Summary of action points based on findings

·         Employment, work training, livelihood incentives, and other economic opportunities continued to be areas with the greatest need for improvement for survivors.

·         Representation of local survivors’ networks through survivor leaders should be maintained and developed through all levels of coordination.

·         Improve the system for ordering prosthetic components and introduce functional waitlists in rehabilitation centers.

Victim assistance commitments

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

Casualties

Casualties Overview

Details and Trends

In 2014, the Thailand Mine Action Center (TMAC) reported four mine/ERW casualties in Thailand. All casualties were men: one casualty was a civilian Cambodian national collecting forest food in Sakaeo province. One casualty was an on-duty military personnel patrolling in Si Sa Ket province. The other two causalities were humanitarian deminers from the military.[1]

The total number of casualties for 2014 represented a significant decrease from 16 in 2013, 20 in 2012, 49 in 2011, and 35 casualties in 2010. The four casualties in 2014 was the lowest number recorded annually in Thailand since data collection began.[2] 

The TMAC recorded all casualties in 2014 and 2013, 13 casualties in 2012, 24 casualties in 2011, and 23 casualties in 2010.[3] In 2014 and in 2013, all casualties recorded by TMAC occurred on the Thai-Cambodian border.[4] There was no report on casualties of improvised mines or similar improvised explosive devices in southern Thailand in 2013.[5]

The most comprehensive casualty data collection for Thailand remains the Landmine Impact Survey (LIS), which identified at least 3,468 casualties as of May 2001 (1,497 killed; 1,971 injured).[6] From June 1998 to the end of 2014, the Monitor recorded 697 mine/ERW casualties in Thailand: 37 people killed, 300 injured, and for 360 it was unknown if they survived. [7]

Victim Assistance

In total, at least 1,383 mine/ERW survivors were recorded in Thailand by the end of 2014. [8]

Summary of victim assistance efforts since 1999[9]

Since 1999, the number of services provided to survivors from both government agencies and civil society organizations/NGOs gradually increased. Government responses to ongoing advocacy efforts by NGOs and local survivors’ groups led to improvements in the quality and coverage of services for mine/ERW survivors. In 1999, few government agencies or civil society groups provided services to survivors, yet by 2013-2014 a wide range of victim assistance services were being maintained.

Coordination among governmental bodies responsible for victim assistance has improved steadily since 2000. NGOs completed a national mine/ERW survivor survey and needs assessment in 2009. By 2010, Thailand had linked victim assistance to the implementation of the Convention on the Rights of Persons with Disabilities (CRPD). The linkages between disability-rights, victim assistance, and community-based rehabilitation (CBR) on the ground strengthened over time through improved interagency cooperation and identification of focal points in relevant ministries.

Access to free healthcare programs increased through universal health coverage, provided survivors were Thai nationals or registered refugees. Emergency transportation was widely available and rescue response time improved with training. CBR and its outreach worker network (which covered 99% of the country by 2007) expanded significantly since 1998–1999. Gradual improvements were made in the availability of employment opportunities, social inclusion activities, and accessibility of existing services. Inclusive education programs provided by the government and relevant organizations increased. There were slight improvements in responding to the specific economic-inclusion needs of survivors working in the agricultural sector.

Victim assistance in 2014

In 2014 government support for strengthening and promotion of local landmine survivor networks was further developed through close consultation with survivors. Changes to policy meant that all survivors, including stateless survivors living in Thailand without identification, were better able to access health services.  Supply of prosthetic components to regional workshops was sometimes delayed causing interruptions to services.

Assessing victim assistance needs

TMAC and other government agencies demonstrated improved coordination in registering data on each new casualty and following up to ensure that they received assistance and support. Use of the record system, which had existed in past years, improved significantly in 2012 and continued improving through 2014.[10]

The National Office for the Empowerment of Persons with Disabilities (NEP) under the Ministry of Social Development and Human Security (MSDHS) organized six workshops on landmine victim assistance in 2012–2013. These workshops were used as a forum to hear survivors’ concerns through local representatives of survivor groups.[11]  It was found that survivors and persons with disabilities required access to updated information on their rights,services. Economic inclusion and microcredit were identified as priority needs.

