Victim assistance (VA) is seen as a lower priority than stockpile destruction and demining programs under the Mine Ban Treaty. While slow improvements were reported in 2007–2008, progress was largely sporadic in efforts to treat, rehabilitate and reintegrate the hundreds of thousands of mine and explosive remnants of war (ERW) survivors. With one year left in the 2005–2009 Nairobi Action Plan (NAP), all States Parties, but particularly the 25 with “ultimate responsibility” for significant numbers of survivors (the “VA25”), will have to increase their efforts if the NAP is truly to have made a difference in the lives of survivors, their families, and communities.
Victim Assistance in 2007–2008
Article 6(3) of the Mine Ban Treaty provides that “each State Party in a position to do so shall provide assistance for the care and rehabilitation, and social and economic reintegration, of mine victims.…” Although it is not made explicit in the treaty, it is understood that all States Parties are “in a position” to assist survivors, as well as their families and affected communities, either directly or through adequate international support. To be effective, assistance should be delivered through a holistic approach that encompasses emergency and continuing medical care, physical rehabilitation, psychological support, and social and economic reintegration. Delivery should be based on respect for the rights of all persons with disabilities and, where possible, making use of existing infrastructure.
Understanding the needs
In the vast majority of states, the number of mine/ERW survivors and especially their needs are not adequately known (see chapter on Casualties).
During the reporting period (May 2007 to May 2008), several states sought to address this gap through improved data collection, “cleaning up” databases or survivor surveys:
- BiH started to revise and consolidate the different casualty databases held by partner organizations.
- In Jordan, the 2006–2007 Landmine Retrofit Survey significantly improved information on mine/ERW casualties as information existing in separate databases was consolidated. A disability survey was also launched in 2008.
- In Lao PDR, the launch of the Lao Victim Information System included a survey of casualties since 1964.
Knowing only the number of survivors is not sufficient to identify their needs. In too many states—especially in at least 19 VA25 states the lack of a clear picture of survivor needs has been impeding adequate service provision:
- In Croatia, operators noted that the lack of information on survivors’ needs was a major hurdle to providing assistance, and called on government bodies to resolve the problem.
- In the DRC, the Information Management System for Mine Action (IMSMA) database did not contain the details needed for an adequate evaluation of survivors’ needs. A needs assessment planned for 2006 was never conducted, due to lack of resources.
- Mozambique stated in its Article 5 deadline extension request that some of its casualty data was “subject to confirmation” and that it does not represent “the real situation” of mine/ERW survivors in the country.
- Serbia has not made progress on establishing a casualty database and made contradictory statements about even needing one.
- In Uganda, progress on the national surveillance network and on inclusion of socio-economic indicators for survivors stalled.
- In Yemen, while casualty data is relatively complete, the needs of survivors have not been adequately assessed and the program continued its restrictive, medical approach to victim assistance.
A number of states initiated, albeit mostly limited, needs assessments in 2007–2008:
- In Cambodia, the NGO-run Cambodia Mine/UXO Victim Information System was to restart assistance to, and the gathering of socio-economic data on, survivors in August 2008 after a three-year suspension.
- Colombia organized meetings of survivors to better understand their needs and make them aware of the services available. These meetings were, however, limited in scope, reaching only some 180 survivors. Colombia stated that a survivor census was needed to enable better assistance to be provided.
- Lebanon started working in 2008 on a system in which each survivor has a file which includes the assistance received, to coordinate work among service providers.
- In Senegal, while data is incomplete, the mine action center unified existing mine action/casualty databases and reportedly started including assistance information in them.
- In Sudan, a survivor needs assessment in two regions indicated that most survivors wanted economic opportunities. However, casualty data contained insufficient detail and reports came in too slowly to be of use for operators.
- Tajikistan conducted a needs assessment to complete casualty data, to plan, prioritize, and monitor VA activities, and to improve stakeholder coordination.
Emergency and continuing medical care
In 2007–2008, a medical approach to VA continued to dominate in terms of the type and quantity of services provided to survivors. Croatia, for example, noted that it “has reached an appropriate level in the provision of physical rehabilitation for people with disabilities, including mine victims, [but] provision of continuous psychosocial rehabilitation and reintegration remains weak. Preventive care is non existent, follow-up care is haphazard and scant ….” It added that there was also an “unacceptably large discrepancy between legislation which exists on paper and its implementation in real life.”
