Summary action points based on findings

• Provide follow-up to address the needs identified by survivors surveyed in 2013 and 2014.
• Make sustainable the existing health, prosthetics, and economic opportunities in the mine-affected northern region.
• Advance the progress made in incorporating victim assistance into the national disability and development sectors with local technical support.
• Replicate small-scale affordable prosthetics and rehabilitation services throughout the country for the assistance of other amputees and survivors of explosive remnants of war (ERW) and weapons, applying the extensive knowledge developed though Albania’s victim assistance program.
• Identify and evaluate the needs of persons with disabilities who live in remote rural areas, including survivors.

Victim assistance commitments

The Republic of Albania is responsible for landmine survivors, cluster munition victims, and survivors of other ERW. Albania has made commitments to provide victim assistance through the Mine Ban Treaty and Convention on Conventional Weapons Protocol V, and has victim assistance obligations under the Convention on Cluster Munitions.

Albania ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 11 February 2013.

Casualties

Casualties Overview

In 2014, the Albanian Mine and Munitions Coordination Office (AMMCO) reported nine casualties of AXO entered in the national database. All were civilians. Five casualties were children (four girls and one boy) and the other four were adult men[1] 

This represented an increase from the three AXO casualties that AMMCO recorded in 2013.[2] It was, however, similar to the eight AXO casualties reported for 2012 and six AXO casualties for 2011.[3] The last landmine casualties reported were in 2005.

A total of 991 mine/UXO and AXO/ERW casualties (150 killed; 841 injured) have been identified in Albania between 1997 and 2014. The Albanian Mine Action Executive (AMAE) casualty database for Kukës region contained information on 272 mine and ERW casualties (34 killed; 238 injured) for the period 1999–2005.

Cluster munitions casualties

There have been at least 55 cluster munition casualties in Albania. The Kukës database recorded 53 casualties from cluster munition remnants (nine killed; 44 injured).[4] Two additional casualties, due to the use of cluster munitions, were also identified.[5]

Victim Assistance

There are at least 841 mine/ERW (including AXO) survivors in Albania.

Victim Assistance since 1999[6]

Since 1999, Albania has made significant progress in developing all components of victim assistance in the northeast with the introduction of an initial victim assistance plan in 2003. Extensive data collection, used for program design and information sharing, contributed to the success of the regional victim assistance program in 2005–2009. Needs-based and comprehensive community-based programming, as well as linkages to broader development strategies, were applied to develop an exemplary victim assistance program. However, after the country was declared mine-free in 2009 resources for victim assistance in Albania declined and were insufficient to meet the needs of survivors.

Since 1999, progress in victim assistance was most prominent in the areas of medical care, employment, and economic support in the northeast. A prosthetic and rehabilitation center was built in the mine-affected region. Conditions at the National Orthotic-Prosthetic Center in Tirana, once the only such facility in Albania, had been deteriorating since 2005, and in 2010 the center lost ICRC support. A five-year project to build capacity in the rehabilitation sector through training of physiotherapists and the establishment of a prosthetics workshop in the mine-affected area was successfully completed by 2012. Some delays in implementation were attributed to general difficulties experienced by the overall healthcare reform process in Albania. However, a teaching program for physiotherapy was successfully established and integrated into the state Nursing Faculty. ALB-AID (formerly VMA-Kukës, founded in November 2000) provided direct victim assistance, including economic inclusion.

Economic inclusion and psychological support remained the most serious needs of survivors. Overall, widespread poverty, unregulated working conditions, and poor medical care posed significant problems for many persons with disabilities.

Victim assistance under the Vientiane Action Plan 2011–2015

Victim assistance activities were coordinated and monitored by AMMCO and carried out in cooperation with implementing partners including ALB-AID, the Ministry of Health, Ministry of Welfare and Youth, Kukës Regional Hospital, Directorates of Public Health, UNDP

Albania, International Trust Fund Enhancing Human Security (ITF), and the University Rehabilitation Institute Republic of Slovenia.

Immediately after Albania was declared mine-free in 2009, international funding for victim assistance was drastically reduced. Although much was said about linking mine action to development, no funding was made available for such activities.[7]

Services provided by state institutions to persons with disabilities, including mine/ERW survivors, improved in the cities of Albania in 2010. Most survivors received some support from the Ministry of Social Welfare and Youth. However, despite improvements, available support was insufficient to meet the basic needs of survivors and all other disabled persons in Albania, particularly in the areas of employment and economic inclusion.[8]

In 2011, the main victim assistance provider in Albania, ALB-AID, continued to implement victim assistance programs at an extremely reduced level due to decreased funding with just one economic inclusion project, which continued into 2012. In other parts of Albania, except the Gerdec munitions storage explosion site, ALB-AID was not able provided direct services to survivors due to the lack of funding.[9]

A study on the transition of internationally supported mine action to national ownership noted that Albania’s victim assistance program had the capacity to expand its focus beyond the mine-affected northern regions, and to the site of the Gerdec munitions storage explosion, to assist survivors of explosive ordnance and other persons with disabilities throughout the country.

