Afghanistan

Victim Assistance

Last updated: 30 October 2017

Summary action points based on findings

  • Expand access to physical rehabilitation needs, particularly in provinces lacking services or where traveling to receive rehabilitation is difficult for survivors.
  • Develop, adopt, and implement a national disability plan that includes objectives that respond to the needs of survivors and recognizes its victim assistance obligations and commitments, together with a monitoring structure.
  • Ensure that meaningful participation of survivors is increased at all levels.
  • Prioritize physical accessibility, particularly for services and for government buildings.
  • Provide psychosocial and psychological support, including peer support in particular to new survivors as well as those who have been traumatized and live in isolation.

Victim assistance commitments

The Islamic Republic of Afghanistan is responsible for significant numbers of survivors and victims of landmines, cluster munitions, and other explosive remnants of war (ERW). Afghanistan has made commitments to provide victim assistance through the Mine Ban Treaty and has victim assistance obligations under the Convention on Cluster Munitions.

Afghanistan ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 18 September 2012.

Victim Assistance

The total number of survivors in Afghanistan is unknown, but in 2006 the number was estimated to be 52,000–60,000.[1]

Victim assistance since 2015

Despite improvements, geographic coverage of healthcare remained insufficient, particularly in terms of physical rehabilitation. Physical rehabilitation services were almost entirely operated by international NGOs and the ICRC under the coordination of the government. The government of Afghanistan was preparing for taking on the responsibility of managing physical rehabilitation services, starting within the local healthcare services level and providing for rehabilitation from the development budget.[2] The ICRC increased its support to medical care, physical rehabilitation, and social reintegration consistently throughout the period, while international NGOs continued to provide the remainder of physical rehabilitation services.[3]

Movement restrictions (due to conflict, lack of accessible roads, and the cost of transport) were persistent obstacles to victim assistance in some parts of the country, which continued through the reporting period.

Handicap International (HI) and the Swedish Committee for Afghanistan (SCA) had to hand over physiotherapy services in health facilities according to a Ministry of Public Health (MoPH) policy requirement that physiotherapy services should be provided only as part of the Basic Package of Health Services (BPHS) through district hospitals and health clinics by end of 2015.[4]

Funding challenges continued to impede progress. In 2013, there was an overall decline in the number of projects being implemented and some organizations were unable to fulfill their planned projects and overall mandates due to a decrease in international financial support. Although resources were greatly reduced, there were still some donors who sustained their support for persons with disabilities in ways that included survivors. The Mine Action Coordination Centre of Afghanistan (MACCA) and the UN Mine Action Service (UNMAS) increased financial support to victim assistance and disability-related projects by registering national and international NGOs, which could then receive specific project funding. By 2017, the MACCA was renamed the Directorate of Mine Action Coordination (DMAC).

Afghanistan reported that, while there was tangible progress on the ground, the scale of victim assistance services was inadequate compared to the need.[5] Funding decreased and many NGOs providing victim assistance and other services for persons with disabilities faced critical financial shortages. Due to the shortage of financial resources some provincial branches of NGOs ceased their victim assistance activities.[6]

Victim assistance in 2016 (or Afghan year 1395)

Since 2014, funding had decreased significantly. As a result, many organizations that provide disability assistance were nearing the point of facing closure, such as the Afghan Landmine Survivors Organization (ALSO), Community Center for Disabled People (CCD), Development and Ability Organization (DAO), and others. Yet the government did not have any plan to provide direct victim assistance, even as the number of survivors was increasing. The lack of funding had a significant negative impact on the probable survival of local NGOs and consequently, on the lives of survivors. The local organizations that had predominately provided service for survivors or persons with disabilities declined although there was not yet a state-led program to serve persons with disabilities that would replace that assistance. Local NGOs reported occasionally being granted small projects, but were unable to compete with the large international NGOs for more sustainable funding. Although the number of survivors continued to increase, disability was not among the priorities of most of donors.[7]

Afghanistan reported that victim assistance, as one of the main pillars of mine action, focused on advocacy, awareness, and prevention activities within the broader context of the disability sector as required by the Mine Ban Treaty.[8] It also stated that the victim assistance sector faced a “critical funding shortfall.” In this context, Afghanistan explained that disability rights and victim assistance agencies “received the least amount of financial support from the international community” and that the limited financial support “endangers” existing capacities and the potential for implementation.[9] Due to the decline in funding, only one prioritized victim assistance project received funding through the mine action center in 2016. The UNMAS/DMAC Victim Assistance Department did not have adequate funding to directly implement projects, but rather maintained a list of prioritized projects to which funds could be allocated.[10] Of the seven projects identified for implementation by UNMAS/DMAC in 2017, only the project for establishing physical rehabilitation centers in Khost and Farah provinces was funded. Six out of nine physical rehabilitation centres supported through the UN Voluntary Trust Fund—including four mobile orthopaedic workshops—faced insecure funding situations.[11]

In 2016, 90% of the population lived more than 100 kilometers from a rehabilitation center and some 20 provinces out of 34 do not have prostheses and orthoses facilities.[12] A lack of female health service providers remained a challenge in rural areas.[13]

Assessing the needs

No specific needs assessment surveys of survivors’ needs were reported in 2016, though many organizations kept their own records on beneficiaries’ needs.

