20] The Nicaraguan Social Security Institute (INSS) does provide financial and prosthesis/orthosis services. However, financial aid is reported to be insufficient—although the amount given has been increasing in recent years—and rehabilitation services are difficult to access for survivors and require long bureaucratic procedures.[21]

Inclusion and participation in victim assistance

In general, war victims, including ERW/mine survivors, participate in the cabinet of persons with disabilities—a body representative of persons with disabilities within the government—and in the federations of persons with disabilities.[22]

In June 2015, the Nicaraguan Federation of Associations of Persons with Disabilities (Federación Nicaragüense de Asociaciones de Personas con Discapacidad, FECONORI) held a regional workshop on inclusive risk management strategies in situations of emergency in Managua. The workshop, supported by UNICEF, included outcomes from a previous forum on risk management and the rights of children and youth with disabilities in Central America.[23]

The Organization of Revolutionaries with Disabilities “Ernesto Che Guevara” (Organización de Revolucionarios Deshabilitados “Ernesto Che Guevara,” ORD) represents 156 ex-combatants, of which 94 are mine survivors. ORD works to ensure that survivors have access to adequate medical care through representations to the Ministry of Health. They reported however, that it remains complicated for members to receive specialized services. ORD also negotiated with the government for improved pensions for ex-combatants with disabilities.[24]

Physical rehabilitation

The Ministry of Health coordinates a network of service providers. The network includes physiotherapy units, rehabilitation services, a teaching hospital, and orthothics production centers.[25] In 2015, a lack of financial support and trained staff remained a challenge to accessing health and rehabilitation services, especially for people living in remote and rural areas.[26] Nicaragua increased investments for the purchase of orthosis and prosthesis components in 2015.[27] Such specialized services are the responsibility of the Nicaraguan Social Security Institute. It was reported in 2015 that the provision of services through the institute was not adequate for addressing the needs of mine/ERW survivors, as it was complex, extremely bureaucratic, and inefficient.[28] State-run clinics and hospitals provided care for veterans and other persons with disabilities, but the general quality of care was reportedly poor.[29]

In 2015, as a result of the negotiations initiated in 2013 with the Ministry of Health, the ICRC SFD signed a multi-year framework agreement (2015–2019) aiming at strengthening coordination and effectiveness of rehabilitation services provided at the national level. These coordination efforts helped resolve import related issues for rehabilitation materials.[30] Discussions also took place with national authorities in order to strengthen collaboration with the National Disability Council (CONADIS).[31]

During the year, the ICRC SFD generally maintained its coverage and continued to deliver orthosis and prosthesis to persons with disabilities, including victims of mines/ERW, as well as reimburse the cost of treatment for economically vulnerable people.[32] In 2015, the ICRC SFD slightly increased the number of devices delivered. Overall, nearly 5% was delivered to survivors, a figure that is similar to last year’s.[33] In 2016, the organization hopes to increase the quality of services through the provision of new trainings and the realization of a satisfaction survey among the beneficiaries in collaboration with the Nicaraguan Red Cross and the Physiotherapy University in Managua.[34]

Civil society organizations such as the Medical Pedagogical Institute Los Pipitos (Instituto Médico Pedagógico Los Pipitos) and Early Rehabilitation and Stimulation Centers, also provide a variety of services to persons with disabilities.[35] In 2015, the ICRC SFD and Los Pipitos signed an annual framework agreement to identify and follow up with service users and promote a multi-disciplinary approach within rehabilitation centers. The agreement includes special provisions to identify children in need of rehabilitation services.[36] In 2015, the rehabilitation center of La Trinidad restarted its activities, attending amputees, including mine/ERW survivors, from northern Nicaragua, where the majority of survivors reside.[37]

A framework agreement for 2015–2017 providing for specific assistance for economically vulnerable women and children was signed between the ICRC SFD and FURWUS (Fundación para la Rehabilitación Walking Unidos, a rehabilitation foundation that includes Walking Unidos and CAPADIFE Rehabilitation Center), which specializes in traumatology and orthopedics.[38] Mechanisms to improve identification of vulnerable patients were developed and are now used by FURWUS.[39]

