Casualties and Victim Assistance

Summary findings

·         Adequate prosthetic and rehabilitation facilities were needed as a priority in the mine affected regions

·         The government ministry responsible for implementing services that uphold the rights of persons with disabilities was made aware of the Republic of Turkey’s victim assistance obligations

·         There was a need for planning and coordination of victim assistance in accordance with Mine Ban Treaty Cartagena Action Plan commitments

·         Physical accessibility plans were delayed throughout Turkey, and there was less accessibility in mine-affected regions than in other parts of Turkey, particularly major cities

Victim assistance commitments

Turkey is responsible for landmine and explosive remnants of war (ERW) survivors. Turkey has made a commitment to victim assistance through the Mine Ban Treaty.

Casualties Overview

Monitor analysis of media reports collected by the Initiative for a Mine-Free Turkey (IMFT) identified at least 69 new casualties in 2012 due to mines (including victim-activated improvised explosive devices, IEDs) and ERW in Turkey. Of the total, 39 were civilians; two thirds of civilian casualties were children (26: 25 boys and one girl) and one was a woman. Thirty casualties were security personnel.[1] The 2012 total represented an increase from the 59 new casualties identified in Turkey from IMFT reporting in 2011.[2]

Included in the total for 2012 were eight Syrian mine casualties (three people killed and five injured) in incidents in the Turkish border minefields while crossing from the Syrian side to Turkey. Two were Syrian opposition military personnel and the others were civilians, including three children (two killed and one injured). Syrians injured by mines along the Turkish border were treated at government hospitals in Turkey.[3]

The government of Turkey reported 82 mine casualties (16 killed; 66 injured) for 2012. No details on military status, sex, or age were provided in the reporting.[4]

In its Article 5 deadline Extension Request of March 2013, Turkey provided information on antipersonnel mine casualties occurring between 2004 and the end of 2012: 882 military personnel (260 killed; 622 injured) and 168 civilians (56 killed; 112 injured). Turkey also included, for the first time, disaggregated information on the age and sex of civilian casualties for a similar time period (10 years); of the total civilian casualties reported, 15 were female and 50 were children.[5] In contrast, Monitor reporting including IMTF data for the period from 2004 to the end of 2012 counted more than twice the number of civilian mine/ERW casualties; 377 civilian casualties of 979 casualties recorded in total.

The total number of mine/IED and ERW casualties in Turkey is unknown. Turkey had reported 4,271 mine/ERW casualties, including 871 people killed and 3,400 injured, as of the end of 2012.[6] However, according to a media report in April 2010, the Ministry of Internal Affairs had recorded 6,360 mine casualties since 1984; 1,269 people were killed (625 security personnel; 644 civilians) and another 5,091 people were injured (with the number of civilians compared to the security personnel injured not reported) in mine incidents.[7] In 2007, a demining specialist reported at least 10,000 mine casualties (mostly civilians) along the Turkish-Syrian border since the 1950s (more than 3,000 killed and 7,000 injured).[8]

Victim Assistance

More than 5,000 people were reported to have been injured by mines in Turkey since 1984.[9]

Victim assistance in 2012

No significant changes in the accessibility or quality of services were reported for 2012. Mine/ERW survivors and persons with disabilities in affected areas did not have access to the same level of services as other persons with disabilities in larger cities in Turkey.[10] Survivors in some areas were becoming discouraged by the lack of developments in victim assistance.[11]

Assessing victim assistance needs

No efforts to assess the needs of mine/ERW survivors in Turkey were reported in 2012. There was no system in place to collect data on mine survivors or their needs. The IMFT collected the most comprehensive information available through media scanning and cross checking with other organizations and local sources.

The office of the Administration for Disabled People collected data on all persons with disabilities but did not distinguish the cause of disability or mine/ERW survivors.[12] The European Commission (EC) continued to report that a lack of broader data and research on persons with disabilities remained a barrier to informed policymaking in Turkey.[13]

The Diyarbakir Lawyer’s Bar Association and the Human Rights Association collected information on mine/ERW casualties in the affected regions; information collected included details on the needs of the survivors and families.[14]

In 2006, Turkey had reported that it was initiating a program of transition to an international injury classification system that would include mines and ERW.[15] No further progress on this transition was reported as of end 2012.

Victim assistance coordination

By 2012, the responsibilities of the Prime Ministry Association of Persons with Disabilities were transferred to the Ministry of Family and Social Policies and its newly established Disabled and Senior Citizens Directorate General, the government entity responsible for protecting the rights of persons with disabilities.[16] Human rights associations claimed the directorate was underfunded, including a national NGO working on advocacy for the rights of persons with disabilities.[17]

A delegation of the ICBL and IMFT discussed victim assistance with a Deputy Undersecretary of the Ministry of Family and Social Policy in March 2013, underlining Turkey’s victim assistance commitments, the links with the Convention on the Rights of Persons with Disabilities (CRPD), and the related responsibilities of the ministry. The Deputy Undersecretary agreed that the role of victim assistance focal point role fitted with the work of the ministry’s department of persons with disabilities and also the social welfare department, which is responsible for pensions and other payments.[18]