TMAC and its Humanitarian Mine Action Units (HMAUs) visited landmine/ERW survivors to assess their needs. From late 2013 to October 2014, TMAC’s Coordination and Evaluation Division carried out a specific project and made 30 follow-up visits to survivors, while also providing small emergency funds to meet urgent needs.[12]

The greatest challenges TMAC found were the distance from communities to prostheses centers and economic inclusion. [13]

Victim assistance coordination[14]

The National Sub-Committee on Victim Assistance did not hold formal meetings in 2013 and 2014, however there was regular coordination among the victim assistance stakeholders including the TMAC throughout the two-year period.[15]

The Master Plan on Mine Victim Assistance 2012–2016 provides five action plans to strengthen victim assistance efforts, in the areas of mine victim database management; physical and psychological rehabilitation; social and economic reintegration; CBR; and sharing of best practices and experience.[16]

Thailand connected its work on victim assistance both in line with planning and implementation of its obligations under the CRDP[17] and also its universal health coverage strategy. Thailand reported that to assist landmine survivors it has adopted a holistic and integrated approach to victim assistance. Care for landmine victims is integrated into the broader legal framework, national plans and programs for persons with disabilities, and is implemented under the umbrella of universal health coverage for all.[18]

Thailand stated that other legislative measures that guarantee the rights of persons with disabilities include: 1) the National Health Security Act; 2) the Emergency Medical Service Act; and 3) The Persons with Disabilities Education Act.[19] Thailand also revised the Persons with Disabilities’ Quality of Life Promotion Act, which provides a comprehensive legal and institutional framework regarding rights and entitlements for persons with disabilities. The revised act decentralized coordination of essential services to the local administrative authorities, which are closer to communities.[20]

In 2014, the National Commission on Promotion and Development of the Quality of Lives of Persons with Disabilities met twice to address issues including: increasing disability pensions; withdrawal of its interpretative declaration to the CRPD;[21] the establishment of provincial service centers for people with disabilities; amendments to regulations under the Person with Disabilities Empowerment Act; procedures for acquiring  accessible public buses; approval of projects for income generating activities; house modifications; making government venues accessible; and the development of an smart phone application to monitor the accessibility of public spaces. [22]

The National Commission also met twice in 2013 to include organizations of persons with disabilities in coordination, activities, and funding opportunities. The Commission drafted or made amendments to seven rules and regulations under the Person with Disabilities Empowerment Act and developed implementation strategies for the Promotion and Development Quality of Lives of Persons with Disabilities National Plan (2012-2015), and related work on disability issues under the Association of Southeast Asian Nations (ASEAN) Socio–Cultural Community (ASCC) framework.[23]

Thailand provided updates on victim assistance activities through statements at the Mine Ban Treaty Third Review Conference in Maputo in June 2014. Thailand also provided information about mine/ERW casualties in its Mine Ban Treaty Article 7 report for calendar year 2013.[24] Thailand also made a statement on victim assistance at the Fourth Meeting of States Parties to the Convention on Cluster Munitions in September 2013[25] and during the General Exchanges of Views at the Fifth Meeting of States Parties to the Convention on Cluster Munitions in September 2014.[26]

Inclusion and participation in victim assistance

In 2013 and 2014, survivor participation continued to increase at the community and provincial levels, and several survivors remained active in leadership roles in their communities. Survivor leaders from different communities also met regularly to discuss local advocacy approaches and to share information and services as well as lessons learned, with the support of the Catholic Office for Emergency Relief and Refugees (COERR).[27]

Survivors were consulted about survey and clearance needs. They were also key informants during the baseline survey, non-technical survey and impact assessment processes conducted by demining operators.[28] Survivors and other persons with disabilities continued to participate in provincial coordination meetings in Chanthaburi.[29] Jesuit Refugee Service (JRS) also supported the transportation, accommodation expenses, and other costs for survivor representatives to attend group meetings of survivor leaders.[30]

TMAC regularly visited mine/ERW survivors to consult them and leaders of survivor networks as did other concerned government agencies and NGOs about their needs.[31]

Through informal networks, survivor leaders assisted other survivors and people with disabilities in making referrals, completing paperwork such as registering for benefits or filling in other forms, and liaising with local authorities at the leader or province level including liaising with NGOs focal points working on victim assistance.[32]

Based on feedback from local landmine-survivor leaders received by Thailand’s governmental team of victim assistance experts which indicated that survivors wanted to meet with other leaders in order to share experiences, in May 2013 the NEP organized the first formal Meeting of Leaders of Landmine Survivors in Aranyaprathet district, Sakaeo province. Some 20 participants from five provinces along the Thai-Cambodia border shared experiences and visited several local victim-assistance facilities.[33]

In 2014, the MSDHS organized two workshops to raise awareness about the rights of persons with disabilities among persons with disabilities and other people in the community. In May 2013, the MSDHS organized a victim assistance workshop to build the capacity of leaders of survivors and relevant parties. It also carried out four workshops on the Quality of Lives of Persons with Disabilities plan, each in a different in mine-affected province.[34] 

Service accessibility and effectiveness[35]

Emergency medical care

The National Institute for Emergency Medicine (NIEM) maintained community emergency health volunteer groups in every province in Thailand.[36] In early 2015, the NIEM, in cooperation with TMAC was planning specialized emergency care training for all Humanitarian Mine Action Units (HMAU’s) together with relevant NGOs. [37]

