LM Report 1999

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Physicians for Human Rights

Tools for Measuring the Magnitude of the Landmine Problem for Victim Assistance

Epidemiological based surveys are essential for properly quantifying the public health consequences of landmines. The results of such studies facilitate the allocation of resources and aid in evaluating the impact of interventions. The development of standardized survey tools will help to ensure that data collection proceeds according to appropriate scientific methods and allow the comparison of data between differing regions and countries.

Two core tools were developed by:

World Health Organization

Physicians for Human Rights (PHR)

International Committee of the Red Cross

Injury Control Center-Uganda

London School for Hygiene and Tropical Medicine

ICBL Member Organizations

These core tools measure the morbidity and mortality associated with landmine injuries and collect information on demographics, device type, pre-hospital care, transportation time and treatment. The first tool is a hospital surveillance survey that integrates into a broader WHO injury surveillance system. The second tool is a community survey undertaken with WHO disease specific sampling techniques. These tools are for data collection as part of an ongoing surveillance system or as sample surveys that are repeated over time. WHO is coordinating the pilot testing of these tools in collaboration with the above mentioned organizations. We hope that these tools will identify areas where landmine injuries are a significant problem and thus target regions where more intensive Level 1 Surveys and other interventions should be undertaken.

PHR and other ICBL members have also developed an additional set of tools to measure:

Pre-hospital care and hospital capabilities

Prosthetic capabilities

Rehabilitation and social reintegration of landmine victims

The participants in this project encourage Landmine Monitor, UNMAS and other governmental or non-governmental organizations to use these tools or modify then as they see fit. They can be used to supplement the findings of a Level 1 Survey or provide data on areas that require further humanitarian mine action assessment. The tools are formatted for the “Epi-Info” system in order to facilitate data entry and centralized analysis. They were meant to be easy to use and inexpensive to administer.

WHO with the help of PHR and other organizations will shortly publish a user’s manual with specific instructions on sampling, data entry and analysis. This manual will provide detailed instructions on answering questions and give interviewer techniques to avoid nonessential and possibly negative interactions with landmine victims.

Core Survey Tools:

Hospital Surveillance of Landmine Injuries:

This tool easily integrates into a WHO injury surveillance system. The goal is to establish a global reporting system where injury data is collected and then transmitted either to centers in Ministries of Health or to international organizations that are responsible for the analysis and dissemination of data. This tool records data on landmine victims at the time they present to a hospital or, if proper records are available, from operating room records and patient charts. In addition, this tool can establish baseline information for repeat surveys undertaken at intervals in the future.

Community Survey of Landmine Injuries:

This survey tool allows for sampled analysis of mine-affect areas and provides information regarding case fatality rates, incidence, prevalence, and the effect landmine injuries have on communities. By using the WHO-EPI cluster technique and random sampling, accurate and scientific data collection can be undertaken to minimize the expenditure of resources, time and money.

Secondary Survey Tools

Country Capacity Overview

This tool collects national data on populations, health facilities and landmine affected regions. The information collected helps to administer the other surveys.

Community Key Informant Survey

This tool collects data from interviews with community leaders or village chiefs to determine areas most affected by landmines and to help determine sample sites for the Community Survey.

Hospital Capability Survey

This tool assesses the capacity of hospitals providing surgical care in regions affected by landmines. The data collected will help in the allocation of donor funding for specific projects or to individual facilities in need of necessary equipment and supplies.

Orthopedic/Rehab Center Capability Survey

This tool assesses the capacity of orthopedic and rehab centers in order to determine where improvements and resources are needed.

Rehabilitation and Social Reintegration Survey

This survey tool randomly samples landmine victims based upon hospital or orthopedic and rehab center records. The information provided will help in determining the specific needs of individuals and the effectiveness of on-going rehabilitation programs with respect to the type of injury, prosthetic care, housing, education, employment and rehabilitation.