Action points based on findings

• Support the capacity of survivor organizations that have been shown to have a critical role in assisting survivors to access mainstream services and programs.
• Commit the necessary resources for the implementation of the recently passed Uganda Building Control Law to eliminate barriers to access for survivors and other persons with disabilities.
• Improve the quality and availability of prosthesis and rehabilitation services.
• Sustain existing physical rehabilitation centers by dedicating sufficient national resources or by mobilizing international assistance to continue activities previously supported by international organizations.

Victim assistance commitments

The Republic of Uganda is responsible for a significant number of landmine survivors, cluster munitions victims, and survivors of other explosive remnants of war (ERW) who are in need. Uganda has made commitments to provide victim assistance through the Mine Ban Treaty and as a signatory to the Convention on Cluster Munitions.

Uganda ratified the Convention on the Rights of Persons with Disabilities on 25 September 2008.

Casualties Overview

In 2014, the Monitor identified two casualties in Uganda, in a single ERW incident. Two children, a boy and a girl, were injured in southwestern Uganda.[1] There were reports of two additional incidents with ERW in the Lango sub-region of northern Uganda; however these reports could not be verified by the Monitor.

The two casualties identified in 2014 represented a decrease from the seven casualties reported in 2013, when both casualties were male civilians.[2]

Following a peak of about 150 casualties recorded per year during 1996–1997, the number of annual casualties has decreased significantly; since 2003, casualties have been 21 or fewer per year.[3] The most recent antipersonnel mine casualty reported occurred in November 2012; Uganda declared itself mine-free in December 2012.[4]

The total number of mine/ERW casualties in Uganda is not known. At least 2,772 casualties (531 killed; 2,241 injured) had been identified by December 2014.[5] Of the people injured, 1,818 occurred in northern Uganda, with the remaining 422 occurring in the west.[6] All casualties in the west were recorded as injured; if any were killed, they were not recorded. This was due to the fact that data collection has been mainly carried out by local survivors’ organizations whose primary interest is identifying survivors. As such, it is certain that people have been killed by mines/ERW in western Uganda who have not been recorded.[7]

Cluster munition casualties

A 2006 survey of mine and unexploded ordnance (UXO) casualties in Gulu district, determined that 3% of recorded casualties (1,387 at the time) were caused by cluster munition remnants. Five other suspected submunition casualties were reported in 2006.[8] As of the end of 2013, no additional casualties caused by cluster munition remnants had been identified since 2006.

Victim Assistance

There are at least 2,239 mine/ERW survivors in Uganda.[9]

Victim assistance since 1999[10]

When monitoring of victim assistance began in 1999, most victim assistance services were provided by international organizations responding to the needs of thousands of internally displaced persons (IDPs) and refugees based in northern Uganda. Services were mainly limited to emergency medical care, trauma response, and physical rehabilitation services. Most services were provided free of charge for mine/ERW survivors. However, long distances and a lack of affordable transportation prevented some 50% of survivors from accessing needed care in that year.

The formation of the Uganda Landmine Survivor Association (ULSA) in 2004 increased opportunities for peer support and survivor-led advocacy, though ULSA’s activities were limited due to its dependence on scarce external funding. By the end of 2011, ULSA had supported the development of dozens of local survivor associations in western and northern Uganda.

With the significant reduction in violence in northern Uganda in 2006 and progress towards peace in neighboring countries, several international organizations closed or reduced their programs in the country between 2008 and 2010, transferring the responsibility to provide victim assistance services to relevant government ministries. At the same time, mine survivors who were IDPs returned home to other parts of the country, increasing the need for updated surveys and victim assistance services in those areas.

Through the end of 2014, the impact of the departure of several international organizations from northern Uganda, including the ICRC’s physical rehabilitation program, continued to be felt and there were gaps in physical rehabilitation, economic inclusion, and psychological support, as well as the means to access all services. The withdrawal of international support for victim assistance in Uganda continued with the 2013 closing of the victim assistance program by Handicap International (HI) in western and northern Uganda. The capacity of local and national organizations was also weakened in 2014 as several groups lost funding or other support from international organizations. As a result, there were more survivors in need of services than there had been some 10 years before.

