Action points basedon findings

• Improve the sustainability, quality, and availability of prosthesis and rehabilitation services, including by enhancing coordination and dedicating the necessary national resources.
• Eliminate barriers to access, including to health and livelihoods, for survivors and other persons with disabilities.
• Closely consult with local survivor organizations in decision making processes.

Victim assistance commitments

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

Uganda ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 25 September 2008. Uganda’s initial report was before the Committee on the Rights of Persons with Disabilities in April 2016 and the next report (combined second to fourth CRPD reports) is due for submission in 2022.

Victim Assistance

There have been at least 2,257 mine/ERW survivors recorded in Uganda.[1]

Victim assistance since 2015

Survivors continued to face significant challenges to access services due to the decreasing availability of services as a result of the departure of international service providers and a lack of donor support. There were gaps in physical rehabilitation, economic inclusion, and psychological support, as well as the means to access all services. Responsibility to provide victim assistance services was officially handed over to government ministries as many international organizations closed or reduced their programs in northern Uganda by 2013.

Since the Ministry of Health assumed responsibility for rehabilitation services from 2012, many rehabilitation centers lacked affordable assistive devices that were adequate for use. Uganda’s disability services supply chain relied mostly on numerous donors, which resulted in a fragmented inconsistent supply devoid of solid national coordination. The central national referral service at Mulago was not able to improve the quality of its services or subsequently to provide leadership for the establishment of any new services.[2]

Due to the departure of many victim assistance providers and funders, by 2017, one of the longest running international support to activities relevant to survivors has been through a conflict reparations program associated with the International Criminal Court (ICC). In addition to implementing court-ordered reparations, the Trust Fund for Victims created under the Rome Statute system, provides grant-based funding for assistance to victims and their families in Uganda, including mine/ERW survivors, through physical, psychological, and material support to activities for physical rehabilitation .

The Trust Fund for Victimsworked with implementing partners to provide prosthetics, reconstructive and general surgery, fragment removal, and physiotherapy sessions. The Trust Fund for Victimsfunding to projects in northern Uganda (nineactive projects in 18 districts)was to be completed by April 2018.The fund planned to launch another competitive bidding process for five-year contracts with new implementing partners in order to provide consistent support to victims.[3] In February 2018, the Trust Fund for Victims called for expressions of interest from qualified firms and NGOs with minimum of two years’ experience in managing similar projects in anticipation of the ICC issuing a new round of funding for “Integrated Physical and Psychological Rehabilitation Assistance for Victims in northern Uganda.”[4] The trust fund launched new projects with the Ministry of Health and local government officials at all levels across the districts of northern Uganda.[5] However as of mid-2017 it had not coordinated with the government victim assistance focal point, the Ministry of Gender, Labor and Social Development (MGLSD) regarding its rehabilitation assistance in northern Uganda.[6]

Victim assistance coordination was nonexistent after 2014. In 2011, the National Intersectoral Committee on Disability was formed and included a mandate to coordinate victim assistance. There has been no victim assistance plan or active disability rights strategy that would replace it since 2015. Uganda’s national victim assistance plan of 2008, was revised in 2010 and extended by two years to 2014, was not subsequently updated, revised, or reviewed. Little progress on the plan’s implementation was reported by survivors in western and northern Uganda. In 2013, the MGLSD held meetings with the Intersectoral Committee on Disability to develop a tool to evaluate the implementation of the Comprehensive Plan of Action on Victim Assistance 2010–2014.[7] Representatives of the Ministry of Health, National Council for Disability, National Union of Disabled Persons of Uganda(NUDIPU), the Uganda Landmine Survivors Association (ULSA), and several disabled persons’ organizations (DPOs) were involved.However, the evaluation of the national victim assistance plan was never begun.[8]

Mine/ERW survivors and survivor’s representative organizations, which relied on NGO support, were not aware of what had happened to the national victim assistance plan onto which they had placed their hopes for improvement in support and services.[9]

