Focus: Explosive remnants of war
By the Victim Assistance Editorial Team at the Landmine and Cluster Munition Monitor.
The Landmine and Cluster Munition Monitor provides research for the International Campaign to Ban Landmines and the Cluster Munition Coalition. It is the de facto monitoring regime for the Mine Ban Treaty and the Convention on Cluster Munitions.
Explosive remnants of war (ERW) and anti-personnel landmines have a devastating impact on children and represent a significant contributing factor to child disability. Since the signing of the 1997 Mine Ban Treaty, however, vast tracts of land have been cleared of these munitions and returned to productive use.
The 1997 treaty; the 1996 Amended Protocol II and 2003 Protocol V to the 1980 Convention on Certain Conventional Weapons; and the 2008 Convention on Cluster Munitions have all had a positive impact in terms of protecting the lives of people living in areas contaminated by ERW and landmines. The global movement to ban landmines and cluster munitions is a testament to the importance of strong political will among key stakeholders in fostering global change.
Mine action programming, which seeks to address the impact of landmines and ERW, is understood to be made up of five pillars – clearance, ERW/ mine risk education, victim assistance, stockpile destruction and advocacy. Despite the great successes in many of these pillars, as indicated by a significant global decline in ERW and landmine casualties, victim assistance continues to stand out as a key area of weakness. This is especially so in the case of children affected by ERW or landmines.
In contrast with the other four pillars of mine action, victim assistance requires a cross-cutting response that includes medical and paramedical interventions to ensure physical rehabilitation, as well as social and economic interventions to promote reintegration and the livelihood of victims.
To date the bulk of mine action assistance and funding has been dedicated to clearance activities. In 2010, 85 per cent of global funds related to mine action were allocated to clearance, while only 9 per cent were allocated to victim assistance interventions. While the International Mine Action Standards – the standards in force for all UN mine action operations – address the mine action programming pillars of clearance, ERW/mine risk education and stockpile destruction, they do not tackle the issue of victim assistance. Moreover, the right to age- and gender-appropriate physical rehabilitation and social and economic reintegration for survivors of landmines and ERW is enshrined in international human rights and humanitarian law. However, few survivor assistance programmes have taken into consideration the specific needs of children, whether they are direct survivors or victims in the broader sense.
The impact on children
There has been a significant decrease in the numbers of people killed or injured by landmine blasts. Between 2001 and 2010, the number of new landmine and ERW casualties reported through the Landmine and Cluster Munitions Monitor, the monitoring arm of the Mine Ban Treaty and the Convention on Cluster Munitions, fell from 7,987 to 4,191. The chart below demonstrates a significant reduction in the total number of civilian deaths and injuries from landmines and ERW in the five-year period between 2005 and 2010.
Nevertheless, the percentage of total casualties represented by child casualties has increased. Annually, since 2005, children have accounted for approximately 20–30 per cent of all casualties from landmines, remnants of cluster munitions and other ERW. Since monitoring began in 1999, there have been at least 1,000 child casualties every year. The number of child casualties of landmines and ERW in 2010 surpassed 1,200, and children accounted for 55 per cent of all civilian deaths – children are now the civilian group for whom landmines and ERW are most deadly. Given that numerous casualties go unrecorded in many countries, the total number of child casualties annually is likely much higher, and in some of the world’s most mine-affected countries, the percentage of casualties represented by children is higher still: In 2011, children constituted 61 per cent of all civilian casualties in Afghanistan. In the same year, they were 58 per cent of civilian casualties in the Lao People’s Democratic Republic, 50 per cent in Iraq and 48 per cent in the Sudan.
If children now constitute the majority of casualties caused by landmines, remnants of cluster munitions and other ERW, since 2008, boys have made up the single largest casualty group, approximately 50 per cent of all civilian casualties. In 2006, the first year in which the Landmine Monitor began disaggregating casualty data by both age and gender, boys represented 83 per cent of child casualties and made up the largest single casualty group among civilians in 17 countries. In 2008, boys represented 73 per cent of child casualties, and were the largest casualty group in 10 countries. In many contaminated countries, boys are more likely than girls to come across mines or ERW, because they are more involved in outdoor activities such as herding livestock, gathering wood and food or collecting scrap metal. Children in general are more likely to deliberately handle explosive devices than adults, often unknowingly, out of curiosity or by mistaking them for toys. Boys are more likely than girls to tamper with the explosive devices they come across. These factors, as well as a tendency towards engaging in risk-taking behaviour, make well-planned risk education especially important for children.
Assistance for child survivors
ERW and landmine incidents affect children differently than they do adults, whether they are directly killed or injured, or become victims as a result of the death or injury of family and community members. Child survivors who are injured have specific needs that must be taken into consideration, in terms of both physical rescue and rehabilitation and social and economic reintegration. Smaller than adults, children are more likely to die or suffer serious injuries from a blast, including severe burns, shrapnel wounds, damaged limbs and other injuries that can lead to blindness or deafness. Their height means that their vital organs are closer to the detonation, and children have a lower threshold for substantial blood loss than adults. If an anti-personnel landmine is stepped on, its blast will invariably cause foot and leg injuries, with secondary infections that usually result in amputation, causing lifelong disabilities and requiring long-term rehabilitation support.
More than one third of all survivors require amputation, and while data concerning the exact percentage of affected children requiring amputation are lacking, the percentage can be expected to be higher for children, given their smaller size. When children survive their injuries, their physical rehabilitation is more complex than that of adult survivors. Children whose injuries result in amputated limbs require more complicated rehabilitation and, because their bones grow more quickly than their soft tissue, several re-amputations may be required. They also need to have prostheses made as they grow. Few countries affected by landmines and ERW have the capacity necessary to address the specific, complex medical and physical rehabilitation needs of child survivors.