In 2016, a disability survey consultant conducted an in-country assessment, stakeholder meetings, and completed the preliminary work to develop the implementation plan for the nationwide disability survey.[14] However, in accordance with instructions from the US Agency for International Development (USAID), in March 2017 the National Disability Survey of Afghanistan (NDSA) was put on hold. The survey was subsequently removed from the scope of the US-funded Afghan Civilian Assistance Program (ACAP III).[15] The last national disability survey was carried out in 2005.[16]

A program evaluation by SCA among community-based rehabilitation (CBR) participants confirmed the high proportion of war and mine/ERW survivors among men with disabilities compared to other groups of persons with disabilities. Persons born with impairments had the same gender breakdown, while disease caused a higher proportion of disability among females.[17]

HI conducted small-scale surveys on needs, capacities, issues, and challenges in project sites (small areas) in order to understand the situations faced by mine/ERW survivors and persons with disabilities. A Knowledge, Attitude, and Practices (KAP) survey conducted by HI community mobilizers among 600 community members in Kandahar.[18]

The Afghans Landmine Survivors’ Organization (ALSO) conducted a study and assessment titled Access of Persons with Disabilities to Education in Afghanistan in 2017. Findings of the study were shared with victim assistance and disability organizations in a conference conducted in Kabul and findings were published for wider distribution.[19]

Victim assistance coordination[20]

Government coordinating body/focal point

The Ministry of Labor, Social Affairs, Martyrs and the Disabled (MoLSAMD), the Ministry of Public Health (MoPH), and the Ministry of Education (MoE) with UNMAS/DMAC Victim Assistance Department technical support; as well as the Afghanistan National Disaster Management Authority (ANDMA)

Coordinating mechanisms

Victim Assistance Coordination Meetings, the Disability Stakeholder Coordination Group (DSCG); the Disability and Physical Rehabilitation Taskforce, and several other groups (see below)

Plan

None: The Afghanistan National Disability Action Plan (ANDAP) revision process was pending the adoption of a new disability policy

 

MoLSAMD is the government focal point for victim assistance and regulating the legislation of disability issues overall.[21] A new Deputy Minister for MoLSAMD was appointed, as the victim assistance focal point in 2015.[22] In 2016, an institutional capacity assessment and action plan was developed for MoLSAMD, by an international consultant supported by UNMAS, and shared with the ministry for implementation purposes.[23] Other national and international stakeholders support the government in developing or amending legislation. The MoPH, the MoE, and MoLSAMD are involved in disability services and advocacy activities. The work of these three key ministries is supported by the Victim Assistance Department of UNMAS/DMAC, which works closely with three ministries and which provides technical support to each for annual planning, priority setting, contract development, and quality assurance for UNMAS-funded activities.[24]

The Victim Assistance Department of DMAC/UNMAS supported a capacity-building need assessment for MoLSAMD that began in the first quarter of 2017. A desk-based assessment with the three key ministries found that there was a lack of reliable data and data collection process in the ministries. Based on the assessment, work with Martyrs and Disability Deputy Ministry of MoLSAMD to develop a new database started in March 2017 and 15 ministry personnel were trained on the database, which was planned to be officially launched later in 2017. New beneficiary data collection forms were also designed.[25]

From the beginning of 2016 through the end of the second quarter of 2017, three additional victim assistance/disability organizations were accredited by DMAC/UNMAS and received certification to conduct activities.[26]

The MoPH plan of action consists of the Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS); physiotherapy services are included in both, while prosthetic services were only included in the EPHS. The MoPH Strategic Framework 2011–2015 counted improving disability services among its priorities, and the ministry’s focal point for disability, the Disability and Physical Rehabilitation Department (DRD), had an implementation strategy for the framework. The MoPH included disability and physical rehabilitation in a new national health policy originally developed for 2015–2020. The national disability and physical rehabilitation strategic plan for the health sector 2016–2020 was drafted and in the approval stages.[27]

No progress was reported on the process of developing a national plan for persons with disabilities. The National Disability Action Plan remained unrevised since it expired in 2011. A new plan was not to be drafted until the finalization of a comprehensive national disability policy. The Afghanistan National Policy for Persons with Disabilities was in its third draft in 2016 and had been made available in local languages for wider consultation and feedback.[28]

The Mine Action Program of Afghanistan (MAPA) adopted a five-year (2016–2021) strategic plan in 2015 addressing the so-called pillars of mine action. A sub-goal of the plan focuses on victim assistance, and related advocacy. Advocacy efforts are undertaken to ensure that disability and victim assistance are addressed in relevant government strategies, policies, and in departmental budgets.[29]

An action plan for implementation of the newly developed Inclusive and Child Friendly Education Policy, making the National Education Strategic Plan III (NESP III 2016–2020) was significantly more inclusive of victim assistance and disability rights than the previous two plans. With these changes, inclusive education was comprehensively addressed in the third strategic plan.[30] A number of policies in Afghanistan referred to services for persons with disabilities, and although relevant to mine/ERW survivors do not necessarily specifically mention victim assistance. Other than the former Inclusive Education Policy of the MoE, among these was the Health and Nutrition Strategy of the MoPH.[31]

