In the years since the Mine Ban Convention (MBC) went into force, the pillar of victim assistance has traveled a meandering path. The plight of landmine victims was the hook that drew the world’s attention to the problem with landmines. It was the devastating effects of landmines on the bodies of innocent civilians that, when brought to our attention, led us to want to do something to eliminate this scourge, but the drama of landmine removal is what has sustained our attention to the issue.
Who can forget the pictures of Princess Diana in Bosnia, where she visited local mine victims accompanied by two landmine survivors, co-founders of the Landmine Survivors Network, Ken Rutherford and Jerry White? Or perhaps you remember better the pictures of the Princess draped in deminers’ personal protective equipment as she visited with HALO Trust in Angola.
The disparate power of these two images indicates the challenge faced by the field of mine victim assistance: while the death and injuries caused by landmines are what ridding the world of the devices is ultimately all about, it is the process of mine clearance that has received the lion’s share of attention from donors and mine action program planners. Getting mines out of the ground prevents future victims, but the thousands of survivors and their families and communities—the “other” victims of landmines—need assistance now to heal and to resume productive, meaningful lives.
How to get landmine victims the services they need in the context of the larger mine action picture continues to confound victim assistance practitioners, although success on a number of initiatives can be attributed to the persistence of the many people and organizations involved in this pillar of mine action.
Victim Assistance’s “Place” in Mine Action
The place of victim assistance in mine action has been debated since at least 1999. That year, the Standing Committee of Experts on Victim Assistance, Socio-Economic Reintegration and Mine Awareness (SCVA) met for the first time since being established by the delegates at the First Meeting of States Parties in Maputo. A number of issues arose at that Standing Committee meeting that have guided its work ever since. The committee has succeeded in addressing some of these issues and still grapples with others. But it is interesting to note the prominence of this concern for the “place” of victim assistance in mine action even at that first meeting.
Participants noted that the activities of victim assistance are more related to the field of health care than to “operational mine action,” which includes clearance and mine awareness.1 The debate has continued ever since, with the SCAV eventually transferring responsibility for mine awareness to what is now called the Standing Committee on Mine Clearance, Mine Awareness and Mine Action Technologies, because it was believed mine awareness fit more properly there than under victim assistance.2
This long-standing debate should come to a head as the study by the Geneva International Center for Humanitarian Demining (GICHD), The Role of Mine Action in Victim Assistance, released in September 2002, is analyzed and discussed. The United Nations Mine Action Service (UNMAS) asked the GICHD to conduct the study in response to the debate over victim assistance’s proper relationship to mine action.3
The GICHD study provides detailed accounts of four case studies of victim assistance programming in the context of mine action operations in some very different settings: Cambodia, Eritrea/Ethiopia, Kosovo and Nicaragua. Based on analysis of the findings of these cases and deliberations among members of a Users’ Focus Group and a Steering Group, the study presents six findings and proposes six recommendations in response.
The study asserts that “mine action should not completely turn its back on victim assistance” but should take on a coordination role and, in “exceptional circumstances,” it “should be prepared to take an active role in the provision of services.”4 Overall, the study should generate much needed discussion and set the stage for UNMAS to launch its policy on victim assistance, which it is currently preparing.
In anticipation of the release of this report, UNMAS staff have been drafting a victim assistance policy paper that would provide guidance to all the UN-affiliated mine action centers (MACs) as to their responsibility in support of victim assistance. While discussion of the content of that policy paper will have to wait since it is not due to be released until early 2003, indications are that UNMAS has not forsaken victim assistance, believing it remains an important pillar of mine action and that MACs do have a role to play in support of victim assistance.
Achievements Within the SCVA Framework
Many non-governmental organizations (NGOs) and international organizations like the International Committee of the Red Cross (ICRC) have worked with governments in mine-affected countries during the last decade to develop programs and facilities to provide medical and rehabilitative care for landmine survivors. Numerous successful programs have eased the physical conditions of survivors and helped victims resume productive lives. Much more remains to be done, and NGOs have redoubled their efforts to provide the needed services and to find more effective ways to operate, especially through enhanced information sharing and better coordination.
The SCVA also can point to some important successes that have meant progress for the field of mine victim assistance. The Working Group on Victim Assistance of the International Campaign to Ban Landmines (WGVA-ICBL) has worked with the SCVA to compile information on programs around the world “whose beneficiaries include but are not necessarily limited to landmine victims.”5 The first edition of this Portfolio of Victim Assistance Programs was published in September 2000 and has been updated annually. It fulfills in part the oft-expressed need for more information about victims and programs available to provide services to them.
An additional tool developed to collect information on victim assistance program is the Form J that was designed in response to the call of the SCVA to know more about what the states party to the MBC are doing to meet their obligation to assist landmine victims, as stipulated in Article 6.3 of the Convention. So far, relatively few states have filed the Form J, which remains voluntary since it is not part of the formal provisions of the MBC’s Article 7 reporting requirements, but a steady increase in its use is evident.6 The SCVA strongly encourages states to file the form so that more can be learned about victim assistance funding and programming.