Thailand improved its medical emergency services by integrating the three main government medical funding schemes. Emergency patients are to be sent to the nearest hospital without being asked about their eligibility, and patients’ expenses are settled directly at one shared focal point for the three funds without patients first having to pay fees out-of-pocket and then await reimbursement.[38]

Physical rehabilitation including prosthetics

The National Health Security Office (NHSO) remained responsible for providing funding for rehabilitation and mobility devices for persons with disabilities in Thailand. [39] Government funding budgeted for the rehabilitation of persons with disabilities increased in 2013 and 2014.[40]

The NHSO continued to promote a system of matching funds, which were integrated with the funds managed by other government agencies. The NHSO fund had two operational components. Under the first, not less than 90% of total resources were dedicated directly to rehabilitation and assistive devices. Under the second, not more than 10% of resources were dedicated to support and promotion of service provision. The NHSO fund also had a policy component that could allow the cost of transportation to services to be covered for persons with disabilities.[41]

The NHSO faced challenges to integrating the health services and benefit packages provided by the hospital-based NHSO with the activities of the community-based rehabilitation (CBR) network. The NHSO recognized the importance of CBR but was only able to provide funded health care services through hospitals or health care units. Therefore the benefits did not reach the community level. In response, the NHSO started to explore solutions and held a seminar to discuss the issues in March 2014.[42]

Continuing a trend ongoing over the past several years, the role of the Sirindhorn Center in providing mobility devices remained minimal compared to when it had been the primary national referral hospital for prosthetics.[43] In 2013 and 2014, the Sirindhorn Center continued to focus on research, development, and innovation of devices, applying more advanced technology and testing.[44]

In 2013 and through 2014, the two UNDP-established repair centers in Sa Kaeo province, which operated with co-support from subdistrict administrative offices, continued but due to reduced funding the quantity of services decreased. As of February 2015, it was uncertain if the subdistrict administrative office would be able to continue prostheses repair activities in 2015, depending on the availability budget support.[45]

Irregular supplies of prosthetics components to prosthetic department of Aranyaprathet hospital caused delays for people waiting for services. The prosthetic workshop did not have a coordinated waitlist so survivors in need either travelled needlessly, or had to call regularly to find out when services were available.[46]

Community-based rehabilitation

The national CBR program remained active in all provinces of Thailand.[47] The NEP, with support fromCBM (previously Christian Blind Mission), hosted the official launch of the Thai edition of the World Health Organization CBR guidelines to support and guide the CBR network in implementing disability work that focuses on community participation.[48]

Economic and social inclusion

Improvement in employment opportunities for survivors was reported. The Ministry of Agriculture and Cooperatives provided small grants and fishery training to new survivors.[49] HMAUs also provided support for income-generation activities as well as for some basic needs.[50] TMAC and all four HMAUs coordinated with relevant government and non-government agencies to facilitate survivors access to services.[51]

Survey data presented in September 2013 found that 20% of all persons with disabilities of working age needed training and capacity building, while 77% needed support for economic inclusion.[52]

The Ministry of Social Development and Human Security and the Ministry of Labor established a task force on the “Promotion of Employment of People with Disabilities for Social Work in Local Community.” A pilot project on Section 35 of the Person with Disabilities Empowerment Action BE 2550 (2007)[53] matches persons with disabilities who live in remote areas with the companies who are required by law to employ persons with disabilities under the quota system, whereby the company supports the person to work in their own communities rather than for the company directly. [54] The Commission approved projects for income-generation activities for people with disabilities in rural areas for the period November 2014 to September 2015.[55]

In 2014, following the reductions in the level of services over several years, JRS focused facilitating/linking victim assistance activities between the field and the capital. In 2013-2014, it reduced services for survivors, citing a general increase of services by government and an internal reprioritization of the organization.[56]  

The Community Based Rehabilitation Program and the Community Learning Center for People with Disabilities project operated in all provinces. Each province contained two centers, while Bangkok had 10 centers in 2013.[57] This marked a significant expansion from having at least one center of each province during 2012.[58]

The government provided five-year, interest-free, small business loans for persons with disabilities. Government regulations require private firms either to hire one person with a disability for every 100 workers or contribute to a fund that benefits persons with disabilities. However this provision was not uniformly enforced. [59]

National registration of persons with disabilities was completed by 2011. All survivors were reportedly registered and random monitoring through leaders of survivor groups in several provinces confirmed that their constituents were registered. Persons with disabilities, including mine/ERW survivors who are registered with the government, can receive monthly, free medical examinations, and assistive devices.[60]

For several years disability benefits were set at 500 Thai Baht (approximately US$15) per month. In November 2014, the Cabinet approved a proposal to increase the disability pension by 60% to 800 Thai Baht per month. [61]

COERR, with support from private donors, started a pilot income-generating project for six survivors and people with disabilities in Sakaoe province for the period September 2014 until March 2015, which included training.[62]