In 2017, ACAP III (April 2015–February 2018), was being implemented by UNMAS to provide “immediate assistance packages including food and non-food items, psychosocial counseling, physical rehabilitation support and economic reintegration packages tailored to individual needs to restore lost livelihoods and assist with recovery.” Activities were anticipated to continue until 2018.[32]

ACAP III is a USAID-funded program through the UN Voluntary Trust Fund for Assistance in Mine Action intended to provide targeted immediate assistance to victims of conflict, mines, and ERW; strengthen existing services; and contribute to the development of government authorities’ capabilities to provide assistance to civilian victims of conflict in Afghanistan. Long-term services are also provided in communities most affected by conflict. Other ACAP III objectives are to link beneficiaries with assistance programs and to improve knowledge of victim assistance services among communities, civil society, and government networks.[33] ACAP III marked a change from the first two ACAP programs, which provided humanitarian assistance only for assistance-eligible incidents to “innocent civilian casualties who have suffered losses resulting from operations between U.S. and coalition military forces and the Taliban or other insurgents.”[34]

Coordination and planning

The coordination group for victim assistance with the participation of key bi-monthly national and international victim assistance and disability organizations and representatives of the line ministries, including the MoPH, MoLSAMD, and the MoE (established by MACCA in 2013), held five meetings in 2016, as it had in 2015; discussion at these meetings focused on ACAP III, assistance to civilian victims of conflict, and mine/ERW and IED civilian victims specifically, as an added value of the victim assistance pillar of the mine action.[35] In 2017, through the end of July, three victim assistance coordination meetings were held to discuss issues of national ownership and the roles of ministries, coordination of activities, and funding raising.[36]

Several other coordination groups regularly held meetings relevant to victim assistance and disability rights, both nationally (from Kabul) and at the regional level. The various coordination group meetings included the following:

  • The Disability Stakeholders Coordination Group (DSCG) (Chaired by the deputy minter of MoLSAMD) conducted 10 meetings in 2016, compared to nine in 2015, with topics including the amending disability law, CRPD reporting, consideration of an independent directorate for disability issues, disability employment within government agencies, and annual events. Another three DSCG meetings through June 2017 focused on amendments to the national disability law.
  • The Disability and Physical Rehabilitation Taskforce (coordinated by the MoPH) held six working group meetings in 2016, compared to five in 2015, an accomplishment being the revision and continued updating of a new disability and physical rehabilitation strategy, disability certification guidelines, and training of physiotherapists and prosthetic technicians. In April 2017, the Physical Rehabilitation Taskforce meeting addressed the annual action plan for Afghan year 1396 (2017–2018).
  • The Advocacy Committee for the Rights of Persons with Disabilities (ACPD) includes advocacy meetings and events on a wide range of issues held by diverse actors from the sector. In April 2017, ALSO hosted an ACPD meeting where committee members jointly finalized the committee’s three-year (2017–2020) strategic action and 2017 action plan. Three ACPD meetings were held in 2017 through June, with the focus on nationwide disability survey planning.
  • The Afghan CBR Network (coordinated by the MoPH-DRD) conducted three meetings in 2016, compared to two meetings in 2015, and discussed implementation of the CBR program carried out in 20 out of 34 provinces of Afghanistan.
  • The Inclusive Child Friendly Education-Coordination Working Group (ICFE-CWG); chaired by the MoE held 10 meetings in 2016, 11 meetings in 2015, and 10 in 2014, and discussed implementation of the Inclusive Education policy and other relevant issues.
  • The Inter-ministerial Committee on Disability; chaired by MoLSAMD also holds occasional meetings.[37] More generally national and regional meetings of the UNCHR-led Afghanistan Protection Cluster (APC) were conducted to avoid duplication and coordinate activities concerning protection of the civilians.

In October 2016, the MoLSAMD, with the support of Counterpart International and USAID, held a two-day national conference, the National Conference for Persons with Disabilities, in Kabul with 450 participants, including the representative of Executive of the Islamic Republic of Afghanistan, the first lady, ministers and deputy ministers, representatives of the national and international institutions, and key stakeholders from provinces, including representation by persons with disabilities. The government affirmed its commitment to the rights of persons with disabilities, specifically capacity-building and vocational training. Problems and challenges, as well as probable future obstacles, were discussed.[38] In cooperation with MoLSAMD, the ACAP III technical advisor provided substantive support to MoLSAMD for the 2016 National Disability Conference.[39]

In follow-up to the National Conference for Persons with Disabilities in Afghanistan, in May 2017 a conference entitled the Afghan Disability Rights Conference: From Policy to Programming was held at the Embassy of Afghanistan in Washington, DC, with 150 participants joining panel discussions and sharing of ideas. Mine/ERW survivors were mentioned together with other persons with disabilities and a mine survivor and persons with disabilities participated on panels.[40]

Reporting

Afghanistan provided information on progress in and challenges to victim assistance at the Mine Ban Treaty Fifteenth Meeting of States Parties in Chile and intersessional meetings in 2016. Afghanistan presented victim assistance developments at the Convention on Cluster Munitions Sixth Meeting of States Parties in September 2016.[41] Afghanistan continued to make extensive use of all sections of its Convention on Cluster Munitions Article 7 report for 2016. Afghanistan also included detailed reporting on victim assistance activities in its Mine Ban Treaty Article 7 reporting for 2016.[42]

