Casualties Overview

In 2011, the Monitor identified 569 casualties from antipersonnel mines, antivehicle mines, victim-activated improvised explosive devices (IEDs), and other explosive remnants of war (ERW) in Pakistan.[1] There were 332 civilian casualties including 213 men, 20 women, and 99 children (75 boys and 24 girls). The remaining 237 casualties were security forces; at over 40% of the total, this was similar to the 46% reported in 2010 and a significant increase from 2009 when security forces made up 25% of all reported casualties. The ongoing violence in Khyber Pakhtunkhwa (KPK, formerly North-West Frontier Province) and Federally Administered Tribal Areas (FATA) continued to be seen as the cause of high numbers of casualties.[2]

The 2011 casualty total represented a significant increase from the 394 mine/ERW casualties indentified in 2010. Given the considerable variation in available annual casualty data, it is not possible to be certain of the extent to which changes in recorded casualties are indicative of actual trends versus shifts in media coverage and use of terminology.[3]

The vast majority of casualties in 2010 (542) occurred in FATA (288), Balochistan (166), and KPK (88). The number of casualties in these areas increased significantly in 2011 compared to 2010 (368); the greatest rise was in Balochistan, which had 64 casualties in 2010.

Pakistan had 293 reported casualties from antivehicle mines in 2011. This number was higher than the previous peak of 249 antivehicle-mine casualties recorded for 2006; at that time, “Antivehicle mines posed the greatest threat to both civilians and military personnel,” the Monitor reported. The 2011 total was more than three times the 91 antivehicle casualties identified in 2010. Reporting of victim-activated IED incidents was down from 2010, when victim-activated IEDs caused more than half of all casualties, a percentage that had been increasing since at least 2007.[4]

The total number of casualties in Pakistan is not known, and there has been no official data collection mechanism. In 2011 reporting, the government reiterated that there were no mine or ERW casualties in Pakistan, as it had in previous years.[5] However, between 1999 and 2011, the Monitor identified at least 3,353 casualties (1,233 killed, 2,025 injured, 95 unknown) from victim-activated explosive items, including landmines and ERW, through media monitoring, field visits, and information provided by service providers.[6] It is likely that the total number of casualties is much higher. Pakistan reported on 1,200 “IED attacks” causing casualties in 2011, “including” antipersonnel mines and antivehicle mines.[7]

Victim Assistance

The Monitor has identified 2,025 mine/ERW survivors in Pakistan since 1999.

Victim assistance since 1999[8]

Pakistan has not had specific programs or a strategic plan to address the needs of mine/ERW/IED survivors. While Pakistan has asserted that mine/ERW/IED survivors “are properly looked after,” most survivors live in poor, conflict-affected regions with limited access to services. Pakistan has legislation which protects the equality of persons with disabilities but enforcement is lacking.

Victim assistance in 2011

In 2011, continuing military and security operations (particularly in KPK and the FATA) as well as other armed violence (which also occurred in Balochistan) impeded civilian survivors’ access to essential services, particularly emergency medical care. Physical rehabilitation services improved and increased.

Assessing victim assistance needs

National NGOs, including Community Appraisal and Motivation Programme (CAMP) and Sustainable Peace and Development Organization (SPADO), collected information on casualties and survivors as part of their broader program activities.

Response International maintained a database of casualties and undertook a two-year casualty survey linked with risk education (RE) activities in Swat Valley covering half the resident population (approximated 500,000 people). The survey finished in November 2011.[9]

It was reported that a government plan for enhancing physical rehabilitation services and vocational training being developed in 2012 would begin with data collection on the needs of people injured in conflict in the FATA and the KPK province.[10]

Victim assistance coordination

Pakistan continued to report that the Military Operations Directorate of the Pakistan Army was the focal point for victim assistance, but did not indicate if this was for both civilian and military survivors.[11] Several ministries were involved in disability issues, including the Ministry of Health and the Ministry of Social Welfare and Special Education.[12] As of the end of 2011, Pakistan had no victim assistance plan; its National Policy for Persons with Disabilities 2002-2025 remained in place. After dissolution of the Ministry of Social Welfare and Special Education in April 2011, its affiliated departments, including the National Council for the Rehabilitation of the Disabled and the National Trust for the Disabled, were handed over to the Capital Administration and Development Division of Medical Science (PIMS) in Islamabad.[13]

