Casualties

Casualties in 2009

For 2009, Landmine and Cluster Munition Monitor identified at least 859 new casualties due to mines, explosive remnants of war (ERW), and victim-activated improvised explosive devices (IEDs) in Afghanistan; this was a significant decrease (13%) from the 992 casualties identified for 2008.

The Mine Action Coordination Center of Afghanistan (MACCA) recorded 539 mine/ERW casualties (118 killed and 421 injured) for 2009 including 491 civilians,[1] 34 deminers, three off-duty military personnel, and 11 of unknown civilian/military status. Children (269) accounted for 55% of recorded civilian casualties (228 boys and 41 girls). Of the 270 adult casualties, 234 were men and 36 were women. One deminer was killed (a national of Bosnia and Herzegovina) and 33 were injured (all Afghan nationals) in 32 accidents.[2]

This represented a significant decrease from the 831 casualties MACCA recorded for 2008.[3] The reason for the steep decline in reported civilian casualties was not known. No changes in data collection in 2009 were known to account for the decrease.[4] As in previous years, MACCA data did not include IED casualties.[5]

Handicap International (HI) recorded 27 additional civilian casualties for 2009 (23 killed and four injured), including 19 children (16 boys and three girls).[6]

Landmine and Cluster Munition Monitor analysis of United States military data made available through the Guardian newspaper identified 293 casualties of victim-activated IEDs (71 killed and 222 injured): 168 foreign military casualties (24 killed and 144 injured), 66 Afghan military casualties (18 killed and 48 injured), and 59 civilian casualties (29 killed and 30 injured) in 166 incidents.[7] For 2008, Landmine Monitor recorded 161 casualties (79 killed and 82 injured) identified through media analysis in addition to those reported by MACCA for 2008 including foreign soldiers and military deminers.[8]

Some 743 casualties of cluster munition remnants were recorded between 1980 and the end of 2009. In addition, at least 26 casualties during the use of cluster munitions have been recorded.[9]

MACCA recorded 20,095 casualties between 1979 and the end of 2009.[10]

Victim Assistance

The total number of survivors in Afghanistan is unknown but in 2006, was estimated to be 52,000–60,000.[11]

There was no comprehensive assessment of the needs of mine/ERW survivors in 2009. Needs assessments or surveys were carried out by individual national and international NGOs in the field and the results were shared with MACCA and relevant ministries. However, there was no centralized distribution of existing data on survivors’ needs.[12] The ICRC reported that in 2009, national casualty data collectors ceased gathering information on new casualties from ICRC-supported centers, as had been done regularly in past years. No external acquisition or crosschecking of their data was carried out.[13] ICRC centers continued to assess and register all survivors assisted.[14]

The Ministry of Labor, Social Affairs, Martyrs and Disabled (MoLSAMD) used MACCA data for planning activities. Reportedly, there was a need for a national disability and injury surveillance mechanism. The Ministry of Public Health’s (MoPH) Disability and Rehabilitation Department (DRD) was responsible for injury surveillance and needs assessment, but had no budget to implement a system.[15]

Victim assistance coordination[16]

Disability Stakeholder Coordination Group meetings were held monthly in Kabul in 2009 and new groups were established in the northern and eastern regions of Afghanistan.[17] A wide range of relevant governmental and non-governmental actors attended the meetings, primarily to discuss their own activities and plans.[18] During 2009, representatives from disabled people’s organizations (DPOs) and survivor organizations noted that coordination with the ministries remained challenging.[19]

The Inter-ministerial Task Force on Disability was expected to “improve coordination between the different ministries.”[20] The MoPH DRD, with the support of task force members, drafted a rehabilitation policy which was under revision at the end of 2009.[21] No formal meetings of the task force were reported to the end of 2009 after the first meeting in October 2008.

In March 2009, a third national workshop was held to discuss the Afghanistan National Disability Action Plan 2008–2011 (ANDAP) and its implementation.[22] A proposed monitoring mechanism for ANDAP had not been approved by the end of 2009.[23] All implementing organizations were asked to apply ANDAP in their plans and services.[24] Some reported adhering to it, but no specific outcomes were reported for 2009.

