Casualties

Casualties Overview

In 2014, there were at least 251 new mine/explosive remnants of war (ERW) casualties in the Republic of the Union of Myanmar, based on information provided by NGOs and other organizations, as well as by state and independent media reports. [1] The majority of casualties were men, but at least 10 casualties were boys, 17 were women, and two were girls. [2]

The actual total number of casualties is expected to be incomparably higher. Although the presence of a number of mine action actors and coverage of victim assistance programs increased, no systematic collection of casualty data occurred in 2014. Due to the lack of an official data collection mechanism, the absence of any basic reporting format or means of sharing data, and the varying sources of annual data available to the Monitor, reporting is believed not to reflect the full extent of mine/ERW incidents and casualties in the country. [3]

Danish Demining Group/Danish Refugee Council (DDG/DRC) has noted that in Kachin state, where increases in casualties have been recorded in recent years, fighting was more intense in 2011–2012 than in 2013–2014, however, more landmine incidents were recorded during this later period. The reason for the increase was not certain. However, data collected by DDG/DRC from a small and unstable area that indicated that half of all casualties were internally displaced persons (IDPs), who may have returned to contaminated land. [4]

As in all past years, the available data contained insufficient details to distinguish trends or to ensure that the details for all casualties were correctly recorded by the source. The actual number of casualties is likely to be much higher. The number of casualties recorded by the Monitor in 2014 was higher than the totals for 2013 and 2012 combined, but was lower than the 381 recorded in 2011. Monitor casualty data for Myanmar represents an aggregation of available sources. [5] Regarding the low casualty total for 2013, DDG noted that “it is perceived that the number of landmine victims far exceed the figure of 101 landmine victims in 2013.” [6] By September 2015, an additional 44 (three killed; 41 injured) casualties for 2013 had been reported, bringing the total of known casualties for that year to 145. This is still believed to be far fewer than actually occurred.

Past reporting by the Monitor has indicated that there are a significant number of military casualties, but such records remain unavailable to the public. [7]

In 2014, mines/ERW remained a source of concern in an estimated 10 out of 14 regions/states. [8] Most mines causing casualties were recorded as antipersonnel mines. It has been reported by local risk education providers that victim-activated IEDs or “craft” antipersonnel mines are among the mine types causing casualties. People involved in mine and victim-activated IED incidents are often not able to distinguish between these types of victim-activated explosive items, so the type is not recorded. [9]

The total number of casualties in Myanmar is unknown. The Monitor reported annual casualty data of 3,745 (396 killed; 3,145 injured; 204 unknown) 1999 and the end of 2014.

In addition to human casualties, village livestock, elephants, and wildlife are also affected by landmines in Myanmar. Most elephants killed and injured by mines are those used in the illegal cross-border timber trade. In December 2014, an elephant was injured by a mine laid near the border with Thailand. [10]

Victim Assistance

At least 3,145 survivors have been identified by the Monitor since 1999. However, this is believed to be only a small fraction of the actual figure, which was estimated by the group Mine Free Myanmar to exceed 40,000. [11]

Victim Assistance in 2014

In 2014, there was an increase in rehabilitation and economic inclusion services available to survivors within Myanmar.

Under an agreement with the government of Myanmar, the ICRC supported government-run rehabilitation centers. The Ministry of Health and the ICRC agreed to build two new physical rehabilitation centres in Kyaing Tong, Shan State, and Myitkyina, Kachin State. [12]

More actors were involved in delivering, planning, and organizing all aspects of victim assistance.

Assessing victim assistance needs

In January and February 2015, DDG/DRC conducted a “Landmine and Explosive Remnants of War Victims Survey” in the Kachin and Kayah states that incorporated needs assessment and evaluation of opportunities for possible future activities. The DDG/DRC found through survey interviews with survivors and victim assistance organizations that the greatest needs included psychosocial support, livelihood assistance, and socio-economic reintegration. They also found that victim assistance needed to be integrated into the larger disability and rehabilitation sector, which also needed to be made sustainable. Recommendations from DDG included the following: [13]

• Create a simple and ad hoc victim information system for sharing and planning purposes;
• Provide emergency victim assistance;
• Facilitate access to physical rehabilitation services;
• Increase psychosocial support initiatives via self-help groups, peer-to-peer services, and disability resource centers;
• Work with these networks to support socio-economic reintegration activities;
• Implement and integrate sustainable socio-economic reintegration support to landmine survivors and persons with disabilities in the community through communities and disability organizations’ networks;
• Provide vocational training and longer-term socio-economic assistance;
• Provide systematic business service assistance and support for the educational needs of the children of survivors.

