Lending a Helping Hand:
Victim Assistance Programs in Africa


Many landmine victims face adverse situations when returning to their communities and trying to live as productive members of society. A number of programs in Africa for landmine victims and the disabled help people not only “get back on their feet,” but also “get back in the saddle” and gain the courage and knowledge to live among their peers with confidence.


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A young amputee practices using the prosthesis that HI provided him through their Sierra Leone project.
c/o Handicap International
by Nicole Kreger and Sarah B. Taylor, MAIC

Introduction

In an overwhelming number of countries, people are falling victim to the landmines and UXO left behind after various wars and internal conflicts. Medical assistance and rehabilitation are often hard to come by in such countries, and where they exist, they are usually costly. Africa has a particularly notable disability crisis. It is believed that over 10 percent of Africa’s population is mobility impaired. In fact, to call attention to the continent’s problem, the Organization of African Unity Heads of State has declared the current decade (2000–2009) the “Africa Decade of Disabled People.” War, poverty, disease, hunger and poor environmental conditions all exacerbate the problems of the disabled, as do discrimination and ignorance about disabilities. In a time when those that most need help often do not have access to it, a number of organizations are working to bring relief and support to them.

In recent years, programs have expanded in response to the growing demand for more comprehensive rehabilitative services, and they have developed new and innovative approaches to covering the gamut of needs for persons with disabilities. This article profiles the programs of five organizations doing victim assistance work in Africa: Handicap International (HI), the Vietnam Veterans of America Foundation (VVAF), the Jaipur Limb Campaign (JLC), the World Rehabilitation Fund (WRF) and POWER The International Limb Project.

Handicap International

Introduction
HI focuses its work on countries with a low level of development and a high degree of conflict with the goal of helping vulnerable people. In Africa, HI contributes to mine clearance, mine risk education, mine data collection and victims’ rights programs. HI carries out such programs in several countries, including Angola, Chad, the Democratic Republic of Congo, Ethiopia, Mozambique and Senegal. Two significant HI programs in Africa are in Sierra Leone and Guinea Bissau.

Victim Assistance in Sierra Leone
The Sierra Leone program is not landmine-specific, but rather helps all people with disabilities, a category that includes landmine victims as well as victims of UXO and improvised explosive devices (IEDs). HI is working with the Ministry of Health in this program that aims to “build a sustainable network of competence and facilities that will enhance the reintegration, general well-being and promotion of the rights of the physically disabled and psychologically suffering population.”1 The program focuses on orthopedic services, psychological support and reintegration (both social and economic) of people with disabilities into society. This initiative, which is funded by One Love Sierra Leone—a British charity formed in 1999 “in response to the horrors and devastation of the Sierra Leone civil war”1—built and equips a regional center for orthopedic and prosthetic training based in the Murray Town Centre for Amputees in Freetown.

The two main Sierra Leone projects that HI has undertaken this year are a psychosocial project and a functional rehabilitation project. The psychosocial project is “aimed at providing support to those suffering psychologically as a result of the war.”2 One of the highlights of this program’s strategy is providing psychological support to both direct and indirect victims of the war. To help these victims, HI has created several activities, including group expression activities as well as therapeutic activities for both individuals and groups. In order to carry out these activities more effectively, HI teamed up with the Institute of Public Administration and Management (IPAM) to provide training in Psychological Care and Social Work. The current training program is conducted in a six-week session, but HI hopes to convert the program into a year-long university training program in the near future.

As HI notes, “[t]he war created the awareness and the urge for the creation and the development of functional rehabilitation services in Sierra Leone.”3 With this in mind, HI’s functional rehabilitation project focuses on “build[ing] up the appropriate functional rehabilitation capacity . . . in the country to meet the needs.”3 Working in three areas of the country—Freetown, Bo and Makeni—HI is developing the needed services and integrating a multidisciplinary approach that targets people with disabilities. HI has partnered with the Ministry of Health and Sanitation (MOHS), the International Committee of the Red Cross (ICRC), Mercy Ships, Brother Schneider, Cheshire Home and World Hope International to achieve its goals in functional rehabilitation.

Victim Assistance in Guinea Bissau
Joining forces with the National Association for Sanitary Development (ANDES), HI helps give support to landmine victims as well as others with disabilities in Guinea Bissau. The Diana, Princess of Wales Memorial Fund funds the project.

