Action points based on findings

• Intensify efforts to improve access to rehabilitationservices from remote and rural areas, including allocating resources to bring beneficiaries for rehabilitation and ensuring that transport is available.
• Hold regular disability sector coordination meetings and link victim assistance coordination with the development of disability strategies.
• Improve state support for psychological and social assistance, including peer-to-peer counseling and survivor-driven economic activities.
• Coordinate the rapid implementation of recently adopted legislation as well as existing policies and planning that could hasten developments in the availability and accessibility of services.

Victim assistance commitments

Lao People’s Democratic Republic (PDR) is responsible for significant numbers of cluster munition victims and survivors of other explosive remnants of war (ERW), as well as landmine survivors, who are in need. Lao PDR has made commitments to provide victim assistance through Convention on Conventional Weapons Protocol V and has victim assistance obligations under the Convention on Cluster Munitions.

Lao PDR ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 25 September 2009.

In 2012, Lao PDR estimated that there were some 15,000 mine/ERW survivors still living, including approximately 2,500 survivors of unexploded submunitions.[1]

Victim assistance since 2015

Lao PDR stated that there were limited resources available and that few donors made victim assistance a priority.[2] The budget allocated to victim assistance is very limited, and as a result Lao PDR cannot pursue its strategic plan for the Dubrovnik Action Plan period through 2020.[3] Lao PDR also noted that it “has a long way to go to fully achieve the victim assistance goals within the broader disability and development frameworks.”[4] No change was reported by Lao PDR in its efforts to raise awareness of the rights of cluster munition victims and persons with other disabilities since 2010 and Lao PDR reported that no organizations were conducting advocacy on victim assistance.[5]

Victim assistance in 2016

Despite ongoing activities, a lack of funding means most mine/ERW survivors were not able to access adequate assistance. Survivors lacked ongoing disability services, like physical therapy, access to prosthetics, mental health support, and livelihood training.[6]

Assessing victim assistance needs

In its initial report on the CRPD submitted in 2017, Lao PDR stated: “War with foreign aggressors has taken its toll on the lives and assets of the multiethnic people and had a heavy impact of the farmland and mountainous forest land used for foraging. 25% of the country is littered with unexploded ordinance (UXOs). Between 1964 and 2008, a total of 50,000 people have fallen victim to UXOs, of whom 30,000 died and 20,000 survived, 13,500 becoming disabled. These victims included women and children. The repercussions of the war, especially these UXOs, have become a major obstacle for the Lao people and socio-economic development and constitute a cause underlying the underdevelopment and poverty of the Lao multiethnic people.”[7]

The National Regulatory Authority (NRA) Survivor Tracking System, a system for collecting data on new casualties, was designed to provide an ongoing survey of all survivors’ needs. The survey was conducted in 10 provinces; some 8,918 survivor profiles were recorded. In 2016, Lao PDR reported that the results of the survey are available for all development partners and victims assistance operators.[8] In addition to the 10 provinces covered by the survivor tracking system, there are known to be mine/ERW survivors in the capital Vientiane. However, most of these are believed to be former military personnel who, as veterans with disabilities, are entitled to special social protection measures and are likely already covered by those systems.[9] Based on the survey data, the UXO Sector the Multi Year Work Plan for the Unexploded Ordnance in Lao PDR (2016–2020) set a target of assisting 1,500 UXO survivors during the period (300 survivors per year).[10]

World Education maintained its own detailed beneficiary database and information storage system. Its Victim Assistance Support Team (VAST) staff, including a data specialist, also had training on the Information System for Mine Action (IMSMA) used by the NRA and were able to make the data compatible.[11]

An Australian-funded project to identify barriers and facilitators to social and economic participation and development for persons with disabilities in Lao PDR together with Lao organizations (government, disabled persons’ organizations (DPOs), and national and international NGOs) was undertaken by Curtin University in order to improve their information about people living with disability, and develop disability-inclusive development policies and programs. Australia also supported a four-week program for Lao government representatives from the ministries of labor and social welfare, health, and education and sports, along with delegates from DPOs, service providers, and advocacy agencies.[12]

