Victim Assistance in Afghanistan
Nearly four percent of Afghani civilians are permanently crippled by landmines and UXO or other tragic circumstances,1 making Afghanistan a country with one of the largest disabled populations in the world. In a country where the health care system is already lacking, there are limited resources available for the estimated 12 civilians who fall victim to landmines/UXO a day.2 Numerous organizations are working to assist Afghani landmine survivors in finding the adequate medical care, rehabilitation and vocational training necessary to integrate them back into society. Although many of these efforts were hindered following the events of September 11th, recently increased mobility in the area has allowed these organizations to re-establish and further strengthen their victim assistance programs throughout the country.
Comprehensive Disabled Afghan Program
Established in 1995 by the United Nations PEACE (Poverty Eradication and Community Empowerment) Program, the Comprehensive Disabled Afghan Program (CDAP) is one of Afghanistan’s largest victim assistance programs. Of the 800,000 disabled Afghanis, 150,000 have received treatment from CDAP facilities. Operating in nearly 45 regions throughout the nation, CDAP employs only Afghan personnel with the exception of one international adviser. They also offer training and necessary resources for smaller organizations interested in implementing their own community-based rehabilitation (CBR) programs.
CDAP’s efforts are broad and include supplying wheelchairs and other mobility aids, training individuals from their homes, and addressing the psychological needs of each patient. Additionally, they work with reintegrating disabled children into the school system, teaching them Braille and sign language, and preparing teachers to attend to the special needs of these children. By providing both male and female patients with relevant vocational training and small personal loans, CDAP gives them a chance to rebuild their self-esteem and earn their own income. Aside from rehabilitation activities, CDAP also assists 800 widows and orphans in earning an income, and they have established 50 different primary schools in communities throughout Afghanistan.
International Committee of the Red Cross
In 1988, the International Committee of the Red Cross (ICRC) implemented an extensive Orthopedic Program for landmine/UXO victims in Afghanistan. In 1995, these services were offered to other persons with disabilities. As of March 2002, the ICRC Orthopedic Program had assisted approximately 48,000 disabled Afghanis (26,000 amputees, 80 percent of which were landmine victims). The program is run through six centers throughout the country, and operations include: producing, repairing, and fitting prostheses, orthoses, and other mobility devices; providing physical rehabilitation; and training civilians to work in the ICRC centers. They also offer weekly home care visits for paraplegics, who are better treated from home than at the center.
In order to provide disabled civilians with more job opportunities, the ICRC has only employed disabled men and women at their Orthopedic Centers since 1995. They have found this to be beneficial not only to the disabled personnel but also to the patients, who find comfort in a staff that fully understands their struggles. Additionally, the ICRC has established a micro-credit program where disabled Afghanis are given a loan to start a small business in the area. Other efforts to reintegrate disabled individuals into society include vocational training for adults and school assistance for children. Their school assistance program allows the children to study either at home or at the nearest school by providing the necessary tuition, supplies and transportation.
Aside from the six ICRC Orthopedic Centers, the ICRC also supports seven surgical hospitals in Afghanistan. After the events of September 11th, they expanded this support to 18 additional hospitals by providing medical supplies and other necessary resources to keep the facilities active. They are also working to restore a few of the hospitals that were completely shut down during attacks, and they have provided a one-time supply run for various first aid stations throughout the country.
Refugee Relief International, Inc.
Refugee Relief International, Inc. (RRI) first began treating landmine victims and other injured Afghani civilians in Pakistan refugee camps during the Soviet Invasion of 1979 to 1989. After the attacks following September 11th, four RRI workers were sent to examine the health facilities in northern Afghanistan. They were devastated to find that there were very few supplies in any of the centers, and most of the available supplies had been catered by humanitarian organizations located outside Afghanistan, so no one knew when the next shipment would arrive. Additionally, there was very little means for transporting patients to better-equipped facilities, leaving most victims with a slim chance of survival. Before completing this visit, the RRI team compiled a list of requested medical equipment and textbooks to bring back when conditions improved.