Through its partnership with ANDES, HI provides technical and operational support for a mine risk education program, hoping to increase awareness of mines and UXO among the general population and teach risk management skills in order to reduce the number of landmine-related accidents. HI also helps strengthen the capacity of local physiotherapy services available to people with disabilities. Also, HI is improving the country’s only orthopedic center, A Casa Amiga do Deficiente, by providing equipment and tools that will assist in orthopedic production and technician training, as well as lighten the burden of the center’s operating costs.

A young girl in Sierra Leone during a rehabilitation session made possible through HI’s assistance.
c/o Handicap International

HI and ANDES are implementing a community-based approach to rehabilitating and reintegrating mine victims and others with disabilities. The two organizations also offer their support to emerging disability organizations. They work with the communities to better understand the needs of the disabled and develop materials and skills that will encourage the disabled and spread awareness on disability issues.

Vietnam Veterans of America Foundation

Introduction
VVAF is a Washington, D.C.-based non-governmental organization (NGO) that “is dedicated to achieving global security through programs that not only reduce the worldwide threat posed by war and conflict but also promote justice and freedom.”4 The organization works on programs throughout the world to rehabilitate people in war-ravaged countries. VVAF is particularly involved in projects with landmines, including the creation of the Campaign for a Landmine-Free World and heavy involvement in the International Campaign to Ban Landmines (ICBL).

Ethiopia: The Omega Initiative
After a request from the United States Agency for International Development’s (USAID’s) Patrick J. Leahy War Victims Fund (LWVF) for international organizations to assist persons with disabilities in Africa, VVAF teamed up with American NGO Pact to execute the Omega Initiative. Through this program, VVAF is providing prostheses, teaching prosthetics and offering rehabilitation services to the war-wounded and disabled population of Ethiopia’s Amhara region. These services focus on two locations: a small government clinic in Dessie that treats a significant number of landmine victims and a new regional rehabilitation center in Bahir Dar. The grant from LWVF provides $8 million (U.S.) in grants over a period of five years.

The Initiative also includes a Sub-Grant Program that provides up to $5 million for organizations providing rehabilitation-related services to people in sub-Saharan Africa. Two technical experts provided by VVAF are collaborating with Pact staff on the Sub-Grant Program in Nairobi, Kenya. They are working to determine which programs in sub-Saharan Africa should receive funding over the next five years. Countries under consideration include Angola, Burundi, the Democratic Republic of the Congo, Rwanda, Sierra Leone and Sudan.

Angola: Regional Community Rehabilitation Center and Sports for Life Program
In 1996, with funds from the USAID LWVF, VVAF created the Regional Community Rehabilitation Center. Located in Luena, the Center manufactures and fits prostheses, in addition to providing rehabilitative care. The rehabilitation services provided there help patients reintegrate into their communities. Regarding this program, VVAF says it “is proud to be one of the few remaining organizations that continues to provide assistance at a time when landmines claim new victims weekly. The key to VVAF’s commitment to its project in Angola is the strength and determination of the Center’s director and the dedication of its staff.”5

VVAF’s Sports for Life Program gives people in countries affected by conflict a chance to take part in sports and recreational activities. VVAF and its partners provide equipment as well as technical and material support for these programs. In Angola, patients of the Luena Rehabilitation Clinic learn and practice their mobility skills through wheelchair basketball drills.

Sierra Leone: Murraytown Orthopedic Workshop in Freetown
VVAF has provided technical assistance and training to 12 Murraytown Orthopedic Workshop technicians in Sierra Leone over the past three years. The Workshop houses hundreds of amputees and provides artificial limbs and rehabilitation to these patients. As part of VVAF’s assistance in Sierra Leone, a VVAF-certified prosthetist trained the local technicians to create and fit artificial limbs over the course of 30 weeks.

JLC provides hundreds of people with prostheses through the COJ in Mozambique.
c/o JLC

Jaipur Limb Campaign

Introduction
The JLC is a UK-based organization that was created “to raise awareness of and promote the wider use of the Jaipur limb technology through projects, development education and networking.”6 The Campaign works to raise awareness about the technology of prostheses, emphasizes knowledge sharing among developing countries, and makes the public aware of technology and disability issues. Another reason for forming the JLC “was the knowledge that there is an ever-increasing number of amputees as a result of the indiscriminate use of anti-personnel landmines in various conflicts around the world.”6