While progress in the health sector is largely unrelated to VA activities, it stands to benefit survivors, for example:
- Afghanistan’s Ministry of Public Health elevated the importance of disability in its strategies and achieved its objective of expanding basic health coverage to 85% of the population by 2008.
- In Azerbaijan, a state program for socio-economic reinvigoration, funded by oil revenues, resulted in the construction of 13 medical centers in 2006–2007, and four more were to be constructed in 2008. International funding also led to the construction or improvement of several medical facilities.
- In Russia (Chechnya), the International Committee of the Red Cross (ICRC) gradually ended its emergency support to Chechnya’s health sector due to vastly improved government efforts.
- In Ethiopia, a unit for emergency preparedness was created in 2007 at the health ministry to develop emergency and rehabilitation services for “injury and violence victims.”
Yet, while most survivors receive emergency medical care, they typically have much greater difficulty obtaining medical care on an ongoing basis. Often they have to pay for services, or cannot even afford transport to the nearest medical center. For example:
- In Colombia, while the government has the capacity to manage health services, they are unequally distributed with specialized services only in major towns. Treatment is only covered when survivors obtain services in their department of residence, even if it is unavailable or inconvenient. Delays in government reimbursements to service providers, complex bureaucracy, road blockades, long distances, and ongoing conflict further hamper civilian access to services in major towns.
- In Palestine, access to health services deteriorated due to movement and import restrictions, power cuts, public sector strikes, and ongoing conflict. Facilities were unable to treat complex injuries, because of a lack of specialists and equipment, and critically ill patients were frequently denied permission to leave Gaza for treatment.
- In Sri Lanka, medical services are weaker in mine- and conflict-affected areas, but persons with disabilities were reluctant to travel as they were required to produce a police report which details the cause of their disability. Military forces curtailed civilian movements and some hospitals in mine-affected areas were attacked during the conflict.
- In Tajikistan, the survivor needs assessment indicated that 80% of survivors needed long-term medical care, but found that the cost and long distances to district hospitals prevented access.
- In Yemen, three-quarters of persons with disabilities needed to travel outside of their communities to receive even basic health services.
Physical rehabilitation still largely depends on international support. When in national hands, supply, management, and staff retention challenges were common. In Angola, none of the rehabilitation centers functioned at full capacity after international pull-out. The ICRC had to step up its assistance to existing rehabilitation centers for, respectively, reasons of access (Colombia), quality (Sudan), and funding (Yemen). In other countries there is no foreseeable end to international support. For example, in Afghanistan the ICRC noted that “the authorities showed little enthusiasm for the idea” of increased national responsibility for physical rehabilitation centers. More positively, in 2008 the Ministry of Social Affairs, Veterans and Youth Rehabilitation in Cambodia presented a three-year plan to gradually take over financial responsibility for the management of physical rehabilitation services.
Survivors faced the same problems accessing physical rehabilitation services as those noted for continuing medical care above. For example:
- For 18 of 26 countries with mine casualties in 2007–2008 where the ICRC operated, it noted explicitly that the cost of services, transportation, or accommodation was an obstacle for people in need of physical rehabilitation. In many cases, the ICRC or NGOs had to cover the costs.
- In Algeria, the ICRC constructed a rehabilitation center for internally displaced persons from Western Sahara in Tindouf because they were unable to access services in Algiers or Spain.
- In Azerbaijan, while Azeris appeared to have good access to services, assistance to Chechen refugees was not provided by state facilities.
- In Iraq, while overall access to rehabilitation increased, steep increases in transport and accommodation costs prevented many people from accessing services.
- In Yemen, the ICRC needed to establish a referral system, and cover its cost, so that people from the restive Sa’ada governorate could access services in the capital Sana’a.
Psychological support and social reintegration
Despite the rhetoric from several states in favor of psychosocial support, these services continued to be accorded little practical importance, and were often limited to peer support. Mental health problems were sometimes stigmatized. In Uganda, survivor organizations were the main psychosocial support providers, but they faced challenges as their funding was blocked for administrative reasons. A few initiatives were undertaken successfully in 2007–2008. In Afghanistan, for example, a survivor organization started the first formal peer-support program for survivors and persons with other disabilities. In Sudan, national bodies and new local VA organizations conducted integrated programs with a psychosocial and a socio-economic component.
