In 1990, Nicaragua registered approximately 135,000 mines buried within its national territory and another 133,435 mines in military stockpiles as a result of the internal conflict witnessed in Nicaragua during the 1980s. Although this article does not touch on the details related to the operations, it is important to note that Nicaragua is the most heavily mined country in Central America and on the entire continent. As of June 2004, approximately 27,400 APMs remain buried within Nicaraguan territory.
There are several departments that are considered the most heavily impacted areas, including the departments of Nueva Segovia and Jinotega. The Organization of American States (OAS) program has verified that a total of 262 communities in Nicaragua—where, as of March 2004, approximately 52,000 inhabitants reside1—are located at a distance of 5 kilometers (3.11 miles) or less from 211 minefields.
Concerning the area of health, in Nicaragua, it is a constitutional right. In fact, as it tends to occur in countries that are highly impacted by APMs, the following are true of Nicaragua:
- It is a country in which 68 percent of the rural population lives in poverty and 28.5 percent lives in extreme poverty.2
- Thirteen years after the end of the conflict, the consequences are still being felt, including considerable damage to the economic and social infrastructure.
- The access to health services is unequal. The report concerning the human development of Nicaragua for 20003 indicates that in urban areas, 1 percent of the population has no access to health services, while in rural areas, the figure is 20 percent.
- About 14 percent of the health sector is financed by external cooperation.3
- It is estimated that in Nicaragua there is a disabled population of approximately 700 people due to landmines and unexploded ordnance. As of June 2004, the OAS program has been able to verify information about 680 of these survivors.
- The information obtained by the OAS program indicates that children represent 4 percent of the affected population and adolescents represent 12 percent.
But what are the profiles or the characteristics of these survivors?
- Ninety percent are males between the ages of 20 and 40.
- They come from eminently rural communities.
- They suffer from multiple disabilities.
- They work in the agricultural sector.
- They are heads of large nuclear families.
- They generally lack housing.
- A small percentage receives a monthly pension from the Social Security System consisting of $7.00 to $26.60 (U.S.).
- The great majority of survivors are unemployed and carry out informal activities to subsist.
The Mine Action Program of the OAS
It should not be a surprise that the OAS Program, initiated in Nicaragua in 1993 to support humanitarian demining operations, identified another challenge that would become one of the five principal functions of the Comprehensive Action Against Anti-personnel Mines (AICMA for its name in Spanish): "Support for landmine survivors including physical and psychological rehabilitation as well as support for their socio-economic reintegration."
The Mine and UXO Victim Assistance Component has supported 538 APM survivors since its establishment in Nicaragua in 1997. The program has been able to attend to the needs of affected communities, providing survivors with support in emergency medical assistance, treatment in physical rehabilitation and psychological attention. It also includes transportation from their communities to rehabilitation centers, lodging, nourishment and medication. In 2004 alone, the OAS program attended to the needs of 174 survivors. Additionally, the program maintains a registry of victims that includes information concerning their personal identification, community of origin, type of injury, type of prosthesis, an account of their accident and photographs of the victim.
Mine survivor Jacinto Hernandez receives training in shoemaking in an INATEC center.
One of the most recent initiatives in this area is the Social Reintegration Program. In collaboration with the National Technological Institute (INATEC) of Nicaragua and within the framework of the National Demining Commission (CND for its name in Spanish), the program has developed and implemented a concept for post-rehabilitation training. The objective of this project is to provide technical job training to mine survivors that have received physical and psychological rehabilitation through the OAS program.
The first phase, implemented with seed money and directed at a limited number of survivors, was highly successful. One of the most difficult (but important) components of mine action was developing technical training and reintegration of victims as productive members of society.
As a criterion of the program, this training offered a new perspective into the concept of comprehensive assistance to survivors. Over a period of nine months, the OAS program provided training as well as medical assistance and physical and psychological rehabilitation, in order to reduce the immediate and long-term effects of APMs on survivors. Likewise, the implementation of community support mechanisms began. In the past year, about 20 percent of the registered survivors from 30 different municipalities of the country have received assistance.
Pantaleon Muños during his training in tailoring.
The Case of Agustin MateyThe process described above can best be illustrated with a specific example. Agustin Matey was an agricultural laborer, head of family and father of five children, who was illiterate, lacked proper housing, and had an income of less than $40 per month. He was originally from the community of Aranjuez San Fernando, a municipality of the department of Nueva Segovia, where, according to official numbers, an estimated 73 percent of the rural population lives in "extreme poverty."