Assessing victim assistance needs

No assessments of the needs of survivors were reported. Data on mine/ERW survivors was not disaggregated among data on other persons with disabilities.[10]

Data collection on persons with disabilities remained a challenge. The final report of the 2014 national census, released by the Uganda Bureau of Statistics in 2016, found that the disability prevalence rate was about 12%.[11] A statistical survey program to apply the Washington Group type questions on disability was ongoing with the Uganda Bureau of Statistics in 2017.[12]

Victim assistance coordination[13]

There were no plans to revise or renew the victim assistance plan which expired in 2014, but Uganda intended to develop a broader and more inclusive plan of action for the rights of persons with disabilities. The MGLSD believed that most issues relevant to survivors would be included in a future national disability plan.The Intersectoral Committee on Disability planned to meet quarterly. No meetings were held in 2016, but in 2017 one meeting had been held by August.[14]

Government agencies responsible for protecting the rights of persons with disabilities, including the Ministry of State for Disabled Persons under the MGLSD and the National Council on Disability (NCD), lacked sufficient funding to undertake significant initiatives.[15]

Uganda has not submitted a Mine Ban Treaty Article 7 report since 2012; its last Mine Ban Treaty Article 7 report (for 2011) did not provide information on victim assistance.[16] Uganda made a statement on victim assistance at the Mine Ban Treaty Fifteenth Meeting of States Parties in Santiago, Chile in November 2016, though not during the victim assistance session, so as such, it is not on record.[17]

Inclusion and participation in victim assistance

Survivors participated in specific public events as well as during the International Day of Persons with Disabilities as members of district unions for persons with disabilities. Survivors often displayed handicrafts and had opportunities to interact with government officials at such occasions.[18] Representatives of ULSA participated in meetings of the NUDIPU at the regional level, and representatives of local survivor associations participated in district-level meetings of NUDIPU.[19]

Five seats in the national assembly are reserved for persons with disabilities.[20] In September 2017, a member of the national assembly addressing a meeting of survivors from across Uganda said that it was necessary for them to reach out to the national assembly and ministries and pursue implementation of victim assistance.[21]

Service accessibility and effectiveness

Victim assistance activities

Medical care

Quality healthcare remained unaffordable and inaccessible to survivors in many regions and particularly in remote and rural areas where limited NGO funding for health services and essential transportation to medical facilities had significantly declined in the period 2014–2017.[22] Limited financing of healthcare adversely affected the quality of health services. Many health facilities, particularly in rural areas, lack essential medicines and necessary staff, and are not offering care in line with clinical guidelines. It was recommended that Uganda reduce high out-of-pocket health expenditures by adopting and implementing a national health insurance scheme that extends coverage to the informal sector, including persons with disabilities and other vulnerable groups.[23] It was reported that there were accessibility challenges at some health centers, especially persons using wheelchairs and those who do not live within a 5km radius of the nearest health facilities.[24]

Physical rehabilitation

Overall rehabilitation centers were inadequate and functioning poorly. The distribution of mobility devices by the government system was not adequately reaching all those in need and were not affordable for the majority of persons with disabilities. It was reported that the state was not providing funding for rehabilitation centers, which are key providers of mobility devices. The Ministry of Health has placed disability services under the category of an unfunded priority. Therefore, rehabilitation centers relied on NGO support and international contributions.[25]

The Mulago National Referral Hospital Orthopedic Workshop in Kampala has remained in a state of disrepair for many years. It relied on donations for devices and otherwise operated a cost-recovery list for prosthetic items that were not funded or provided by charitable organizations.[26] A survey in 2012 noted that the national referral hospital did not seem to be in a position to provide leadership and guidance for prosthetics and orthotics services in Uganda because even after significant investments, its development had stagnated.[27] In 2017, there was no reported improvement in the situation.[28]

Equipment and materials needed to make prosthetics were either in disrepair or non-existent. Gulu Regional Orthopedic Workshop (GROW) in northern Uganda, which is the nearest district to most mine/ERW survivors, was no longer carrying out its outreach program and was fully dependent on funding from the Trust Fund for Victims.[29]