Survivor inclusion and participation

Persons with disabilities and their representative organizations were included in decision-making and participated in the various coordination bodies. However, it was reported that their views were not fully taken into account. Survivors and other victims were involved in short-term decisions only, being invited to meetings was seen as a means of pacification.[43] It was reported that survivors involved in planning and coordination presented ideas and had expectations that they would be considered, but the implementing organizations, government, and donors were not able to respond to all the needs survivors presented.[44] With only a few organizations involved in implementation of victim assistance projects, survivors were not adequately included in service provision.[45]

The inclusion of persons with disabilities, survivors—and their representative organizations, if and where they existed—remained totally insufficient. Participation was generally not effectively included as an essential component of activities.[46]

Some NGOs had a proportion of employees who were persons with disabilities. The ICRC Afghan Physical Rehabilitation Program was managed by persons with disabilities. The rehabilitation program maintained a policy of “positive discrimination,” employing and training only persons with disabilities. Service provision was entirely managed by survivors and persons with disabilities, including technical and administrative positions. The ICRC continuously consulted with and involved survivors in the decision-making process as survivors were fully integrated into its operations. The positive discrimination policy also aimed to demonstrate that persons with disabilities are an asset to society, not a burden.[47] HI staff in Afghanistan included 14% of persons with disabilities.[48] At HI rehabilitation centers 19% physical rehabilitation center staff are persons with disabilities, most of them being mine survivors.

Service accessibility and effectiveness

Victim assistance activities

Name of organization

Type of organization

Type of activity

MoLSAMD

Government

Technical support, training, and coordination; providing pensions and allowances, organizing of service for survivors with disabilities and families of persons killed

MoPH

Emergency and continuing medical care, medication, surgery, awareness-raising, counseling (supported by the World Bank, UN, and donors), physical rehabilitation and psychosocial support

MoE

Inclusive education and assistance through education

Afghan Amputee Bicyclists for Rehabilitation and Recreation (AABRAR)

National NGO

Physiotherapy, education, and vocational training; sport and recreation; capacity-building for local civil society organizations (CSOs) and disabled persons’ organizations (DPOs)

Afghan Landmine Survivors Organization (ALSO)

Advocacy workshops and implementing services through local partners; referral of students to education centers from basic to advanced level; research and promoting access to education

Community Center for Disabled People (CCD)

Social and economic inclusion and advocacy; art training for war survivors and job placement

Development and Ability Organization (DAO)

Social inclusion, advocacy, rehabilitation, and income-generating projects

Kabul Orthopedic Organization (KOO)

Physical rehabilitation and vocational training

Rehabilitee Organization for Afghan War Victims (ROAWV)

Economic inclusion training and awareness raising

Empor Organization (EO)

For profit organization

Physical rehabilitation and prosthetics; technical support for advanced technology limbs for ACAP III beneficiaries

Afghanistan Independent Human Rights Commission (AIHRC)

National organization

Awareness-raising and rights advocacy program for DPOs; monitoring

EMERGENCY

International NGO

Operating surgical centers in Kabul, the Panjshir Valley, and Lashkar-gah and a network of first aid posts and health centers

Handicap International (HI)

Victim assistance, disability advocacy and awareness, capacity-building of disabled persons’ and survivors’ organizations; physical rehabilitation, including prosthetics, rehabilitation training

Swedish Committee for Afghanistan (SCA-RAD)

Health care, CBR, physical rehabilitation, psychosocial support, economic inclusion through revolving loans, inclusive education, advocacy, and capacity-building

ICRC

International organization

Emergency medical care; physical rehabilitation, including physiotherapy, prosthetics, and other mobility devices; economic inclusion and social reintegration, including education, vocational training, micro-finance, and employment for persons with disabilities, including mine/ERW survivors and Ministry of Defense/military casualties; schools for orthopedic technicians and physiotherapists; sport and support to the Paralympic Committee

 

Emergency and continuing medical care

The health sector in Afghanistan was not reaching as many people as needed services and a more inclusive policy and implementation was required. Difficulty with human resources as well as conflict within the national government made the delivery of inclusive public health and affected all Afghans difficult, especially persons with disabilities.[49]

Conflict in Afghanistan resulted in the need for an increase in medical care, while there were fewer resources available. As was the case in recent years, many of the weapon-wounded patients treated at ICRC-supported hospitals were injured by mines or ERW: 679 out of 1,850 (or 37%) in 2016, and 1,065 of the 2,202 (or 48%) reported for 2015.[50] In 2016, more than 1,500 weapon-wounded people reached the hospitals by means of an ICRC-funded transport system of taxis and ICRC vehicles.[51] In 2015, some 2,100 weapon-wounded people reached the hospitals through the system, 1,600 people in 2014, and 1,000 in 2013.[52]

The number of newly registered amputees recorded in the ICRC orthopedic center data demonstrated that the number of survivors and amputees remained constant since 2013:

  • 2014: 1,318 amputees registered, including 538 mine survivors, 51 other war incidents, and 729 persons amputated for other reasons;
  • 2015: 1,261 amputees registered, including 521 mine survivors, 47 other war incidents, and 693 persons amputated for other reasons;
  • 2016: 1,317 amputees registered, including 525 mine survivors, 44 other war incidents, and 748 persons amputated for other reasons; and
  • January–June 2017: 560 amputees registered, including 238 mine survivors, 26 other war incidents, and 296 persons amputated for other reasons.[53]

During 2016 and through July 2017, ACAP III provided some 11,400 war victims with immediate assistance packages of food and non-food items.[54]

Physical rehabilitation, including prosthetics

Physical rehabilitation was not available in all provinces of Afghanistan.Rehabilitation centers were concentrated in 16 of the 34 Afghan provinces and patients were often forced to travel long distances to access services. Six rehabilitation centers faced funding shortages in 2016–2017.[55] DAO reported that the provision of physical rehabilitation was “tremendously reduced” in both its physical rehabilitation centers in Kunar and Uruzgan province due to a severe funding problem. As a result, persons with disabilities in these provinces remained without prosthetic limbs in 2016–2017.[56] Previously, in 2015–2016, DAO had managed to increase coverage and the number of people served by establishing a new fixed and mobile physical rehabilitation center for persons with disabilities, covering all districts of Uruzgan, and nearby districts from Zabul and Daikondi provinces.[57]

A lack of female health service providers especially in the field of physical rehabilitation was a challenge in rural areas, which resulted in women and girls with disabilities having less access to services.[58]

Through ACAP III an additional seven rehabilitation facilities (three static centers and four mobile centers) were established in Khost, Uruzgan, Faryab, Kunduz, Kabul, and Farah provinces. In 2016, UNMAS/DMAC established physical rehabilitation centers in Khost and Farah provinces. The project, implemented by AABRAR, started in September 2016 and was completed by the end of April 2017. The Khost and Farah centers delivered 176 prostheses among the 2,416 direct beneficiaries receiving rehabilitation services. Additionally, disability awareness and advocacy training was provided to 2,917 people at the centers.

Physiotherapists in Afghanistan are mostly employed by NGOs and international organizations. The goal for long-term sustainability of rehabilitation is to gradually shift services into government institutions, as the medical sector is improved and is able to take over the provision of rehabilitation services.[59]

Delivery of prostheses in the seven ICRC centers in 2016 totaled 4,321, 59% (or 2,553) of which were for mine/ERW survivors;[60] in 2015, 4,120 (2,474 of which were for mine/ERW survivors).[61] In the first six months of 2017, 2,072 prostheses were manufactured, 1,227 of them for mine/ERW survivors. Over several years to 2017, the ICRC program has been facing a worrying increase in the number of children affected by cerebral palsy (CP) or who are spinal cord injured (paraplegics and tetraplegics) as these two categories of disability were totally neglected by the health system. New units had to be created, training organized, and qualified staff increased. ICRC requests for an intervention of the MoPH, through its DRD, were not responded to and governmental hospitals were not providing assistance.[62]

In support of the national and local authorities HI began a project to harmonize training curricula for local physiotherapist and orthopedic technicians, opened training centers in seven provinces (in Kandahar, Herat, Nangarhar, Balkh, Takhar, Kapisa, and Kabul), and increased the capacity of the existing rehabilitation facilities. The EU-funded project, Toward Improved Access to Quality Physical Rehabilitation in Afghanistan (TIQRA), launched in December 2015, supports the government of Afghanistan to improve the of delivery of public health services with a special focus on contributing to the expansion of and improved access to quality physical rehabilitation in underserved areas. A consortium of three partners: HI (as lead organization), Norwegian Afghanistan Committee (NAC), and Swedish Committee for Afghanistan (SCA) were implementing the project.[63]

In Lashkar Gah, Helmand province, the planning for the construction of a new ICRC orthopedic center was in progress in 2017. The center was designed to provide Helmand with a permanent and well-equipped rehabilitation center to replace the existing functional but temporary facility.[64] State plans for 2017–2018 included establishing three physical rehabilitation centers in Khost, Farah, and Kunar provinces respectively, funded by Canada through the UN Voluntary Trust Fund.[65] The MoPH maintained a priority list of provinces for future expansion of rehabilitation and prosthetic services under the Essential Package of Hospital Services (EPHS). It was planned to have nine physical rehabilitation centers placed under the supervision of the MoPH over a period of 10 years.[66]

The ICRC reported that, as acknowledged by the MoPH authorities, it would be unrealistic to consider the government capable of ensuring the required rehabilitation services itself. It is anticipated that it will take years before the national authorities have the capacity to fully manage the long-term functioning of services.[67]

ACAP III provided home-based physiotherapy to civilian victims of conflict in all 34 provinces of Afghanistan. Physiotherapists also provided referrals to local facilities and travel assistance. In 2017, ACAP III was providing a limited number of amputees with high-tech electric upper limbs for the first time in Afghanistan, with technical support for UNMAS from the EMPOR Organization.[68]