Modified buildings with accessible toilets for survivors and people with disabilities in Aranyapratet were provided through the donations of a small volunteer group. Toilet instillation based on the sanitation needs of the most vulnerable in the community was assessed through requests to local survivor leaders by survivors, persons with disabilities and their families.[63]

Laws and policies

The constitution and law prohibit discrimination against persons with physical, sensory, intellectual, and mental disabilities in education, transportation, access to health care, or the provision of other state services. Government enforcement was not consistently effective. The law also mandates that persons with disabilities have access to information, communications, and newly constructed buildings, but these provisions were not uniformly enforced.[64]

In 2013, Thailand issued the revised “Person with Disabilities Empowerment Act B.E.2556 (2013).” The key changes included increasing the role of the NEP, introducing focal points for disability with more authority and responsibility to work at the department level, expanding services to the persons with disabilities without legal status in Thailand, particularly stateless persons, and establishment of service centers by organizations of persons with disabilities and local authorities.[65]

Thailand has a Master Plan for Development of Women with Disabilities B.E 2556-2559 (2013-2016). The plan’s six key objectives include: promotion of accessibility to equal rights and ending discrimination against women and female children with disabilities; elimination of violence against women and female children with disabilities; promotion of health and quality of life for women and female children with disabilities; capacity building; promotion of the capacity of organizations of women with disabilities; and promotion of positive attitudes towards these groups. [66]

In what was regarded as a significant victory for the right of accessibility for persons with disabilities in Thailand, in January 2015 the Supreme Administrative Court ordered Bangkok Governor and the Bangkok Metropolitan Administration to carry out three essential accessibility measures to facilitate use of public transit by persons with disabilities within one year.[67]

Thailand ratified the CRPD on 29 July 2008.

Services for Myanmar nationals in 2013

Mine survivors from Myanmar who went to Thailand for assistance received medical care and rehabilitation at hospitals in refugee camps, in public district hospitals in the Thai-Myanmar border provinces and from NGOs.[68] Hospitals in Thailand also provided medical care and rehabilitation to survivors from Cambodia.[69]

Victim assistance activities on Thai-Myanmar Border and in Thailand for Myanmar nationals

The Mae Tao Clinic (MTC), an NGO health facility run by and for asylum seekers and migrants from Myanmar, provided prosthetic limbs and other medical services near the join border. In addition to the successes, the program faced hurdles that were beyond the Clinic’s control. MTC reported that the supply of artificial feet (ordered from Cambodia by HI) often could not keep up with the demand. Loss of experienced technical staff who resettle overseas was also a challenge to capacity. The program’s financial future was more secure with a long-term support guarantee for the Clinic’s prosthetics program made by an Italian community organization.[70] In 2013 the number of MTC prosthetics fitted decreased by some 5% from in 2012.[71]

The refugee-run Care Villa facility continued to offer special care and assistance to blind amputee landmine/ERW survivors residing in the Mae La refugee camp. HI provided prosthetic limbs, orthotics, and other assistive devices for refugees in some of the camps and has also trained refugees in the Mae La camp to make the prostheses.[72] In 2013, Care Villa residents (mostly landmine survivors that are both amputees and blind) received only very basic rations. The United Methodist Committee on Relief (UMCR) reported providing funding to help provide physical and psychosocial support at Care Villa as well.[73]

ICRC continued to pay for the surgical treatment in Thai hospitals of weapon-wounded people from Myanmar unable to be treated in their own country. Despite reduced fighting in parts of Myanmar, 42 weapon-wounded patients in 2013 from there sought treatment in Thai hospitals and had their medical costs covered. The number of people reduced from 111 in 2011 to 38 in 2012. It slightly increased to 42 in 2013.[74]

In 2013 and 2014, the peace talks between members of armed ethnic groups and Myanmar government representatives continued.[75] Although it was uncertain if the groups would reach a cease-fire agreement,it 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. Given the global economic situation and competing demands in other countries, particularly Myanmar, it was becoming harder to sustain enough donor funding to provide basic services to refuges living in camps in Thailand.[76]  The work of the MTC was similarly threatened by the redirection of donor funding.[77]

HI also continued to produce prosthetics and to support rehabilitation in refugee camps as well as to support self-help groups. Key activities included functional rehabilitation services, livelihood and social inclusion for persons with physical disabilities in three camps in Tak province and two camps in Mae Hong Son province.[78]

As part of humanitarian mine action study visit organized by the Ministry of Foreign Affairs of Thailand in August 2013, a delegation from Myanmar visited the Aranyaprathet Hospital in Sakaeo province to observe services for landmine survivors including operations, prosthetic services, and rehabilitation, as well as the Prostheses Foundation in Chiang Mai Province and two community learning centers for persons with disabilities in Chiang Mai and Lampang Provinces which served as models for a community-based rehabilitation.[79]