Comprehensive Rehabilitation Services Uganda (CoRSU) on the Kampala-Entebbe road, offers free corrective surgery and orthopedic services to children, while adults had to pay for services and prosthetic devices. Income from private patients was used to subsidize the cost of services for poor children with disabilities.[30]

Psychological support

Although professional mental healthcare is available in major hospitals,mental health services are absent at district general hospitals and psychiatric hospitals have no community outreach programs. Mental health services are rarely gender sensitive.[31]

Social and economic inclusion

ULSA implemented livelihood and income-generation activities with remaining AAR Japan support.[32] A number of survivor groups create and sell regionally specific crafts to generate income.[33]

The Mubende Rehabilitation Center for military personnel offersphysical and psycho-social rehabilitation and support to disabled combatants and family. The center provides various sports options for rehabilitation with training provided by Uganda National Actionon Physical Disability (UNAPD).[34]

Water, Sanitation, and Hygiene

The Gulu Disabled Persons Union (GDPU) worked to install an accessible, drainable pit latrine and a hand washing station each year in a local primary school in Gulu.[35]

Laws and policies

The law prohibited discrimination against persons with disabilities, but without penalties, it was not enforced and discrimination was common.[36] The government encouraged banks and financial institutions to provide financial services to persons with disabilities who may have difficulties accessing loans due to a lack of collateral.[37]

According to a 2017 report by the Equal Opportunity Commission, the majority of buildings in Uganda were not fully accessible by persons with disabilities, which created challenges to accessing goods and services at public facilities.[38] Infrastructure continued to be built without due regard to the accessibility needs of persons with disabilities. The Uganda Human Rights Commission reported that there were noregulations to operationalize the Uganda Building Control Law of 2013, which would make the accessibility standards that were launched in 2010 obligatory and enforceable.[39]

Landmine survivors in northern Uganda reported that they do not have access to adequate prosthetic devices, mobility aids, or medical care that would allow them engage in economic activities. Economic inclusion and income-generation activities were among priorities for survivors.[40] In 2015, survivors in Gulu announced plans to seek redress through the court system, for the lack of governmental protection during the conflict and the lack of support since their mine incidents. The proposed class action for financial reparations was stirred by similar compensation schemes for people who had lost cattle and property due to armed conflict in Uganda. They saw such assistance as just and equivalent to the compensation received by others who had suffered due to conflict. In response, the government said it has allocated the funds to “compensate” landmine survivors. As of 2017, survivors had not yet organized a coordinated campaign for reparations or announced which specific measures parliament could enact in terms of payments and provisions or alternatives in terms of improvement of services [41] The National Union of Disabled Persons (NUDIPU) has a legal department that brings cases of breaches of the rights of persons with disabilities to court. Cases often take years to process and persons with disabilities often give up before their case is tried.[42]

The most recent information available, a 2012 report released by the National Council on Disability (NCD), indicated 45% of persons with disabilities were literate, compared with 71% in the general population.[43] Even when persons with disabilitieshave the necessary qualifications and experience,most potential employers did not give them chances to compete for employment positions. The majority of persons with disabilities who find work are employed in the informal sector and live in abject poverty due to limited livelihood opportunities. Although the Persons with Disabilities Act (2006) initially provided for a 15% tax deduction incentive to private companies that employed 10 or more persons with disabilities, it was reduced to a 2% tax deduction for any employer including persons with at least 5% disabilities among employees. The new arrangement proved unsuccessful, with many companies expressing the view that the rebate was insufficient to serve as an incentive. While Section 13(3) of the Persons with Disabilities Act (2006) provides for Ministerial authority to determine the quota, or percentage, of persons with disabilities to be employed, it has not been enforced by delegated legislation.[44]

Uganda stated that it is receiving and hosting many refugees who are mine survivors, and thus required additional resources to meet their needs.[45]