Victim assistance coordination

The NRA shared victim assistance information with stakeholders and attended meetings of actors in the disability sector. Victim assistance remained a minor component of the work of the ministries responsible for disability issues.[13]

A victim assistance strategic plan, adopted in 2014, addresses seven sections of victim assistance implementation: data collection; medical care; physical rehabilitation; psychological support and social inclusion; economic rehabilitation and education; legislation and policy; and coordination.[14] The victim assistance strategy authorizes the NRA to cooperate with the National Committee for Disabled and Elderly People (NCDE) to develop a sector-wide strategy for persons with disabilities; with the Ministry of Labor and Social Welfare to ensure adequate employment access; and with the Ministry of Health on the physical and psychological needs of cluster munition victims.[15]

The Ministry of Labor and Social Welfare holds primary responsibility for the needs of, and related services to, persons with disabilities through the NCDE. Service providers enter into memoranda of understanding (MoUs) with the relevant state ministries responsible for the sector in which the NGOs will operate.[16]

In 2014, World Education began implementing a multi-year the United States Agency for International Development (USAID)-funded project for the disability sector: Training, Economic Empowerment, Assistive Technology, and Medical and Physical Rehabilitation (TEAM).[17]

In 2017, the USAID Regional Development Mission for Asia reported an intent, through a call for implementers, to provide US$15 million funding over a five-year period for services and support to the disability sector in Lao PDR.[18]

Victim assistance is one of the three main components of the NRA strategy, entitled “Safe Path Forward II 2011–2020.”[19]

Lao PDR has its own national Sustainable Development Goal (SDG), “SDG18: Lives Safe from UXO,” launched during an ASEAN Summit in Vientiane in September 2016. SDG18 targets include support to healthcare and livelihoods of UXO victims.The project “Moving towards achieving SDG18 – Removing the UXO obstacle to Development in Lao PDR”will be implemented by UXO Lao and the UNDP through to the end of 2021.

Reporting

In 2017, Lao PDR reported on victim assistance in its Convention on Cluster Munitions Article 7 Report for calendar year 2016, and made a statement on victim assistance at the Convention on Cluster Munitions Seventh Meeting of States Parties in September 2017.[20]

Inclusion and participation in victim assistance

Representatives of theLao Disabled People’s Association(LDPA), Lao Disabled Womens Development Center (LDWDC), and Quality of Life Association (QLA)–Xieng Khouang province, actively participated in consultative processes and special events, including annual review meetings and ERW sector-wide working group meetings.[21]

Lao PDR has never included a survivor on its delegation for the Convention on Cluster Munitions Meetings of States Parties or intersessional meetings.

Service accessibility and effectiveness

Victim assistance activities

Emergency and continuing medical care

Village health volunteers (6,000) provided basic healthcare and first responder emergency assistance in rural areas across Lao PDR. World Education worked with the Ministry of Health, various international NGOs, and village health volunteers to create a comprehensive First Aid curriculum for volunteers in 2016.[22] The approved curriculum was being used for training in Xieng Khouang, Houaphan, and Sekong provinces.[23] World Education and provincial departments of health jointly implemented the War Victims Medical Fund (WVMF) project.[24] In 2016, the Ministry of Health, supported by World Education and QLA, provided 67 survivors with medical care, while 18 survivors from 2015 also received follow-up treatment.[25]

Physical rehabilitation, including prosthetics

The Ministry of Health provides prosthetic and orthotic services in Lao PDR under the Center for Medical Rehabilitation and associated physical rehabilitation centers, and in cooperation with COPE. There are five rehabilitation centers, the National Rehabilitation Center (NRC) and another in each urban provincial center.[26] Clients are reimbursed for travel costs and are provided with a small living allowance during their stay for rehabilitation.[27] In 2016,136 survivors received rehabilitation services through COPE (129 men and seven women).[28]