In April 2012, the IMFT also visited the Minister of Family and Social Policy regarding the Disabled and Senior Citizens Directorate General and issues of rehabilitation, employment, and education for mine survivors, and also regarding the activities of the new directorate. The IMFT presented the need for a national action plan, corresponding with the Cartagena Action Plan, for the implementation of victim assistance commitments under the Mine Ban Treaty. The Minister indicated that work on victim assistance should be implemented under the new directorate.[19]

Turkey has never had government victim-assistance coordination. The Administration for Disabled People, under the Prime Minister, was previously the central government body responsible for protecting the rights of persons with disabilities. The administration was established in 1997; however, until 2011 it had not followed, and had not been aware of, victim assistance issues.[20]

Mine Ban Treaty Article 7 reporting on victim assistance is updated annually by Turkey, but only covers treatment received by survivors at military medical facilities. Article 7 (and Convention on Conventional Weapons Article 13) reporting did not include information on services available to civilian mine/ERW survivors at civilian facilities, or on survivors injured in previous years.[21] Turkey did not make statements on victim assistance at the Twelfth Meeting of States Parties to the Mine Ban Treaty in 2012 or at the Mine Ban Treaty intersessional Standing Committee meetings in May 2013.

Survivor inclusion and participation

Survivors reported that they were not included in the planning or implementation of services relevant to their needs.[22] The Disabled and Senior Citizens Directorate General had not engaged survivors and was not familiar with the issue of victim assistance or specific needs in mine affected areas.[23]

Service accessibility and effectiveness

Victim assistance activities[24]

Emergency and ongoing medical care

A study of examples of surgical intervention after mine injures of varying severities by the Medical Association Diyarbakir emphasized the time-sensitivity of emergency medical care; the study emphasized that longer intervals between injury and surgery corresponded to more severe levels of amputation. Among the study group, the average time to receive first medical care was nine hours; 13 of 186 survivors recorded in the study died due to infection.[25]

All persons with disabilities have the right to access the free first-aid services at public and private healthcare centers. Those without social insurance can apply for a special “green card” to be eligible for services. However, in practice those persons with disabilities eligible for the green card medical insurance still contributed to part of their medical expenses, eliminating the availability of free services.[26] Regulations in the Healthcare Application Notice, issued by the Social Security Organization of Turkey, restricted access to medicines, equipment, and mobility devices for persons with disabilities, even when deemed necessary by medical professionals.[27]

Healthcare facilities in towns in the mine-affected region (other than the largest cities) are underfunded, have inadequate staff levels and equipment, and often were not able to address survivors’ emergencies or ongoing medical needs.[28]

Physical rehabilitation, including prosthetics

There was a significant need for prosthetics and rehabilitation services to be established in other mine/ERW-affected provinces. There was also a need to establish facilities that could address the needs of child survivors. Holders of the green card could only apply for new prostheses every five years. This was detrimental to the rehabilitation of child mine/ERW survivors who require frequent replacements while growing.[29]

The Dicle University Research Hospital prosthetics center was the only such center for all mine-affected regions. By early 2013, it was still open but had effectively ceased to operate; this eliminated the only free option for prosthetics for civilian mine/ERW survivors. Use of the facility declined in 2008 when it began to provide services only to those having state provided healthcare “green cards” for the disadvantaged. In addition, the lack of assistance for transportation or accommodation expenses for survivors coming to the center from distant provinces limited access.[30]

In the absence of a free rehabilitation center, in order obtain prostheses, mine/ERW survivors and other persons with disabilities face complicated procedures to apply for poor quality prosthetics available through the national health system. Even this assistance is out of reach to many mine/ERW survivors due to the geographical distance and their poverty levels.[31]

Laws and policies

In 2012, a number of parliamentary questions were asked about the number of survivors and casualties and the support that they receive. The Ministry of Interior reported that military personnel received physical and physiological treatment in TAF-RCC as well as vocational training and employment opportunities. Military survivors have received salaries and employment opportunities via the Ministry of National Defence and the Ministry of Interior.

Civilian survivors could apply for compensation through Law 5233, the Law on the Compensation of Damages that Occurred due to Terror and the Fight Against Terrorism. The Diyarbakir Lawyers’ Bar Association continued to help mine/ERW survivors access benefits to which they were entitled, such as compensation under Law 5233, and to promote victim assistance. Survivors have called for a review of the compensation process to ensure timely and appropriate outcomes.[32]

A need for specific policies to address the social support needs of child mine/ERW survivors was identified in 2009.[33] No progress was reported by the end of 2012.

The constitution permits positive discrimination for persons with disabilities; however, the principle is not adequately reflected in policy measures. Legislation prohibits discrimination against persons with disabilities in access to healthcare, employment, education, transportation, and in the provision of state services. The law was not enforced effectively.[34]

A strategy paper on accessibility for persons with disabilities was adopted, along with a related national action plan. Difficulties in accessibility to education, health, social, and public services and public places and transportation for persons with disabilities continued.[35] Turkey lacked a comprehensive strategy to fund commitments to create physical accessibility. Physical barriers to public buildings and all relevant facilities still existed. Deadlines for public institutions’ mandatory compliance to provide accessible services were extended or postponed.[36]

Turkey ratified the CRPD on 28 September 2009.[37] However, in 2012 Turkey had not yet established a national mechanism for monitoring implementation of the CRPD and its optional protocol.[38]