Pakistan reported that a “deliberate procedure/programme is in place” for the victims of IEDs. This was reported to be individual rehabilitation programs including emergency and ongoing medical care and physical rehabilitation at army medical units and hospitals, as well as economic reintegration through monetary compensation and employment. It was not reported if civilians could access these services.[14]

Pakistan provided contact information on victim assistance coordination in its Convention on Conventional Weapons (CCW) Protocol V Article 10 report and did not update information on victim assistance available in its CCW Amended Protocol II Article 13 report.[15]

Survivor participation and inclusion

No information was available about mine/ERW survivors being included in government coordination, implementation, or monitoring of disability plans.

Service accessibility and effectiveness

Victim assistance activities[16]

Ongoing violence throughout 2011, mostly in northern Pakistan, and higher annual casualties from mines/ERW and other weapons increased the demand for victim assistance. ICRC reported that access was severely hampered due to violence and insecurity, or due to related government restrictions and security measures which limited the ICRC’s ability to provide assistance to the civilian population. Insecurity, displacement and natural disaster prevented many civilians, including those in Balochistan, KP and FATA, from reaching services.[17] In addition, many people with disabilities were reportedly unaware of services available at government hospitals and orthotic workshops.[18]

The ICRC contributed to the medical care of 124 survivors of mines or ERW in 2011, with more than 8,700 weapon-wounded patients treated in its hospital in Peshawar or through support to other hospitals. A visiting ICRC reconstructive surgeon treated patients disfigured by weapon wounds.[19] The Pakistani government had a medical support plan that detailed the emergency medical evacuation of casualties from mines/IEDs and ERW to army medical units and field hospitals in the affected areas.[20] Pakistan reported that these services were “adequate.”[21] Doctors Without Borders (Médecins Sans Frontières, MSF) found that low standards of equipment and hygiene in hospitals in affected areas negatively impacted the quality of services.[22] Despite the security situation, in 2011 MSF continued to provide emergency and surgical care at a new emergency medical department in Hangu district of KPK, which opened in 2010.[23] In 2011, MSF provided emergency medical care including surgery to thousands of patients in hospitals in Dargai and Timurgara in KPK and in Hangu very near the Afghan border. MSF also provided emergency care in the district hospital of Chaman, Balochistan province, a town on the border with Afghanistan where Afghans affected by conflict often seek medical assistance.[24]

In 2011, there were almost 40% more mine/ERW survivors receiving prosthetics (720 of 2,005 total beneficiaries) in ICRC-supported rehabilitation centers as compared to 2010 (517 of 1,386 total beneficiaries). In 2010, there had been a 90% increase in the number of mine/ERW survivors receiving prosthetics compared to the number in 2009. The ICRC attributed the increase to enhanced support to physical rehabilitation centers and improvements in the referral system and staff skills combined with a greater public trust in the services.[25] Rehabilitation services for military survivors of mines/IEDs and ERW were available through army hospitals. Complicated cases were referred to the Armed Forces Institute of Rehabilitation Medicine (AFIRM).[26]

Few psychological support and economic inclusion programs were available in Pakistan.

The ICRC continued providing small grants and business training through the Muzaffarabad Physical Rehabilitation Center. Discussions regarding the handover of the running of the Muzaffarabad center to the Ministry of Health continued in 2011.[27]

According to the Pakistani government, IED survivors were provided with monetary compensation, employment, and commercial or agricultural property. No figures were provided on the number of survivors who received this assistance, or if any were civilian.[28]

The government declared the federal capital and provincial capitals as “disabled-friendly cities.” Special education centers were established in main cities. Employment quotas for persons with disabilities lacked adequate enforcement mechanisms. Organizations that refused to hire persons with disabilities could choose to pay a fine to a disability assistance fund. The National Council for the Rehabilitation of the Disabled provided job placement and loan facilities as well as subsistence funding. However, most individuals with disabilities were supported by their families.[29] The law provides for equality of the rights of persons with disabilities, but not all provisions were implemented in practice.[30]

The ICRC promoted equal access to all assisted centers through several activities such as increasing the number of women professionals and providing healthcare and dormitory areas for women.[31]

Pakistan ratified the Convention on the Rights of Persons with Disabilities on 5 July 2011.