In many states, for example Yemen, survivors receive psychosocial support within the family network as it is not a priority for the VA program. Persons with disabilities, particularly women and girls, are hidden from view. In Mauritania, there are no psychosocial support programs for survivors, and mental health is not a priority or even well understood. The only mental health center is in Nouakchott and is understaffed. In Iraq, conflict has had a major impact on mental health, but psychosocial care is largely non-existent, and lacks trained staff. More positively, in Vietnam national funds were allocated for the first time to inclusive education, which allows children with disabilities to learn within ordinary schools, as part of the national disability strategy.
In 2007–2008, the weakest component of VA undoubtedly remained economic reintegration. Although economic opportunities were the top priority as expressed by survivors themselves, all VA25 countries except Thailand noted that these services were the weakest component of their VA programs, ranging from limited to non-existent, and mostly carried out by NGOs.
Economic reintegration activities tended to be small scale and not focused on or tailored to the needs and educational levels of survivors, putting them in a weak position compared with other vulnerable groups. When they were conducted, activities often took no account of the labor market and lacked follow-up to ensure employment opportunities or business sustainability. While many countries had employment quotas for persons with disabilities and in some cases even sanctions for not adhering to them, implementation was poor nearly everywhere, as the following cases illustrate.
- Guinea-Bissau noted in June 2008 that economic reintegration of survivors is a challenge for the state, and even the entire society. It lacked funds for vocational training and micro-credit programs.
- In Tajikistan, 90% of survivors interviewed during survey activity indicated they urgently needed economic opportunities.
- In Yemen, for the third successive year the socio-economic component of the VA program went unfunded, and previous beneficiaries had difficulties managing their businesses.
- More positively, Norwegian People’s Aid (NPA) in Lebanon provided micro-credit consultancy services to national partners and evaluated all micro-credit projects by survivors for additional support and better returns.
Most services to survivors remained center-based, and insufficiently supplemented by community-based rehabilitation (CBR). Referral mechanisms were weak to non-existent. CBR programs, which are an essential complement to national programs, are designed to improve service delivery and create equal opportunities for persons with disabilities who have limited access to services. CBR integrates all components of VA while using local resources and skills, and actively promotes empowerment and participation of persons with disabilities through the development of disabled people’s organizations (DPOs), increased community decision-making and accountability, and needs-based programming.
Some countries, such as Cambodia, Eritrea and Thailand, expanded CBR in 2007–2008, but elsewhere it was lacking. Recognizing the need for better CBR practices, the World Health Organization (WHO) started developing CBR guidelines for publication in late 2008. It presented its work during the VA experts’ parallel program at the intersessional Standing Committee meetings in June 2008. The WHO noted that while CBR requires community and DPO involvement, links to the national government are also needed through a national policy, coordination body, and budget allocation. There is also a need to recognize gender equality in programs, provide management training and reward community workers (often volunteers).
Despite the fact that three-quarters of countries with casualties in 2007–2008 have disability legislation, there were still reports of discrimination in more than 90%. Discrimination against civilian mine/ERW survivors included the provision of pensions, with military survivors receiving considerably higher pensions, for example in Serbia.
- In Croatia, people injured during the war received pensions 10 times higher than those injured after the war;
- In Colombia, new legislation appeared to limit compensation options for survivors; and
- In Rwanda, disability pensions were only half of the minimum wage.
The UN Convention on the Rights of Persons with Disabilities
On 3 April 2008, the UN Convention on the Rights of Persons with Disabilities received its 20th ratification, triggering its entry into force 30 days later. The disability convention requires the inclusion of disability issues in mainstream policy agendas, service provision, commitment of resources, capacity-building, coordination through disability focal points, monitoring, and offers a complaints mechanism through its Optional Protocol.
As of 1 September 2008, there were:
- 130 signatories to the convention, including 16 VA25 members;
- 71 signatories to the Optional Protocol, including 10 VA25 members;
- 34 ratifications of the convention, including six VA25 members (Croatia, El Salvador, Jordan, Nicaragua, Peru, and Thailand); and
- 20 ratifications of the Optional Protocol, including three VA25 members (Croatia, El Salvador and Peru).
On a positive note, in Peru legislation was amended so that mine survivors and their families could benefit from collective compensation.
