Survivor assistance action points

• Train prosthetists and ensure that orthopedic centers have sufficient equipment and material.
• Ensure the sustainability and accessibility of physical rehabilitation and psychosocial support in the Casamance region.
• Ensure regular and effective coordination of victim assistance with all stakeholders and update the National Victim Assistance Action Plan.
• Develop economic inclusion projects for mine/explosive remnants of war (ERW) survivors in the Casamance region.
• Ensure the inclusion of mine/ERW survivors in the planning of victim assistance.

Victim assistance since 1999

Services were limited in the Casamance region, with reliance on NGOs. Remaining challenges:

• Emergency, continuing healthcare, and psychological support.
• Inadequate economic inclusion and access to education programs.

Survivor assistance planning and coordination

International commitments and obligations

Laws and policies

The Republic of Senegal prohibits discrimination against persons with disabilities by law, however it did not enforce these provisions adequately in 2018.[11] The law also mandates accessibility for persons with disabilities, but the government did not effectively enforce the law.[12] Through the Equal Opportunity Card initiative, launched in 2015, persons with disabilities, including mine/ERW survivors, will have free access to health and rehabilitation services, education, employment, and transportation, among other state services.[13] However, access to these services was not yet effective.[14]

Major Developments

Survivor assistance was reported to have been suspended since July 2017.[15] The state did provide funding for victim assistance since 2015.[16] There is an annual planned budget for victim assistance, which is included in the annual workplan of the CNAMS, but over the last two years, the CNAMS has not received the required budget.[17] The 2017–2021 National Community-based Rehabilitation Programme (PNRBC) for persons with disabilities was approved on 5 July 2018;[18] nevertheless, the individual budgetary support to persons with disabilities for education, training, physical rehabilitation, emergency assistance, and annual family security grants within the framework of the PNRBC did not meet the needs of the majority.[19] The national survivor network reported a decrease in victim assistance services and resources in 2018.[20]

The three-year economic inclusion project for mine/ERW survivors, funded by Humanity & Inclusion (HI) and implemented by ISAD, ended on 31 December 2018. Two other HI-funded economic inclusion projects implemented in Ziguinchor, Dakar, Kolda, and Sédhiou ended on 30 April 2019.[21]

Needs assessment

No structured needs assessment survey was conducted in 2018 or in the first quarter of 2019;[22] however, ISAD collected information on the needs of mine/ERW survivors during risk education sessions.[23]

Medical care and rehabilitation

Despite the provisions for emergency care, follow-up medical care, and prosthesis fitting free of charge to mine/ERW survivors covered in the conventions signed between the CNAMS, three regional hospitals (Ziguinchor, Kolda ,and Sédhiou), and three departmental health centers in affected areas (Oussouye, Bignona, and Goudomp), survivors generally have to pay to receive these services because the hospitals and health centers have not received funding from the CNAMS since 2015.[24] Consultations outside of these health centers are paid for by the survivors.[25]

The Ziguinchor orthopedic center was facing deteriorating equipment, a constant shortage of raw materials and prosthetic parts,[26] and a lack of trained personnel.[27] The center does not have an annual budget; rather, the regional hospital is responsible for the budget of the center, but it did not purchased prosthetic parts in 2018.[28] The center is, therefore, dependent on foreign donations of material, including prosthetic parts.[29] The majority of patients treated at the Ziguinchor orthopedic center are mine survivors.[30] The Kolda orthopedic center is supported by HI. Raw material is provided to the Kolda orthopedic center either by HI or by the Kolda regional hospital.[31] However, prosthetists have not received any training on the use of new technologies, and the HI-funded project of building a new prosthetic workshop for the center ended before the workshop was built.[32]

Within the framework of the agreement between the CNAMS, ISAD, and the ICRC, 34 Senegalese mine/ERW survivors received new prosthetic devices from the Centro de Reabilitação Motora (Center for Motor Rehabilitation, CRM) in Guinea-Bissau in 2018.[33] ISAD facilitates transport to Guinea-Bissau for survivors, as well as accommodation for the duration of the treatment.[34] The project was ongoing in 2018 and in the first quarter of 2019.[35] Since the project started in 2016, around 90 mine/ERW survivors from Senegal received new prosthetic devices in Guinea-Bissau.[36]

Socio-economic and psychosocial inclusion

Under the Social Orientation Law on the Promotion and Protection of the Rights of Persons with Disabilities, all destitute persons who hold an Equal Opportunity Card and are enrolled in higher education institutions are eligible to a university scholarship.[37] Family security grants are also provided to families in need, including persons with disabilities and mine survivors.[38] The CNAMS, however, reported that there were no resources for economic-inclusion activities in 2018.[39] In 2018, ISAD was monitoring the implementation of income-generating projects for survivors.[40] The ICRC provided cash grants to vulnerable people, including victims of mines/ERW, to start small businesses.[41]

There was a decrease in the accessibility of psychosocial support services.[42] The psychological support and educational counseling services provided to mine/ERW survivors by the Academic Centre for Educational and Professional Orientation (Centre académique de l’orientation scolaire et professionnelle, CAOSP) and the Kenya Psychiatric Center with funding from the CNAMS ended in 2014 for lack of funding.[43] While services remain available, they are no longer free of charge, and transportation and accommodation are also paid by patients.[44] Neither the CAOSP nor the Kenya Psychiatric Center were able to resume their outreach activities to affected communities in 2018 due to the severe lack of funding.[45] As a result, no mine/ERW survivors received psychological support from the CAOSP or the Kenya Psychiatric Center in 2018.[46]

Cross-cutting

The specific needs of children are taken into account in the provision of physical rehabilitation.[47]

ISAD and the Women’s Platform for Peace in Casamance conducted advocacy activities for women survivors in 2018;[48] however, they are often ostracized in the community because of their disability.[49] The National Disability Action Plan 2017–2021 takes into account women with disabilities, and a committee of women with disabilities was set up under the Senegalese Federation of Associations of Persons with Disabilities to promote the rights of women with disabilities and their participation in the design and implementation of public policies.[50]

Survivor assistance providers and activities