Casualties

Casualties Overview

In 2013, 22 mine/ERW casualties in 14 incidents were recorded in the Democratic Socialist Republic of Sri Lanka, compared to 47 casualties in 28 incidents in 2012. Five people were killed and 17 injured, a significant decrease compared to five killed and 42 injured in 2012, but similar to 2011 when one person was killed and 23 injured. In 2012, one Sri Lankan deminer working for the NGO HALO Trust was killed in the town of Jaffna;[1] the rest of the casualties were civilians. Half of all casualties were children (10 boys and one girl) and three of the adult civilian casualties were women. In 2012, eight casualties were caused by mines (four as a result of antipersonnel mines and four from antivehicle mines) and the remainder by ERW. More than 45% of all casualties occurred in the district of Kilinochchi, in northern Sri Lanka.[2]

In 2013, UNICEF reported that since the 1980s some 22,150 mine/ERW casualties had been recorded, including 1,576 civilian casualties. However, from 2006 to 2009 accurate casualty information was difficult to access due to ongoing conflict, likely resulting in under-reporting.[3] In April 2010, it was reported that since the 1980s there were a total of 21,993 mine casualties, including 1,419 civilian returnees; 3,770 recorded amputees among the armed forces, police, and civil defense forces; and 16,804 mine casualties among the non-state armed group, Liberation Tigers of Tamil Eelam (LTTE).[4] From 1999 to the end of 2013, the Monitor identified 1,451 casualties in Sri Lanka (144 killed; 573 injured; 734 unknown).[5]

Victim assistance since 1999

There has been an overall increase is availability and accessibility of healthcare and social services in Sri Lanka for mine/ERW survivors and persons with disabilities in general, particularly with regard to government-provided services.[6] In the north and east of Sri Lanka, a number of primary care hospitals have been opened while roads have been re-built and maintained, increasing availability and accessibility of services since 2010.[7]

Hundreds of thousands of displaced persons returned to their homes after the end of the conflict in late 2009, including persons with disabilities and injuries, creating a need for services in new areas. The public health system provided medical treatment to mine/ERW survivors, while post-operative care, including psychosocial support, counseling, and mobility aids were provided on an increasing scale by the government and national NGOs supported by international organizations.[8] Access and availability of physical rehabilitation services for persons with disabilities in Sri Lanka, including mine/ERW survivors, dramatically increased since 2012 through initiatives by the government, international organizations, and NGOs. This is principally due to more rehabilitation centers becoming operational and a general improvement of public transportation infrastructure.[9] In particular, a new train line was opened in 2013 linking up Kilinochchi in the north to the capital, Colombo.[10] However, in 2013 a mapping of the physical rehabilitation sector in Sri Lanka led by Handicap International (HI) in collaboration with various stakeholders showed that there remained gaps in terms of geographical coverage, especially at the community level with an unequal service distribution among districts; a lack of capacity among existing providers; a shortage of trained workers; as well as unclear referral mechanisms between public health facilities and physical rehabilitation services.[11] Other important challenges were the lack of awareness among persons with disabilities about the existence and importance of physical rehabilitation, as well as the lack of long-term follow-up at home and community level, which may result in people abandoning their rehabilitation or stopping their use of their assistive devices.[12]

Victim Assistance

The total number of survivors in Sri Lanka, both civilian and military, was estimated to be in the thousands.[13] The National Mine Action Centre (NMAC) reported 1,474 registered civilian mine survivors injured in Sri Lanka between 1985 and the end of 2011.[14]

Assessing victim assistance needs

In 2013, there was no comprehensive data on the number or the needs of mine/ERW survivors, victims of war, or other persons with disabilities.[15] Details of mine/ERW incidents were recorded in the national Information Management System for Mine Action database. In 2013, the Ministry of Social Services and Social Welfare (MoSS) maintained and updated a database of persons with disabilities for the north and east of the country; however, a national database was still lacking.[16] Starting in 2009, mine action actors began planning to establish a fully functional data collection mechanism on persons with disabilities, including mine survivors, and on available services.[17] The 2010 National Strategy for Mine Action Sri Lanka announced that an injury surveillance system was functioning but at a limited scale. It further proposed that by December 2011 data could be managed by adapting the Cambodia Mine Victim Information System (CMVIS) to Sri Lanka’s needs.[18] Throughout 2010, discussions with the MoSS were ongoing and by June 2011 a UNICEF consultant had visited Sri Lanka regarding the establishment of a Victim Assistance Surveillance System.[19] In March and April 2013, a new web-based National Injury Surveillance System was piloted at the Base Hospital in Horana, and was reported to provide a feasible and sustainable means of injury surveillance in Sri Lanka.[20]