In 2017, there was only one qualified doctor specializing in rehabilitation medicine in Lao PDR.[29] The lack of licensed ortho-prosthetists and physiotherapists in rehabilitation centers results in a level of demand that was not adequately met.[30] A 2016 study, carried out at the Vientiane Savannakhet and Xieng Khouang rehabilitation centers, showed that while respondents reported being “quite satisfied” with the prosthetic devices received, only 66.5% of devices used were said to be in good condition; 12.8% said they were not currently using their device, and some had not used their device at all. Among lower limb prosthetic users surveyed, 61.5% (88) were mine/ERW survivors.[31]

HI worked on improving servicesat the five rehabilitation centers. This included supporting the design and implementation of a national rehabilitation strategic action plan and corresponding guidelines developed by the Ministry of Health; a more effective training program through the Center of Medical Rehabilitation and Medical Technologies Faculty, and establishing a management system. A national rehabilitation taskforce with five sub-taskforce groups were to be established.[32]

In 2015, the ICRC took over the physical rehabilitation project from its MoveAbility Foundation, formerly known as the ICRC Special Fund for the Disabled.[33] Having moved resources from economic inclusion to rehabilitation, the ICRC began to support three physical rehabilitation centers in Lao PDR in 2015.[34] However, an assessment of rehabilitation needs led the ICRC to reconsider and conclude its support for three prosthetic centers. It focused instead on strengthening national capacities in rehabilitation services management in 2016. The Ministry of Labor and Social Welfare declined an ICRC offer to train technicians and physiotherapists at one center. The ICRC facilitated a study tour of a Cambodian rehabilitation center for Lao government officials.[35]

Economic and social inclusion and psychological support

World Education and QLA provided vocational training and economic support specifically for survivors. Survivors also received education scholarships through World Education. Through World Education, 212 survivors (including 98 women) received education scholarships and 24 survivors (four were women) were provided economic inclusion support. QLA provided vocational training for 34 survivors received economic inclusion support and 58 survivors received education scholarships. One very poor survivor also received a house.[36]

HI ran a project to support persons with disabilities, including survivors and their family members, with income-generating and livelihood activities.[37] At the end of June 2016, the project in ERW-affected districts Nong and Sepone of Savannakhet province, was completed. In May 2016, the project was extended to Kaysone Phomvihane district, Savannakhet province, and Pake district in Champassak province.[38]

Psychological support was generally not available in Lao PDR. World Education’s integrated victim assistance project, carried out by its Victim Assistance Support Team (VAST), mapped services and provided individual support to survivors to address psychologic and other needs, including referrals to services. VAST also operates a peer support program with survivor facilitators providing psychosocial assistance. Five new peer support facilitators were engaged In 2016.[39] In 2016, 215 survivors (including 54 women) received psychosocial assessments and support through World Education.[40]

Laws and policies

Social protection programs support war veterans with disabilities unable to work, however there were no social protection programs to support other persons with disabilities in similar situations. DPOs recommended that social protection programs should be extended to include all persons with disabilities.[41]

The Decree on the Rights of Persons with Disabilities (Decree No. 137, 2014) was adopted alongside the Decree on the Organization of Operation of National Committee for Disabled People and the Elderly (Decree No. 232) as the mechanism for coordination of implementation with the National Committee for Disabled and Elderly People(NCDE).[42]

In 2016, HI continued to supported efforts to establish strategic planning for implementation of the Decree on the Rights of Persons with Disabilities at national and local levels. Thus, HI technically supported the NCDE and Ministry of Labor and Social Welfare in developing the policy framework for persons with disabilities in Lao PDR. The project aimed to conduct an inclusive process with persons with disabilities and representative organizations and 12 consultative meetings, in order to facilitate the development of the national disability strategy and its corresponding measurable action plan in 2017.[43]

Legislation adopted in 2009[44] requires that the construction of buildings, roads, and public places provide facilities for persons with disabilities, according to a list of access requirements for public facilities.[45]

Lao PDR reported that the government works together with the LDPA to organize training and seminars for court officials and other relevant bodies concerning the rights of persons with disabilities to access the justice system and procedures for assistance in the event of a problem or complaint.[46]