The government assumed greater responsibility for some services, particularly physical rehabilitation with many of the rehabilitation centers requesting cost sharing, but was unable to fill the gaps left by program closures. In 2012, the Ministry of Health assumed responsibility from international organizations for supplying materials and components at several rehabilitation centers. Government-purchased prosthetic materials were of a lower quality, thereby directly affecting the quality of prosthetic devices. The Ministry of Health indicated that it was “struggling to sustain services.”[11]

Throughout the period, victim assistance coordination was very limited. Uganda developed a national victim assistance plan in 2008, which was revised in 2010 and extended by two years to 2014. In 2011, the National Intersectoral Committee on Disability was formed and included a mandate to coordinate victim assistance.

Victim assistance in 2014

In 2014, survivors faced increasing challenges to access services due to the decreasing availability of services as a result of the departure of international service providers and a lack of donor support.

On 31 December 2013, the Uganda Building Control Law was passed, making obligatory the accessibility standards that were launched in 2010. In September 2015, the Uganda Human Rights Commission wrote, “The Government of Uganda enacted the Building Control Act 2013 however it has not yet developed regulations to operationalize the Act. In addition, PWDs [persons with disabilities] face a challenge of the public transport being largely a domain of the market forces without any legal controls regarding how PWDs should be transported.”[12]

Assessing victim assistance needs

The Uganda Bureau of Statistics (UBOS) included disability-related questions drafted by the Ministry of Gender, Labour and Social Development (MGLSD) in consultation with disabled person’s organizations for the 2014 national census. The results of the consensus were not announced as of July 2015.[13] This was an outcome of efforts in 2012 to design a standard data collection tool on disability with specific sections asking for information on mine/ERW victims.[14] Uganda’s Comprehensive Plan on Mine Victim Assistance 2010–2014 sought to establish a database on disability by 2011.[15]

In 2014, ULSA collected information on survivors and their needs in Yumbe and Amuru districts in follow up to their work in 2013, and in several counties within the districts of Amuru, Nwoya, Pader, and Agago, all in northern Uganda. All data collected was shared with other stakeholders.[16] The Kasese Survivors’ Group collected and shared data about survivors on an ongoing basis.[17]

In 2009, Uganda collected baseline data to identify the needs of survivors and the gaps in services in four districts in northern Uganda.[18] Through the same survey, all disability-related services and providers in mine-affected districts were mapped.[19]

Victim assistance coordination[20]

There were no meetings of the Intersectoral Committee of Disability in 2014.[21] In 2013, MGLSD convened two meetings of the Intersectoral Committee on Disability to develop and test a monitoring tool to be used to evaluate the implementation of the Comprehensive Plan of Action on Victim Assistance 2010–2014.[22] Representatives of the Ministry of Health, National Council for Disability, National Union of Disabled Persons of Uganda (NUDIPU), ULSA, and several disabled persons’ organizations (DPOs) took part in exercises to validate the monitoring tool.[23] The Intersectoral Committee on Disability met less frequently than in previous years, as did the National Disability Council, due to a lack of funding.[24]

As of April 2014, the evaluation of national victim assistance plan had not begun; it was to begin once funding was mobilized.[25] Little progress was seen in the plan’s implementation by survivors in western and northern Uganda.[26] ULSA reported that government efforts to implement the plan seemed to be “lacking” and mainly attributed progress to the activities of civil society groups, such as ULSA, HI, and the Association of Volunteers in International Services (ASVI).[27] A representative of the MGLSD cited a lack of funding, lack of knowledge of survivors’ rights, and the limited capacity of survivor organizations as challenges to the plan’s implementation.[28]

After expiry of the Victim Assistance Plan in 2014, there is no plan to revise it but rather to come up with a broader and more inclusive plan of action for disability. There has been challenges with obtaining financial resources to carry out the plan.[29]

Monthly meetings of leaders of DPOs, including ULSA, were convened by NUDIPU to share information about ongoing activities and look for opportunities for collaboration. As one outcome of these meetings, DPOs and the National Council for Disability proposed a strategy to support ULSA in urging the government to ratify the Convention on Cluster Munitions in 2014.[30]

Uganda provided updates on progress in and challenges to victim assistance at the Mine Ban Treaty Thirteenth Meeting of States Parties in Geneva on 4 December 2013.[31] Uganda did not report on victim assistance at meetings of the Convention on Cluster Munitions during the reporting period. Uganda did not submit a Mine Ban Treaty Article 7 report for 2013; its last Mine Ban Treaty Article 7 report (for 2011) did not provide information on victim assistance.[32]