NGOs providing mine risk education (MRE) collected data on mine/ERW survivors through house-to-house visits and provided information to the NMAC. MRE providers also maintained separate records on persons with disabilities, including mine/ERW survivors and war victims, while identifying the needs of survivors and referring them to available services.[21] Government Social Service Officers also collected data on persons with disabilities during field visits.[22] Victim assistance providers including HI, Motivation, and Caritas Valvuthyam maintained their own databases on services provided to mine/ERW survivors. The Department of Social Services, under the MoSS, also maintained records on their beneficiaries at district level. Data was shared with service providers during monthly district-level disability coordination meetings. Mapping of disability service providers in Vavuniya and Mannar districts was done in 2010 and updated in 2011, 2012, and 2013.[23]

Victim assistance coordination[24]

In Sri Lanka, the Ministry of Healthcare and Nutrition’s Division of Rehabilitation for Youth, Elderly, Disabled and Displaced and the MoSS are the lead government agencies for disability. The former is responsible for medical concerns and the latter for social.[25] Other ministries, particularly the Ministry of Education and the Ministry of Defense, also address important issues relevant to persons with injuries and disabilities.[26]

In 2013, the MoSS organized a series of consultation meetings to discuss matters related to persons with disabilities as well as to assist in the drafting of a new Disability Rights Bill and a new National Disability Action Plan.[27] The new National Action Plan for Disability was drafted in 2013 under the leadership of the MoSS and Ministry of Health with the support of international organizations. The plan was approved in January 2014 and contains seven pillars: (1) Empowerment; (2) Health and Rehabilitation; (3) Education; (4) Work and Employment; (5) Mainstreaming and Enabling Environments; (6) Data and Research; and (7) Social and Institutional Cohesion. While it focuses on persons with disabilities in general, the plan also includes mine/ERW victims—in particular, support and increased accessibility to the rehabilitation sector, as well as community-based rehabilitation (CBR), are integral parts of the plan.[28]

The 2010 National Strategy for Mine Action in Sri Lanka includes victim assistance objectives.[29]

Survivor inclusion

Disabled persons’ organizations are included in the various coordination mechanisms. Survivor representatives and persons with disabilities also participated in MoSS coordination meetings and played key roles in drafting the disability action plan.[30]

Service accessibility and effectiveness

Victim assistance activities[31]

The Ministry of Healthcare and Nutrition continued to implement the national long-term plan for physical rehabilitation that aims at ensuring access to physical rehabilitation services in 40 district hospitals. This objective was realized in four districts in 2013: Vavuneiya, Trincomalee, Batticaloa, and Kilinochi. However, in all four places the functioning of the centers were heavily reliant on support from international NGOs.[32] UNICEF support for victim assistance continued to be reduced overall in 2013 due to lack of funding. However, it was reported that there had been an increase in financial support, including from the World Bank, to the disability sector in 2013.[33] The MoSS provided some support to persons with disabilities, including covering the cost of prosthetics and orthotics services.

The ICRC continued technical and material support to the JJCDR, the only center providing physical rehabilitation on the Jaffna peninsula. The center offers a broad range of services, including the provision of prosthetics, orthotics, various mobility aids, physiotherapy, microcredit, and financial support for disabled students.[34] In 2013, 34% of all prostheses were provided to mine/ERW survivors.[35] The ICRC continued to gradually reduce financial support to JJCDR, with a decrease of 15% in the amount reimbursed per appliance by the ICRC in 2010, 30% in 2011, and 50% in 2012. In 2013, the ICRC’s contribution to reimbursements amounted to less than 7% of JJCDR’s operational budget, with the rest being covered by other income and various donors.[36]

In addition, in 2013 the ICRC continued to collaborate with the Navajeevana Physical Rehabilitation Centre, located in the south of the country, where the ICRC covered the cost of services to economically-vulnerable persons with physical disabilities. This program was brought to its conclusion at the end of 2013. A total of 169 persons with disabilities have received prostheses or orthoses during the three-year life of the program.[37]

