Action points based on findings

• Sustain programs offering psychological support and income-generating projects to survivors and others with similar needs with national resources.
• Increase awareness of Law 763 on the rights of persons with disabilities and dedicate resources to its implementation and enforcement.
• Report in a timely manner on victim assistance activities, including by allocating a designated focal point in government, before national and international audiences.
• Ensure there is an active coordination mechanism for victim assistance.

Victim assistance commitments

The Republic of Nicaragua is responsible for a significant number of landmine survivors and survivors of other explosive remnants of war (ERW) who are in need. Nicaragua has made commitments to provide victim assistance through the Mine Ban Treaty, Protocol V of the Convention on Certain Conventional Weapons, and is also a State Party to the Convention on Cluster Munitions.

Nicaragua ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 7 December 2007.

Casualties Overview

There were no mine/ERW casualties identified in 2014 in Nicaragua. [1] In 2013, one civilian was injured by an ERW in October in the Province of Leon. [2] This was consistent with recent low annual casualty figures following the completion of clearance in 2010. [3] The last reported landmine casualty occurred in 2010. [4]

As of December 2014, Nicaragua recorded 1,303 mine/ERW casualties (92 killed, 1,211 injured), including 42 deminers (five killed, 37 injured). [5]

Victim Assistance

PADCA reported that there were 1,205 mine/ERW survivors living in Nicaragua as of May 2015. [6]

Victim assistance since 1999

Between 2002 and 2013, all registered mine survivors in Nicaragua had received support from the Organization of American States (OAS), with international funding, to access physical rehabilitation and/or economic inclusion assistance. However, these services could not be provided in 2014, as the OAS did not receive new funds. [7] As of May 2015, the OAS remained the focal point in charge of the Information Management System for Mine Action (IMSMA) data on victim assistance. [8]

Throughout this period, most other persons with disabilities were unable to access basic medical and rehabilitation services and fewer than half of adults with disabilities earned any income, including a pension.

In 2009, increased government funding to the Ministry of Health expanded the availability of some services for all Nicaraguans, including for survivors, most especially medical and physical rehabilitation services.

Also in 2009, with support from the ICRC Special Fund for the Disabled (SFD), the Ministry of Health established a new rehabilitation center in northern Nicaragua, close to where many survivors are located. In 2012, the ICRC SFD financed an economic inclusion program for persons with disabilities, conducted by the Polus Center’s national program (FURWUS), which continued its activities through 2014. In 2013, with support from the Pan American Health Organization and the World Health Organization, two projects for socio-economic inclusion of mine survivors including vocational and productive project training were carried out, one of them specifically in the department of Estelí. [9]

Victim assistance coordination

The Nicaraguan Demining Commission’s (Comisión Nacional de Desminado, CND) Sub-Commission for Medical Assistance and Rehabilitation of Mine Survivors is the victim assistance coordination mechanism and the Ministry of Health is the focal point. Both have been inactive in recent years. [10]

Nicaragua did not provide updates on progress or challenges in victim assistance at the Mine Ban Treaty Thirteenth Meeting of States Parties in Geneva in December 2013 or at the Third Review Conference in Maputo in June 2014. Nicaragua’s most recent Mine Ban Treaty Article 7 report (for calendar year 2012) included no information on casualties or victim assistance. [11] In its most recent Convention on Cluster Munitions Article 7 report (also for calendar year 2012), Nicaragua indicated that Form H on victim assistance was not applicable. [12]

Service accessibility and effectiveness

In 2014 and 2015, through the program “Todos con Voz” (“A Voice for All”), the Ministry of Health continued to carry out home visits to persons with disabilities, including victims of mines/ERW, to provide basic medical attention, deliver mobility devices, and refer patients to regional hospitals as needed. Since 2010, brigades of Cuban and Nicaraguan doctors have made thousands of outreach visits. [13]

At the CRPD Meeting of the States Parties in 2014, Nicaragua announced the creation of a multi-sectorial team to work on a national rehabilitation strategy that would prioritize a community-based approach. [14]

Between 2002 and the end of 2013, all registered mine/ERW survivors had received support from the OAS to access physical rehabilitation and/or economic reintegration assistance. Starting in 2011, OAS support to mine victims was limited to physical rehabilitation and economic reintegration assistance was no longer available. [15] In 2014, the OAS received no financial support for victim assistance activities and therefore could not provide assistance to mine/ERW survivors. [16]

