Casualties

Casualties Overview

In 2012, there were at least 106 new mine/explosive remnants of war (ERW) casualties in the Republic of the Union of Myanmar, based on state and independent media reports as well as information provided by NGOs and other organizations.[1] Of the 2012 total, 91 casualties were civilians and 15 were military personnel. The majority of casualties were men, at least three casualties were boys, three were women, and one was a girl.

The 2012 total represented a significant decrease in casualties compared to the 381 from 2011, identified through similar reporting sources. The Monitor casualty data for Myanmar represents an aggregation of available sources.[2] However, due to the lack of systematic data collection and varying sources of annual data, reporting is believed not to reflect the full extent of mine/ERW incidents and casualties in the country. As in the past, the data contained insufficient details to distinguish trends or to ensure that the details for all casualties were correctly recorded. The actual number of casualties is likely to be much higher.[3]

Past reporting by the Monitor has indicated that there are a significant number of military casualties recorded, but such records are not generally available to the public.[4]

Most mines causing casualties were recorded as antipersonnel mines. It has been reported by local risk education providers that victim-activated improvised explosive devices (IEDs) or “craft” antipersonnel mines are among the mine types causing casualties. People involved in mine and IED incidents are often not able to distinguish between these types of victim-activated explosive items, so the type is not recorded.[5]

The total number of casualties in Myanmar is unknown. The Monitor has identified 3,349 (319 killed; 2,829 injured; 201 unknown) between 1999 and the end of 2012.

In addition to human casualties, village livestock and elephants are also affected by landmines in Myanmar. Most elephants killed and injured by mines are those used in the illegal cross-border timber trade. In February 2013, an elephant was injured by a mine laid near the border with Bangladesh.[6]

Victim Assistance

At least 2,829 survivors have been identified by the Monitor since 1999.

Victim Assistance in 2012

In 2012, there was an increase in rehabilitation and economic inclusion services available to survivors within Myanmar. The ICRC and the government of Myanmar reached an agreement which allowed the ICRC to restart support to government-run rehabilitation centers. The centers had been operating without external support since 2007.

More actors were involved in delivering, planning, and organizing all aspects of victim assistance.

Assessing victim assistance needs

In 2012, Dan Church Aid (DCA) conducted research and an in-depth situational analysis, collected baseline data, and made recommendations for future programming to assist survivors and their families in the areas of health and rehabilitation, training, and other potential activities in victim assistance. DCA had previously carried out a casualty and victim assistance survey and a suspected mined area survey in localities that were recognized as the most contaminated in Myanmar.[7]

The Ministry of Health does not disaggregate injuries due to mines/ERW incidents from other traumatic injuries.[8]

Victim assistance coordination

There was no government victim assistance coordination mechanism in 2012.

There was greater awareness of the need for victim assistance. In January 2013, MP Aung San Suu Kyi, the head of the Myanmar parliamentary Rule of Law, Stability, and Peace Committee, was reported to have stated publically that she would work to ensure landmine survivors received vocational training and prosthetic devices, demonstrating an increasing awareness on the part of the government to address the issue of victim assistance.[9]

The Department of Social Welfare, within the Ministry of Social Welfare, Relief and Resettlement, was responsible for community-based rehabilitation and for carrying out social welfare services related to the rights of persons with disabilities.[10] Several institutions were involved in physical rehabilitation; the Ministry of Health, the Ministry of Defense and the Myanmar Red Cross Society played an important role in the provision of mobility aids, especially prosthetics and orthotics. The Disability Working Group, assembled to coordinate and implement the National Plan of Action for Persons with Disabilities 2010–2012, stopped meeting after only a few meetings because the various organizations involved chose to run their programs independently.[11]

The ICRC, in cooperation with the Ministry of Social Welfare, Relief and Resettlement, organized a two-day seminar on prosthetics and orthotics to improve services and to propose the creation of a national coordination mechanism.[12]

No inclusion of survivors in victim assistance planning or activities was reported in 2012.

Service accessibility and effectiveness

Victim assistance activities[13]

Emergency and continuing medical care

In rural Myanmar, most villages lack basic healthcare. Patients travel hours, and in some hilly regions nearly an entire day, to reach hospitals or clinics. Due to a lack of healthcare services, people in rural areas may rely on treatment from untrained health workers, or  rely on local, traditional remedies.[14]

The ICRC supported an amputation surgery seminar for thirty inexperienced surgeons working in remote stations of southeastern Myanmar in 2012. The training also emphasized appropriate surgical techniques allowing for optimal use of a prosthetic device. [15]

During decades of conflict in Myanmar, ethnic communities and organizations developed their own health provision structures which continued to be the main providers of health care in the mine-affected and remote areas. In recognition that those networks needed to continue to function until the adequate convergence of state and national health systems, the Health Convergence Core Group (HCCG) was formed in May 2012. The HCCG aimed to prepare existing community-based health networks inside Myanmar for future work with government health agencies and other international, national, and local actors. [16]

The HCCG is composed of four ethnic health organizations and four community-based health organizations: Burma Medical Association, Back Pack Health Worker Teams, Karen Department of Health and Welfare, Karenni Mobile Health Committee, Mae Tao Clinic, Mon National Health Committee, National Health and Education Committee, and the Shan Health Committee.[17]

