Casualties

Casualties Overview

In 2013, there were at least 101 new mine/ERW casualties in the Republic of the Union of Myanmar, based on information provided by NGOs and other organizations, as well as by state and independent media reports.[1] Of the 2013 total, 64 casualties were civilians and 19 were military personnel.[2] The majority of casualties were men, but at least seven casualties were boys, eight were women, and three were girls.[3]

For the second year in a row, the number of casualties recorded by the Monitor was lower than previous years. The 2013 total represents a significant continued decrease in total annual casualties compared to the 381 from 2011, and only slightly less than the 106 casualties identified in 2012 through similar reporting sources. The Monitor casualty data for Myanmar represents an aggregation of available sources.[4] However, due to the lack of official systematic data collection and the varying sources of annual data available to the Monitor, reporting is believed not to reflect the full extent of mine/ERW incidents and casualties in the country. As in the past, the data contained insufficient details to distinguish trends or to ensure that the details for all casualties were correctly recorded by the source. The actual number of casualties is likely to be much higher.[5]

Past reporting by the Monitor has indicated that there are a significant number of military casualties recorded, but such records are not generally available to the public.[6]

In 2013, mines/ERW remained a source of concern in an estimated 10 out of 14 regions/states.[7] Most mines causing casualties were recorded as antipersonnel mines. It has been reported by local risk education providers that victim-activated IEDs or “craft” antipersonnel mines are among the mine types causing casualties. People involved in mine and IED incidents are often not able to distinguish between these types of victim-activated explosive items, so the type is not recorded.[8]

The total number of casualties in Myanmar is unknown. The Monitor reported annual casualty data of 3,450 mine/ERW casualties (348 killed; 2,898 injured; 204 unknown) between 1999 and the end of 2013.

In addition to human casualties, village livestock, elephants, and wildlife are also affected by landmines in Myanmar. Most elephants killed and injured by mines are those used in the illegal cross-border timber trade. In February 2013, an elephant was injured by a mine laid near the border with Bangladesh.[9]

Victim Assistance

At least 2,898 survivors have been identified by the Monitor since 1999. However, this is a fraction of the actual figure, estimated to exceed 40,000.[10]

Victim Assistance in 2013

In 2013, there was an increase in rehabilitation and economic inclusion services available to survivors within Myanmar.

Under an agreement with the government of Myanmar, the ICRC supported government-run rehabilitation centers. The centers had been operating without external support since 2007.

More actors were involved in delivering, planning, and organizing all aspects of victim assistance.

Assessing victim assistance needs

In 2012, DanChurchAid (DCA) conducted research and an in-depth situational analysis, collected baseline data, and made recommendations for future programming to assist survivors and their families in the areas of health and rehabilitation, training, and other potential activities in victim assistance. DCA had previously carried out a casualty and victim assistance survey and a suspected mined area survey in localities that were recognized as the most contaminated in Myanmar.[11] In 2013, no new initiatives were implemented to assess the needs of mine/ERW victims in Myanmar.

The Ministry of Health does not disaggregate injuries due to mines/ERW incidents from other traumatic injuries.[12]

Victim assistance coordination

There was no government victim assistance coordination mechanism in 2013.

There was greater awareness of the need for victim assistance. In January 2013, member of parliament Aung San Suu Kyi, the head of the Myanmar parliamentary Rule of Law, Stability, and Peace Committee, was reported to have stated publically that she would work to ensure landmine survivors received vocational training and prosthetic devices, demonstrating an increasing awareness on the part of the government to address the issue of victim assistance.[13]

The Department of Social Welfare, within the Ministry of Social Welfare, Relief and Resettlement, is responsible for community-based rehabilitation and for carrying out social welfare services through preventive, protective, and rehabilitative measures.[14] Several institutions were involved in physical rehabilitation; the Ministry of Health, the Ministry of Defense, and the Myanmar Red Cross Society played an important role in the provision of mobility aids, especially prosthetics and orthotics.[15] The Disability Working Group, assembled to coordinate and implement the National Plan of Action for Persons with Disabilities 2010–2012, stopped meeting after only a few meetings because the various organizations involved chose to run their programs independently.[16]

To follow up the round-table seminar on prosthetics and orthotics organized in 2012 by the ICRC in cooperation with the Ministry of Social Welfare, Relief and Resettlement, the ICRC had bilateral meetings with the Department of Social Welfare in 2013 to discuss the creation of an official coordination body.[17]

No inclusion of survivors in victim assistance planning or activities was reported in 2013.