The right of survivors to participate in planning and implementing VA programs
It is commonly understood that in order to be effective, VA programs need to be based on the needs identified by survivors, their families, and their communities. The NAP urged states to include survivors and persons with disabilities in policy-making, implementation and monitoring. However, in many countries, DPOs lacked funding and capacity to carry out sustainable long-term plans and influence policy-making, limiting them to ad hoc activities. For example, in Afghanistan, with more than three-quarters of a million persons with disabilities, it was noted that the disability movement remained in “its infancy” due to a lack of capacity and negative societal attitudes. Persons with disabilities were unable to effectively promote their own interests.
Meeting VA25 Victim Assistance Objectives 2005–2009
In December 2004, 24 States Parties with significant numbers of survivors (see table below) accepted that they had “the greatest responsibility to act, but also the greatest needs and expectations for assistance” in providing adequate VA to survivors, as outlined in 11 concrete actions in the NAP. In June 2008, Jordan joined what is now called the VA25 group, noting that although its total number of recorded survivors (640) “may not compare highly on a global scale, it is significant when measured against the size of the population.”
The NAP aims to support VA through States Parties’ commitment to: enhance health services; increase physical rehabilitation; develop psychosocial support capacities; actively support socio-economic reintegration; develop and implement relevant policy frameworks; give consideration to gender and age; enhance data collection; integrate mine survivors in the work of the treaty; and ensure the contribution of relevant experts. Those in a position to do so are called on to promptly assist States Parties with a demonstrated need for external support. Under the NAP, states are also required to monitor and report regularly on progress so that “an unambiguous assessment of success or failure” can be made in 2009.
In 2005, the VA25 group also endorsed a framework for measurable action provided by the co-chairs of the Standing Committee on Victim Assistance and Socio-Economic Reintegration. The questionnaire developed by the co-chairs, Nicaragua and Norway, contained four key aims:
- assessing the VA situation in each member country;
- developing SMART (specific, measurable, achievable, relevant, and time-bound) objectives to be reached by 2009;
- creating plans to achieve the objectives; and
- indicating the means needed to achieve the plans.
Subsequent co-chairs continued to encourage the VA25 to make progress on these four key elements, recognizing that the best way to assure progress is working intensively on a national basis. To assist them in this effort a VA expert at the Geneva International Centre for Humanitarian Demining’s Implementation Support Unit was recruited to provide process support, including in-country visits, distance support (for example by email), outreach to other relevant organizations, consultation with survivors, and assistance with the organization of interministerial workshops. Between 2005 and November 2007 “process support” visits were undertaken to 19 of the 25 States Parties and it was envisaged to visit all countries by 2009. In 2008 to August, visits had been undertaken to Afghanistan, Cambodia, Ethiopia, Jordan, Tajikistan, and Thailand.
VA25 countries and estimated number of survivors
Estimated number of survivors
238 (in Kukës)
Unknown, recorded number 159 in LIS
Unknown, verified 153 between 1999-2007
Unknown, between 1,350 and 1,960 recorded
Unknown, 1,489 recorded to end 2007
Unknown, 5,412 recorded
Unknown, between 1,414 and 1,638 recorded
Unknown 1,138 recorded
Unknown, between 2,225 and 3,142 recorded
Unknown, at least 2,498 (but estimates as high as 84,000)
Unknown, at least 7,275 (LIS 2004)
Unknown, at least 847 casualties
Unknown (earlier estimates of 10,000 to 30,000 now said to be unreliable)
At least 265
At least 570
Unknown, estimates between 1,370 and 3,000
Unknown, 2,711 recorded to end 2007 but estimates up to 10,000
At least 420
Unknown, at least 1,971 according to 2001 LIS*
Unknown, at least 1,100
Unknown, at least 2,473
*LIS = Landmine Impact Survey
VA25 Progress in 2007–2008
In 2007–2008, Landmine Monitor identified the most progress in Afghanistan, Albania, Sudan, and Uganda. Albania, as the most consistent performer in the VA25 process, reported at least partial progress on most of its objectives with 2007–2008 deadlines. The three others developed SMART and sustainable plans integrated into their disability frameworks through increased stakeholder and government involvement, while continuing to progress on earlier objectives. Afghanistan added extra components to its objectives (CBR and inclusive education), as did Sudan (coordination, survivor inclusion and resource mobilization).
