Summary action points based on findings

• Widely disseminate, fund, and implement the recently adopted National Victim Assistance Plan among all government departments and ministries as well as among provincial and local governments.
• Prioritize rehabilitation and economic inclusion assistance for the most vulnerable among the survivor population, based on physical, psychological, and socioeconomic needs.
• Rebuild prosthetic and orthopedic capacity in the country.
• Respond to the specific needs of women victims, the largest demographic group of victims as the members of affected families and communities, who continue to cope with financial, social, and emotional loss.

Victim assistance commitments

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

Mozambique ratified the Convention on the Rights of Persons with Disabilities on 30 January 2012.

Casualties

Casualties Overview

In 2015, the HALO Trust reported six casualties. Three persons were killed and three injured in two incidents; half of the casualties (one killed; two injured) were caused by antipersonnel mines and the other three (two killed; one injured) by unexploded ordnance. All of the casualties were civilians and of the four casualties whose gender was reported, two were women.[1] The Network for Mine Victims (Rede para Assistência às Vítimas de Minas, RAVIM), reported that in one incident one child was killed and two others injured by an antipersonnel landmine that they found and detonated when they hit it with a hammer.[2]

The total number of mine/ERW casualties in Mozambique is unknown, but there were at least 2,472 through the end of 2015. The most extensive collection of casualty data to date remains the nationwide Landmine Impact Survey (LIS), completed in 2001; it recorded 2,145 mine/ERW casualties but did not provide a breakdown of those killed and injured.[3] An additional 289 casualties (110 killed; 176 injured; three unknown) were identified between 2002 and 2015.[4]

Cluster munition casualties

There were no reported cluster munitions casualties in 2015,[5] but there are known to be casualties from earlier incidents involving cluster munition remnants, though these were not distinguished from ERW in the data and would require a survey to identify them.[6] Cluster munition casualties have been reported among non-state armed group members from Zimbabwe (when it was formerly Rhodesia) on the territory of Mozambique during cluster munition bombing.[7]

Victim Assistance

The total number of mine/ERW survivors in Mozambique is not known. Between 2009 and 2012, 1,502 survivors were identified through needs assessments carried out in three provinces (Maputo, Inhambane, and Sofala).[8] Based on the finding of the 2009 national survey on disability, that 6.8% of all disabilities in the country were caused by mines and other conflict related causes, the Ministry of Women and Social Action (Ministério da Mulher e da Acção Social, MMAS, renamed and reorganized in January 2015 as the Ministry of Gender, Children and Social Action, Ministério do Género, Criança e Acção Social—MGCAS) projected that there were 10,900 mine/ERW survivors in Mozambique.[9] In a survey of Sofala Province, Handicap International (HI) found that 14.5% of persons with disabilities had impairments that were caused by landmines,[10] which, by extrapolation, would suggest as many as 23,200 landmine survivors in the country.

Victim assistance during the Cartagena Action Plan 2010–2014 and Vientiane Action Plan 2011–2015

Mozambique has identified victim assistance as the weakest component of its mine action program. By 2009, all medical and rehabilitation centers were managed by the government, many of which had previously been managed by international organizations and the Mozambique Red Cross. Five of Mozambique’s 10 rehabilitation centers offered accommodation but demand sometimes exceeded availability. However, even after the government assumed responsibility for the management of rehabilitation centers, they have remained dependent on international financial assistance for prosthetic materials. Production of prostheses in all centers was suspended in 2012 as a result of a decline in international funding for these materials, and this suspension continued into 2013. In 2015, HALO Trust was unable to identify a competent producer of prosthetics in the country. The supply of rehabilitation services has also been limited due to a lack of trained technicians.

Throughout the period, survivors have had almost no access to economic and social inclusion programs or psychological assistance. International and national NGOs, including the national Network for Mine Victims (Rede para Assistência às Vítimas de Minas, RAVIM), have reached a limited number of survivors to assist them in accessing services or provide basic economic relief or support for income-generating projects.

The National Demining Institute (IND), the Ministry of Health (Ministerio de Saude, MISAU), and the MGCAS (formerly the MMAS) officially shared responsibility for the coordination of victim assistance. However, for most of the period, Mozambique has lacked a coordination mechanism and a victim assistance plan.

