Victim
Assistance: Who Contribution To Intersessional Process
Introduction
The signing of the Convention on the
Prohibition of the Use, Stockpiling, Production and Transfer of Anti-Personnel
Mines and on their Destruction in December 1997 catalysed the creation of a
political momentum around the issue of landmines.
This created an opportunity to promote the public health approach to victim
assistance, starting with assistance to mine victims. The small percentage of
victims due to landmines however (0.3% of the disease burden), as compared with
other causes of injury and trauma (such as violence and road traffic accidents)
made it imperative to shift from a focus on mine victims to a more comprehensive
victim assistance approach that does not discriminate between different sources
of injury and trauma.
WHO, in conjunction with the ICRC, stimulated the endorsement of a concerted
public health strategy regarding mine victim assistance within the international
agenda. The Joint ICRC-WHO Strategy for the Prevention, Care and
Rehabilitation of Victims of Landmines emphasised the need to carry out an
integrated, non-discriminatory approach to victim assistance and provided the
framework for policymaking and programming. The framework allows policymakers to
design a comprehensive national plan of action that incorporates victims of all
types of trauma, identifies priorities, and presents a holistic plan that
emphasises existing strengths and overcomes gaps and duplications.
Victim assistance emphasises capacity-building for the implementation of
sustainable support to victims. It promotes a new humanitarian vision that
focuses on long-term action and effective, transparent partnership, based on the
needs of victims, and the co-ordination of all relevant actors and programmes.
Locally appropriate victim assistance, through the promotion of violence
prevention, psychosocial rehabilitation and social reintegration, represents a
first step in the community healing process. A comprehensive understanding of
the factors that lead to violence and the availability of resources victims can
access to manage the health, social and environmental consequences provides an
opportunity for social reintegration and elaboration of the trauma in a healthy
manner. The community can thus prevent the resurgence of violent attitudes and
behaviour, and start working towards a peace-building process.
Progress achieved in the field of victim assistance needs to be consolidated
and expanded within a broader human security context. The promotion of human
security offers a framework to plan and implement interventions for the
improvement of community security, and to approach non-intentional injuries,
suicide, violence and crime from a health promotion and prevention perspective.
Such an approach recognises that many security issues share the same risk
factors, such as drugs, alcohol abuse and small arms, and it is advantageous to
consider such risks in a global manner to promote the efficacy and efficiency of
interventions. Furthermore, a same organisation, such as a municipality, is
concerned by an ensemble of security concerns. It thus becomes more efficient to
approach such an institution with a comprehensive issue of security rather than
with piecemeal concerns. A global vision of human security allows for a shared
understanding between different disciplines and sectors, and contributes to the
development of global initiatives that aim to not only reduce a distinct
concern, but also aims to promote the deeper issue of population security.
WHO/PVI proposes to build a network of expertise at the national level,
composed of community actors, NGOs, academicians from the university, and the
government and thus facilitate the development of culturally appropriate,
sustainable approaches to victim assistance within a human security framework.
Local experience, supplemented by lessons learned from other humanitarian
contexts, can contribute to the design of appropriate training initiatives for
all sectors concerned.
The following provides an overview of the translation of victim assistance
into country action:
From Ottawa to Maputo
The signing of the Convention on the
Prohibition of the Use, Stockpiling, Production and Transfer of Anti-Personnel
Mines and on their Destruction in December 1997 catalysed the creation of a
political momentum around the issue of landmines. WHO, in conjunction with the
ICRC, stimulated the endorsement of a concerted public health strategy regarding
mine victim assistance within the international agenda:
The Treaty Signing Conference in Ottawa on December 1997 represented the
first official WHO involvement in the landmine arena.
Immediate steps were taken following the Conference at the WHO political and
technical levels. WHO developed, in consultation with the ICRC, a Plan of action
on a concerted public health response to anti-personnel mines.
As a follow-up to these consultations, a WHO resolution (EB 101.R23)
“Concerted public health action on anti-personnel mines” was
approved by the Executive Board at its 101st session and later
endorsed at the Fifty-first World Health Assembly (Resolution WHA 51.8) on May
1998.
WHO and the ICRC collaborated to outline key principles in mine victim
assistance. The Joint ICRC-WHO Strategy for the Prevention, Care and
Rehabilitation of Victims of Landmines emphasised the need to carry out an
integrated, non-discriminatory approach to victim assistance and provided the
framework for policymaking and programming.
Following discussions with the Swiss Representatives at a donor meeting on
demining and victim assistance in Ottawa on March 1998, the Swiss government,
based on the ICRC-WHO Strategy and with the technical assistance of the WHO, the
ICRC and UNICEF, elaborated the Bern Manifesto, which emphasised equity
in access to services, sustainability, and country ownership.
The WHO Interregional Workshop on Landmine Victim Assistance at Kampala
strongly endorsed the principles included in the Bern Manifesto and in the
ICRC-WHO Strategy. The workshop brought the Ottawa Process to affected states,
to the people and to the health sector, as it provided the opportunity for
representatives from the Ministries of Health and the WHO Country Offices of the
States present to work together with members of ICRC; UNICEF,
ICBL[1] and Handicap
International in the elaboration of a framework on mine victim assistance. The
meeting paved the way for national health policy aiming at victim assistance
through capacity-building and strengthening of the health sector.
In this way, the “bottom-up process” was initiated, giving voice
to the countries and providing them with the means and tools to manage country
needs and thus further ensure sustainability.