The Sri Lankan School for Prosthetics and Orthotics (SLSPO) continued to train and build the capacities of professionals and increased the quality of services provided to mine/ERW survivors.[38]

Since 2010, HI expanded its physical rehabilitation services in Kilinochchi and Mullaitivu districts in the north and in Batticaloa district in the east to address the needs resulting from the process of displaced persons returning to their places of origin. Due to the size of the area, HI introduced a mobile rehabilitation unit to provide physical rehabilitation services in remote areas. Since 2010, HI increased the number of beneficiaries receiving physical rehabilitation services in Batticaloa in the east by over a quarter, due to a higher number of persons with disabilities and injuries relocating in the area and also due to beneficiaries being able to travel without restrictions. In 2012, HI began the handover of the prosthetics and orthotics clinic at the Teaching Hospital in Batticaloa to the Ministry of Health. The handover process for the physical rehabilitation services provided in Kilinochchi and Mullaitivu to the Ministry of Health was almost completed by 2012.[39] In 2013, HI continued to provide support to these three centers; however, with external funding coming to an end, the outreach rehabilitation programs were to be discontinued in 2014.[40]

Psychological assistance and social support increased in Sri Lanka through the MoSS program. However, services remained limited and did not meet the needs of survivors.[41] The National Counseling Centre under the MoSS expanded operations after the conflict ended, providing counseling services and psychosocial-support workers deployed primarily in areas with high numbers of internally displaced persons and relocated communities.[42] The MoSS National Program on Community Based Rehabilitation for Persons with Disabilities continued to provide a range of services in 25 districts including home-based rehabilitation, peer-support groups, and support to access education for children with disabilities. However, due to reduced funding since UNICEF discontinued its support to the program in 2012, CBR activities were mainly focused on social inclusion in 2013.[43] MRE facilitators provided peer support to survivors alongside their risk reduction activities in 2013.[44]

The Department of Social Services, as well as some MRE operators, provided livelihood-development programs targeting persons with disabilities, including conflict victims, through income-generation activities and housing support.[45] At the government’s request, the ICRC started a livelihood support program for people linked to past armed-conflict who had been discharged from physical rehabilitation centers. As a result, 152 persons with disabilities increased their families’ income (benefiting 615 people in total) by starting/resuming businesses, such as livestock breeding, thereby easing their social reintegration.[46]

The 1996 Act on the Protection of the Rights of Persons with Disabilities was amended in 2012 to incorporate the provisions of the Convention of the Rights of Persons with Disabilities (CRPD). At the end of 2012, the draft law was submitted and awaiting approval by the Attorney General.[47] By the end of 2013 it had not been approved and further discussions on it were ongoing as part of a long and sensitive process.[48] Discrimination continued to occur in employment, education, and the provision of state services including public transportation.[49] Negative attitudes and societal discrimination towards persons with disabilities remained common, especially in rural areas, which led to long-term isolation of persons with disabilities.[50]

In April 2011, the Supreme Court of Sri Lanka directed that provisions for access by persons with disabilities should be enforced when constructing public buildings and that those not applying the ruling should be penalized.[51] Another important development with regard to accessibility was a Public Interest Litigation Fundamental Rights Application, filed by accessibility activist Dr. Ajith C. S. Perera, for physical accessibility of private buildings for persons with disabilities. In June 2013, the Supreme Court directed the Attorney General to follow-up with the MoSS concerning the establishment of accessibility facilities at public buildings, which it found should also cover private sector buildings.[52]

In 2013, the MoSS conducted awareness-raising workshops on the need for accessible public and government buildings in Vavuniya, Jaffna, Mulatiyu, Mannar, and Kilinochchi. These meetings led to construction to make buildings accessible in 14 districts.[53] However, access to buildings and public transportation for persons with disabilities remained rare at the end of 2013.[54] Persons with disabilities were reported to have been negatively affected by restrictions on aid projects being implemented in the north. A lack of inclusion of persons with disabilities in development initiatives, and “a lack of coordination between upholding disability rights and general human rights” was also reported.[55]

Sri Lanka signed the CRPD in March 2007.