Casualties

Casualties Overview

The local NGO Informal Service Sector Center (INSEC) of the Federal Democratic Republic of Nepal recorded 14 ERW casualties in 2013. This continues the trend of decreasing annual reported casualties. Of the total casualties in 2013, all casualties were civilians and close to 80% (11) were children (nine boys; two girls). All three adult casualties were men. All casualties were caused by unexploded or abandoned improvised explosive devices.[1] No antipersonnel landmine casualties were reported in 2013 or since 2011.

The total number of casualties in Nepal remains unknown. The Monitor identified 937 mine/ERW casualties (239 killed; 698 injured) between 2003 and 2013.[2] From 1999 to 2002, the Nepal Campaign to Ban Landmines (NCBL) reported 1,326 casualties (522 killed; 804 injured).[3] However, the NCBL figures were thought to include other conflict casualties.[4]

Victim Assistance

The total number of mine/ERW survivors in Nepal is unknown, but at least 698 survivors have been recorded.

Victim assistance since 1999

Access to government-provided support for mine/ERW survivors and persons with disabilities in general was reported to have improved since 2010, along with limited improvement of emergency services across the country.[5] However, socioeconomic initiatives for mine/ERW survivors and other persons with disabilities decreased due to a lack of funding.[6] In addition, the UN Nepal Country Team report stated an acute lack of trained and skilled professionals in the field of habilitation and rehabilitation severely impacted medical, psychological, social, and vocational support for persons with disabilities.[7]

In 2013, it was widely reported that mine/ERW survivors were not receiving necessary or adequate assistance. It was also reported that the provision of assistance and benefits was not well regulated in practice.[8] Complex administrative procedures continued to prevent many persons with disabilities from becoming registered and obtaining government support.[9]

Assessing victim assistance needs

No comprehensive assessment of the needs of mine/ERW survivors in Nepal has been conducted in recent years.[10] A lack of general accurate data on the situation of persons with disabilities in Nepal was reported, making it “difficult to assess the precise status of marginalization and vulnerability.”[11]

INSEC continued to maintain its casualty surveillance system, which was operational in all 75 districts.[12] The Nepalese Army reported that it was not within their mandate to track data on casualties or survivors for inclusion in the Information Management System for Mine Action (IMSMA) database they maintain. However, a Geneva International Centre for Humanitarian Demining (GICHD) evaluation of UN Mine Action Nepal reported that all parties recognize that INSEC’s victim surveillance system is a temporary solution and it is ultimately the responsibility of the government to maintain such a system.[13]

Statistics from the 2011 National Census and the National Federation for the Disabled were reported not to have included comprehensive data on the number of persons with disabilities as a result of conflict.[14]

Victim assistance coordination[15]

The MoPR is responsible for the financing of mine action and assisting conflict related victims. However, in 2013 its ability to fulfill this role was constrained by a lack of capacity.[16] There was no coordination of victim assistance activities in Nepal in 2013.[17] Throughout 2011, victim assistance continued to be discussed in the meetings of the MAJWG, an informal working committee that coordinated mine action activities, including victim assistance. It was coordinated by the MoPR and UNICEF and attended by government and UN agencies, NGOs, and the ICRC. However, in 2013 the MAJWG did not meet regularly due to the change in the mine action government focal point; the position has been vacant since 2012.[18] Victim assistance was sometimes addressed in meetings of the MAJWG in 2013, and in 2014 it started a discussion on challenges relating to data collection on mine/ERW victims and formed a group in view of drafting a report on victim assistance.[19]

A five-year National Victim Assistance Strategic Framework was developed with the main victim assistance agencies under the leadership of the MoPR in August 2009. However, the strategy was not yet being used as a framework for victim assistance activities by January 2014 and there was a general lack of awareness about its existence among government mine action actors.[20]

The Ministry of Women, Children and Social Welfare (MoWCSW), the Ministry of Health and Population, and the MoPR were responsible for caring for persons with disabilities and for the provision of physical rehabilitation. In particular, the MoWCSW was responsible for implementing programs related to disability including the registration process of persons with disabilities.[21] However, most persons with disabilities continued to rely on services funded through international assistance for regular physical rehabilitation.[22]

Survivor inclusion

No inclusion of survivors in planning or coordination was reported. Survivors were included in the implementation of victim assistance activities, such as psychological support and advocacy, through the NCBL’s informal National Network of Mine Victims.[23]

Service accessibility and effectiveness

Victim assistance activities[24]

Emergency and continuing medical care

Improvements in emergency medical care were reported. By the end of 2013, the ICRC and the Nepal Red Cross Society volunteers in 51 of the 75 districts countrywide had provided first aid to almost 13,600 people, including to mine/ERW survivors. In 2013, reports of obstruction and damage sustained by ambulances prompted advocacy and awareness-raising activities by both the ICRC and the Nepal Red Cross Society on the need to respect medical personnel and infrastructures.[25]

In 2013, the ICRC also continued to donate, on an ad hoc basis, medical supplies to 36 hospitals with a view to provide medical/surgical care to wounded and other patients. In a joint project with Kathmandu University, the ICRC continued to support emergency room trauma-management courses.[26]

Physical rehabilitation including prosthetics

Access to physical rehabilitation services remained a challenge for the rural population in 2013. Potential beneficiaries living in mountainous areas hesitate to travel long distances because of limited and unreliable public transport, as well as the expenses involved. Although the ICRC continued to reimburse these expenses for some patients, most persons with disabilities cannot afford transportation costs to reach a physical rehabilitation center.[27]