In addition to the physical trauma, the psychological consequences of surviving an ERW or landmine blast are often devastating for the development of the child. They include a sense of guilt, loss of self-esteem, phobias and fear, sleep disorders, inability to speak and trauma that if left untreated can result in long- term mental disorder. Such psychological effects of war on children are difficult to document, and they are not limited to children who have sustained physical injuries.
The social and economic reintegration needs of child survivors also vary considerably from the needs of adults. Addressing the psychosocial impacts outlined above relies heavily on age-appropriate psychosocial support and access to education. In many countries, child survivors are forced to cut short their education because of the time needed for recovery, and because rehabilitation represents a financial burden for families. Access to free education for children with disabilities as a result of a landmine or ERW injury is necessary both to promote a sense of normalcy in their lives, enabling them to recover from the psychosocial distress of their injury, and to reintegrate them with their peer group and allow them to fully participate in society.
Yet children left with a disability following a landmine or ERW blast are more vulnerable than others to the denial of this right: They may no longer be able to walk to school, and other transportation alternatives are seldom in place. Even when they are able to get to school, classrooms may not be accessible for children with disabilities, and their teachers may not be trained in adapting to the needs of children with disabilities.
Opportunities for income generation and livelihood support are especially necessary to support children and adolescents left with a disability as a result of landmines or ERW. Unfortunately, such opportunities seldom if ever take age considerations into account. Where age has been considered, as it was during a 2008–2010 project in Cambodia, the challenges to ensuring age-appropriate interventions for children and adolescents were such as to exclude those under 18 from victim assistance livelihood interventions altogether.
This failure to address the specific needs of and risks to children and adolescents is reflected in the livelihood and economic strengthening sector more generally: A 2011 review of 43 studies on the impact of economic strengthening programmes in crisis contexts in low-income countries found that some of these efforts had, paradoxically, increased the risk that children would be pulled out of school and put to work or that girls would be subject to violence. The programmes studied featured such initiatives as microcredit, skills training and agricultural interventions. The review called on economic strengthening practitioners to “build children’s protection and well-being into the assessment, design, implementation, monitoring and evaluation of economic strengthening programs.” In addition, livelihood and income generation opportunities for children and adolescents must take into account not only their age but also their sex and the cultural context in which they live. Because children with disabilities are among those most vulnerable to deprivation, violence, abuse and exploitation, there is an urgent need to ensure that victim assistance programmes take the specific needs of child survivors into consideration.
Meanwhile, children who are victims of landmines and other ERW as a result of the death or injury of caregivers and family members, including family breadwinners, also have needs that differ from those of adults. Like child survivors, they too may be more vulnerable to the loss of education opportunities, separation from their families, child labour and other forms of exploitation or neglect.
Despite the particular victim assistance needs of children, few victim assistance programmes take age- and gender-specific considerations into account. While research has been conducted on victim assistance in general, and guidance has been developed on what such programmes should look like, to date there has been little if any focus on children and adolescents. Meanwhile, while States parties to the Mine Ban Treaty, Protocols II and V of the Convention on Certain Conventional Weapons, and the Convention on Cluster Munitions must regularly report on national-level implementation of these international instruments, they do not report on their efforts to address the specific needs of survivors according to their age. It is not surprising then that in a 2009 survey of more than 1,600 survivors from 25 affected countries conducted by Handicap International, almost two thirds of respondents reported that services for children were “never” or “almost never” adapted to address their specific needs or ensure that services were age appropriate.
Child victims, including those directly and indirectly affected, have specific and additional needs in all aspects of assistance. However, the information available about efforts to address these needs is limited. Most children involved in mine or ERW incidents are injured. Yet most data collection systems do not record their needs.
As children account for an increasing percentage of the total civilian casualties from ERW and landmines, it is essential to implement specific policy and programmatic recommendations on victim assistance that meet the needs of child survivors. These recommendations include:
- Supporting and promoting the establishment of national injury surveillance systems able to provide systematic and continuous information on the magnitude and nature of ERW and landmine injuries (and other types of injuries if appropriate), including age- and gender-disaggregated data about child casualties.
- Integrating a victim assistance component into the International Mine Action Standards, including through technical notes and best-practices guidelines, with specific guidance and considerations on child-specific survivor and victim assistance.
- Developing and promoting the establishment of victim assistance databases able to provide systematic data to monitor the rehabilitation, psychosocial and socio-economic needs of each child and adult survivor appropriately and across time.
- Sensitizing governments, mine action actors, donors and other relevant stakeholders, through both international and national forums, on the importance of prioritizing victim assistance (including for child survivors and the children of people killed by victim-activated explosives) as a key pillar of mine action and international laws.
- Making government, humanitarian and developmental actors and service providers aware of the importance of ensuring the availability of age- and gender-specific health and physical rehabilitation, psychosocial support, protection, education and livelihood support services for child survivors and victims of ERW and landmines.
- Training health professionals, including emergency response personnel, surgeons and ortho-prosthetic service providers, in the specific considerations and special needs of child survivors.
- Training education service providers, including school management, teachers and educators, in providing accessible and appropriate education for child survivors and victims.
- Formulating national laws, plans and policies responding to the needs of survivors and victims of ERW and landmines, or of persons with disabilities in general, so that they integrate and respond to the age- and gender-specific needs of child survivors and victims.
- Integrating a strong victim assistance component into the draft UN Inter-Agency Mine Action Strategy, including specific child-survivor assistance considerations.