Afghanistan provided information on progress and challenges for victim assistance in 2009 at the Second Review Conference of the Mine Ban Treaty in November–December 2009, at the meeting of the Standing Committee on Victim Assistance and Socio-Economic Reintegration in June 2010, and a brief update in Form J of its Article 7 report.[25]

Relevant coordination meetings included representatives from survivors’ organizations and survivors were included in provision of victim assistance services through NGOs during 2009. Afghanistan’s delegation to the Second Review Conference included a survivor. Other survivors from Afghanistan also participated, representing their own organizations.[26] However, it was also reported that overall inclusion of survivors was inadequate, due in part to prejudices against persons with disabilities.[27]

Service accessibility and effectiveness

Victim assistance activities in 2009[28]

There were many stakeholders in the victim assistance and disability sector.[29] MACCA was not aware of any that ceased their activities in 2009, as in 2008, or of any new organizations.[30] The deteriorating security situation severely affected the delivery of humanitarian services in a growing number of geographic areas and disproportionately impacted vulnerable individuals, including mine/ERW survivors.[31]

ICRC-supported hospitals assisted more than double the number of people injured by mines/ERW in 2009 as compared to 2008 (an increase of 133%).[32] However, Afghan Red Crescent Society first-aid volunteers and other community first-aid workers lacked the training to provide complex medical treatment. In response to the lack of local emergency capacity and the poor security situation, the ICRC evacuated war-injured persons to appropriate facilities through a system of private taxis.[33] No new emergency medical care training was reported to MACCA for 2009. Additional mobile medical teams were established to assist the nomadic Kochi people: 30 teams in 2009, from eight in 2008. Health staff in 15 of the mobile teams received training from the MoPH DRD in physical rehabilitation and disability awareness in order to better identify and assist beneficiaries with disabilities.[34]

No significant changes in physical rehabilitation, including prosthetics, were reported for 2009. The establishment of new peripheral prosthetic centers would have been needed to make significant improvements for survivors.[35] As of 2009, the MoPH’s Basic Package of Health Services included providing physiotherapists in 56 hospitals, including a male and female physiotherapist in each. However, the number of physiotherapists graduating annually was insufficient to fulfill this requirement.[36] By the end of 2009, there were still no physical rehabilitation services available in the southeastern region of Afghanistan. However, funding for equipment and running costs of the newly built Khost Orthopedic Workshop was approved by the Ministry of Finance in the fiscal year 2009 (Afghan year 1388) though the center was not yet operational.[37]

As in past years, no significant changes were reported in economic or social inclusion activities.[38] The lack of psychosocial support, particularly peer support, remained one of the largest gaps in the government-coordinated victim assistance and disability programs.[39] In 2009, training on the psychosocial aspects of disability was included in other awareness-raising training for MoPH staff.[40]

Differences in treatment in Afghanistan were often not based solely on needs, but were influenced by the economic and social situation of survivors as well as their gender and cause of disability. Women and elderly persons with disabilities received fewer services for these reasons.[41]

The constitution prohibits any kind of discrimination against citizens and requires the state to assist persons who have disabilities and to protect their rights, including healthcare and financial protection. The constitution also requires the state to adopt measures to reintegrate and to ensure the active participation in society of persons with disabilities.[42] There were no laws or concrete plans to ensure accessibility and this remained a significant challenge as persons with disabilities in Afghanistan lacked access to many existing services. In Kabul for example, some 95% of public buildings were not accessible for persons with disabilities including mine/ERW survivors.[43] The National Law for the Rights and Privileges of Persons with Disabilities, developed in 2006 and passed in 2008, was finally adopted in December 2009, but it was not yet enforceable pending its being published in the official gazette of the Ministry of Justice.[44]

As of 1 September 2010, Afghanistan had not signed the UN Convention on the Rights of Persons with Disabilities.