The five-year collaborative project to support Albania in developing a national physical medicine and rehabilitation (PMR) system concluded in 2012. The Nursery Faculty of Tirana continued to implement a sustainable program of physiotherapy training into 2015.

However, rehabilitative medicine remained at the beginning stage in Albania and was far from meeting the needs of survivors and other persons with disabilities. Some rehabilitation, mainly physiotherapy, was offered by small private clinics and professionals. More structured private services offered rehabilitation with other forms of therapy in addition to physiotherapy.[10]

ALB-AID developed a project to build a sustainable survivors network in 2012, and simultaneously began planning to undertake needs assessment surveys in order to expand opportunities to access physical rehabilitation services for ERW survivors and amputees in other parts of the country. In 2013, ALB-AID, with help from AMMCO, conducted an assessment of socioeconomic and health needs of marginalized UXO/AXO victims within the framework of the Albanian Mine Action Programme (AMAP).[11]

These survey projects resulted in detailed, consolidated socioeconomic data on survivors and their needs that was shared with Albanian line ministries and local municipal service providers for social support services. The project also raised awareness among local government institutions (social welfare departments) of their responsibilities to address the need for social and economic inclusion of UXO/AXO survivors.

Assessing victim assistance needs

In 2013–2014, a “Needs Assessment of Socio-Economic and Medical needs of marginalized Explosive Remnants of War (ERW) victims in Albania” was conducted in six regions (Korçë, Elbasan, Durrës, Peshkopi, Gjirokastër, and Berat) with the financial support of the Austrian government, and in two other regions (Shkodër, Lezhë) with the financial support of the US government through International Trust Fund Enhancing Human Security. The assessment focused on reviewing the status of the survivors, identifying their specific needs, and drafting recommendations for the Government to provide them with relevant assistance. During 2014, 168 UXO/AXO and other ERW victims and their families were visited. Of that total, 126 persons were directly interviewed.[12] ALB-AID employed capacity from both its survivor network and from the personnel who had worked at the unplanned munitions explosion area of Gerdec to survey survivors some of whom live in extremely remote areas.[13] In 2013, 396 ERW survivors and their families were visited, of which 296 were interviewed.

During survey in eight counties of Albania, ALB-AID identified 255 previously unidentified casualties, including 110 from the period 1945–1990 and 145 from 1991–2014. These were to be entered into the AMMCO database as a complete dataset following the completion of the last three districts to be surveyed (Tirana, Fier and Vlora), which was planned for March 2016.[14]

Victim assistance coordination[15]

AMMCO is responsible for coordination of victim assistance activities, resource mobilization, and liaising with the government. In 2014, AMMCO’s mandate continued to involve expanding Albania’s existing victim assistance program to include other AXO and UXO survivors and persons in need of assistance.[16]

The objectives of Albania’s National Victim Assistance Plan were aligned with the recommendations of the Cartagena Action Plan.[17] The National Victim Assistance Plan is designed to contribute to the enhancement of emergency and continuing medical care, physical rehabilitation, psychosocial support, socioeconomic inclusion, data collection, as well as to the relevant laws and policies for all mine/ERW survivors throughout Albania.[18]

The national Mine Action Plan (2010) aimed to make victim assistance sustainable by building sufficient national capacity and by linking future progress with implementation of the National Strategy on People with Disabilities (NSPWD).[19]

In order to strengthen coordination, implementation, and sustainability of the victim assistance plan, AMMCO participated in, and presented to, a number of meetings and visits in 2014, including: a visit of the Minister of Health with the ambassadors of Slovenia and Austria to the Kukës Hospital and with regional authorities; and meetings with the US Department of State and ITF, US embassy, German embassy, and the OSCE.[20]

The newly reformed National Disability Committee was chaired by the minister of social welfare and included representation from seven disabled persons’ organizations (DPOs) and seven service providers.[21]

Albania provided reporting on victim assistance activities in Form J of its Mine Ban Treaty Article 7 report for 2014.[22] Detailed information on victim assistance was reported in Form H of Albania’s Convention on Cluster Munitions Article 7 report for 2014.[23] Victim assistance activities were also reported in its Convention on Conventional Weapons (CCW) Protocol V reporting.[24]

Participation and inclusion

Survivors were represented in victim assistance planning and implementation of services, including the AXO survivor survey, through participation in ALB-AID.[25] A landmine survivor leader was also a representative of a unique political party that specifically represents persons with disabilities.