Social and economic inclusion and psychological support

A lack of dedicated resources severely inhibited capacities to provide employment for persons with disabilities, including mine/ERW survivors.[69] The ICRC secured employment for persons with disabilities[70] and supported vocational training.[71] The ICRC also provided micro-credits for persons with disabilities and their families, distributed stationery kits to students, and supported home tuition for children.[72] From September 2015 through June 2016, the CCD implemented a project to support the war victims in Kunduz province.[73]

The ACAP III project supported 4,300 eligible war victims, including mine/ERW-affected victims, with tools based on their economic reintegration needs.[74]

A lack of psychosocial support, particularly peer support, has remained one of the largest gaps in the government-coordinated victim assistance and disability programs, although some national and international NGOs provided these services. Psychosocial counseling services were provided to civilian conflict victims nationwide through ACAP III.[75] During 2016 through July 2017, a total of 12,500 eligible war victims received psychological support and counseling through ACAP III.[76]

Overall there were very limited opportunities for sports for persons with disabilities throughout the country. The ICRC offered persons with disabilities social inclusion opportunities and also continued to promote a wide range of sporting activities.[77] The Afghanistan men’s and women’s wheelchair basketball national teams were sponsored to travel abroad to compete in international tournaments.[78]

In 2016, UNMAS could not financially support inclusive education training due to lack of funding. Other stakeholders, including SERVE, SCA, and AAR Japan, continued to provide financial and technical support for inclusive education training of MoE school teachers and enrolment of children with disabilities in general schools (at least 1,600 beneficiaries from 2016 through July 2017).[79] Through August 2017, UMMAS/DMAC only had enough resources available for its victim assistance department to provide technical support for inclusive education activities of the MoE. UNMAS/DMAC continued to seek funding to support inclusive education directly as had been the case until 2014.[80] ALSO held a conference on the results of its study on education needs in 2017. The main objective was to promote access of persons with disabilities to primary, secondary, and higher education.[81]

Gender

Many NGOs, both national and international, provided assistance to women with disabilities in major provinces. However, women with disabilities in remote provinces and districts required more support. The Mine Action Program of Afghanistan (MAPA) Gender Mainstreaming Strategy 2014–2016, including victim assistance, was addressed through coordination and gender mainstreaming officers in NGOs.[82] The Gender Mainstreaming Strategy 2014–2016 stated, “Existing discrimination and bias sometimes mean that women can be hard to reach when implementing surveys and as a result, this means that their priorities–frequently the priorities of their children and of basic community survival–can be excluded. In areas such as victim assistance…gender determines the access to and impact of activities and services, where females often face more restrictions compared to males.”[83] In mid-2016, a gender consultant completed in-country assessment of gender considerations in ACAP III and measures to improve gender awareness in MoLSAMD services.[84]

After it expired, the Gender Mainstreaming Strategy 2014–2016 was replaced with a UNMAS/DMAC gender and diversity policy; as well as being represented in the fourth goal (on gender) of the National Mine Action Strategic Plan. A new Gender Associate with UNMAS/DMAC was recruited in March 2017 to coordinate gender issues, including victim assistance and disability contexts.[85]

Services for women and also for children were not sufficient to reach those in need or to cover all disabled women or children in the country.[86]

Laws and policies

The Law on the Rights and Benefits of Person with Disabilities and the Law on the Rights and Benefits for Relatives of Martyrs and Disappeared Persons remained the key legislative provisions. The Law on the Rights and Benefits of Persons with Disabilities was amended[87] in March 2013. However, the law contained discriminatory provisions and was not in conformity with the principles of the CRPD. In 2015, a working committee for amending the disability law was established.[88] By the end of 2016, Afghanistan stated that “the complete amendment of the Law on the Rights and Benefits of Persons with Disabilities has been initiated to comply with the international human rights obligations, as well as to address problems on its practical implementation.”[89] The process of amending the legislation was completed by May 2017 and the draft submitted to Ministry of Justice. The revised law was subsequently returned to MoLSAMD to be sent to Ministry of Justice for approval and publication in official gazette as “The Law of Persons with Disabilities.” The law was pending approval by the national government in August 2017.[90]

According to legislation, persons with disabilities should comprise 3% of state employees. In 2015, the Independent Joint Anti-Corruption Monitoring and Evaluation Committee reported that many persons interviewed noted that numerous violations of the Law on the Rights and Privileges of Persons employment quota occurred due to bribery and nepotism that resulted in job opportunities being taken away from persons with disabilities.[91]

The constitution prohibits any kind of discrimination and requires the provision of assistance to persons with disabilities, which include healthcare and financial protection.[92] In 2017, it was reported that “in practice, the situation is quite different and many persons with disabilities are deprived of basic rights.”[93]

Except the monthly pension, no other resources were allocated for victims or survivors directly.[94] Pensions are reported to be “totally insufficient” and not all persons with disabilities were eligible to receive them.[95] Discrimination in the allocation and payment of pensions by which only war victims were entitled to benefits persisted.[96]

Although Afghan disability legislation mandates that ministries, government offices, transportation facilities, and all new public construction should include facilities for the persons with disabilities in their design, it was reported that it rarely occurs.[97] In 2016, MoLSAMD, with support of the World Bank, started renovation of the ministries premises in order to improve accessibility for persons with disabilities in line with accessibility guidelines and standards. The renovation was completed in the first quarter of 2017.[98]

It was reported that although Afghanistan had joined the relevant treaties and conventions, the provisions were not implemented.[99]

In 2015–2016, DAO trained some 500 medical practitioners in the application of the CRPD and its obligations to provide adequate medical care to persons with disabilities.[100] One hundred NGO employees in five provinces[101] were also trained in CRPD and disability rights awareness.[102]

In 2016, Afghan DPOs submitted a detailed parallel (alterative, or “shadow”) CRPD report to the Committee on the Rights of Persons with Disabilities.[103]



[1] Handicap International (HI), “Understanding the challenge ahead: National disability survey in Afghanistan 2005,” Kabul, 2006.