Physical rehabilitation was predominantly provided through government and local non-governmental centers in 2013, with the majority of funding support from international organizations. The ICRC continued to support physical rehabilitation service provision at the Green Pastures Hospital in Pokhara and at the Yerahity Rehabilitation Centre (YRC). Since 2009, YRC is the sole government-run facility in Nepal able to provide physical rehabilitation services for military personnel and civilians. A total of 119 amputees from 10 different districts were assessed and 86 prostheses were repaired. Thirty amputees were referred to the Green Pastures Hospital and 14 to the Yerahity Rehabilitation Centre. In 2013, 1,371 people, including mine/ERW victims, benefited from various services at ICRC assisted centers. They included amputees, 11% of which were mine survivors, whose mobility was enhanced by artificial limbs. Children represented 8.3% and women 29.83% of the total number of beneficiaries.[28]

Building sustainability within the rehabilitation centers remained a priority. The ICRC and Handicap International (HI) encouraged the relevant government institutions to take increasing responsibility for the financing of rehabilitation centers, with a view to eventually phasing out support. HI progressively decreased annual contributions to the budgets of the five rehabilitation centers it supported while building capacity by providing managerial and technical support and training for prosthetic technicians.[29] To ensure sustainability, the National Association of Service Providers in Rehabilitation, with ICRC input, drafted a national plan for physical rehabilitation services. The Ministry of Women, Children and Social Welfare demonstrated a commitment to providing financial support to existing centers. Similarly the MoPR is responsible for providing rehabilitation services to all victims of conflict.[30] Discussions further explored the possibility of providing interim support for disabled people.[31] Mine/ERW survivors and other persons with disabilities continued to benefit from referral links and information sharing between HI, INSEC, the ICRC, and the Nepalese Army.[32]

In 2013, to enhance access to rehabilitation services, the ICRC and the Nepal Red Cross Society worked together for disseminating essential information regarding the existing service providers and outreach activities to disabled persons and to local organizations and authorities. The ICRC reimbursed travel expenses and physical rehabilitation services to 51 conflict-related victims. To enhance local capacities/service quality, three technicians from the two ICRC-supported centers underwent formal schooling abroad; others benefited from on-the-job training.[33]

Psychological support

Psychological assistance was reported to be almost non-existent.[34] However, each community affected by a mine/ERW incident received emergency risk education, including psychological support aspects within a period of about 10 days after the incident.[35] The NCBL provided some informal counseling in conjunction with other activities.[36]

Social and economic inclusion

The NCBL continued to support the National Network of Mine Victims, an informal survivor peer support network with 18 district representatives, but lacked funds to expand the program or identify and engage other survivors in 2013.[37] NCBL supported education for child survivors and other children with disabilities, especially girls through a scholarship programme targeting girls who have either lost a parent due to the conflict, or have been physically impacted by a mine/ERW and/or cannot afford to pay school fees.[38] In 2013, the Ministry of Education provided scholarships for 67,800 children with disabilities to attend public or private schools.[39]

The availability of social and economic inclusion services for mine/ERW survivors and other persons with disabilities continued to decrease in 2013 and most of them had to rely almost exclusively on family members for assistance.[40] This trend was particularly affected by the end, in 2012, of education grants to child mine/ERW survivors, as well as special income-generation grants for vulnerable families with the most affected child survivors, provided by UNICEF and its partners, due to a lack of funding.[41] Similarly, NCBL was not able to provide livelihood grants in 2013 due to lack of funds.[42] In 2013, the ICRC provided support to two conflict-disabled people to restore a degree of self-sufficiency through the organization’s supported micro-economic initiatives.[43]

MoPR, UNICEF, HI, and the National Federation for Disabled Nepal disseminated a victim assistance handbook throughout Nepal (in 70 districts) to service providers including health and physical rehabilitation centers, disabled persons’ organizations, human rights groups, and Village Development Committees. Monitoring of the handbook’s use indicated that it was used to improve understanding of what types of services are available, to learn about the rights of survivors, and to advocate for survivors’ rights.[44]

Legislation and policies

The government Conflict Victim Relief and Rehabilitation Program supports mine/ERW survivors.[45] However, mine/ERW survivors did not receive adequate recognition of their needs because they represented only a small number of the people who, by definition, received rights as conflict victims, including many internally displaced persons. Procedures for receiving benefits and services as a mine/ERW survivor with a disability were often prohibitively complicated.[46] These involved registering with two or three different ministries that lacked internal coordination procedures.[47]

The Nepalese interim constitution addresses the rights of persons with disabilities, but government efforts to enforce existing laws and regulations to improve rights and benefits for persons with disabilities were not effective in 2013.[48] Persons with disabilities in Nepal were systematically excluded from the mainstream of social, economic, and political life and discrimination against persons with disabilities continued to be reported in employment, healthcare, education, transportation, and other state services.[49] Many adults with disabilities were reported to be unemployed or discouraged from actively seeking work, and of those working, many are either underemployed or paid below minimum wage.[50] It was estimated that less than 2% of persons with disabilities were employed. Among those 2%, even not even one third were women.[51]

In 2012, the Supreme Court ordered the government to do more for persons with physical and mental disabilities, such as providing a monthly stipend, building shelters, and appointing one social welfare worker in each district, but progress was minimal.[52]

Nepal ratified the Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol on 7 May 2010.