Victim assistance coordination

A Technical Group on Victim Assistance, facilitated by Handicap International was established in September 2014. The 17-member group held monthly meetings in Yangon. The Technical Group on Victim Assistance is a sub-working group of the national Mine Risk Education Working Group, and was tasked to define the victim assistance component of the 2015–2016 Mine Risk Strategic National Plan. Since its establishment, it also monitors implementation of victim assistance and shares information on victim assistance issues. It also creates a bridge between the Mine Risk Education Working Group and disability-rights actors. Members of the Technical Group on Victim Assistance include international NGOs, national NGOs, the UN, the ICRC, and the Myanmar Red Cross Society (MRCS), as well as international cooperation agencies. [14]

There was no government victim assistance coordination mechanism in 2014. However, in February 2015 a representative of the Ministry of Social Welfare, Relief and Resettlement reported that Myanmar was taking an integrated approach victim assistance, based on the CRPD, in its national disability law and national social protection strategy.[15]

In December 2014, the formation of the Myanmar Council of People with Disabilities was announced. A council member stated that the group would “work to adopt a law to protect disabled people and to implement the CRPD [Convention on the Rights of Persons with Disabilities].” [16] The Department of Social Welfare, within the Ministry of Social Welfare, Relief and Resettlement, is responsible for community-based rehabilitation and for carrying out social welfare services through preventive, protective, and rehabilitative measures. [17]

Several institutions were involved in the coordination of physical rehabilitation; the Ministry of Health, the Ministry of Defense, and the MRCS played roles in the provision of mobility aids, especially prosthetics and orthotics. [18] The ICRC had bilateral meetings with the Department of Social Welfare, Relief and Resettlement in 2013 and 2014 to discuss the creation of an official coordination body in follow-up to a round-table seminar on prosthetics and orthotics organized in 2012. [19] In 2015, the ICRC led an initiative to define prosthetics and orthotics national standards to be managed within the Victim Assistance Technical Group. [20]

No inclusion of survivors in victim assistance planning or activities was reported in 2014.

Service accessibility and effectiveness

Victim assistance activities [21]

Emergency and continuing medical care

In rural Myanmar, most villages lack basic healthcare. Patients travel hours, and in some hilly regions nearly an entire day, to reach hospitals or clinics. Due to a lack of healthcare services, people in rural areas may rely on treatment from untrained health workers, or rely on local, traditional remedies. [22]

Most health workers employed by ethnic and community-based health organizations attend initial training and periodic professional development seminars, with additional clinical supervision at the Mae Tao Clinic or other ethnic health clinics. Medics working in areas with landmines receive more intensive training in trauma management. [23]

The Health Convergence Core Group (HCCG) continued to work to improve health systems. It is composed of four ethnic health organizations and four community-based health organizations: Burma Medical Association, Back Pack Health Worker Teams , Karen Department of Health and Welfare, Karenni Mobile Health Committee, Mae Tao Clinic, Mon National Health Committee, National Health and Education Committee, and the Shan Health Committee. [24]

Physical rehabilitation, including prosthetics

As most rehabilitation centers are located in major cities and travel costs are high, persons with disabilities, especially those living in rural areas, often face tremendous difficulties in order to access services. [25]

The Ministry of Health approved the construction of two new physical rehabilitation centers proposed by the ICRC, one for Myitkyina (Kachin State) in 2015 and another for Kyaing (Tong Eastern Shan State) in 2016. The centers were needed to address the high demand for services in those conflict-affected regions. Project agreements for both centers were signed by the Ministry of Health and the ICRC in November 2014. [26]

In 2014, the ICRC continued to support the Hpa-an Orthopaedic Rehabilitation Centre (HORC), run jointly by the Myanmar Red Cross Society and the ICRC, and to support three centers managed by the Ministry of Health, located in Mandalay and Yenanthar, enabling people living in remote areas to have access to services.

The ICRC increased support to the Myanmar Red Cross Society’s Outreach Prosthetic Programme for areas covered by the HORC, as well as for Upper and Central Myanmar covered by Yenanthar Leprosy Hospital . This program enabled persons living in remote areas to have access to services free of charge, including prosthetic and orthopedic devices, lodging, transport, and medical assistance if necessary. [27] In July, HORC, supported by the ICRC, launched a mobile repair workshop. Outreach programs were essential to enabling people living in remote areas to have access to the closest service providers. [28] In 2014, 49% of prostheses delivered in ICRC-supported workshops were for mine/ERW survivors (502 of 1,027). [29]

In agreement with the Ministry of Health, the ICRC handed over its role in supporting the National Rehabilitation Hospital (NRH) in Yangon to the NGO Exceed Worldwide, in December 2013 . Exceed Worldwide also financially supported the Myanmar School of Prosthetics & Orthotics at the University of Medical Technology in Yangon. The I CRC remained a key partner and had an active role in forming a Myanmar branch of the International Society for Prosthetics and Orthotics (ISPO). [30]

The Myanmar Physically Handicapped Association (MPHA) produces prosthetics at a small workshop in its office in Yangon. Recipients must pay for their prosthetic or find a donor; however, MPHA provides a few prosthetics at no charge to the very poor. [31] DCA operates a mobile prosthetic limb clinic that assists landmine survivors who have little or no access to similar services offered elsewhere in the country. [32]