It needs to be noted, however, that the achievements of these VA programs owe much to the sustained support of UN programs in which dedicated VA staff have provided coordination capacity. When such support departed, as in Uganda in late 2007, progress subsequently slowed. Other countries, such as Croatia and Thailand, largely depended on their own resources, but made less progress.
Overall, most progress was made in supporting the planning process, rather than undertaking activities to assist survivors directly. This is not surprising as a large percentage of the VA25’s combined objectives related exactly to data gathering, strategy and policy development, awareness-raising, and coordination. Of Peru’s objectives, only one was related to the implementation of activities. In Guinea-Bissau, only two of 11 objectives were activity-based. Other notable cases were Angola, El Salvador and Nicaragua.
Planning and coordination progress in 2007–2008 included:
- Of the 10 states that have improved their objectives, six did so during the current reporting period. Others, such as Nicaragua and BiH, reported revisions to their objectives but had not formally presented them to other States Parties just a year before the plans should be fulfilled.
- Of the eight states that have submitted formal plans, five did so during the reporting period. Thailand also developed a plan, but it was not available. Cambodia and Chad said their plans would be ready in late 2008. During the previous reporting period, seven states announced the development of plans, but only El Salvador formally submitted its plan.
- At least 11 VA25 countries initiated an interministerial coordination process to work on achieving their 2005–2009 objectives.
- Burundi did not develop objectives and Colombia’s objectives remained incomplete.
Activity progress in most VA25 countries was limited to certain sectors, for example:
- improved data collection in Tajikistan and Eritrea;
- improved access to free medical services in Guinea-Bissau and expansion of emergency services in Thailand;
- improved physical rehabilitation services in Cambodia;
- improved access to and availability of inclusive education in Mozambique and psychosocial care training of CBR and hospital staff in Senegal;
- affirmative economic integration action in Eritrea and BiH;
- ratification of the UN Convention on the Rights of Persons with Disabilities was an objective achieved by Croatia and El Salvador; and
- many countries, such as Burundi and Colombia, made progress in awareness-raising and the development of guidelines.
Progress in VA was often achieved independently of the VA25 process, and activities were often undertaken without coordinating with it. For example, disability policy was under development in Yemen but without input from the country’s VA focal point. In Ethiopia and Nicaragua, access to healthcare improved through health strategies independent of the VA process. In Peru, economic reintegration opportunities improved through partnerships with the private sector.
In some countries, progress in 2007–2008 was hampered by the continued lack of financial means, particularly in Tajikistan. Other countries reported both insufficient capacity and financial resources, such as Chad, DRC, and Guinea-Bissau. In addition, the 2005–2009 objectives were not always used to guide VA activities in 2007–2008, for example in BiH and Serbia. Colombia’s assistance program for survivors (and other conflict-injured) is not part of its stated NAP objectives.
In 2007–2008, NGOs, DPOs and survivors have been increasingly involved in the planning process, but this was often still done on an ad hoc basis. Few countries can demonstrate the systematic involvement of intended beneficiaries in the development of VA plans. Afghanistan is one of the positive exceptions.
While VA is a long-term process that will extend far beyond 2009, several states delayed their deadlines in recent revisions of the objectives. Several also set completion targets past the 2005–2009 timeframe. Angola delayed nearly all objectives to 2011. Afghanistan and Cambodia’s plans cover the period from 2008–2011/2012. BiH intended to include revised plans for fulfilling its objectives in a strategy for 2009–2019. Peru foresaw development of a VA strategy only in 2009. These delays make measuring progress by 2009 difficult, and could—and probably will—send the signal that little was achieved.
Reporting on VA25 progress
When States Parties set their own objectives for 2005–2009, quantifiable indicators were correctly deemed essential to measure progress. While the vast majority of VA25 states included VA experts in their delegations to treaty-related meetings, and made statements in 2007–2008, they delivered status reports rather than progress reports. These statements will, as the co-chairs rightly said, produce a “body of evidence” on VA activities, but not on progress made. Review of the 2007–2008 VA statements and Article 7 reports showed that nearly all states reported activities in ways that cannot be measured, for example, mentioning the number of people receiving a particular service without noting increases/decreases or the reasons why.