Shortly after Christmas of 2001, two RRI medical workers set off on a week-long mission to deliver medical supplies to smaller Afghani villages and assist as many injured civilians as possible. Each day of their trip, they visited a different village and found there was nowhere near enough time to meet the demands they found there. Although they were unable to help everyone, they were able to treat hundreds of civilians and military officials, as well as use their leftover funds to provide food for one of the villages they visited. During this mission, the workers were also able to establish a network for facilitating future operations, as resources become available.
Since 1985, Handicap International (HI) has been conducting various mine action activities in Afghanistan. These activities include helping disabled persons learn to walk again by providing necessary orthopedic equipment and technical support to an Orthopedic Center in Kandahar. Additionally, HI is working with eight different refugee camps in Pakistan in rehabilitating disabled Afghani civilians. Finally, in order to make demining efforts in Afghanistan more efficient, HI workers have been interviewing landmine survivors throughout the country to find out where the most injuries are occurring. Once this data has been collected and disseminated, they hope to use it when prioritizing the regions with the greatest need for clearance.
Trauma Care Foundation
Because finding immediate medical care is vital to a landmine victim’s survival, the Trauma Care Foundation has been exploring ways to make this care more readily available in Afghanistan and other war-stricken countries. The biggest problem they’ve encountered is that in areas where the economy is already struggling, there are very few doctors and surgeons prepared to assist the extensive needs of the victim, and it could take hours (that the patient does not have) to reach the nearest suitable health facility. As a result, during the Afghani Battle of Jalabad (1989–1992), the Trauma Care Foundation began training health workers in the middle of war zones to treat victims before sending them to the appropriate hospitals in Pakistan. These efforts helped the patient’s chance of surviving the trip to the nearest surgical center increase significantly. Currently, the organization is studying the ability of self-help groups and micro-credit loans to improve the mental well-being of landmine survivors.
Center for International Rehabilitation
Working with the Department of Veterans Affairs Chicago Healthcare System, the Rehabilitation Institute of Chicago and Northwestern University, the Center for International Rehabilitation (CIR) has been designing wheelchairs to fit the specific needs of each disabled individual since 1996. One of their most well-known products is the CIR chair, which is the first chair distinctively engineered to meet the needs of Afghanistan’s harsh environment. The CIR chairs are constructed and distributed in Afghanistan by disabled civilians with parts made under CIR supervision in Pakistan. All of these efforts are a part of the CIR “Wheelchairs for Afghanistan” program.
The Mobility Project
The Mobility Project is a non-profit organization that collects and restores used wheelchairs and other medical equipment for persons with disabilities that cannot afford this much-needed equipment. Additionally, in a few of their countries of operation, they have trained disabled civilians to restore wheelchairs and other devices themselves, and they have established the facilities for them to conduct this work. So far, the Mobility Project has made three deliveries to Afghanistan and Pakistan, assisting hundreds of landmine victims and other disabled individuals. In addition to delivering the material, their volunteers adjust each mobility device to fit the needs of each particular patient.
Another aspect of the Mobility Project is to enhance further rehabilitation by providing a sports program in the area. The volunteers feel that playing sports is a way to not only rebuild the individual’s physical and emotional strength but also to show them exactly how much mobility their new wheelchair brings them. Although this past year’s events have halted their project in Afghanistan and Pakistan, they hope to resume operations as soon as possible.
These organizations are only a few of the ones making a significant effort to rehabilitate and reintegrate landmine/UXO victims in Afghanistan. By addressing the needs of the entire individual rather than just treating the wound, they are making a huge difference in the lives of people who otherwise would have no chance of surviving in the world. These groups are taking steps not only to rehabilitate the individual, but also to rehabilitate the nation by providing job opportunities to enhance a desperately struggling economy. Although the landmine problem in Afghanistan is one of the most severe and will continue to hinder the country’s growth for years to come, these programs provide some much-needed hope for the entire nation.