Inclusion and participation in victim assistance

There was a significant reduction in survivor participation in 2014. This can be attributed to the fact that there was no government funding for victim assistance programs. However, survivors participated at the International Day for the Disabled as members of their district union for persons with disabilities. Survivors displayed crafts and had chance to interact with government officials at the function.[33]

ULSA was included in meetings of the Intersectoral Committee on Disability.[34] With the decreased frequency of meetings, there were fewer opportunities for survivors to participate in the coordination and planning of victim assistance.[35] Survivor leaders took part in developing the monitoring tool for the victim assistance plan.[36] Survivors met with members of parliament through breakfast lobbying meetings organized by ULSA.[37]

Representatives of ULSA participated in monthly meetings of NUDIPU at the regional level, and representatives of local survivor associations participated in district-level meetings of NUDIPU.[38]

Survivors and persons with disabilities were involved in the identification and assessment of survivor needs and in supporting other survivors in accessing medical, rehabilitation, and economic inclusion services.[39] Survivors were involved in training sessions on various legal instruments designed to protect and promote their rights.[40]

Landmine survivors from Uganda participated in the Regional Victim’s Conference organized by the African Youth network, held in May 2014. At this conference survivors met other war victims from the region, offered peer support, and shared experiences.[41]

ULSA’s director participated at the Mine Ban Treaty Third Review Conference in June 2014 and helped government delegates in preparing statements at the conference. In San Jose, at the Convention on Cluster Munitions Meetings of States Parties in September 2014, ULSA’s director also supported the government delegates prepare their speeches.

Service accessibility and effectiveness

Victim assistance activities[42]

Medical care

In 2013, the Ministry of Health trained village health teams in emergency first aid. Additional improvements to healthcare were planned through the Health Sector Strategic Investment Plan III 2012–2015, but a lack of funding for the implementation of this plan impacted the availability of services for landmine survivors and other persons with disabilities.[43]

Section 8 of the Persons with Disabilities Act of 2006 calls on the government to promote special health services for persons with disabilities by providing access to reproductive health services that are relevant to women with disabilities, ensuring user friendly hospital materials are available to persons with disabilities visiting hospitals, and encouraging public health programs relevant to persons with disabilities. However, it was uncertain if these provisions were being implemented.[44]

There are several hard-to-reach districts in Uganda with limited amenities such as piped water and electricity. Needs assessment conducted by ULSA in 2014 indicated that survivors in Yumbe District, located in the far northern part of Uganda, had difficulties accessing healthcare due to the poor road network. There was also a lack of interest in the region by Uganda’s development partners. Yumbe Hospital served approximately half a million people but had just two doctors. Most patients had to travel to Arua Regional Referral Hospital in order to access physical rehabilitation.[45]

ULSA, Watoto Church, and some local survivor groups assisted survivors in accessing medical care, including corrective surgery.[46] The African Youth Initiative Network (AYINET) covered the costs for conflict victims seeking treatment, these included food, accommodation, medicines, transportation, post-operative care, and counseling services.[47] Additionally, counseling is offered to family members and communities. In 2015, 60 survivors in Pader and Agago districts received support for medical referrals through the ICBL-CMC Survivor Network Project of ULSA.[48]

Physical rehabilitation

Since the Ministry of Health assumed responsibility for some rehabilitation services in 2012, many rehabilitation centers lacked quality affordable devices. The costs for prosthetic devices presented insurmountable obstacles to care for most survivors. The least expensive prosthesis was estimated to cost $125, well beyond the means of the average person living in rural Uganda.[49] In western Uganda, survivors  had to travel to northern or eastern Uganda for prosthetics when the breakdown of the orthopedic casting oven at the Buhinga Orthopedic Workshop prevented the production of prosthetics.[50]

Mulago National Referral Hospital had a functioning orthopaedic workshop and was fully staffed, but was in need of renovation. Although the government of Uganda talks of free medical care, services at this center is at a fee and most often not affordable to survivors.