The SCVA also oversaw the compilation of existing guidelines on victim assistance that NGOs and other service providers can consult when planning programs for landmine victims. Several organizations have invested considerable effort in developing guidelines that address topics ranging from providing medical and rehabilitative care to collecting injury data and incorporating assistance to victims into a broader development-oriented framework.7
Because the field of mine victim assistance had done so much work along these lines, the decision was made to postpone indefinitely the development of formal International Mine Action Standards (IMAS) for victim assistance. Detailed guidelines and standards were issued in 2001 for the field of mine clearance, and the guidelines for mine awareness issued in 1999 are in the process of being revised and released as part of the IMAS package. But at a February 2001 UNMAS meeting in Geneva, a tentative decision was made that because the field of victim assistance already had developed guidelines, “there was no real need to develop IMAS for this area.”8
While this decision speaks to the initiative of the people and organizations involved in victim assistance, it also has resulted in a more diffused approach to carrying out their activities. Instead of one definitive and integrated set of guidelines, victim assistance practitioners have a list of different guidelines to draw upon. The ICBL’s “Guidelines for the Care and Rehabilitation of Survivors” has been widely accepted and used by victim assistance practitioners, but the guidance it provides is of a general nature. Its content constitutes guiding principles, not specific, detailed guidelines, let alone what could be considered standards.9
New Initiatives to Address Lingering Issues
Despite the progress made via the SCVA framework to aid states party as they assist landmine victims, three issues before the Standing Committee at that first meeting in 1999 remain stubbornly on its agenda in 2002. These issues have proved to be difficult to address and remain obstacles to be overcome in the near term. They also are issues that will be affected by the ongoing debate over the place of victim assistance in mine action. In 2002, all three also have benefited from new initiatives that, when taken together, clear a forward path for victim assistance. These issues are:
1. How to collect and share needed data on victims.
2. How to gain sufficient attention from donors.
3. How to coordinate victim assistance activities more effectively.
Collection and Exchange of Data
The victim assistance community continues to lament the absence of sufficient data on mine and UXO victims, despite the many years of efforts by the ICRC, World Health Organization (WHO) and various NGOs like Handicap International (HI) and Physicians for Human Rights to develop casualty surveillance systems. In some cases, data exists but is not being adequately shared; in other cases, it still is not being collected in a consistent and useful way. In a few cases, such as in Cambodia, data on victims is collected and utilized in an effective way to support the operations of various programs for survivors and other victims.
The expanded use of the Information Management System for Mine Action (IMSMA) has led to more mine-affected countries collecting victim data and generating reports based on the data. However, the issue continues to arise at SCVA meetings and in other mine victim assistance venues. Sheree Bailey, in a report to the SCVA meeting in May 2002, reported that “some progress has been made since 1999 in implementing data collection systems to record information on landmine casualties” but that gaps remain and data collection often is not comprehensive.10
In response to the dearth of adequate landmine casualty data, the Office of Humanitarian Demining Programs of the U.S. Department of State asked the Mine Action Information Center (MAIC) at James Madison University to research the problem and “formulate courses of action for the systematic and accurate collection and processing of casualty-related data.”11
MAIC staff conducted a review of previous initiatives to develop information-gathering methodologies and analyzed nine different casualty data collection systems currently in use in mine-affected countries. One of these nine systems was IMSMA, which has become the most widely used information management system in mine-affected countries. Based on the comparative analysis of the nine systems, a survey was designed and distributed to victim assistance experts and mine action database operators. The MAIC then hosted a workshop that brought together 20 people with experience in either mine victim assistance programs or information management. The workshop built on the results of the survey and the other findings of the MAIC study. Over the course of the workshop, the participants discussed and finally agreed on a list of recommendations for actions to take to improve the collection and sharing of landmine casualty data.
While the participants only made one recommendation for a specific change to IMSMA’s incident victim functionality (in use of the terms “incident” and “accident”), they did raise questions about several of the data fields and recommended a formal review of IMSMA’s data fields by experts in the realms of mine clearance, mine risk education and victim assistance. This is important because, while the workshop participants and other victim assistance experts who reviewed the workshop report at the SCVA meeting in May 2002 favored IMSMA, many agreed that IMSMA’s incident victim functionality could be improved; they just could not agree how to do it. But there was strong support for a formal review with the goal of ensuring that what data is being collected via IMSMA is relevant and appropriate.
This conclusion relates directly to the debate over the role of mine action in victim assistance. Due to the participation of GICHD staff in the workshop, this issue permeated the deliberations. Although the workshop participants did not make a formal recommendation to retain an explicit role for mine action in victim assistance, many of the participants agreed that the MACs and national demining offices (NDOs) played an important role in victim data collection and that they should continue to collect the data. They also recognized that there was a limit to what the MACs/NDOs should be expected to collect, and so what they collected needed to be carefully evaluated for its relevancy. They pointed out that the data “collected through IMSMA is only part of the information that is needed to plan and implement victim assistance programs.”12
Another major set of recommendations agreed on by the participants related to the proper role of national Ministries of Health in the collection and sharing of landmine casualty data. The recommendations sought to draw the Ministries of Health more actively into the data collection and management processes, recognizing that MACs and NDOs have a role to play in promoting and supporting the Ministries in carrying out this responsibility.
