Casualties Overview

In 2010, the Monitor identified 394 casualties from antipersonnel mines, antivehicle mines, victim-activated improvised explosive devices (IEDs), and other explosive remnants of war (ERW) in Pakistan.[1] Nearly half of all casualties were security forces (46%), a significant increase from 2009 when they were 25% of all reported casualties. Forty-four child casualties were identified (32 children killed; 12 injured), representing 21% of all civilian casualties; most (41) were boys. Adult men (332 or 84%) continued to make up the largest casualty group; 18 casualties were female.

As in 2009, the vast majority of casualties in 2010 (368) occurred in Federally Administered Tribal Areas (FATA) (241), Balochistan (64), and Khyber Pakhtunkhwa (KP, formerly North-West Frontier Province) (63). Victim-activated IEDs caused more than half of all casualties, a percentage that has been increasing since at least 2007.[2] Victim-activated IEDs killed 44 people and injured 159 people, including 15 children.

The 394 casualties identified in 2010 represented a similar number to the 421 casualties identified in 2009; given significant variation in available annual casualty data the slight decrease is not necessarily indicative of change.[3] The ongoing violence in KP and FATA continued to be seen as the cause of high numbers of casualties.[4]

In the first eight months of 2011, initial reports indicated the number of casualties had already increased compared with 2010 and 2009.[5]

The total number of casualties in Pakistan is not known, and there has been no official data collection mechanism. In 2010 and 2011, the government reported that there were no ERW casualties in Pakistan.[6] However, between 1999 and 2010, the Monitor identified at least 2,784 casualties (1,025 killed; 1,664 injured; 95 unknown) from victim-activated explosive items, including ERW, through media monitoring, field visits, and information provided by service providers.[7] It is likely that the total number of casualties is much higher. For example, in 2011, it was reported in the media that 6,710 Pakistani soldiers were injured in conflict in recent years and that IEDs were the greatest cause. It was not reported what proportion of the IEDs were victim-activated.[8]

Victim Assistance

The Monitor has identified 1,664 mine/ERW survivors in Pakistan.[9]

Assessing the needs of victims

No efforts were reported in 2010 to assess the needs of mine/ERW survivors.

Victim assistance coordination

Victim assistance coordination[10]

Pakistan reported that that the Military Operations Directorate of the Pakistan Army was the focal point for victim assistance, but did not indicate if this was for both civilian and military survivors.[11] During the year, there was increased cooperation among nongovernmental service providers. Bilateral cooperation between individual service providers and government agencies also increased in order to provide survivors with information and referrals to existing services.[12] The Ministry of Social Welfare and Special Education and its National Council for the Rehabilitation of Disabled Persons are responsible for the protection of the rights of all persons with disabilities.[13]

There was no victim assistance plan in 2010. Pakistan reported that a “deliberate procedure/programme is in place” for the victims of IEDs. However, this was reported to be individual rehabilitation programs including emergency and ongoing medical care and physical rehabilitation at army medical units and hospitals, as well as economic reintegration through monetary compensation and employment. It was not reported if civilians could access these services.[14]

Pakistan provided information on victim assistance coordination in its Convention on Conventional Weapons (CCW) Protocol V Article 10 report and information on victim assistance available to IED casualties in its CCW Amended Protocol II Article 13 report.[15]

Survivor Inclusion

No information was available as to whether or not mine/ERW survivors were included in government coordination, implementation, or monitoring of disability plans.

Service accessibility and effectiveness

Victim assistance activities in 2010[16]

Ongoing violence throughout 2010, mostly in northern Pakistan, and the greater use of victim-activated IEDs increased the demand for victim assistance.[17] In response to this increased demand, several international and national organizations increased the availability of services in the affected areas, particularly in KP and FATA, increasing emergency medical services and opening new physical rehabilitation centers. However, the deteriorating security situation restricted access to these services. Mine/IED and ERW survivors were prevented from traveling to services and hospitals and access roads were closed. The security situation also restricted humanitarian access to survivors and other victims of the violence, along with the transport of medical supplies.[18] This was further exacerbated by flooding that began in July 2010 in violence-affected areas, washing out bridges and roads, and increasing the numbers of people requiring medical attention.[19]

The Pakistani government had a medical support plan that detailed the emergency medical evacuation of mine/IED and ERW casualties to army medical units and field hospitals in the affected areas.[20] Pakistan reported that these services were “adequate.”[21] MSF found that low standards of equipment and hygiene in hospitals in affected areas negatively impacted the quality of services.[22]

In 2010, access to health care, both emergency and ongoing medical attention, remained difficult for mine/IED/ERW survivors in violence-affected communities. To respond to the increased demand for medical services, the ICRC doubled the capacity of its Peshawar field hospital. It also continued to support mobile health units and provided medical supplies and equipment to local hospitals in violence-affected areas as well as war-surgery training.[23] In 2010, MSF started to provide emergency surgery once again in Swat, KP, after closing the program in early 2009, and opened a new emergency medical department in Hangu district of KP.[24]

HHRD and PIPOS each opened two new rehabilitation centers in conflict-affected areas of the country. Overall, among the five rehabilitation centers supported by the ICRC, there was a 90% increase in the number of mine/ERW survivors receiving prosthetics in 2010.[25] In an effort to increase access to rehabilitation services, the ICRC conducted outreach visits in Kashmir and reimbursed patients for transportation and accommodation costs to all ICRC-supported centers and for the cost of treatment at PIPOS centers.[26]

Rehabilitation services for military mine/IED and ERW survivors were available through army hospitals. Complicated cases were referred to AFIRM. In 2010, AFIRM was unable to meet the demand for rehabilitation services due to a lack of staff and funding. Wait-lists of up to a year to be admitted were reported. Those who were admitted could wait several months before receiving a prosthetic device. The quality of the prosthetic devices available depended on the rank of the soldier rather than their needs.[27]

As in previous years, few psychological support and economic inclusion programs were available. HI continued to provide psychosocial support begun as part of its emergency relief program in 2009 and LCD provided counseling for all persons with disabilities in conflict-affected areas. LCD launched a livelihood project in KP for persons with disabilities, aiming to include 1,500 beneficiaries.[28] The ICRC continued providing small grants and business training through the Muzaffarabad Physical Rehabilitation Center, which had a 33% increase in the number of beneficiaries as compared with 2009.[29]

In 2010, SPADO expanded its efforts to connect survivors in KP and FATA to all available victim assistance services.[30]

According to the Pakistani government, IED survivors were provided with monetary compensation, employment, and commercial or agricultural property. No figures were provided on the number of survivors who received this assistance in 2010, or if any were civilian.[31] Employment quotas for persons with disabilities lacked adequate enforcement mechanisms.[32]

The law provides for equality of the rights of persons with disabilities, but not all provisions were implemented in practice.[33] Pakistan ratified the Convention on the Rights of Persons with Disabilities on 5 July 2011.