Victim Assistance in the World Today

by Mike Boddington [ Cooperative Orthotic and Prosthetic Enterprise and National Regulatory Authority ]

According to average budgets of the 2007 Portfolio of Mine Action Projects, victim-assistance programs are the third most-funded category after clearance and humanitarian mine-action program oversight. The author thinks the global mine-action community needs to reconsider how it handles victim assistance. This article outlines the qualities necessary for effective victim assistance and calls the community to action.

Think about it: Without victims, there would be no mine action. It is only because people get maimed and killed that we clear mines. It is only because people get seriously injured that we educate them to prevent landmine accidents. In fact, we would never have secured a mine-ban convention1 were it not for the horrific accidents experienced by civilians.

It seems strange to me that victim assistance is a low priority when it comes to funding; the lion’s share of funding goes to clearance. Clearance is, of course, expensive. In Lao PDR, it costs between US$64 and $8342 for every landmine or item of unexploded ordnance cleared. Since millions of units require clearance, both in Laos and around the world, that adds up to big bucks—and by the logic that prevention is better than a cure, getting rid of landmines and explosive remnants of war3 makes a lot of sense.

Creativity Needed

It will, however, take a very long time to remove the remaining ERW, and we will likely continue to see landmine/ERW victims, regardless of how much we educate against risky behavior. In February 2006, the Prime Minister of Cambodia, Hun Sen, set a goal of zero victims by 2015. Setting goals like that brings a guffaw to mine-action practitioners. They say such an ambition is impossible to achieve; yet I subscribe to that sort of thinking because any victim is a gross violation, and until we start thinking zero victims, we cannot devise ways to achieve this important marker. Perhaps we will then find that it is not impossible.

In 1995, I estimated that the total amount of money flowing into prosthetics and orthotics in low-income, mine-affected countries was about $40 million a year. Five years later, with the benefit of the International Campaign to Ban Landmines’ Portfolio of Landmine Victim Assistance Programs4 (prior to its amalgamation with the United Nations Mine Action Service Portfolio), there was a total of $20 million earmarked for victim assistance, of which $15 million was slated for prosthetics and orthotics. The terrible truth is that the passage of the Ottawa Convention1 diminished the money available for victim assistance because it concentrated on mine clearance. This decrease occurred even though the monetary total flowing into humanitarian mine action increased.

COPE has been able to increase the number of clients fitted with devices tenfold since it was established in 1997. Before that, it would have been unthinkable to see so many patients waiting or undergoing service.
Graphics courtesy of Joe Pereira

Today, we can look at the statistics we have available and we see that about $30 million is flowing into victim assistance from official (government) sources every year, fluctuating only slightly annually.5 Those funds have to cover all six elements of victim assistance, not just physical rehabilitation.6 Of course, it does not include all of the money donated by foundations and small donors to nongovernmental organizations, but it is very difficult to know how much money they donate. I think it is unlikely, though, that we would find that the total amount going into prosthetics and orthotics—i.e., physical rehabilitation—was as much as the 1995 figure of $40 million.

What Not to Do

There are many things people in the mine-action community do to try to help victims. There are times, however, when what we do can have a negative, rather than a positive, effect on people. The following are three examples of instances when victim assistance may result in false hopes:

  1. Going into mine-affected areas as a journalist and taking pictures of victims; the victims think that, perhaps, someone will now notice their plight and do something to help them.
  2. Doing a survey of mine victims, visiting their houses and finding out the nature of their injuries and what they need to assist them; they will think that help is now definitely on the way.
  3. Establishing some service—like physical rehabilitation—running it for a few years and then closing it down due to lack of funding; people become used to receiving assistive devices and then get put back to where they were before (or worse)—having sampled what life can be like.

The last of these has happened repeatedly. Establishing a good service in a country can take at least 15 years. Few donors are able and willing to support a program for this length of time; therefore, running a project in the long term means finding a continuing succession of donors willing to pick up the baton and run with it for a few years.

This situation leads to the sustainability issue: Donors want to know whether the project will be sustainable when they complete their three-year input.7 No, of course it won’t. A project is sustainable if it will continue. If you end the funding after three years and you take away the foreign expertise, can you expect it to continue? The Vice-Minister of Health from Mozambique, Abdul Razak Noormahomed, addressed the Second Meeting of States Parties to the Ottawa Convention in Geneva in 2000. He said, “Don’t come to countries like mine and set up your expensive rehabilitation projects and then expect our governments to take them over. We won’t. We can’t even provide primary health care for 50 percent of our populations. Why should we spend money that would immunize 1,000 children against polio on a single person who has lost his leg and will simply become another statistic in the pool of unemployed?”

Let’s Meet Our Requirements

There is an obligation written into the Ottawa Convention that says: “Each State Party in a position to do so shall provide assistance for the care and rehabilitation and social and economic reintegration of mine victims…”8 The clause goes on to suggest how such assistance might be routed.

Fundamentally, any nation that has signed the Convention is required to help victims if they are in a position to do so. I interpret “in a position to do so” as “having the money”; simply put, it is the job of the richer signatories to fund the poorer signatories. That just has not been happening.

One of the problems is, of course, that we do not know how much money is needed. That is to say, we do not know how many victims there are in need of assistance. We also do not know what sort of assistance they need. There was a movement in 2001–2003 to prepare a regional victim-assistance plan for Southeast Asia, but that appears to have yielded no significant output. What is required is a victim-assistance plan for the world, and the Southeast Asian plan could have been the first plank in that.