The MAIC casualty database study and workshop certainly have not resolved the problem of inadequate victim data, but they have indicated some next steps to take as the mine action community continues to grapple with the challenges it faces as it works to ameliorate the dangers of landmines.
The Funding Challenge
Another lamentation of the mine victim assistance community is the inability to get sufficient funds from donors so that needed services can be provided to all victims. This challenge is complicated by the differing views about what services are needed and exactly to whom should they go. What services are needed and for whom is determined by whether the focus is on survivors—that is, persons who received injuries in mine accidents—or on victims more broadly conceived—survivors along with their families and other members of communities affected by the presence of landmines. While the all-encompassing definition of mine victim developed by the WGVA-ICBL13 is widely accepted, its use presents real difficulties for program planning and funding prioritization, a point that the GICHD study The Role of Mine Action in Victim Assistance does a good job of examining (pp. 11–13).
Regardless of this lack of clarity and its responsibility for the funding conundrum, victim assistance programs seem to receive a smaller percentage of the funds being directed to mine action than the clearance and mine awareness pillars. The Landmine Monitor and HI both address issues of funding flows to victim assistance as well as the difficulties of victim data collection, and both groups report that victim assistance programs collectively receive a fraction of the funds that go to clearance.14 Sheree Bailey of the Landmine Monitor also asserts that the funding levels for victim assistance declined from the year 2000–2001.15 However, in her report to the SCVA, Bailey indicates that in reality, it is difficult to measure funding levels because of inadequate reporting. Despite the continued urging of the SCVA, a majority of states party still have not filed Form J’s, which are used to report on victim assistance programs and funding.
In its Landmine Victim Assistance World Report 2001, HI examines some of the reasons for the “opacity” in information on victim assistance funding. Among the factors at play are that mine victim assistance often is integrated into broader “mine action” or “aid for war victims” initiatives so that funds actually allocated to mine victim assistance cannot be disaggregated. HI also notes that assistance can be provided by decentralized sources like hospitals and universities and can be provided as “in-kind” aid that is sometimes not reported. Such factors make it difficult to know precisely how much aid is going into victim assistance programs. Despite the uncertainty about total funds for victim assistance, the general perceptions are that victim assistance receives less support from donors.
It was such perceptions that prompted the call for a special meeting of the Board of Advisors of the International Trust Fund for Demining and Mine Victims Assistance held in Slovenia in July 2002. The special meeting was organized as a workshop to examine the state of victim assistance programs in the countries of southeast Europe and to develop strategies for improving regional funding, cooperation and coordination for mine victim assistance initiatives.16 The goal was to identify the shortfalls in programming and to link needed funds to organizations and institutions that can provide the services required.
The regional focus of the workshop was similar to the HI-organized Southeast Asia Regional Conference on Victim Assistance entitled “Moving Forward Together” held in November 2001 in Thailand. That conference built on previous work conducted at a series of national workshops held earlier in 2001. The regional conference facilitated the exchange of information among victim assistance providers in the region and examined strategies for enhanced national planning for victim assistance.
Both regional gatherings allowed victim assistance providers to exchange ideas, highlight their successes and develop strategies for better planning and coordination. Increased and better-focused funding of programs was an explicit goal of the Slovenia workshop, but success in improved national planning and regional coordination should improve the chances of garnering increased international funding and attention to victim assistance programs in both regions.
Improved Coordination of Victim Assistance
An increased emphasis on improved coordination of victim assistance programming, evidenced in the southeast Europe and southeast Asia initiatives, also is apparent in the consultative process launched by UNMAS at the behest of the SCVA to identify ways the Standing Committee can focus its support to states party to the MBC in the area of victim assistance. One component of this process is the distribution of a questionnaire to states party focal points. The goal is to gather information from the states that will allow the SCVA to identify a “focused and concise set of critical issues in the field of victim assistance,” to identify “concrete progress that can be made by 2004 and beyond” (2004 is the year of the MBC Review Conference), and to identify “the Standing Committee’s particular role in contributing to progress.”17 Preliminary results from the questionnaire indicate four critical issues that the SCVA should address “national planning by States Parties, prosthetics services, emergency medical care and economic reintegration.”18 Such guidance from the states presumably will set the direction of the SCVA’s future course of action, leading up to the 2004 Review Conference.
Also in search of input from states party to the MBC, the Landmine Monitor issued a questionnaire in 2002 in order to assist states in presenting information on their victim assistance needs and capacities. The Landmine Monitor plans to report on its findings at the January 2003 meeting of the SCVA.19 This initiative hopefully will help spur more countries to provide information on their victim assistance needs and programs. Such information, combined with enhanced international coordination and financial support for victim assistance programs, hopefully will set the stage for more focused attention to the pillar of victim assistance as it becomes clearer what the remaining needs are and what can be done to address them.