States are solely responsible for defining what can be achieved, when and how, as well as self-monitoring and reporting. Discussions on how to measure VA progress towards the Second Review Conference were at center stage in 2007–2008, with the ICBL and ICRC becoming more vocal on the need for improved progress monitoring by the states themselves. The ICRC noted that “it is rare to find a monitoring system which can track progress in the 24 [now 25] affected countries,” adding that states should take guidance from the UN Convention on the Rights of Persons with Disabilities, which stipulates the need for focal points, which can be individuals or a coordination body, and an independent monitoring mechanism.
Future of the VA25
In June 2008, the co-chairs noted that the VA25 group could grow “as more States Parties report on their responsibilities to significant numbers of survivors.” With Jordan joining this group in 2007–2008, this could encourage Iraq—one of the States Parties outside the VA25 with the largest number of survivors and a leading candidate to make it a VA26—to declare such a responsibility and receive subsequent focused support. No public announcements have been made about reducing the size of the current group, but it could be an option if a state has made sufficient progress.
In 2007–2008, Landmine Monitor also identified the first instance of the VA25 influencing states outside it, with Lebanon specifically stating it had used the co-chairs’ framework in developing its 2008 VA action plan.
VA Strategic Framework
For countries with a small mine/ERW problem, a specific VA plan is redundant, while many countries with larger numbers of mine/ERW survivors include VA as a strategic objective in mine action plans. Yet several severely-affected countries noted service gaps and duplication because of the absence of a specific strategy for VA. The mine action authority in Peru even stated that a VA strategy was needed, otherwise “the various sectors do not feel obliged to provide assistance and allocate funds for this.”
Nevertheless, only 21% of countries recording casualties in 2007–2008 had specific VA plans; nearly all were VA25 countries (88%). Ten VA25 states did not have a specific VA plan as of June 2008. Neither did the States Parties with a high number of casualties, Iraq and Turkey. Of states not party with casualties, only Azerbaijan and Lebanon had a VA plan in 2008. In other states not party with a high number of casualties, progress on developing a plan stalled in 2007–2008 (Lao PDR and Sri Lanka) or was never considered (Myanmar, Pakistan, and Vietnam). In 2007–2008, two countries started working on VA plans: Egypt and Mauritania. Development of a plan in Algeria was delayed due to the bombing of the UN compound in late 2007.
Good practice: linking victim assistance to disability plans
The November 2007 VA25 mid-term review report noted that although VA should be viewed as part of the overall public health, human rights, and social service frameworks, “In many instances the preparation of victim assistance objectives do not take broader national plans into consideration.”* In 2007–2008, only two countries made a considerable step to ensure sustainability and integration of VA in the disability sector. Rather than developing a specific VA plan within the VA25 process, both Afghanistan and Uganda created a comprehensive disability plan assigning significant responsibilities to government bodies, and leaving final responsibility and coordination to the ministry in charge of disability. Afghanistan’s plan was further included in the country’s national development strategy while Uganda’s plan was predominantly compiled from relevant parts of existing strategies, making disability/VA a mainstreamed issue.
Albania linked sustainability of VA to progress in the national disability strategy and VA has, for several years, been integrated into regional development strategies. In Sudan, components of the VA strategy were integrated in workplans and budgets of relevant ministries. Several other countries also made mention of the need for VA in their Poverty Reduction Strategy Papers (Guinea-Bissau, Senegal and Tajikistan).
* “Mid-Term Review of the Status of Victim Assistance in the 24 Relevant States Parties,” Eighth Meeting of States Parties, Geneva, 21 November 2007, p. 4.
National ownership and sustainability
In June 2008, the co-chairs noted that, “National ownership is not a specific aim of the Nairobi Action Plan, perhaps because it should go without saying.…” Nearing the Second Review Conference, national ownership and sustainability will become increasingly crucial to ensure long-term VA.
Of states reporting casualties in 2007–2008, 46 did not assign VA coordination responsibilities. In 22, VA was in the portfolio of mine action authorities. In five, responsibility was divided between the mine action center and relevant ministries; for only seven was it a ministerial responsibility. Only in El Salvador was the government disability coordination body responsible for VA.
For severely mine/ERW-affected countries, this raises the question of whether mine action centers are the best place to ensure sustainability and true integration of VA in broader disability structures, even if the centers were given the mandate to delegate tasks to ministerial levels. Responsibilities for disability are often diffused in government structures, and are rarely more than a small part of a ministry’s portfolio—usually the ministry responsible for social affairs. Few countries with casualties in 2007–2008 have a separate body in charge of disability issues that has sufficient authority to bring about change. In August 2008, Afghanistan appointed a deputy minister for disability affairs. The only other such case is Uganda, which has a state minister for disability affairs.