In view of the venue of the First Conference of State Parties to the
Convention on the Prohibition of the Use, Stockpiling, Production and
Transfer of Anti-Personnel Mines and on their Destruction, further steps
were taken by WHO/HQ, jointly with the Swiss and the Mozambican governments, to
translate into action the principles elaborated in Kampala. Following several
meetings in Maputo with Ministries concerned as well as with representatives of
donor countries and NGOs, they developed a Strategic Framework for Planning
Integrated Mine Victim Assistance Programmes, and demonstrated its applicability
through the elaboration of a national Mozambican plan of action on victim
assistance.
The presentation of the Strategic Framework by Switzerland at the Conference,
and the incorporation of the principle of integrated public health action into
the Maputo Declaration constituted a key step in the progress towards its
adoption at a national level and towards national ownership that would ensure
long-term sustainability of action.
Intersessional Process: From Maputo To Geneva 2000
Standing Committee of Experts on Victim
Assistance, Socio-Economic Re-integration and Mine Awareness
Five expert committees were established as part of the intersessional process
from Maputo to the September 2000 Geneva Meeting of State Parties. The Standing
Committee of Experts focusing on landmine victim assistance holds Switzerland
and Mexico as chairs and Japan and Nicaragua as rapporteurs. The committee
offers a potential mechanism to maintain transparency of donor contributions and
international development projects.
The venue is used to monitor the implementation of the Convention at the
country level and to allow government, multilateral and non-governmental actors
to co-ordinate action for the promotion of national victim assistance
programming and policymaking. The participants aim to establish a basis for the
development of a portfolio of collaborative, sustainable country plans that
could be presented at the Second Meeting of State Parties to the Convention.
A regional approach has been adopted, whereby one country represents each
region: Nicaragua, Cambodia, Mozambique, and Bosnia-Herzegovina. Government
representatives and non-governmental counterparts at the country level present
the status of country plans and outlined the key areas requiring technical and
financial assistance from donors and technical agencies.
Consolidation of achievements on victim assistance
Following the collaboration established with the
African and American regions, and the first meeting of the Standing Committee of
Experts, the WHO aims to present a portfolio of consolidated achievements based
on the ICRC/WHO policy agenda to the Second Meeting of State Parties at Geneva
in September 2000. The Second Meeting of State Parties represents a key arena to
present coherent, comprehensive country victim assistance plans to donors.
Countries have the opportunity to discuss their plans and co-ordinate, with the
technical assistance of agencies such as WHO, a series of donor countries around
their plan of action.
Towards this goal, a regional process has been initiated:
African Region: Three countries as reference programmes: Burundi,
Mozambique and Uganda. The Mozambican government has fully endorsed the plan
already.
Region of the Americas: Nicaragua and additional Central American
countries are in the process of being selected.
Asia and the Western Pacific Regions: Collaboration with WPRO/SEARO
should commence. Vietnam, Laos, Cambodia, Thailand and Sri Lanka are the
countries considered.
Eastern European Region:Bosnia and Kosovo have been selected to
receive intensified support for the elaboration of strategic plans
WHO Country-based Process
AFRO: The African Region
Operationalisation of the Post-Maputo Agenda,
Harare, May 1999
On the occasion of a Maputo follow-up PVI/AFRO meeting in Harare in May 1997,
Dr. Samba, Regional Director for the WHO Regional Office for Africa, established
a Regional Working Group to elaborate a concerted public health response to
landmine victim assistance for the African region.This group worked
closely with the WHO/PVI/HQ to identify 3 countries for intensified assistance
according to the following criteria: magnitude of the problem, commitment at the
highest government level, security, an ongoing program, and English, French or
Portuguese speaking (in order to facilitate the expertise and documentation in
the 3 languages of the Regional Office). The three countries (Mozambique,
Uganda, Burundi) were selected from those participating in the Kampala Process,
thus providing a continuum from the elaboration of principles regarding victim
assistance to the planning and implementation of country-level action.
HQ/AFRO Country Planning Meeting: Harare, August 1999
Within the purview of translating established principles of mine victims
assistance into action, a Technical PVI/AFRO Meeting was organised at Harare on
August 16-18, 1999 to further the agenda within the African region. The meeting
aimed to support an integrated public health approach to landmine victim
assistance in Mozambique, Burundi and Uganda through the elaboration of country
plans of action and the mobilisation of technical, financial and political
resources.
It was decided to present a regional, country-based approach at the Standing
Committee of Experts of the Ottawa Process, that would reflect country needs and
allow donors to visualise opportunities to become involved in the victim
assistance process. The desire was noted to replicate the Harare process in
other regions and promote the presentation of plans for each region within the
intersessional arena.
A tool was presented to promote country-level coherency in action and to
allow countries to present a comprehensive plan to potential donors,
particularly through the intersessional process.
AMRO/PAHO: The Region of the Americas
PAHO began to implement in January 1999 a tripartite agreement with the
governments of Canada and Mexico to collaborate with the Central American
countries to achieve an integral approach for the rehabilitation of landmine
survivors.
A joint planning process was initiated between WHO headquarters and PAHO to
launch co-ordinated victim assistance in the Central American region. The
preliminary planning involved four countries: Nicaragua, El Salvador, Guatemala,
and Honduras. A first formal planning meeting with Nicaragua will take place in
March 2000 to develop a national plan of action. The victim assistance
programming process in Central America will be accompanied by a WHO
headquarters-PAHO consultation on public health and human security.