Action points based on findings

• Make adequate prosthetic and rehabilitation facilities a priority in the mine-affected regions.
• Begin coordination of victim assistance obligations with the input of the General Directorate of Services for the Disabled and Elderly in the Ministry of Family and Social Policies.
• Plan and coordinate victim assistance in accordance with Mine Ban Treaty Maputo Action Plan commitments

Victim assistance commitments

The Republic of Turkey is responsible for landmine and explosive remnants of war (ERW) survivors. Turkey has made a commitment to victim assistance through the Mine Ban Treaty.

Turkey ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 28 September 2009.[1]

Casualties Overview

Monitor analysis of media reports collected by the Initiative for a Mine-Free Turkey (IMFT) and a report published by Human Rights Watch identified at least 28 new mine/ERW casualties in 2014 in Turkey. Of the total, 27 were civilians; the majority of civilian casualties were children (19). One recorded casualty was security personnel.[2] The 2014 total represents a slight increase from the number of casualties reported in 2013 but it remains a significant decrease from the 69 new casualties identified in Turkey from IMFT reporting in 2012.[3]

Included in the total for 2014 were 19 mine casualties from Syria (four killed and 15 injured) in incidents in the Turkish border minefields while crossing from Syria into Turkey. Six casualties among people fleeing from Syria to Turkey were recorded in 2013, with eight recorded the year before. At least 15 of the Syrian casualties were children. Syrians make up 64% of all casualties identified in Turkey in 2014.

Initial emergency medical care for the injured who survive is provided in the Suruç Public Hospital. Depending on their medical needs, they may also be transferred to the Şanlıurfa Mehmet Akif İnan Training and Research Hospital. The exact number of people killed and injured by landmines on the border minefields was not known due to a lack of accurate reporting. According to one of the doctors in the Suruç Public Hospital’s Department of General Surgery, “The mine incidents are reported in the hospital records as ‘wound due to firearms’…Still, I can say that the number of incidents and victims is much greater than the numbers mentioned in the press.”[4] Media reports also indicate the total number of Syrian casualties along the Syria-Turkey border could be much higher than reported with large numbers of displaced persons residing in the minefield.[5]

The government of Turkey reported that there were 26 casualties (one killed; 25 injured) in 2014.[6] This represented an increase from the eight casualties reported in 2013. No specific details on civilian status, sex, or age were provided in the reporting.

In its Article 5 deadline Extension Request of March 2013, Turkey provided information on antipersonnel mine casualties occurring between 2004 and the end of 2012: 882 military personnel (260 killed; 622 injured) and 168 civilians (56 killed; 112 injured). Turkey also included disaggregated information on the age and sex of civilian casualties for a similar time period (10 years); of the total civilian casualties reported, 15 were female and 50 were children.[7] In contrast, Monitor reporting, which included IMFT data for the period from 2004 to the end of 2012, counted more than twice the number of civilian mine/ERW casualties; 377 civilian casualties of 979 casualties recorded in total.

The total number of mine/IED/ERW casualties in Turkey is unknown. Turkey had reported 4,271 mine/ERW casualties, including 871 people killed and 3,400 injured, as of the end of 2012.[8] However, according to a media report in April 2010, the Ministry of Internal Affairs had recorded 6,360 mine casualties since 1984; 1,269 people were killed (625 security personnel; 644 civilians) and another 5,091 people were injured (with the number of civilians compared to security personnel injured not reported) in mine incidents.[9] In 2007, a demining specialist reported at least 10,000 mine casualties (mostly civilians) along the Turkish-Syrian border since the 1950s (more than 3,000 killed and 7,000 injured).[10] The Monitor analysis of the period of 2010–2014 found 273 new casualties (74 killed; 199 injured).[11]

Victim Assistance

More than 5,000 people were reported to have been injured by mines in Turkey since 1984.[12]

Victim assistance in 2014

No significant changes in the accessibility or quality of services were reported for 2014. In its Article 7 report, the Government of Turkey reported that 58 mine/ERW survivors received assistance in the form of indemnity, salary, or a job, however, this report only covers treatment received by survivors at military medical facilities.[13] Mine/ERW survivors and persons with disabilities in affected areas did not have access to the same level of services as other persons with disabilities in larger cities in Turkey.[14]

Assessing victim assistance needs

No efforts to assess the needs of mine/ERW survivors in Turkey were reported in 2014. There was no system in place to collect data on mine survivors or their needs. The IMFT collected the most comprehensive information available through media scanning and crosschecking with other organizations and local sources.

The European Commission (EC) continued to report that a lack of broader data and research on persons with disabilities remained a barrier to informed policymaking in Turkey.[15]

The Diyarbakir Lawyer’s Bar Association and the Human Rights Association collected information on mine/ERW casualties in the affected regions; information collected included details on the needs of the survivors and families.[16]

In 2006, Turkey had reported that it was initiating a program of transition to an international injury classification system that would include mines and ERW.[17] No further progress on this transition was reported as of end 2014.

Victim assistance coordination

The Ministry of Family and Social Policies through its Disabled and Senior Citizens Directorate General is the government entity responsible for protecting the rights of persons with disabilities.[18] Turkey has never had government victim assistance coordination.