Comprehensive Rehabilitation Services Uganda (CoRSU), on the outskirts of Kampala, offered free corrective surgery and orthopedic services to children, while adults had to pay for services, as well as for prosthetic devices.[51] Watoto Church in Kampala supported survivors to access services.[52]

The Arua Regional Referral Hospital orthopedic center serves the West Nile Region, but was not fully equipped.[53] It had trained personnel and accommodation for clients, but lacked most of the materials needed.[54]

In another northern district, Lira, the orthopedic workshop was still functional in 2014, although some materials were no longer in stock, interrupting the production of new prostheses. Minor repairs to prosthesis were still carried out. The Gulu Regional Orthopaedic Workshop (GROW), which is the nearest district the survivors can access, also lacked materials. GROW could not provide services to survivors who traveled to the center in 2014 seeking a replacement prosthesis.[55]

ULSA assisted a limited number of survivors in Amuru and Yumbe Districts to access mobility devices in 2014, through a partnership in the United Kingdom.[56]

Psychological support

Professional mental health care was available in major hospitals for those patients who were seen to be in need of this assistance.[57] In addition, Community Development Officers are able to provide counselling support to survivors.[58] Most survivors who received some psychological support, received it through survivor groups. ULSA and local survivor groups continued to provide this assistance in both northern and western Uganda, with new survivor groups, including in Yumbe District, organized by ULSA in the Acholi sub-region of northern Uganda. Approximately 2,150 survivors and victims are part of survivor groups supported by ULSA.[59]

AYINET provided psychosocial support to over 3,000 victims of conflict, including landmine survivors, since they started their programs in 2005. Their services continued through 2014.[60]

MGLSD produced a guide for trainers in psychosocial support and provided training for community development and rehabilitation officers.[61]

Since 2013, inclusive sports were more widely available, with many groups of persons with disabilities participating.[62] Funding received from the Chinese Lions Club, through the Agitos Foundation, supported the establishment of the Uganda Paralympic Sports Development Project. The support has led to the establishment of the Uganda Wheelchair Basketball Association, which includes landmine survivors among its players. The distribution of eight racing wheelchairs and 14 chairs for basketball has increased opportunities for survivors and other persons with disabilities to participate in sports. In May 2014, the national sports policy changed so that all school sports competitions are inclusive.[63]

Social and economic inclusion

To supplement the government’s efforts in addressing the needs of survivors, ULSA implemented livelihood support through a victim assistance project in the districts of Amuru, Pader, and Agago. It also implemented livelihood support for survivors in Yumbe District. It was the first such assistance provided in the district.[64]

Action on Disability and Development (ADD) initiated an internship program for youth with disabilities; ULSA was among several organizations acting as hosts in 2014.[65]

Laws and policies

The law prohibited discrimination against persons with disabilities, but it was not enforced and discrimination was common.[66] The Uganda Human Rights Center received complaints of discrimination in employment and access to transportation and other public services.[67] The review of the Disability Act 2006 to ensure harmonization with the CRPD was completed by the end of 2013 with the 2006 Act found to be aligned.[68] However, DPOs organized to cite various shortcomings in the current law.[69]

In 2014, NUDIPU noted with concern that the national identification registration process was not accessible. Fingerprints were required to complete the registration and there was no alternative option for amputees.[70]

The government of Uganda has made an effort to provide affirmative action programs for persons with disabilities to ensure that they benefit from economic activities.[71] While the government offers incentives for private companies to hire persons with disabilities, it does not have any requirements to provide a certain percentage of government jobs to persons with disabilities.[72]

In the past the government of Uganda provided a tax incentive of 15% to employers where persons with disabilities make up at least 10% of their employees. Changes to this policy resulting from abuse by employers who were hiring persons with disabilities for low paying jobs, meant that in 2014, companies with 5% of employees as persons with disabilities received a 2% tax break.[73]

On 31 December 2013, the Uganda Building Control Law was passed, making obligatory the accessibility standards that were launched in 2010.[74] New building structures must comply with the accessibility standard. A study conducted by architects in Kampala in 2013 found that 95% of the buildings in the city were inaccessible to persons with special needs, most lacked ramps or elevators.[75] In 2014, DPOs were conducting advocacy on accessibility in Uganda. Some public places, including schools and toilets, were not physically accessible for persons with disabilities. Commuter vans and buses were not accessible for wheelchair users.[76]

In 2014, landmine survivors in northern Uganda announced plans to seek redress through the court system for the lack of governmental protection during the conflict and the lack of support since their mine incidents. Survivors reported that they did not have access to mobility aids or to medical care that would allow them to engage in economic activities. They saw such assistance as just reparations equivalent to the compensation received by others who had suffered due to conflict. In response, the government said it has allocated the funds to “compensate” landmine survivors.[77]

Uganda has universal primary and secondary school policies that promote education for all. Persons with disabilities are entitled to enroll in school with other learners. However, challenges remain, including long distances to reach schools, stigma, and inadequate assistive devices.[78]