Service accessibility and effectiveness

Victim assistance activities[18]

Emergency and continuing medical care

In rural Myanmar, most villages lack basic healthcare. Patients travel hours, and in some hilly regions nearly an entire day, to reach hospitals or clinics. Due to a lack of healthcare services, people in rural areas may rely on treatment from untrained health workers, or  rely on local, traditional remedies.[19]

In 2013, the ICRC supported the second amputation surgery seminar for twenty-five junior surgeons working in remote stations of southeastern Myanmar. The training also focused on the most appropriate surgical techniques allowing for optimal use of a prosthetic device.[20]

During decades of conflict in Myanmar, ethnic communities and organizations developed their own health provision structures, which continued to be the main providers of healthcare in the mine-affected and remote areas. In recognition that those networks needed to continue to function until the adequate convergence of state and national health systems, the Health Convergence Core Group (HCCG) was formed in May 2012. The HCCG aimed to prepare existing community-based health networks inside Myanmar for future work with government health agencies and other international, national, and local actors.[21]

The HCCG is composed of four ethnic health organizations and four community-based health organizations: Burma Medical Association, Back Pack Health Worker Teams, Karen Department of Health and Welfare, Karenni Mobile Health Committee, Mae Tao Clinic, Mon National Health Committee, National Health and Education Committee, and the Shan Health Committee.[22]

Physical rehabilitation, including prosthetics

As most rehabilitation centers are located in major cities and travel costs are high, people with disabilities, especially those living in rural areas, often face tremendous difficulties in order to access services.[23]

In 2013, the ICRC offered the Ministry of Health assistance to develop two Physical Rehabilitation Centers in Myitkyina (Kachin State) and in Kyaing Tong (Eastern Shan State) to address the high demand of the services users in those regions affected by the conflicts. The Ministry of Health approved the construction of Myitkyina PRC in 2014 and then Kyaing Tong PRC in 2015.[24] In 2007, ICRC support of Ministry of Health and Ministry of Defense rehabilitation centers had been suspended due to restrictions imposed on its operations.[25]

In 2013, the ICRC continued to support the Hpa-an Orthopaedic Rehabilitation Centre (HORC), run jointly by the Myanmar Red Cross Society and the ICRC, and to support three centers managed by the Ministry of Health located in Yangon, Mandalay, and Yenanthar enabling people living in remote areas to have access to services. The ICRC increased support to the Myanmar Red Cross Society’s Outreach Prosthetic Programme for areas covered by the HORC as well as for Upper and Central Myanmar. This program enabled persons living in remote areas to have access to services free of charge, including prosthetic and orthopedic devices, lodging, transport, and medical assistance if necessary.[26] In 2013, the ICRC supported the construction and refurbishment the HORC’s foot production units, which allowed them to create 3,842 prosthetic feet for their patients.[27] Expansion of the outreach activities at the HORC, and an increase in the production of prostheses at the center, resulted in a 25% increase in the number of prostheses produced in 2013 over 2012.[28] In 2013, 44% of prostheses were for mine/ERW survivors (761 of 1,741).[29]

In 2013, the ICRC also prioritized admission for child amputees at the HORC during the school summer-holiday season through a program designed to facilitate access for children without disrupting their studies; the number of child admissions increased by 20% (61 in 2012 compared to 49 in 2011).[30]

In December 2013, in agreement with the Ministry of Health the ICRC handed over the its role in supporting the National Rehabilitation Hospital (NRH) in Yangon to the NGO Exceed Worldwide. The organization also financially supported the Myanmar School of Prosthetics & Orthotics, which is being built on the campus of the University of Medical Technology in Yangon.