On May 15, 2001, Matey was working in the fields with four colleagues in La Finca La Española located in San José del Bayuncún-San Fernando, property of Rene Paguagua. As he was walking the outline of the terrain of the Finca, he stepped on an APM, causing serious injuries to his left leg, as well as injuring his right leg. One of his colleagues, Pablino Gómez Amaya, received slight injuries to his head and back.
Following the mine explosion, Matey was transported by stretcher to a location where there was access to a vehicle. Seven hours following the accident he received medical attention in the Modesto Agurcia Hospital in the city of Ocotal. The attending doctors stated that the injury to his left leg was irreparable and he required a transtibial amputation. The director of the hospital immediately notified the offices of the OAS program in Ocotal, initiating the medical assistance process. Notification of the program can be transmitted through the CND, police, mayors or the Nicaraguan army, which in several cases has supported transportation and emergency treatment with the army's demining unit. If necessary, the CND may contact the Red Cross for the acquisition of blood.
A week later, an infection developed in Matey's limb and the OAS program coordinated his transfer to the Fernando Vélez Paiz Hospital in Managua. There, a series of surgical cleanings was unsuccessful in reducing the infection that led to a transfemoral amputation of his limb.
Through the victim assistance component of the OAS program, Matey's medical, hospital, surgery, medicine, nutrition and surgical cleaning expenses were covered. Additionally, the program paid a per diem for Matey's wife, who accompanied him. After 15 days of hospitalization, the program transferred him back to his home community.
In September of the same year, three months after the accident, he was transported from his community to Managua and registered in the National Prosthesis Center for a two-month period in which he prepared to use his prosthesis. In this particular phase, the program can transfer the patient to any of the three entities that have the capacity to provide rehabilitation to survivors.
Following the corresponding appraisal by the physical therapist, Matey entered the period known as pre-prosthesis for four to six weeks. During this time, he learned different mechanisms to strengthen his limb, overcame the trauma caused by the amputation of his leg and practiced the different movements of his limb that would facilitate the use of his prosthesis.
Once this phase was concluded, Matey's limb was measured to produce the prosthesis. He was then given leave for a week before initiating the prosthesis phase for a three-week period. During this phase, the survivor learns to utilize the prosthesis, practicing for hours in the morning and during the afternoon on terrain that includes a few obstacles similar to those he would encounter in his community.
By December 2001, Matey was already able to utilize his prosthesis. In addition, ophthalmological assistance was provided due to damage to his eyes caused by the blast wave of the mine explosion.
Three months after completing his physical rehabilitation, on April 4, 2002, Matey registered in the first phase of the social reintegration of APM survivors component. For nine months, he studied woodworking. On November 6, 2002, he received a certificate of recognition for having graduated from INATEC's woodworking course. During his stay, in addition to being trained and receiving psychological attention, he learned to read and write.
On February 25, 2003, Matey was provided with a revolving fund established for the participants of the first phase as part of the inauguration of the second phase of the program. Additionally, he received basic woodworking tools from the CND to support his reintegration.
By April 2003, Matey had already established a partnership with another survivor and formed a woodworking workshop in their community of Aranjuez-San Fernando. He first invested in a motor for a winch, basic tools, wood and other materials. By June 2003, Matey had been able to establish an income for his family and as he himself expressed, customers are appreciative of the fact that his workshop was installed in their community; now they do not have to search for carpenters from other communities.
Projections and Challenges
Apart from these achievements, enormous challenges still remain in the area of victim assistance. The component, in coordination with national authorities, is projected to continue offering medical assistance, physical and therapeutic rehabilitation, as well as psychological attention to all the survivors that are identified and require support.During 2004, 67 survivors were assisted. Additionally, it is projected that 100 more survivors will benefit from the Training Component.
In the particular case of Nicaragua, it can be noted that success is not due solely to the participation of the OAS program in victim assistance but to the coordinated action of the different entities involved to assist each survivor. The objectives of the OAS program do not aim solely to accomplish a mine-safe Nicaragua, but also to continue relieving the suffering caused to survivors by promoting physical, psychological, social and economic rehabilitation. With the continuing support of the international community, the joint efforts of local, national and international institutions can advance this aspect of the broad, noble vision of the overall mine action effort.
*All photos courtesy of the author.
- OAS Mine Action Database. Managua.
- Government of Nicaragua. Estrategia Reforzada de Crecimiento Económico y Reducción de Pobreza. Managua. Artes Gráficas, 2001.
- United Nations Development Programme. El Desarrollo Humano en Nicaragua. Equidad para Superar la Vulnerabilidad. Managua, 2000.
National Coordinator, OAS
De la Iglesia El Carmen 1 c Abajo
Frente a la Embajada de France
Tel: +504 266-1251
Fax: +505 266-0584