In July 2014, Peace Myanmar Aid Foundation ran a mobile prosthetics workshop that provided prosthetics to mine survivors from 22 villages in Shwegyin, in eastern Bago Region. [33]

Psychosocial support

In March 2015, a psychosocial program combined with a community-based prosthetics service was launched by Handicap International, MPHA, and the ICRC for survivors. This joint activity created the first Victim Assistance Centre in Myanmar, in Kyaukkyi township, eastern Bago Region. [34]

Economic and social inclusion

A lack of understanding about persons with disabilities as well as poor infrastructural accessibility make it difficult for persons with disabilities to attend school or find employment. The Association for Aid and Relief (AAR) Japan Vocational Training Center for Persons with Disabilities provides training in tailoring, hairstyling, and computers free of charge in Yangon . Most trainees are persons with disabilities as landmine survivors or due to polio. The center supports graduates to achieve economic independence, gain employment, open their own shops, or become teachers at the center. [35]

In 2014, AAR Japan completed physical accessibility and water resources assistance activities in Thit Sar Aye Myaing village, in Karen state, where there are 94 landmine survivors among a population of 1,500 people. [36]

Disabled veterans can apply for housing in specially built settlements. A settlement of disabled former soldiers, visited by the Monitor in May 2013, was located on an all-weather road outside Taungoo and had water and electricity. Transport to schools for children was provided. From the settlement, former military personnel could contact a local military officer and request transport to the local hospital, if needed. Former soldiers also could obtain free intercity transport on public buses and were provided with replacement prosthetics as needed at no cost. Those disabled military personnel who did not apply for housing in the special settlement were eligible for a one-time grant of 500,000 kyat (US$590). All disabled military personnel are eligible for a small pension. [37]

Laws and policies

Until recently, there were no laws specifically prohibiting discrimination against persons with disabilities in employment, education, access to healthcare, or in the provision of other state services; the government does not provide ample protections for these persons. There were few official resources to assist persons with disabilities. Persons with disabilities reported societal stigma and discrimination, as well as abuse from civilian and government officials. [38]

In June 2014, activists requested that landmine victims be included within the draft disability law being discussed in parliament. [39] It was reported that the draft law gave preferential treatment to military disabled veterans over civilians with disabilities, including giving priority to providing employment to military personnel. [40] In June 2015, the bill on the rights of persons with disabilities was sent to the National Assembly with amendments from the President’s office. [41] The National Assembly passed the Law on the Rights of Persons with Disabilities on 5 June 2015. The process of drafting by-laws for the Law on the Rights of Persons with Disabilities also started on that date. [42] In October 2015, the first meeting for the creation of by-laws took place, with the participation of the Myanmar Council of Persons with Disabilities, ensuring that persons with disabilities participate in the process, in accordance with the CRPD. [43]

Military veterans with disabilities received benefits on a priority basis, usually a civil service job at equivalent pay. Official assistance to non-military persons with disabilities in principle included two-thirds of pay for up to one year for a temporary disability and a tax-free stipend for permanent disability; however, the government did not provide job protection for private sector workers who became disabled. In March 2013, the government enacted a law designed to assist the families of deceased and injured military personnel. [44] In December 2014, Myanmar adopted and launched a National Social Protection Strategic Plan. Beginning in 2016, the program will provide a disability allowance to all persons certified with a disability. The disability allowance will be 16,000 kyat (US$13) per child per month, and 30,000 kyat (US$25) per month per adult until age 64. The program will be implemented nationwide by the Ministry of Social Welfare, Relief and Resettlement. [45]

On 7 December 2011, Myanmar acceded to the CRPD. The convention entered into force on 6 January 2012. Myanmar is yet to submit its initial report to the convention, which was due by January 2014.

Victim assistance for Myanmar citizens in Thailand

Landmine survivors from Myanmar who go to Thailand to seek asylum can receive medical care and rehabilitation in refugee camps as well as in public district hospitals in the Thai-Myanmar border provinces. [46]

However, throughout 2014 and into 2015, the availability of this assistance in the Thai border camps was becoming increasingly uncertain. There is a continued reduction in financial assistance by some donors to NGOs in order to focus on activities within Myanmar. [47] In July 2014, Thailand’s National Council for Peace and Order (NCPO) was reported to have “reached an agreement with the commander-in-chief of Burma’s military to repatriate the 120,000 refugees accommodated in the nine refugee camps on the Thai Burma border.” [48]

However, subsequently in early 2015, a Thai army spokesperson said he was not aware of any set timeline for the refugees’ return, but that the government was eager to close the camps. The spokesperson was quoted as saying, “It would be better for Thailand if the process and repatriation can be done as soon as possible but at the same time, we understand the limitations and we respect the Myanmar authorities.” [49]

Previously, in 2014, the UNHCR had reported that conditions in southeastern Myanmar are not yet fully conducive to the organized returns of refugees. The barriers to return included the absence of permanent ceasefire, the presence of mine fields, and lack of critical infrastructure in some areas. [50]