Review of VA statements made in 2007–2008 showed that most countries with mine/ERW survivors relied quite heavily on services provided by international NGOs and external funding. At least six VA25 states mentioned explicitly that a lack of funding prevented them from achieving their VA goals. Although not exhaustive, Landmine Monitor research for 2007–2008 also indicated that in nearly 40% of countries with casualties during this period, services were carried out predominantly by international operators. In 27% of countries there was an equal share of national and international operators. Only three countries operated exclusively with national capacity in assisting its survivors (Cyprus, Poland and the United States).
While the work of international operators is invaluable, sometimes they have been substituting for the government for so long that there is an overdependence on them and decreased ownership, interest and room for action by those who are primarily responsible—the national authorities. In Nicaragua, operators noted in 2007–2008 that they had not observed progress towards national ownership or the development of a sustainable VA program. Reportedly the efficiency with which the international operator provided assistance to survivors decreased the government’s motivation to develop national capacity in this area.
Yet international agencies can add to the problem if they invest too little in capacity-building of local partners, particularly survivor organizations and DPOs. During this reporting period this was, for example, the case for survivor organizations in Uganda and Senegal. In contrast, national NGOs in Afghanistan took on substantial roles in VA implementation, training, and support to DPOs. International organizations should invest more in national capacity-building.
Some positive progress towards increased national ownership was made in 2007–2008, as several mine action programs or VA providers prepared for complete nationalization and an eventual handover of VA responsibilities to relevant government structures, such as in Albania (by 2009), and Sudan. In Angola in July 2008, the ICRC handed over one of its largest rehabilitation programs to the Ministry of Health after 29 years, stating that the ministry should now have sufficient capacity to administer it.
Coordination between relevant ministries is a key issue for VA and was promoted within the framework of the VA25 process. In 2007–2008, it became clear that when such coordination exists, services tended to be more comprehensive and in line with other relevant strategies in a country. While some VA25 countries made progress, systematic interministerial coordination was only in place in 22% of countries with casualties in 2007–2008. In 2007, Zambia started an interministerial process to assign VA tasks and prevent duplication. In Algeria, mine action is coordinated by an interministerial committee. Among States not party, Lao PDR is a prominent example of interministerial coordination (as is the area of Abkhazia).
Victim Assistance Obligations in the Convention on Cluster Munitions
The 2008 Convention on Cluster Munitions is a landmark treaty for VA because, beyond the obligations in the Mine Ban Treaty, it makes the provision of VA a formal requirement for all States Parties with victims, and calls for international assistance. It formally adopted the common understanding that the definition of a “victim” expands to the affected individual, their families and affected communities, and that VA has to be rights-based and in line with other relevant disability or development strategies. Drawing on lessons learned from the Mine Ban Treaty and the VA25 process, it specifies that VA needs to be focused, measurable, coordinated, and result-oriented. There are stipulations on the creation of national strategies, focal points, inclusion of “victims” in planning and implementation, and clear progress reporting obligations.
Finally, calls for increased monitoring of outputs by both affected and donor states grew louder during the reporting period. Notably, the ICRC stated that “the donor community should report more on the allocation of funds but also ensure that recipient countries provide more information on the extent to which those funds have advanced the enjoyment of rights of persons with disabilities.” Landmine Monitor observed that three years into the NAP most states and service providers are not able to estimate how many survivors have received assistance and how, nor are they able to assess if the number of people benefiting from services increased or decreased from one year to another, or indeed since 2005. Only 23 countries used voluntary Form J to report on VA activities; almost invariably the reports did not include measurable statistical information.
Reliable beneficiary statistics are crucial to measure progress, identify gaps and duplications in VA service provision, as well as to provide effective follow-up services. In 2007–2008, some programs sought to improve data collection on VA services, such as Albania, BiH and Lebanon.
More generally, however, poor data collection and reporting mechanisms remain prevalent. Few countries have a centralized body dealing with disability statistics and services. Hospitals often do not record the cause of injury. Nearly all VA operators count sessions rather than individuals, recording the person each time a service is provided, resulting in “double-counting.” They do not distinguish between mine/ERW survivors and other beneficiaries, and do not distinguish between new patients and old patients. Nor do they record sufficient patient details. Due to the lack of cooperation between stakeholders, or of a coordinating focal point, the same people are counted by every service provider they see. For example, although only an estimated 1,100 survivors were recorded in Uganda, some 2,644 services were reportedly provided in 2007.