Programs in Africa
One JLC program in Africa is the Centro Ortopédico Jaipur (COJ) in Manjacaze, Mozambique. After a 1995 feasibility study requested by the Ministry of Social Affairs (MICAS), JLC partnered with the Mozambique Red Cross Society (CVM) to set up the COJ in 1996. The program was designed to be a center for amputees that provides limb-fitting and orthotic services. Funds from JLC paid for the construction of the center as well as the equipment, materials and training. The COJ “is the first rehabilitation center to be wholly run by a Mozambican NGO.”7 Providing community-based rehabilitation, the center has concentrated on:

  • Constructing a purpose-built center in the district town of Manjacaze
  • Training technical and project personnel on appropriate technology
  • Identifying disabled people (mostly landmine victims) for rehabilitation
  • Providing mine awareness training

The COJ has provided over 300 limb fittings since February of 2000. Besides the prostheses provided, many of these people have taken advantage of social and economic support programs. The center also serves as a social gathering place for members of the community with disabilities. In the future, the center hopes to continue its programs and increase its capacity for social and economic rehabilitative services.

JLC’s other program in Africa is a program called DIGNIDADE, which is located in Angola. The program is a partnership between JLC and a local NGO, the League for the Reintegration of Disabled People (LARDEF). Because finding employment is one of the biggest challenges for disabled people, this program seeks to create jobs for these people and at the same time provide a service to the community.

The DIGNIDADE program provides seven three-wheeler vehicles to provide transportation to the local population. Amputees are given priority for jobs as drivers and other support staff. The project helps at least 15 people and their families by giving them employment with benefits. LARDEF hopes to expand this program into two other local areas and involve 36 vehicles.

World Rehabilitation Fund

Introduction
The WRF has programs in over 150 countries that focus on medical, psychosocial and economic rehabilitation for the disabled. One of WRF’s primary focuses is survivors of landmine and other war-related injuries. WRF is “committed to improving the lives of people with disabilities.”8

WRF Projects in Mozambique
In Africa, WRF is working on several programs to assist the disabled people of Mozambique. WRF has teamed up with local and international partners such as Mozambique’s IND, the African Medical and Research Foundation (AMREF), the Association for the Mozambican Disabled (ADEMO) and POWER The International Limb Project. By working with both government organizations and NGOs, WRF hopes to strengthen existing programs and develop new projects to help mine victims and their families by giving them the tools they need to be economically self-sufficient.

For one of WRF’s projects, the organization has partnered with the United Nations Development Program (UNDP) in a three-year effort “to plan and promote new approaches to the socio-economic integration of landmine victims and others with disabilities.”8 This effort, which began in 1999, also involves programs in Cambodia and Lebanon. One of the main goals of this venture is identifying gaps in current services and strengthening existing ones. A result of this project is the WRF Guidelines for the Socio-Economic Reintegration of Landmine Survivors, a publication intended to support the efforts of policy makers and aid organizations working in mine-affected countries.

In another project, WRF is working with the IND to help the Mozambique government adopt a national approach to victim assistance. This project focuses on two major areas of the victim assistance policy: developing policies and guidelines for effective coordination at all levels and improving the investigation and reporting of mine incidents. These focus areas are based on needs expressed by the IND, and WRF will collaborate with the IND as well as the UNDP and government ministries to meet these needs.

In July 2001, WRF provided funds for a project with AMREF in Mozambique’s Inhambane province. The project called for an economic development plan to be followed by a pilot project that addresses the needs identified by the community. Local community members—including those with disabilities—played an important role in planning, implementing and managing the activities. This is an important aspect of the project because it gives the community (especially those with disabilities) a sense of importance and empowerment.

NGOs POWER and ADEMO are working to implement two vocational training programs to which WRF has lent its support. The programs—metalwork and computer training—are being held at the Centro de Reabilitação Infantil Malhangalene (CRIM) in Maputo and are available to any disabled person with a Grade 4 level of schooling. The metalwork course, a five-month curriculum, includes learning about the production of wheelchairs and other assistive devices for the disabled. The relatively new computer training course lasts for two months. These courses also help the disabled become financially independent through assistance with self-employment and a job placement service.

WRF’s last endeavor in Mozambique is creating a Directory of Services for the Disabled and expanding on a “Grassroots” Sensibility Curriculum. The main goal of this project is to raise awareness of disability issues among the general population. The Directory will be distributed by province and include information on actual available services with the hopes of “improving access to information on what services are available to assist the disabled and to prevent the disability from becoming worse.”8 The Sensibility Curriculum will elaborate on materials currently available to create a prototype curriculum for educating communities.

