Casualties

Casualties Overview

In 2012, the Monitor identified 247 casualties from mines/other explosive remnants of war (ERW) including victim-activated improvised explosive devices (IEDs) in the Islamic Republic of Pakistan. Among 170 recorded civilian casualties,[1] there were at least 54 children (42 boys and 12 girls) and 16 women: the majority of civilian casualties were men. Security forces represented 31% of the total, with 77 recorded casualties.

Khyber Pakhtunkhwa (KPK, formerly North-West Frontier Province), the Federally Administered Tribal Areas (FATA), and Balochistan continued to have the highest numbers of mine/ERW casualties in Pakistan; the combined annual totals for these areas accounted for more than 90% of all mine/ERW casualties in Pakistan in 2012.[2]

The 2012 casualty total represented a significant decrease from the 569 mine/ERW casualties identified in 2011. However, given the considerable variations in availability of annual casualty data, it is not possible to be certain of the extent to which changes in recorded casualties are indicative of actual trends versus shifts in media coverage and use of terminology.[3]

The number of annual casualties caused by antivehicle mines reported in 2012 (100) fell significantly, by about two-thirds, from 2011 (293). However, antivehicle mine incidents continued to cause a significant portion of recorded casualties (41%). The number and ratio of antivehicle mine casualties in 2011 was highest since the Monitor reporting of the differentiation between mine types began in 2006 (249).

The proportion of total mine/ERW casualties reported to have been caused by victim-activated IEDs continued to be more than three times lower than recorded in 2010, when victim-activated IEDs caused more than half of all casualties. Prior to 2010, the ratio had been increasing since at least 2007.[4]

Due to the lack of official data or a comprehensive data-collection mechanism, the total number of casualties in Pakistan is not known. In its transparency reporting for 2012, Pakistan reiterated, as it had in previous years, that there had been no mine or ERW casualties.[5] However, between 1999 and 2012 the Monitor identified at least 3,597 (1,356 killed; 2,148 injured; 93 unknown) from landmines, victim-activated IEDs, and ERW.[6] It is likely that the total number of casualties is much higher. Pakistan reported on 1,091 “IED attacks” causing casualties in 2012, “including” antipersonnel mines and antivehicle mines; Pakistan asserted, “No Explosive Remnants of War (ERW) exist in Pakistan.”[7]

Victim Assistance

The Monitor has identified 2,148 mine/ERW survivors in Pakistan since 1999.

Victim assistance in 2012

Access to services, particularly medical care, in FATA, KPK, and Balochistan was restricted due to violence, a lack of security, and as a result of related government restrictions and security measures which limited the ability of aid organizations to provide assistance.[8] Due to the killing of a staff member, the ICRC decreased most of its activities significantly in May 2012, but continued to support all but one of the rehabilitation centers it had formerly assisted.[9] Many other service providers also either reduced or halted operations owing to the security situation.[10]

Assessing victim assistance needs

National NGOs, including the Sustainable Peace and Development Organization (SPADO), collected information on casualties and survivors as part of their broader program activities. In 2012, SPADO reported that a combination of reduced funding, the security situation, and restrictions on its activities in FATA and KPK reduced its information gathering activities to media monitoring for new mine/ERW casualties.[11]

The ICRC provided mine/ERW victim data collection training for 20 doctors from hospitals and other medical facilities at two workshops in FATA.[12]

Victim assistance coordination

Pakistan reported that the Military Operations Directorate of the Pakistan Army was the focal point for victim assistance, but also asserted that there were no casualties. It was not indicated if the Military Operations Directorate was responsible for both military and civilian survivors.[13] Pakistan has also reported that a “procedure/program” for victims of IEDs is in place through 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. However, it was not reported if civilians could access these services.[14]

Several ministries were involved in disability issues, including the Ministry of Health and the Ministry of Social Welfare and Special Education.[15] Responsibility for special education, social welfare, and the protection of the rights of persons with disabilities was passed to the provincial level after the dissolution of the Ministry of Social Welfare and Special Education in April 2011.[16] Pakistan has a National Policy for Persons with Disabilities (2002–2025).