In 2015, HI described the situation of victim assistance in Mozambique as “truly unenviable.”[11] HI noted that orthopedic services did not meet standards and that the quality and availability of mobility aids was increasingly poor, while wait times for assistive devices were getting longer. There were far too few centers offering care management.[12]

Victim assistance in 2015

In 2015, a lack of both availability and access prevented survivors from getting the rehabilitation services they needed. Even after the production of new prosthetic devices resumed, as materials became available, long waitlists remained for survivors seeking new and replacement prostheses. As in previous years, rehabilitation centers remained out of reach for survivors living in rural areas, due to poor infrastructure and a lack of transportation. There was a small increase in work training and livelihoods opportunities. In November 2015, Mozambique adopted a national plan for victim assistance, which was developed as a complementary component of the National Disability Plan 2012–2019.

Mozambique identified two main challenges to the implementation of victim assistance activities. These were, insufficient financial and qualified human resources and weak coordination of activities between the relevant sectors and a lack of information about the activities that each sector undertakes.[13] From the time of the Mine Ban Treaty Third Review Conference in Maputo in mid-2014, HI was proactively working to raise funds for victim assistance, but noted a lack of success and that donors seemed to lose interest in victim assistance as a result of the completion of the work of demining in Mozambique.[14]

Assessing victim assistance needs

In 2012 and 2013, RAVIM and HI completed a survey on the living conditions, capacities, and needs of 300 mine/ERW survivors and approximately the same number of other community members, including family members of survivors, in 12 districts within the provinces of Sofala and Inhambane in June 2013.[15] In 2015, RAVIM completed a survey of landmine survivors in seven districts in the province of Gaza in advance of an income-generation project funded by the Survivors Network Project.[16] HALO Trust conducted a very limited survey to identify landmine survivors in two districts in May and June 2015 for a prosthetic project (see below).[17]

Results from surveys in all three provinces informed the development of a national plan for victim assistance and were used in the ongoing planning of assistance programs.[18] No other survey or needs assessment was made in 2015.[19]

Victim assistance coordination in 2015[20]

The National Disability Council hosted several dissemination meetings for the national disability plan and the Plan of Action for Victim Assistance 2016–2019 (PAAV). These meetings were ad hoc and not scheduled according to any specific plan for dissemination.[21]

In November 2015, the Council of Ministers of Mozambique approved the PAAV. The plan has three main objectives:

• To promote the equal rights, full participation, and empowerment of mine/ERW victims;
• To ensure the principle of equal opportunity for mine/ERW victims; and
• To monitor and coordinate all activities implemented on behalf of mine/ERW victims.

The plan’s strategic priorities are social assistance; access to healthcare, physical rehabilitation, and psychosocial support; socioeconomic reintegration through vocational training and access to income-generating opportunities; and the promotion of the rights of victims and other persons with disabilities.[22] The PAAV was produced with the involvement of civil society, private sector, associations of disabled persons and RAVIM, Handicap International, religious confessions, and international partners.[23] The PAAV includes monitoring mechanisms that involve the government, civil society, and survivors; a lack of such participation in a monitoring mechanism was a gap in the broader national disability plan.[24]

National Disability Plan 2012–2019 includes a section on specific assistance for mine/ERW survivors.[25] Mozambique’s National Development Strategy (2015–2035) includes references to persons with disabilities.[26]

Mozambique provided casualty data in the update on victim assistance in its Convention on Cluster Munitions Article 7 report for 2015, but as of June 1, had not submitted the Article 7 report for the Mine Ban Treaty.[27]

Inclusion and participation in victim assistance

In Mozambique, fewer than 25% of survivors were members of a survivor network or disabled people’s organization (DPO) and the percentage was much lower among civilian survivors than veteran survivors.[28]

Mine/ERW survivors were represented in the coordination of disability and victim assistance issues through RAVIM’s participation in two meetings of the National Disability Council. The National Disability Council has since been replaced by the National Council on Social Action (CNAS) and RAVIM has yet to be invited participate in meetings of that body.[29] RAVIM continues to participate in the Forum of Disabled Associations of Mozambicans (FAMOD) and through FAMOD engaged in policy monitoring exercises, including the civil society report of the Convention on the Rights of Persons with Disabilities.[30]

In 2015, RAVIM continued to work with HI in urban centers implementing an information and referral service designed to identify persons with disabilities, including survivors, and accompanying them in accessing needed assistance.[31]

No survivors were included in the delegation of Mozambique at international meetings of the Mine Ban Treaty and Convention on Cluster Munitions in 2015.

Service accessibility and effectiveness

Victim assistance activities[32]

Emergency and continuing medical care

There was at least one medical doctor (general practitioner) in each country of each district due to efforts made to increase the availability of medical care. However, these doctors’ posts were not always accompanied by the necessary equipment to adequately respond to the specific needs of persons with disabilities, including survivors. The most important service for survivors was the compensation for the costs involved in accessing healthcare, but such services remained confined in the provincial capitals. Many poor people live in rural areas and lack the financial resources to reach existing services.[33]

Overall the physical rehabilitation sector was not considered as a priority by Mozambique, consequently the amount of funding and opportunities for further development was reduced.