A delegation of the ICBL and IMFT discussed victim assistance with a deputy undersecretary of the Ministry of Family and Social Policy in March 2013, underlining Turkey’s victim assistance commitments, the links with the CRPD, and the related responsibilities of the ministry. The deputy undersecretary agreed that the role of victim assistance focal point fitted with the work of the ministry’s department of persons with disabilities and also the social welfare department, which is responsible for pensions and other payments.[19]

In 2014, IMFT met with the Group Deputy Chairpersons of the political parties and the Head of the Parliamentary Commission on Human Rights at the Parliament to discuss Turkey’s obligations under the Mine Ban Treaty. IMFT provided a number of suggested actions including the initiation of the mine risk education in schools.[20]

Mine Ban Treaty Article 7 reporting on victim assistance is updated annually by Turkey but only covers treatment received by survivors at military medical facilities. Turkey’s Article 7 report for 2014 states that 14 survivors completed rehabilitation and medical care, while services to 28 were ongoing. Article 7 (and Convention on Conventional Weapons Article 13) reporting did not include information on services available to civilian mine/ERW survivors at civilian facilities.[21] Turkey did not make statements on victim assistance at the Mine Ban Treaty Thirteenth Meeting of States Parties in 2013 or at the Mine Ban Treaty Third Review Conference in Maputo.

Survivor inclusion and participation

Survivors reported that they were not included in the planning or implementation of services relevant to their needs.[22] The Disabled and Senior Citizens Directorate General had not engaged survivors and was not familiar with the issue of victim assistance or specific needs in mine affected areas.[23]

Service accessibility and effectiveness

Victim assistance activities[24]

Emergency and ongoing medical care

A study of examples of surgical intervention after mine injures of varying severities by the Medical Association Diyarbakir emphasized the time-sensitivity of emergency medical care; the study emphasized that longer intervals between injury and surgery corresponded to more severe levels of amputation. Among the study group, the average time to receive first medical care was nine hours; 13 of 186 survivors recorded in the study died due to infection.[25]

All persons with disabilities have the right to access the free first-aid services at public and private healthcare centers. Those without social insurance can apply for a special “green card” to be eligible for services. However, in practice those persons with disabilities eligible for the green card medical insurance still contributed to part of their medical expenses, eliminating the availability of free services.[26] Regulations in the Healthcare Application Notice, issued by the Social Security Organization of Turkey, restricted access to medicines, equipment, and mobility devices for persons with disabilities, even when deemed necessary by medical professionals.[27]

Healthcare facilities in towns in the mine-affected regions (other than the largest cities) are underfunded, have inadequate staff levels and equipment, and often were not able to address survivors’ emergencies or ongoing medical needs.[28]

Initial emergency medical care for Syrian refugees injured in Turkey has been provided locally. However, the hospitals were not accurately distinguishing landmine casualties from other war victims in their patient profiles.[29] In the refugee camps near Suruç, mine survivors could receive medical assistance from volunteer healthcare workers, but there were only two ambulances and both were also used for transporting goods.[30] Turkey provides emergency medical care for Syrians but costs involving physical rehabilitation, mobility aids, and plastic surgery are not covered so refugees have to rely on donors and humanitarian organizations. Turkey received around 2,500 injured Syrians (including landmine, cluster munition, and ERW survivors) a month in 2014.[31]

Physical rehabilitation, including prosthetics

There was a significant need for prosthetics and rehabilitation services to be established in other mine/ERW-affected provinces. There was also a need to establish facilities that could address the needs of child survivors. Holders of the green card could only apply for new prostheses every five years. This was detrimental to the rehabilitation of child mine/ERW survivors who require frequent replacements while growing.[32]

The Dicle University Research Hospital prosthetics center was the only such center for all mine-affected regions. In 2014, it was still open but had effectively ceased to operate; this eliminated the only free option for prosthetics for civilian mine/ERW survivors. Use of the facility declined in 2008 when it began to provide services only to those having the state-provided green cards for the disadvantaged. In addition, the lack of assistance for transportation or accommodation expenses for survivors coming to the center from distant provinces limited access.[33]

In the absence of a free rehabilitation center, in order obtain prostheses, mine/ERW survivors and other persons with disabilities face complicated procedures to apply for poor quality prosthetics available through the national health system. Even this assistance is out of reach to many mine/ERW survivors due to the geographical distance and their poverty levels.[34]

Laws and policies

Civilian survivors could apply for compensation through Law 5233, the Law on the Compensation of Damages that Occurred due to Terror and the Fight Against Terrorism. The Diyarbakir Lawyers’ Bar Association continued to help mine/ERW survivors access benefits to which they were entitled, such as compensation under Law 5233, and to promote victim assistance. Survivors have called for a review of the compensation process to ensure timely and appropriate outcomes.[35]

In 2014, the Turkish parliament ratified legislation on the establishment of the National Mine Action Center. As of December 2015, the National Mine Action Center was established and had a mandate to coordinate victim assistance. It was in the process of building that capacity.[36]

A need for specific policies to address the social support needs of child mine/ERW survivors was identified in 2009.[37] No progress was reported by the end of 2014. Children with disabilities faced difficulties in accessing affordable and inclusive education services. The monitoring, evaluation, and inspection of private special education and rehabilitation services required particular attention.[38]

The constitution permits positive discrimination for persons with disabilities, although the principle is not adequately reflected in policy measures. Legislation prohibits discrimination against persons with disabilities in access to healthcare, employment, education, transportation, and in the provision of state services; however, the law was not enforced effectively.[39] On 6 February 2014, the Turkish parliament amended national laws to bring state obligations in line with international definitions and standards.[40] Persons with disabilities continued to face serious difficulties in accessing employment in the private sector, though there is a limited upward trend in the public sector. Turkey lacked a comprehensive strategy to fund commitments to create physical accessibility. Physical barriers to public buildings and all relevant facilities still existed. Deadlines for public institutions’ mandatory compliance to provide accessible services were extended or postponed.[41] Diyarbakir, the largest city in the mine-affected regions, has become increasingly physically accessible due to the work of local disabled persons’ organizations and the local government.[42]