United States Agency for International Development: Patrick J. Leahy War Victims Fund
Access to Rehabilitation Services Improves Lives
Established in 1989, the United States Agency for International Development’s (USAID) Leahy War Victims Fund is an important source of U.S. assistance to civilian survivors of conflict in developing countries. The Fund’s financial and technical support develops sustainable, quality physical rehabilitation services, including prosthetic and orthotic, physical and occupational therapy, and assistive technology services in conflict-affected countries. The fund supports the development of a range of services while maintaining its focus on victims of conflict and persons with disabilities.
In 2022, the Leahy War Victims fund provided more than $13 million to support the rehabilitation of survivors of conflict in 13 countries. To date, the fund has provided approximately $337 million in assistance to more than 50 countries.
USAID’s physical rehabilitation activity in Nepal, funded by the Leahy War Victims Fund, aims to establish a sustainable, integrated, public-private rehabilitation system to improve the functional independence of victims of conflict (including from landmines and unexploded ordnance) and others that would benefit from rehabilitation services. The activity is working to establish sustainable rehabilitation services within the health system by employing a systems strengthening approach and the World Health Organization Rehabilitation 2030 strategy and tools. Additionally, the activity provides technical support to local physical rehabilitation centers throughout Nepal and fosters relationships between the physical rehabilitation centers and public sector physiotherapy units. The activity is implemented by Humanity and Inclusion.
Historically, Sudurpaschim Province is one of the least developed in the country, and access to rehabilitation services is limited. The Nepalese Civil War 1996–2006 had a significant impact on Sudurpaschim Province and resulted in many civilian victims of conflict (including survivors of landmines and explosive remnants of war). According to the Landmine Monitor, the total number of mine/explosive remnants of war survivors in Nepal is unknown, but at least 1,060 survivors of landmines or explosive remnants of war incidents have been recorded. The physical rehabilitation activity strives to ensure that civilian victims of conflict have access to appropriate services in five provinces.
Ram Bahadur Badayak
Ram Bahadur Badayak. Credit: HI
Ram Bahadur Badayak is a farmer from Sudurpaschim Province, Nepal. He lives in a multigenerational home with his wife, son, daughter-in-law, and grandchildren. After Ram had his leg amputated several years ago, he was unable to return to work in the field. This led to him developing significant stress, low-self-esteem, and depression.
A community outreach worker from the Nepal National Social Welfare Association, one of USAID’s partners under the rehabilitation activity, referred Ram to the prosthetic service of the physical rehabilitation center so he could be fitted for a prosthetic device. The local social welfare association holds outreach events and mobile physical rehabilitation “camps” to identify civilian victims of conflict, persons with disabilities, and others who would benefit from rehabilitation services and refers them to the appropriate service such as prosthetics, physical therapy, assistive technology and/or social services.
After receiving his initial prosthetic device, Ram continues to use rehabilitation services for repairs and periodic replacement and encourages other people in his community, especially victims of the conflict, to use these services. The physical rehabilitation project emphasizes that the need for rehabilitation does not end with a single visit. Follow-up care is crucial and the team can provide referrals to other services, such as vocational training or psychosocial services tailored to individual needs.
“With timely access to the rehabilitation services, one can regain function and mobility like Ram Bahadur,” says Nepal National Social Welfare Association prosthetist Krishna Raj Bhatta. “Even after amputation, it is extremely important for patients to have access to prosthetics and other assistive services to improve their health and well-being.”
Devices such as prosthetic limbs help survivors perform their daily activities with the greatest degree of independence. Access to rehabilitation services and appropriate assistive technology further enables survivors to earn a living, attend school, and engage in community activities.
For Ram, having access to rehabilitation services means that he can resume work as a farmer and support his family. He explains, “The prosthetic limb does not feel artificial, [it is] a part of me.” His confidence has increased, and he has become more active. Recently, Ram participated in a physical rehabilitation activity to highlight the importance of rehabilitation services to promote the integration of persons with disabilities.
U.S. Department of Defense: Humanitarian Demining Research and Development Program
The U.S. Army Humanitarian Demining Research and Development Program develops, demonstrates, and validates new landmine and unexploded ordnance detection and clearance technologies using a rapid development process that focuses on the transformation of commercial off-the-shelf equipment into demining technologies that are improving the safety and efficiency of mine clearance worldwide. The Humanitarian Demining Research and Development Program also uses mature technologies or leverages existing military countermine technologies for implementation in a humanitarian demining role.