[2] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[3] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[4] For example, HI reported that there are 15 district health clinics in Kandahar province, but none of them provide rehabilitation services. Response to Monitor questionnaire by Juliette Coatrieux, HI, 26 April 2015; and SCA, “SCA Initiates National Physical Rehabilitation Workshop,” 29 December 2014. See also SCA, “Commitment for Change: Strategic plan 2014–2017,” undated.

[5] Statement of Afghanistan, Mine Ban Treaty Third Review Conference, Maputo, 24 June 2014.

[6] Response to Monitor questionnaire by MACCA (consolidated questionnaire including information from MoE, MoLSAMD, and MoPH), April 2015.

[7] Response to Monitor questionnaire by Islam Mohammadi, Executive Director, ALSO, 30 July 2017.

[8] Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J.

[9] Statement of Afghanistan, Mine Ban Treaty Fifteenth Meeting of States Parties, Santiago, 29 November 2016.

[10] Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H.

[11] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[12] “Financial Access to Rehabilitation Services in Afghanistan in 2016,” cited in response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[13] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[14] UNMAS and USAID, “Monthly Status Update – July 2016 Afghan Civilian Assistance Program (ACAP III),” August 2016.

[15] UNMAS and USAID, “Monthly Status Update – April 2017 Afghan Civilian Assistance Program (ACAP III),” May 2017; and UNMAS and USAID, “Monthly Status Update – March 2017 Afghan Civilian Assistance Program (ACAP III),” April 2017.

[18] In Daman, Dand, and Arghandab districts.

[19] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[20] Mine Ban Treaty Article 7 Report (for calendar year 2015), Form J; and Convention on Cluster Munitions Article 7 Report (for calendar year 2015), Form H.

[21] Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J; and response to Monitor questionnaire by MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), April 2015.

[22] Email from MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), 7 April 2016.

[23] Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J.

[24] Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H.

[25] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[26] Ibid.

[27] Email from MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), 7 April 2016; and Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J.

[28] Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H.

[29] Email from MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), 7 April 2016.

[30] Ibid.; and Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H.

[31] Response to Monitor questionnaire by Juliette Coatrieux, HI, 26 April 2015.

[32] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[34] USAID, “Afghan Civilian Assistance Program II (ACAP II),” Fact sheet, 11 August 2014.

[35] Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J; and email from MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), 7 April 2016.

[36] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[37] Ibid.

[39] UNMAS and USAID, “Monthly Status Update – October 2016 Afghan Civilian Assistance Program (ACAP III),” November 2016.

[40] The conference was held in partnership with the US International Council on Disabilities, the US-Afghan Women’s Council, Georgetown University’s Center for Child and Human Development, Counterpart International, and Trivision. Embassy of Afghanistan, “Final Report Afghan Disability Rights Conference: From Policy to Programming May 23 and 24, 2017 Washington, DC,” undated, but 2017.

[41] Statements of Afghanistan, Mine Ban Treaty Third Review Conference, Maputo, 24 June 2014; Convention on Cluster Munitions Intersessional Meetings, 9 April 2014; Convention on Cluster Munitions Fifth Meeting of States Parties, San Jose, 4 September 2014; and Thirteenth Meeting of States Parties, Mine Ban Treaty, Geneva, 3 December 2013.

[42] Mine Ban Treaty Article 7 Report (for calendar year 2016), Form J; and Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H.

[43] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[44] Response to Monitor questionnaire by Islam Mohammadi, ALSO, 30 July 2017.

[45] Response to Monitor questionnaire by Mohammad Shafaq, CCD, 1 August 2017.

[46] Responses to Monitor questionnaire by Alberto Cairo, ICRC, 14 April 2016, and 14 April 2015; and by Omara Khann Muneeb, Director, DAO, 5 April 2016.

[47] ICRC, “The ICRC's physical rehabilitation work in Afghanistan,” Fact sheet, June 2016.

[49] The conference was held in partnership with the US International Council on Disabilities, the US-Afghan Women’s Council, Georgetown University’s Center for Child and Human Development, Counterpart International, and Trivision. Embassy of Afghanistan, “Final Report Afghan Disability Rights Conference: From Policy to Programming May 23 and 24, 2017 Washington, DC,” undated, but 2017.

[50] ICRC, “Annual Report 2015,” Geneva, 2016, p. 336. The hospitals treated 1,827 weapon-wounded patients in 2014 (a similar number of beneficiaries compared to 2,023 in 2013); 42% (861) were injured by mines/ERW (compared to 47%, 950 in 2014). ICRC, “Annual Report 2014,” Geneva, 2015, p. 282; and ICRC, “Annual Report 2013,” Geneva, 2014, p. 282.