POWER

Introduction
POWER The International Limb Project began in 1994 “to offer free, high-quality limbs to landmine victims in countries recently ravaged by conflict and to train local people and organizations to deliver these services.”9

Its mission “is to deliver enabling services for people with disabilit[ies] in low-income countries [and] to cooperate with government and others in capacity-building towards a sustainable service through education and training.”9 Working towards this mission, POWER has developed several programs to assist the disabled in Mozambique.

Projects in Mozambique
In 1995, POWER took over a program started by the ICRC that included running four prosthetic and orthotic clinics in Mozambique. Since then, the program has continued to flourish, and its focus has shifted from strictly physical rehabilitation to include the reintegration of the disabled into society. POWER is receiving assistance in the form of a grant from the European Commission to implement a four-year program that will help several disability organizations improve on their current capacities.

As mentioned above, POWER, along with WRF and ADEMO, is helping to provide disabled adults with vocational training in Maputo, Mozambique’s capital. These courses include metalwork and leatherwork, taught by volunteers from the British Executive Service Overseas. POWER hopes to expand on these with bakery and carpentry courses, provided the funding is available. The organization also offers a basic education to disabled children at the same school.

In a partnership with LWVF and the United Nations International Children’s Emergency Fund (UNICEF), POWER established a national network of rehabilitation clinics. These clinics include a staff of local professionals trained in prosthetics and orthotics. Although POWER’s contract with LWVF concluded in May, the organization still sponsors two Mozambican prosthetic and orthotic technicians getting degrees at Strathclyde University in Scotland. The course ends in September of 2003, at which time the two will return to Mozambique’s Ministry of Health.

POWER also created an association of disability organizations called the Council for Action on Disability (CAD). CAD includes POWER’s partner ADEMO as well as a number of governmental organizations and NGOs who serve people with disabilities. POWER is seeking to expand this program to have it include partnerships with a network of European organizations.

Conclusion

These programs are only a few of the many being undertaken every year, in both Africa and the rest the world. Through the help of the above organizations and various others, many landmine victims are able to overcome their injuries and regain more than just the use of their arms and legs—namely a sense of self-worth and a feeling of belonging.

Endnotes

  1. http://www.onelovesl.org. September 17, 2002.
  2. Handicap International Publication. Project Summary: Psychosocial. January 5, 2002.
  3. Handicap International Publication. Project Summary: Functional Rehabilitation. January 5, 2002.
  4. http://www.vvaf.org. September 17, 2002.
  5. VVAF’s Humanitarian Programs: Angola, http://vvaf.org/humanitarian/index.shtml. September 17, 2002.
  6. The Jaipur Limb Campaign. July, 15 2002. http://www.jaipurlimb.org/aboutus/index.htm. September 17, 2002.
  7. Centro Ortopédico Jaipur, Mozambique. Jaipur Limb Campaign. August 2002.
  8. WRF Donor Reference Document. Project in Mozambique: World Rehabilitation Fund. Updated August 2002.
  9. POWER Proposal. Support for Disabled People in Mozambique. April 2002.

Contact Information

Handicap International, UK
Claire Acworth, Programme Support Officer
5 Station Hill
Farnham, Surrey
GU9 8AA
United Kingdom
Tel: (+44) 01252 821429
Fax: (+44) 01252 821428
E-mail: hi-uk@hi-uk.org
Website: http://www.handicap-international.org/uk/index.html

VVAF
Wendy Batson
1725 Eye Street NW
Fourth Floor
Washington, DC 20006-2412
Tel: 202-483-9222
Fax: 202-483-9312
E-mail: wbatson@vi.org
Website: www.vvaf.org

Jaipur Limb Campaign
Isabel Silva, Projects Officer
11 Goodwin Street
London N4 3HQ
United Kingdom
Tel: +44 (0)20 7272 9501
Fax: +44 (0)20 7272 9544
E-mail: mail@jaipurlimb.org
Website: http://www.jaipurlimb.org/

World Rehabilitation Fund
Heather Burns, President
386 Park Ave. South-Suite 500
New York, NY 10016 USA
Tel: (212) 725-7875
Fax: (212) 725-8402
E-mail: hburns@worldrehabfund.org
Website: http://www.worldrehabfund.org/index.html

POWER
Sarah Hodge
4 Church Rd.
Lewknor, Oxfordshire
OX9 5TP
United Kingdom
Tel: 44-1844-353-001
Fax: +44-1844-353-401
E-mail: shodge@power4biz.net
Website: http://www.power4limbs.org/

Nicole Kreger
MAIC
E-mail: kregernx@jmu.edu

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