Physical rehabilitation

The Ministry of Health coordinates a network of service providers that include physiotherapy units, rehabilitation services, a teaching hospital specialized in rehabilitation, and prostheses and orthotics production centers. [17] Civil society organizations such as the Medical Pedagogical Institute Los Pipitos (Instituto Médico Pedagógico Los Pipitos) and Early Rehabilitation and Stimulation Centers, also provided a variety of services to persons with disabilities in 2014. [18]

In the first half of 2014, the ICRC SFD provided technical monitoring and advice, as well as support to five physical rehabilitation centers throughout the country. It also sponsored four scholarships for a distance-learning course on prosthetics and orthotics provided by the University Don Bosco in El Salvador, and organized a clinical training course on the manufacturing of polypropylene hip-disarticulation prostheses, to which 3 participants from its partners in Nicaragua were invited. [19]

In 2014 the ICRC SFD maintained high-level contacts with the Ministry of Health and other actors of the physical rehabilitation sector, including disabled people’s organizations. Negotiations between ICRC SFD and the Ministry of Health on a framework agreement to improve national coordinating mechanisms among the country’s five rehabilitation centers, which started in 2013, continued through 2014. [20] Discussion focused on the Ministry of Health adopting a leading management role in the of physical rehabilitation sector, in particular with regard to decentralized services. [21]

Throughout 2014 and into 2015 the ICRC SFD continued strengthening the management capacity of the Production of Technical Aids and Ortho-prosthetic Device National Center (Centro Nacional de Producción de Ayudas Técnicas y Elementos Ortoprotésicos, CENAPRORTO). CENAPROTO was able to substitute for ICRC SFD in offering training opportunities for professionals from the region. [22] The ICRC reported that in 2014 the center was sufficiently subsidized by the Ministry of Health—whose funding has been increasing steadily in the last two years—in order not to depend on SFD financial support in the near future. [23] In total, CENAPRORTO produced 294 prosthetic devices, a slight decrease compared to 2013 when 302 devices were produced. [24]

In 2014, the ICRC SFD increased the availability of physical rehabilitation by providing materials and supplies to five different rehabilitation centers or outreach services. It reimbursed the costs of assistance for 144 patients who received prosthetic limbs, a 12% increase compared to 128 patients in 2013. In total, 85 mine/ERW survivors received prostheses from four orthopedic centers, which represented at least 28% of total prosthesis produced. In 2013, 17% of all beneficiaries were survivors. [25] However, the ICRC SFD has reported that landmine survivors “represent 30% of amputees in Nicaragua.” [26]

Social and economic inclusion

The Inter-institutional Network for Equality and Non Discrimination in the Working Environment (Red Interinstitucional de Igualdad y la No Discriminación en el Empleo) carries out awareness-raising activities and works to strengthen national legislation in order to foster equality of rights and opportunities for persons with disabilities. [27]

In 2014, 25 people, including 23 mine victims (92% of beneficiaries), benefitted from an ICRC SFD economic inclusion program for persons with disabilities implemented by Polus Center’s national program (FURWUS). [28]

Laws and policies

On 4 March 2014, implementing regulations for Law 763 on the Rights of Persons with Disabilities were approved. [29] In April 2011, Nicaragua approved Law 763 to replace the previous law on disability; Law 763 is aligned to the CRPD. Despite legal protection, discrimination was widespread in 2014 in employment, education, transportation, access to healthcare, and other state services. The government did not effectively enforce the law. The press reported the Managua Mayor’s Office sponsored relevant training for bus drivers through transportation cooperatives. However, complaints continued regarding the lack of an accessible public transportation system in the capital. While some buses were accessible to persons with disabilities, reports continued that drivers of the accessible-equipped buses either refused to stop to allow persons with disabilities to board or intentionally broke lift and ramp equipment on their buses. Despite the existence of technical norms on accessibility, persons with disabilities faced severe problems accessing schools, public health facilities, and other public institutions. The law did not restrict persons with disabilities’ right to vote, although many voting facilities were not accessible to persons with disabilities. [30] Provisions on accessibility in the construction of new buildings were respected overall, but the majority of old buildings had not been adapted. [31]

Special Law 830 on Assistance to Ex Combatants for Peace, Unity and National Reconciliation, approved in 2013, regulates assistance for basic necessities and socio-economic reintegration to former combatants, including those living with disabilities and their families. [32]