[51] ICRC, “Annual Report 2016,” Geneva, 2017, p. 317.

[52] ICRC, “Annual Report 2014,” Geneva, 2015, p. 279; and ICRC, “Annual Report 2013,” Geneva, 2014, p. 281.

[53] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[54] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[55] Ibid.

[56] Response to Monitor questionnaire by Bismillah Safi, Admin/Finance Manager, DAO, 30 July 2017.

[57] Daichopan, Zabul and Kijran, Daikondi are closer to Uruzgan. Response to Monitor questionnaire by Omara Khann Muneeb, DAO, 5 April 2016.

[58] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[59] AAPT, “PT Services in Afghanistan,” undated.

[60] ICRC, “Annual Report 2016,” Geneva, 2017, p. 319.

[61] ICRC, “Annual Report 2015,” Geneva, 2016, p. 336.

[62] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[63] HI, “Federal Information – Country Card Afghanistan,” August 2016; and response to Monitor questionnaire by Taimur Ahmed, HI, 7 June 2016.

[64] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[65] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[66] These were Kunduz (regional center), Farah, Bamyan, Paktia, Badghis, Baghlan, and Zabul. Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[67] ICRC Physical Rehabilitation Programme (PRP), “Annual Report 2014,” Geneva, 2015; and response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[68] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[70] More than 40 people gained employment.

[71] Some 390 people attended vocational training.

[72] ICRC, “Annual Report 2016,” Geneva, 2017, p. 316.

[73] Response to Monitor questionnaire by Mohammad Shafaq, CCD, 1 August 2017.

[74] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[75] UNMAS, “Portfolio of Mine Action Projects: ACAP III,” undated; and UNMAS and USAID, “ACAP III Monthly Status Updates,” for 2016 and 2017.

[76] Email from ACAP III Data Monitoring Associate, to DMAC, 7 August 2017, cited in response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[77] ICRC, “Annual Report 2016,” Geneva, 2017, p. 319; and response to Monitor questionnaire by Alberto Cairo, ICRC, 14 April 2016.

[78] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[79] SCA provided training to 1,400 teachers, SERVE for 100 teachers, and AAR Japan trained 30 child protection officers in two school of Parwan province that resulted in the enrollment of 56 children with hearing, visual, and mental impairments. Convention on Cluster Munitions Article 7 Report (for calendar year 2016), Form H; and response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[80] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[81] Response to Monitor questionnaire by Islam Mohammadi, ALSO, 30 July 2017.

[82] Response to Monitor questionnaire by Juliette Coatrieux, HI, 26 April 2015; and by Mohammad Naseem, ABRAAR, 22 April 2015.

[84] UNMAS and USAID, “Monthly Status Update – July 2016 Afghan Civilian Assistance Program (ACAP III),” August 2016.

[85] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[86] Responses to Monitor questionnaire by Ali Mohabati, Coordinator for the Rights of Persons with Disabilities, AIHRC, 9 April 2016.

[87] Articles 4,8, 19, and 24 of the law were amended.

[88] Email from MACCA (consolidated questionnaire, including information from MoE, MoLSAMD, and MoPH), 7 April 2016.

[89] Statement of Afghanistan, Mine Ban Treaty Fifteenth Meeting of States Parties, Santiago, 29 November 2016.

[90] Response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[91] Independent Joint Anti-Corruption Monitoring and Evaluation Committee Vulnerability to Corruption, “Assessment of the Payment System for Martyrs and Persons Disabled by Conflict,” 3 June 2015, p. 5.

[92] US Department of State, “2016 Country Reports on Human Rights Practices: Afghanistan,” Washington, DC, 13 April 2017.

[93] The conference was held in partnership with the US International Council on Disabilities, the US-Afghan Women’s Council, Georgetown University’s Center for Child and Human Development, Counterpart International, and Trivision. Embassy of Afghanistan, “Final Report Afghan Disability Rights Conference: From Policy to Programming May 23 and 24, 2017 Washington, DC,” undated, but 2017.

[94] Response to Monitor questionnaire by Islam Mohammadi, ALSO, 30 July 2017.

[95] Response to Monitor questionnaire by Alberto Cairo, ICRC, 29 July 2017.

[96] Response to Monitor questionnaire by Bismillah Safi, DAO, 30 July 2017.

[97] Farid Tanha, “Afghanistan: Fighting for Disability RightsDisabled people say they face social prejudice and government inaction,” The Institute for War & Peace Reporting, 6 April 2017.

[98] Statement of Afghanistan, Fifteenth Meeting of States Parties, Santiago, 29 November 2016; and response to Monitor questionnaire by UNMAS/DMAC, 8 August 2017.

[99] Response to Monitor questionnaire by Alberto Cairo, ICRC, 14 April 2016.

[100] The CRPD trainings were conducted in Laghman, Ghazni, Hirat, Kandahar, Takhar, Badakhsahn, Bamyan, Paktia, and Logar.

[101] The provinces were Ningarhar, Kabul, Hirat, Balkh, and Zabul.

[102] Response to Monitor questionnaire by Omara Khann Muneeb, DAO, 5 April 2016.