Pakistan provided contact information on victim assistance coordination in its Convention on Conventional Weapons (CCW) Protocol V Article 10 report but did not update information on victim assistance in its most recent CCW Amended Protocol II Article 13 report.[17]

Survivor participation and inclusion

No information was available about the inclusion of mine/ERW survivors in coordination, implementation, or monitoring of strategies that are relevant to them. However, the government planned to include persons with disabilities, along with national and international NGOs, in formulating an action plan for implementation of the Convention on the Rights of Persons with Disabilities (CRPD).[18] The ICRC noted that some persons with disabilities were actively involved in organizing disability-focused congresses and seminars in 2012.[19]

Service accessibility and effectiveness

Victim assistance activities[20]

Emergency and continuing medical care

Local hospitals were inadequately equipped and staffed to respond to the needs of survivors, lacking specialized medical, surgical, and first aid facilities for affected areas.[21] Pakistan reported a plan for the emergency medical evacuation of casualties from mines/IEDs and ERW to army medical units and field hospitals in the affected areas.[22]

The ICRC increased the capacity of the Pakistan Red Crescent Society, including through emergency assistance and war surgery training. In 2012, less than half the annual number of weapon-wounded patients were registered at ICRC-supported hospitals overall compared with 2011 (4,134 in 2012 and 8,700 in 2011). ICRC-supported hospitals reported treating 19 mine/ERW survivors in 2012 (124 in 2011).[23]

MSF noted that health services in Pakistan were often not affordable. In many regions, insecurity further restricted access to services. MSF provided emergency medical care, including surgery in hospitals in Dargai and Timurgara in KPK. MSF also provided emergency and surgical care at the emergency medical department in Hangu district of KPK near the Pakistan-Afghan border into 2012. The hospital was handed over to the Ministry of Health in August 2012. Afghans affected by conflict often sought medical assistance in the district hospital of Chaman, Balochistan province, also operated by MSF.[24]

Physical rehabilitation including prosthetics

Access to rehabilitation services remains a challenge for most people with disabilities, particularly those in rural areas. Barriers to access services included a lack of transport, poverty, lack of awareness about services, cultural and physical barriers, and the security situation. In 2012, significantly fewer mine/ERW survivors (430 of 1,682 beneficiaries in total) received prosthetics at ICRC-supported rehabilitation centers, a decrease of about 40% from 2011 (720 of 2,005 beneficiaries in total). This was a change from the trend of increased services for mine/ERW survivors in recent years.[25]

Following the kidnapping and murder of an ICRC delegate in the area, the Christian Hospital Rehabilitation Centre in Quetta was closed immediately. Discussions to transfer the center to the national disability and rehabilitation NGO, Chal Foundation, were ongoing in 2013.[26] The ICRC maintained its support for PIPOS in Peshawar and its nine satellite centers in KPK; for the CHAL Foundation and its five centers in the northwest and Baluchistan; for the Hayatabad Paraplegic Centre in Peshawar; the ICRC-managed Muzaffarabad Physical Rehabilitation Centre; and the Akbar Kare Institute in Peshawar, all on an ad hoc basis. In 2012, wheelchair services were enhanced through cooperation with Motivation UK, which donated wheelchairs and provided an introductory course at PIPOS.[27]

Prior to closing their operations in May 2012, Response International had provided physiotherapy to mine/ERW survivors.[28]

Rehabilitation services for military survivors of mines/IEDs and ERW were available through army hospitals. Complicated cases were referred to the Armed Forces Institute of Rehabilitation Medicine.[29] The quality of prosthesis received was based on military rank rather than need.[30]

Social and economic inclusion

In 2012, the ICRC supported the establishment of cricket and basketball teams to promote physical therapy benefits.[31] By May 2012, the ICRC had either completed or suspended providing small grants and business training through the Muzaffarabad Physical Rehabilitation Centre. However, many of the recipients from the previous year received follow-up support from the National Society.[32]

Pakistan reported that IED survivors were provided with monetary compensation, employment, and commercial or agricultural property. No figures were provided on the number of survivors who received assistance, or on how many were civilian or military.[33] Few psychological support and economic inclusion programs were available in Pakistan.[34]

The government declared the federal capital and provincial capitals as “disabled-friendly cities.” Special education centers were established in main cities. Employment quotas for persons with disabilities lacked adequate enforcement. Most persons with disabilities were supported by their families. The law provides for equality of the rights of persons with disabilities, but this was not fully implemented in practice.[35]

The ICRC promoted equal access to all assisted centers through several activities, such as increasing the number of women professionals and providing healthcare and dormitory areas for women.[36]

Pakistan ratified the CRPD on 5 July 2011.