The program’s current technology development areas include hazardous area confirmation, vegetation and obstacle clearance, landmine and unexploded ordnance detection, mechanical-mine and unexploded ordnance clearance, mechanical-mine neutralization, post-clearance quality control, and information management. Technology development plans are based on feedback from ongoing field evaluations, biannual requirements workshops with implementing partners and country programs, and periodic site assessments with these same partners.
The Humanitarian Demining Research and Development Program partners with humanitarian demining organizations to conduct operational field evaluations of developmental technology in their own demining operations to provide assessment and feedback on new technologies. Operational field evaluations are one of the most important aspects of the program because the equipment undergoes testing in actual minefields. These evaluations allow the host country to operate the equipment and determine whether it is useful, cost effective and efficient, and is key to Humanitarian Demining Research and Development success in research and development.
The program coordinates extensively with U.S. Department of Defense Geographic Combatant Commands, the office of the Department of Defense Deputy Assistant Secretary of Defense (Policy) for Special Operations and Low Intensity Conflict, U.S. Department of State’s Office of Weapons Removal and Abatement, and the Defense Security Cooperation Agency and its Humanitarian Demining Training Center, host nation mine action centers, and foreign militaries to ensure that program requirements are being met.
In FY2022, the program performed testing and operational field evaluations in Afghanistan, Angola, Bosnia and Herzegovina, Cambodia, Chile, Iraq, Kosovo, Lebanon, Palau, Sri Lanka, Syria, Thailand, Ukraine, Vietnam, the West Bank and Zimbabwe.
U.S. Department of Defense: Humanitarian Demining Training Center
The Defense Security Cooperation Agency operates the Department of Defense Humanitarian Demining Training Center at Fort Lee, Virginia. The Center trains and prepares U.S. military forces, U.S. government stakeholders, and international partners to conduct humanitarian mine action missions, explosive remnants of war disposal, and physical security and stockpile management using "Train the Trainer" instructional methods.
The Center conducts the Humanitarian Mine Action Basic Course that prepares U.S. service members to teach others the curriculum on landmine clearance and battle area clearance that conforms to International Mine Action Standards and international best practices. The course also covers humanitarian mine action mission planning and course development, including lesson plans, communication, and policy and laws related to conventional weapons destruction. Students are exposed to a wide variety of clearance techniques and equipment, as well as internationally recognized best practices for clearance of hazard areas.
The Humanitarian Demining Training Center also conducts a non-resident course via a mobile training team. The course provides an overview of the humanitarian mine action program including applicable laws, policies and regulations, international treaties, International Mine Action Standards, test and evaluation, and concept of operations.
In addition, the Center provides program management support, capacity-building training, technical assistance, and demining and stockpiled conventional munitions assistance to partner nations for mine action programs and physical security and stockpile management administered by the U.S. military’s geographic combatant commands: Africa Command, Central Command, European Command, Indo-Pacific Command, and Southern Command. When a partner nation is accepted into the Department of Defense mine action program, the Center deploys program analysts to assess the state of a partner nation’s capability to conduct demining and stockpile conventional munitions management. The assessment provides a viable plan with established objectives and outcomes and is a tool used by combatant commands to request resources funded by the Department of Defense's Overseas Humanitarian, Disaster, and Civic Aid Appropriation to execute mine action projects. The Defense Security Cooperation Agency in consultation with the Office of the Under Secretary of Defense for Policy, Special Operations Low Intensity Conflict, Stability and Humanitarian Affairs, and the Department of State’s Office of Weapons Removal and Abatement approve mine action and stockpiled conventional munitions assistance projects. Subjects cover demining, battle area clearance, explosive ordnance disposal, underwater unexploded ordnance disposal, and physical security and stockpile management of conventional stockpiled munitions. Training is conducted in accordance with U.S. law and policy, and international guidelines governing mine action, unexploded ordnance disposal, and physical security and stockpile management.
Humanitarian Demining Training Center personnel also provide a suite of tools and expertise to perform physical security and stockpile management, landmine clearance, explosive ordnance disposal, and underwater unexploded ordnance disposal in partnership with other public organizations or private industry. The beneficiaries of this capacity building are foreign junior military officers, non-commissioned officers, and civil servants tasked with conducting mine action. In order to sustain the capabilities of partner nation humanitarian mine action programs, the Center, in coordination with the Office of Weapons Removal and Abatement, also executes projects to enhance the skills of mine action managers and ministerial or executive level personnel through seminars and workshops on legal, policy, and programmatic topics at the operational and strategic levels.
The Humanitarian Demining Training Center continually improves its management systems and educational services to meet the changing needs of customers and U.S. humanitarian mine action programs. In FY2022, the center spent $19.5 million to execute its vital global mission.
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