Service accessibility and effectiveness

Victim assistance activities[26]

Medical care and Rehabilitation

The National Trauma Center, located within the Military Hospital in Tirana, is responsible for treating people with injuries and trauma. Emergency training for doctors and nurses was provided by Turkey, with the aim of creating an improved and modern emergency response capacity. AMMCO communicated with the Ministry of Health during these developments.[27]

At the Kukës Regional Hospital Physiotherapy unit and at the district hospital in Tropoja, training was provided by the government and NGOs. A full set of physiotherapy equipment was delivered to the Kukës Hospital. More than 400 patients benefited from the services provided by the unit. The Kukës prosthetics workshop produced 38 new prostheses and made 73 major repairs for survivors and other amputees in 2014. The Nursing Faculty of Tirana continued to implement its program of physiotherapy training in 2014; 20 students graduated in 2014, and 25 more were registered for 2014–2015.[28]

A physiotherapy educational program based on European standards is being implemented by the Nursing Faculty of Tirana. The prostheses workshop and the physiotherapy unit were operating completely within the Kukës Hospital structure, providing services for amputees including cluster munitions survivors and other persons with disabilities.

During 2014, the Prosthetic Workshop at Kukës Regional Hospital was able to support about 38 amputees with new prostheses and 73 others with major repairs.[29]

ADRF operated a wheelchair service from 2004 to January 2015. As part of the related project, from 2013–2015 it organized training of hospital-based staff and physiotherapists in providing wheelchair service and adjustments.[30]

Economic and social inclusion and psychological support

Generally, resource constraints and lack of infrastructure made it difficult for persons with disabilities to participate fully in many social activities. Governmental social services agencies were often unable to implement their programs due to lack of funding.[31]

In 2015, ADRF was assisting local governments with action plans for enhancing the employment of persons with disabilities on the basis of new national legislation. It also held capacity-building workshops on the issues, including one in Kukës.[32]

National laws and policies

Due to the differentiated status of certain DPOs and associations and the lack of official status for certain disabilities, there was unequal access to rights among persons with disabilities.[33] Differences in legal status meant that most mine survivors with disabilities were not eligible for the state benefits available to some other groups of persons with disabilities.[34] This was a main concern for survivors; if they were not working when they were injured (or blinded or para/quadriplegic), they were not recognized as persons with disabilities under the law and therefore did not receive disability benefits.[35] 

The legal framework for persons with disabilities was revised in July 2014, when Albania adopted Framework Law No. 93/2014 “On the Inclusion of and Access for People with Disabilities,” which aims to break down the unequal status system. It promotes and protects the rights of persons with disabilities through the provision of assistance and support with a view to affording them full and effective participation in society on an equal basis with others. Non-discrimination and gender equality are two key principles of the law. 

The new law covers all groups of persons with disabilities. It provides for a multidisciplinary commission responsible for examining and evaluating the disability of each applicant. It also includes the establishment of a State Committee for Persons with Disabilities to be composed of representatives of different ministries and civil society organizations. Implementation of the new law will require significant improvements in infrastructure and access to services.[36] Some NGOs criticized the law because they asserted it would transfer some powers from civil society organizations to the government.[37]

Secondary legislation to ensure the implementation of the law was being developed by the newly reformed National Disability Council. This included a sub-act of incentives for the employment of persons with disabilities. Incentives include six full salaries after which 50% of salary is provided through government support and coverage of employees’ social insurance. The package was supported by USAID.[38]

Legislation prohibited discrimination against persons with disabilities in employment, education, access to healthcare, and the provision of other state services. However, service providers did sometimes discriminate against persons with disabilities. The law mandated that new public buildings be accessible to persons with disabilities, but this was not regularly enforced.Widespread poverty, unregulated working conditions, and poor medical care posed significant problems for many persons with disabilities.[39] Persons with disabilities continued to face difficulties in accessing education, employment, healthcare, social services, or decision-making.[40] 

However, persons with disabilities continue to face difficulties in accessing education, employment, healthcare, and social services.[41] The People’s Advocate (ombudsperson) identified the following problems faced by persons with disabilities in Albania in 2014:[42]

• Persons with disabilities who live in remote rural areas sometimes did not benefit from social and healthcare services.
• Mentally ill persons (persons with psychosocial impairments) did not benefit from these services in the same way as the other categories of persons with disabilities.
• Persons with disabilities did not have access to public urban transportation.
• Lack of access to justice, governmental structures at central and local level, media, and business for persons with disabilities remained a concern.
• There was a lack of suitable access to public and private premises.
• Legal provisions for the employment of persons with disabilities were not applied.

Previous delays in disability and pension payments were addressed. Preparations for pension reforms in the social protection sphere also advanced and legislation was amended in July 2014.[43] Changes in legislation that altered the criteria for disability pensions affected some persons with disabilities adversely.

Survivors’ representatives reported that due to the amendments of July 2014, access to the disability pension was reduced for many mine/ERW survivors. This was a result of instructions on the implementation of the legislation, issued by the Ministry of Health and Ministry of Social Welfare and Youth,  restricting the granting of pension to double amputees.[44]

Law No. 54/2012 amending the Law on Social Programmes for Housing Inhabitants in Urban Areas prioritizes the housing needs of women with disabilities, among other vulnerable groups of women.

ADRF and the Civil Rights Defenders organization published a monitoring report on the Law on Protection against Discrimination in the Field of Disability, and a survey report on Objectives in the Governmental Program and Plan for Disability, both in December 2014.