United Nations Mine Action Service’s annual Portfolio of Mine Action Projects is working toward that, but it still only embraces 31 mine-affected countries. For reasons best known to themselves, major players—such as the International Committee of the Red Cross and Handicap International—decline to include information about their programs. One thing that the Portfolio does allow us to see, however, is the way in which coordination, administration and oversight of humanitarian mine-action programs have grown to consume a substantial part of the total funding. The analysis of the 2007 Portfolio data reveals the following average budgets per year:

Average budgets of mine-action programs  in the 2007 Portfolio. Average budgets of mine-action programs in the 2007 Portfolio.
Drawn from an analysis of data contained in the UNMAS Portfolio of Mine Action Projects.

Of course, the sum for the Geneva International Centre for Humanitarian Demining is not included here, either—that would increase the coordination figure.

It is hard to understand why victim assistance has fared so badly. One oft-stated reason is that it mainly involves the provision of services, and it is not the job of international donors to provide services in low-income countries. I am not going to argue that issue here; I simply refer you to the point made by the Mozambican Vice-Minister of Health above.

One Solution

In the early 1990s, Stan Windass, then-Director of the Cambodia Trust, Trustee of POWER International (a British NGO that provides victim assistance) and Director of the Foundation for International Security, put forward a proposal that a Mine Victims Fund should be established. He suggested that it would be funded sufficiently and continuously to provide for most of the needs of projects supporting mine victims. His proposal stated this fund would be totally independent, impartial, professional and transparent. It would also have an institutional memory of all of the victim-assistance projects around the globe. The idea attracted many supporters, but it also had its detractors, especially among the NGO community who saw it as a Trojan horse for some of Windass’ NGO interests. The characteristics of the proposed Mine Victims Fund—independence, impartiality and transparency—can quickly prove this to be a lie.

It is time to take that idea out of the cupboard and dust it off. Without such a fund, there appears to be no prospect that innocent victims can ever receive the amends they both need and deserve and which they might have thought would be forthcoming upon ratification of the Ottawa Convention. JMA icon

The views expressed here are those of the author and are not necessarily shared by the organizations for which he works or to which he alludes.

Biography

Mike Boddington became involved in humanitarian mine action/victim assistance while working on rural development in Cambodia in 1991. That led him to found POWER International, an NGO aimed at assisting mine victims. POWER established activities in Laos, Mozambique, Nicaragua, Sri Lanka, Vietnam and Zambia. Boddington retired in 2001; then in 2002, he moved to Laos to further victim-assistance efforts there. He continues his retirement while working with the Cooperative Orthotic and Prosthetic Enterprise and the National Regulatory Authority in Lao PDR.


Endnotes

  1. Author is referring to the Ottawa Convention. The Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-personnel Mines and on Their Destruction, Oslo, Norway. 18 September 1997. http://www.icbl.org/treaty/text/english. Accessed 20 May 2008. The document was opened for signature in Ottawa, Canada, 3 December 1997, and thus is commonly known as the Ottawa Convention.
  2. Laos National Regulatory Authority, Annual Report, 2006, showing the results from three clearance organizations in Laos. Cost of removal varies per item of UXO removed from $64 (67,275 items) through $564 (2,625 items) to $834 (2,958 items), with an average of $113 (72,858 items).
  3. Explosive remnants of war is a term used to describe unexploded ordnance that is left after a military conflict or engagement. For more information see “Explosive Remnants of War and International Humanitarian Law.” International Committee of the Red Cross. http://www.icrc.org/web/eng/siteeng0.nsf/iwpList2/About_the_ICRC?OpenDocument. Accessed 13 May 2008.
  4. “Chronology.” Landmine Survivor’s Network. http://www.landminesurvivors.org/inside_chronology.php?year=2000. Accessed 14 May 2008.
  5. Editor’s Note: The 2008 Portfolio of Mine Action Projects includes victim assistance projects with budgets totaling $25,178,239, representing about 6 percent of the total for all the projects in the Portfolio ($404,353,683). As woefully small as this amount seems, as a percentage of the funds requested through the Portfolio, this is actually an increase over 2005 and 2006. The Landmine Monitor Report 2007 discusses these trends and the difficulties in sorting out the funding streams for victim assistance in its “Executive Summary” referenced above. The Portfolio of Mine Action Projects can be found at: http://www.mineaction.org/projects_funding.asp. Accessed 30 May 2008.
  6. Author is referring to the elements of victim assistance adopted by the States Parties to the Ottawa Convention, originally listed as nine elements and now condensed to six. These are: data collection; emergency first aid and ongoing medical care; physical rehabilitation; psychological support and social reintegration; economic reintegration; and disability laws and policies. International Campaign to Ban Landmines. http://www.icbl.org/news/isc07docs (Sub-articles: guiding principles). Accessed 28 May 2008.
  7. Editor’s Note: The Vietnam Veterans of America Foundation has been providing support (including rehabilitation, treatment and training) to mine and UXO victims in Cambodia since 1991. For more information about their programs, see “Profile: Vietnam Veterans of America Foundation.” Journal of Mine Action. Mine Action Information Center. http://www.jmu.edu/cisr/journal/3.3/profiles/vietnam_veterans.htm. Accessed 29 May 2008.
  8. Article 6 of the Ottawa Convention. See Endnote #1.

Contact Information

Mike Boddington
Technical Advisor Victim Assistance
National Regulatory Authority
Ban Sisavath Tai Road
P.O. Box 345
Vientiane / Lao PDR
Tel: +856 20 561 00 50
Fax: +856 21 252 819
E-mail: mbodd(at)laopdr.com
Web site: http://www.nra.gov.la/

Executive Consultant and Monitoring Officer
COPE (Cooperative Orthotic and Prosthetic Enterprise)
National Rehabilitation Centre
Thanon Khou Vieng
P.O. Box 6652
Vientiane / Lao PDR
Tel: +856-20 561 00 50
Fax: +856-21 218 427
E-mail: mbodd(at)laopdr.com
Web site: http://www.copelaos.org/