The Myanmar Disabled Person’s Organization (MDPO) produces prosthetics at a small workshop in its office in Yangon. Recipients must pay for their prosthetic or find a donor; however, MDPO provides a few prosthetics at no charge to the very poor.[31] DCA operates a mobile prosthetic-limb clinic that assists landmine survivors who have little or no access to similar services offered elsewhere in the country.[32] In July 2014, Peace Myanmar Aid Foundation ran a mobile prosthetics workshop which provided 53 prosthetics to mine victims from 22 villages in Shwegyin in eastern Bago Region.[33]

No psychological or psychosocial services available to mine/ERW survivors were reported in 2013.

Economic and social inclusion

A lack of understanding about persons with disabilities as well as poor infrastructural accessibility make it difficult for persons with disabilities to attend school or find employment. The Association for Aid and Relief (AAR) Japan Vocational Training Center for Persons with Disabilities provides training in tailoring, hairstyling, and computers free of charge. Most trainees are persons with disabilities due to polio or they are landmine survivors. The center supports graduates to achieve economic independence, gain employment, open their own shops, or become teachers at the center.[34]

Within a limited geographical scope, the First Myanmar Basic Disability Survey 2008–2009, endorsed by the Ministry of Social Welfare, Relief and Resettlement, indicated that 1,276,000 people in Myanmar (2.32% of the population) live with some form of disability. The survey further found that 85% of persons with disabilities were unemployed and their level of education was considerably below the national average.[35]

Disabled veterans can apply for housing in specially built settlements. A settlement of disabled former soldiers, visited by the Monitor in May 2013, was located on an all-weather road outside Taungoo and had water and electricity. Transport to schools for children was provided. From the settlement, former military personnel could contact a local military officer and request transport to the local hospital, if needed. Former soldiers also could obtain free intercity transport on public buses and were provided with replacement prosthetics as needed at no cost. Those disabled military personnel that did not apply for housing in the special settlement were eligible for a one-time grant of 500,000 kyat (US$590). All disabled military personnel are eligible for a small pension.[36]

Laws and policies

There are no laws specifically prohibiting discrimination against persons with disabilities in employment, education, access to healthcare, or in the provision of other state services; the government does not provide ample protections for these persons. In 2013, there were few official resources to assist persons with disabilities.[37] Furthermore, persons with disabilities reported societal stigma and discrimination,[38] as well as abuse from civilian and government officials.[39]

In June 2014, activists requested that landmine victims be included within the draft disability law being discussed in parliament.[40] The upper house of parliament approved a proposal for a disability rights law in September 2011. The proposal was drafted following recommendations developed by Leprosy Mission International and the Ministry of Social Welfare in May 2011.[41] It was reported that the draft law gave preferential treatment to disabled military veterans over civilians with disabilities, including giving priority to providing jobs to military personnel.[42] As of September 2014, the law had not yet been approved.

Military veterans with disabilities received benefits on a priority basis, usually a civil service job at equivalent pay. Official assistance to non-military persons with disabilities in principle included two-thirds of pay for up to one year for a temporary disability and a tax-free stipend for permanent disability; however, the government did not provide job protection for private sector workers who became disabled. In March 2013, the government enacted a law designed to assist the families of deceased and injured military personnel.[43]

On 7 December 2011, Myanmar acceded to the Convention on the Rights of Persons with Disabilities (CRPD). The convention entered into force on 6 January 2012.

Victim assistance for Myanmar citizens in Thailand

Landmine survivors from Myanmar who go to Thailand to seek asylum can receive medical care and rehabilitation in refugee camps as well as in public district hospitals in the Thai-Myanmar border provinces.[44]

However, throughout 2013 and into 2014 the availability of this assistance in the Thai border camps was becoming increasingly uncertain. Political reforms in Myanmar resulted in discussions around 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.[45] Furthermore, in July 2014 Thailand’s National Council for Peace and Order (NCPO) “reached an agreement with the commander-in-chief of Burma’s military to repatriate the 120,000 refugees accommodated in the nine refugee camps on the Thai Burma border.”[46] This change of situation, including the shift in funding priorities, was reported to be premature, and the UNHCR has said conditions in south-eastern Myanmar where the refugees come from are not yet fully conducive to organized returns. This includes the absence of a permanent ceasefire, the presence of mine fields, and lack of critical infrastructure in some areas.[47]