Physical rehabilitation ,including prosthetics

As most rehabilitation centers are located in major cities and travel costs are high, people with disabilities, especially those living in rural areas, often face significant difficulties in order to access services.[18]

In 2012, the Ministry of Health agreed to an ICRC offer to resume support to three physical rehabilitation centers operated by the ministry. Support to the Ministry of Health centers started in late 2012.[19] In 2007, ICRC support of Ministry of Health and Ministry of Defense rehabilitation centers was suspended due to restrictions imposed on its operations.[20]

In 2012, the ICRC continued to support the Hpa-An Orthopaedic Rehabilitation Centre (HORC), jointly run by the Myanmar Red Cross Society and the ICRC. The ICRC increased support to the Myanmar Red Cross Society’s Outreach Prosthetic Programme for areas covered by the HORC in upper and central Myanmar. This program enabled persons living in remote areas to have access to the closest service providers, including the Ministry of Health center at the Yenanthar Leprosy Hospital. Expansion of the outreach activities at the HORC, and an increase in the production of prostheses at the center, resulted in a 39% increase in the number of prostheses produced in 2012 over 2011. In 2012, 56% of prostheses were for mine/ERW survivors (914 of 1,618).[21]

ICRC also increased the accommodation capacity of the center with the construction of an additional dormitory. ICRC prioritized admission for child amputees at the HORC during the school summer-holiday season through a program designed to facilitate access for children without disrupting their studies; the number of child admissions increased by 44% (49 in 2012 compared to 34 in 2011).[22]

The Myanmar Disabled Person’s Organization (MDPO) produces prosthetics at a small workshop in its office in Yangon. In 2012, it provided about 50 prosthetic devices. Recipients must pay for their prosthetic or find a donor; however MDPO provides a few prosthetics at no charge to the very poor.[23] DCA operates a mobile prosthetic limb clinic that assists landmine survivors who have little to no access to similar services offered elsewhere in the country.[24]

No psychological or psychosocial services available to mine/ERW survivors were reported in 2012.

Economic and social inclusion

A lack of understanding about persons with disabilities and poor infrastructural accessibility make it difficult for persons with disabilities to attend school or find employment. The AAR Japan Vocational Training Center for Persons with Disabilities provides training in tailoring, hairstyling, and computers free of charge. Most trainees are persons with disabilities due to polio or they are landmine survivors. The center supports graduates to achieve economic independence, gain employment, open their own shops, or become teachers at the center.[25]

Within a limited geographical scope, the First Myanmar Basic Disability Survey 2008–2009 found that 85% of persons with disabilities were unemployed and their level of education was far below the national average.[26]

Disabled veterans can apply for housing in specially built settlements. A settlement of disabled former soldiers, visited by the Monitor in May 2013, was located on an all-weather road outside Taungoo and had water and electricity. Transport to schools for children was provided. From the settlement, former military personnel could contact a local military officer and request transport to the local hospital, if needed. Former soldiers also could obtain free intercity transport on public buses and were provided with replacement prosthetics as needed at no cost. Those disabled military personnel that did not apply for housing in the special settlement were eligible for a one-time grant of 500,000 kyat (US$590). All disabled military personnel are eligible for a small pension.[27]

Laws and policies

There are no laws specifically prohibiting discrimination against persons with disabilities in employment, education, access to health care, or in the provision of other state services; the government does not provide ample protections for these persons. The government did not actively discriminate against persons with disabilities in employment, access to health care, education, or the provision of other state services or other areas, but there were few official resources to assist persons with disabilities. There are no laws mandating accessibility to buildings, public transportation, or government facilities.[28]

A specific disability law remained in draft form as of September 2013.[29] In September 2011, the upper house of parliament approved a proposal drafted following recommendations developed by Leprosy Mission International and the Ministry of Social Welfare in May 2011 for a disability rights law.[30] By June 2013, following a meeting with chairpersons of parliamentary committees, the parliament committed to help to promulgate the disability rights law as soon as possible. [31]

It was reported that the draft law gave preferential treatment to disabled military veterans over civilians with disabilities, including giving priority to providing jobs to military personnel.[32]

Military veterans with disabilities received benefits on a priority basis, usually a civil service job at equivalent pay. Official assistance to non-military persons with disabilities in principle included two-thirds of pay for up to one year for a temporary disability and a tax-free stipend for permanent disability; however, the government did not provide job protection for private sector workers who became disabled. In March, the government enacted a law designed to assist the families of deceased and injured military personnel.[33]

The government does not provide social protection for private sector workers who became disabled. There was inadequate state funding for services to assist persons with disabilities.[34]

On 7 December 2011, Myanmar acceded to the Convention on the Rights of Persons with Disabilities (CRPD). The convention entered into force on 6 January 2012.

Landmine survivors from Myanmar who go to Thailand to seek asylum can receive medical care and rehabilitation in refugee camps as well as in public district hospitals in the Thai-Myanmar border provinces.[35]

However, in the first half of 2013 the availability of this assistance in the Thai border camps was becoming increasingly uncertain. Political reforms in Myanmar resulted in the possibility of refugees being returned, leading to a reduction in financial assistance by some donors to NGOs in order to focus on activities within Myanmar.[36] This shift in funding was reported to be premature, and the UNHCR has said that the return of refugees will not be promoted until mined areas in Myanmar are identified and cleared.[37]