 Angola, Bosnia and Herzegovina (BiH), Burundi, Chad, Colombia, Croatia, the Democratic Republic of Congo (DRC), El Salvador, Eritrea, Ethiopia, Guinea-Bissau, Mozambique, Peru, Senegal, Serbia, Sudan, Thailand, Uganda, and Yemen.
 Statement of Croatia, Eighth Meeting of States Parties, Dead Sea, 21 November 2007.
 For more information, see WHO, Disability and Rehabilitation Team, “Community Based Rehabilitation,” www.who.int.
 Ministry of Social Affairs Labor, Martyrs and Disabled, “Afghanistan National Disability Action Plan 2008–2011,” Kabul, May 2008, p. 29.
 UN, “Final Report, First Review Conference,” Nairobi, 29 November–3 December 2004, PLC/CONF/2004/5, 9 February 2005, p. 3. Of these countries, 23 reported responsibility at the First Review Conference in Nairobi from 29 November to 3 December 2004 and with Ethiopia’s ratification of the Mine Ban Treaty on 17 December 2004, the number increased to 24.
 Statement of Jordan, Standing Committee on Victim Assistance and Socio-Economic Reintegration, Geneva, 3 June 2008. Jordan reported responsibility for significant numbers of survivors at the Eighth Meeting of States Parties in November 2007 and further clarified its situation in its Article 5 deadline Extension Request, 31 March 2008.
 UN, “Final Report of the First Review Conference,” APL/CONF/2004/5, 9 February 2005, pp. 99–101.
 “Mid-Term Review of the Status of Victim Assistance in the 24 relevant States Parties,” Eighth Meeting of States Parties, Dead Sea, 21 November 2007, p. 6.
 Afghanistan (2007–2008), Albania (November 2007), Angola (November 2007), Croatia (April 2007), DRC (2006), El Salvador (November 2007), Serbia (April 2007), Sudan (November 2007), Tajikistan (2006), and Uganda (November 2007).
 Afghanistan (2007–2008), Albania (2006 and updated), Angola (2007), El Salvador (2007), Sudan (2007), Tajikistan (April 2007), Uganda (2007), and Yemen (2006).
 The others were BiH, DRC, Eritrea, Guinea-Bissau, Peru, and Serbia.
 Afghanistan, Angola, Albania, BiH, Cambodia, DRC, El Salvador, Sudan, Tajikistan, Thailand, and Uganda. Mozambique improved interministerial coordination for implementation of the national disability plan but not for VA specifically.
 Statement by Markus Reiterer, Austria, co-chair of the Standing Committee on Victim Assistance and Socio-Economic Reintegration, “Closing remarks,” Eighth Meeting of States Parties, Dead Sea, 21 November 2007.
 ICRC, “ICRC Statement on Victim Assistance,” Eighth Meeting of States Parties, Jordan, 21 November 2007.
 “Niños son las principales víctimas de campos minados en nuestro país” (“Children are the main victims of minefields in our country”), El Comercio, 6 August 2007, www.elcomercio.com.
 Cambodia and New Zealand, co-chairs, “Towards the Second Review Conference,” Standing Committee on Victim Assistance and Socio-Economic Reintegration, Geneva, 6 June 2008.
 Article 5(1) provides that: “Each State Party with respect to cluster munition victims in areas under its jurisdiction or control shall, in accordance with applicable international humanitarian and human rights law, adequately provide age- and gender-sensitive assistance, including medical care, rehabilitation and psychological support, as well as provide for their social and economic inclusion. Each State Party shall make every effort to collect reliable relevant data with respect to cluster munition victims.”
 Article 6(7) provides that: “Each State Party in a position to do so shall provide assistance for the implementation of the obligations referred to in Article 5 of this Convention to adequately provide age- and gender-sensitive assistance, including medical care, rehabilitation and psychological support, as well as provide for social and economic inclusion of cluster munition victims….”
 ICRC, “ICRC Statement on Victim Assistance,” Eighth Meeting of States Parties, Dead Sea, 21 November 2007.