Physical rehabilitation including prosthetics

Despite apparent gains in the rehabilitation sector in 2014, the availability of raw materials for production of prosthetic devices again declined in 2015. The orthopedic center at Maputo Central Hospital had no raw materials and could not respond to the demand of survivors and other amputees. Physical rehabilitation services were only available at the provincial level orthopedic centers, which meant that many survivors were required to travel to access these services, although transportation costs can be prohibitive.[34]

HALO Trust launched a small prosthetics project to support several survivors in their area of operations, specifically Magoe district in Tete province and Mossurize district in Manica province. This was the first dedicated victim assistance project by HALO in Mozambique. HALO identified a small group of survivors who would benefit from prosthetic limbs and would not require any additional support, as HALO was closing down operations in anticipation of completing landmine clearance. HALO was not able to identify an adequate and reliable provider of prosthetics in Mozambique so it chose a provider based in Zimbabwe and paid for the service provider to travel to Mozambique twice; first to measure the participating survivors and a second time for delivery and fitting of the prostheses.[35]

Economic and social inclusion and psychological support

The availability of economic inclusion services, including training, loans, and microcredit, remained “the great Achilles heel,” with credit inaccessible to survivors due to high demands for collateral.[36] The National Institute of Employment and Vocational Training (Instituto Nacional de Emprego e Formação Profissional, INEFP) promoted training that was inclusive of persons with disabilities, but this often led to disappointment because the labor market could not absorb the number of trainees.[37]

The HI victim assistance project identified more than 1,300 persons with disabilities (including 199 mine/ERW survivors) and provided referrals or provided personalized support for livelihood opportunities; including vocational training, access to credit, and inclusion in existing local businesses. The project operated in three districts of Sofala, one of the most mine-affected provinces.[38] In each of the districts, HI improved the physical accessibility of the vocational training centers.[39]

The practices of many credit institutions made it difficult for loans to be issued to persons with disabilities due to their requirements of permanent employment for applicants. Some credit institutions demonstrated discrimination against persons with disabilities. RAVIM and other DPOs offered income-generation programs as an alternative to credit loans.[40]

Psychological support, including counseling and peer support, remained an important area of need because many mine/ERW survivors reported experiencing trauma long after the incident. Most survivors did not have access to psychological support. The only organization providing peer to peer support was RAVIM, which provided those services with the support of partner organizations. Due to inadequate resources, RAVIM was not able to cover the entire country.[41] All participants in the HI victim assistance program received home-based psychosocial support.[42] Nationally, mental health services are woefully inadequate and Mozambique’s only psychiatric hospital cannot keep up with demand or provide adequate basic nutrition, medicine, or shelter. Families are required to provide sustenance for the patients, but some patients with disabilities are simply abandoned.[43]

HI ran various social inclusion projects that provided information, referrals, and personalized social support for all persons with disabilities including, but not exclusively focused on, mine survivors.[44]

Social inclusion continued to pose a major challenge and persons with disabilities remained among the poorest of marginalized groups in society. However, there were some positive improvements in the field of inclusive sports due to the activities of the national sports association of persons with disability, the sport federation for disabled persons, and the Paralympic committee. These bodies were run by persons with disabilities. Mozambique also funded the participation of athletes with disabilities to take part in national and international tournaments.[45]

Laws and policies

Legislation guaranteed the rights and equal opportunities of persons with disabilities. However, the government lacked the resources to implement the law and discrimination remained common. The law required the physical accessibility of public buildings for persons with disabilities but progress in ensuring access to public buildings was “very slow.”[46]

Civil society organizations reported that, in contrast to the past, “the political environment is, unfavorable and not taking real steps to improve the implementation of the Convention [CRPD]”. It was also reported that the “political system also excludes the disabled person, not involving them in [sic] decision - making process.”[47]

Persons with disabilities were generally not employed in the public service despite the existence of a ministerial decree regulating their admission to state institutions, which was in practice almost never implemented.[48] Educational opportunities for children with disabilities were extremely limited, due to a lack of teacher training on how to address their needs and due to physically inaccessible school buildings.[49] In Maputo, persons with disabilities were able to ride the public buses for free, but the buses are not accessible for persons with physical disabilities so many were forced to pay for transport in unregulated mini-buses and private transport, such as the back of pick-up trucks.[50]