In 2015, the ICRC SFD continued to support rehabilitation training at the University Don Bosco (UDB) in El Salvador, to strengthen the management capacity of the national prosthetic-orthotic production center (Centro Nacional de Producción de Ayudas Técnicas y Elementos Ortoprotésicos, CENAPRORTO). The ICRC reported that by early 2015 CENAPROTO had the technical capacity to offer training opportunities for professionals from the region as a substitute for ICRC SFD-supported training.[40] In 2014, CENAPROTO was sufficiently subsidized by the Ministry of Health in order not to depend on SFD financial support in the near future.[41] In total, CENAPRORTO produced 304 devices in 2015, a slight increase compared to 2014 when 294 devices were produced.[42]

Oversight of distribution of wheelchairs, training in wheelchair production, and related services was carried out and project led by World Vision-UCP Wheel for Humanity and Nicaragua’s Future (El Futuro de Nicaragua), in collaboration with the Ministry of Health and “A Voice for All” program.[43]

Social and economic inclusion

FECONORI regularly participated in a working group on inclusive education led by the Ministry of Education, and actively contributed to fostering collaboration between civil society organizations and decision makers.[44] In October 2015, FECONORI, with support from the MyRight project,[45] mapped best practices for the professional inclusion of persons with disabilities, in coordination with public and private sector representatives.[46]

In 2015, the NGO Inclusive Vision (Visión Inclusiva) increased its geographical coverage by implementing an inclusive education project in Masatepe and Masaya municipalities.[47]

The Ministry of Health put in place a social and economic inclusion program “A Voice for All” in 2010. Through this program, persons with disabilities and their families are receiving medical treatment and community-based rehabilitation training. In 2015, the ICRC SFD met regularly with program’s representatives with a view to strengthening cooperation in the implementation of the CRPD.[48]

The ICRC SFD delivered an economic inclusion program for persons with disabilities until 2013. In May 2015, the SFD decided that it should not remain involved in the implementation or the funding of socioeconomic programs due to insufficient financial capacity and lack of expertise.[49]

Laws and policies

In April 2011, Nicaragua approved Law 763 to replace the previous law on disability; Law 763 is aligned to the CRPD.[50] In March 2014, implementing regulations for Law 763 on the Rights of Persons with Disabilities were approved.[51] No major progress was reported in the implementation of the law in 2015.

Despite the existence of legal provisions, discrimination towards persons with disabilities was widespread in 2015, especially in employment, education, access to healthcare, and other state services. Electoral facilities were also reported to be largely inaccessible. The law was not enforced effectively to ensure accessibility to buildings, information, and communications. Generally, public institutions did not sufficiently coordinate with the labor ministry regarding the rights of persons with disabilities. The mayor’s office in Managua sponsored training on accessible transportation for bus drivers, however most transportation remained inaccessible. Despite the existence of technical regulations on accessibility, schools and health centers also were mostly inaccessible for persons with disabilities.[52] In general, accessibility standards are respected in the construction of new buildings, but the majority of older buildings were not adapted to be physically accessible to persons with disabilities.[53]

Special Law 830 on Assistance to Ex-Combatants for Peace, Unity and National Reconciliation, approved in 2013, regulates assistance for basic necessities and socioeconomic reintegration to former combatants, including those with disabilities, and their families.[54]

According to Article 1 of Law 830 its provisions relate to participants in the following groups:

•  Sandinista combatants and their historical collaborators, heroes and martyrs’ mothers;
• Sandinista popular army to December 1994;
• The Ministry of Interior and its bodies and auxiliary bodies to December 1994;
• Members of the Reserve Units, enrolled to 25 April 1990;
• Those in military service, enrolled to 25 April 1990;
• Members of the Nicaraguan Resistance, including the demobilized, from 1988 to 1990 and including those who were captured and were deprived of liberty when the peace agreement was signed; and
• Indigenous resistance demobilized between 1988 and 1990 As of April 2015.

The regulations regarding economic inclusion quotas were rarely implemented and a high number of ex-combatants were unemployed, with only a pension for war-disabled persons that is not sufficient to cover basic living expenses.[55] As of April 2016, implementing regulations for Law 830 had not been approved and as a result the provisions of the legislation were not being fully applied.[56] Ex-combatants also demanded that the law include a life-long pension equivalent to the amount received by retired people, or financial compensation for the years spent in military service.[57]