Guidelines for the Socio-economic Reintegration of Landmine … · 2010-04-08 · assistance in helping them to resume their roles as productive community members and contribu-tors

Guidelines for theSocio-economic Reintegrationof Landmine Survivorswritten by

Jack Victor, Steven Estey and

Heather Burns Knierim

The Guidelines for the Socio-economic Reintegration of Landmine Survivors, August 2003.

The report, produced by the World Rehabilitation Fund, together with the United Nations Development Programme,is available on the World Rehabilitation Fund’s website at www.worldrehabfund.org.

Additional printed copies may be requested in writing to the World Rehabilitation Fund 386 Park Avenue South,Suite 500, New York, NY 10016 or by e-mail at [email protected].

Text material may be reprinted and distributed, but all rights are reserved and should be cited accordingly.

The World Rehabilitation Fund appreciates your feedback and recommendations. Please send your comments to theabove address.

Cover: WRF Uganda—After receiving their new limbs, Ugandan amputees prepare to return to their communitiesand resume productive agricultural work. Photograph by WRF.

IntroductionThe Mine Ban Treaty entered into force March 1, 1999. Article 6, paragraph 3, of the Treatyrequires that States Parties, “in a position to do so shall provide assistance for the care and rehabili-tation, and social and economic reintegration of mine victims.” The Treaty states:

…assistance may be provided, inter alia, through the United Nations system,international, regional or national organizations or institutions, non-governmentalorganizations or institutions, the ICRC (International Committee of the Red Cross),National Red Cross or Red Crescent societies and their International Federation,non-governmental organizations, or on a bilateral basis.

While it is preferable that nations conform to the goals of the Mine Ban Treaty, it is recognized thatTreaty non-signatories are also making contributions to the development of programs to meet theneeds of landmine survivors.

Following the entry into force of the Treaty, the International Campaign to Ban Landmines (ICBL)Working Group on Victim Assistance (WGVA) produced a document entitled Guidelines for theCare and Rehabilitation for Survivors (ICBL, 2000). This document provides an extremely useful setof overall guidelines, which have begun to be used as a reference tool around the world. TheWGVA document discusses, among other things, the need for increased assistance in the area ofeconomic integration initiatives, comprehensive psychological and social supports, legislation, publicawareness and access to a variety of already existing programs.

Since the publication of the WGVA Guidelines, it has come to light that further elaboration onefforts related to socio-economic reintegration of survivors would be useful for both States devel-oping national policy and practitioners in the field. Thus, UNDP formulated and funded a projectto look at the socio-economic reintegration of mine victims. The project was executed by theWorld Rehabilitation Fund (WRF), and included the development of a series of more detailedguidelines on the specific topic of socio-economic reintegration. UNDP also enlisted the cooperationof the United Nations Mine Action Service (UNMAS) in recognition of that agency’s role as the UNfocal point for all mine-related activities.

Prior to initiating the Socio-economic Reintegration program and considering the Guidelines, WRFconducted a round of focus group meetings with both landmine survivors and rehabilitationprofessionals in Lebanon, Uganda and Guatemala. Feedback from survivors revealed that the mostacute needs identified by landmine survivors were not the medical rehabilitation services, butassistance in helping them to resume their roles as productive community members and contribu-tors to their families’ well being.

In 2002, the Anti-Personnel Mine Ban Treaty Standing Committee on Victim Assistance and Socio-economic Reintegration (SCVA) conducted a consultative process to identify its priorities. Thatprocess confirmed the findings of the WRF-led focus groups.

These findings accentuate the limited attention being paid to socio-economic reintegration issuesin the development of victim or survivor assistance programs. The findings also pointed to theneed for guidelines to assist policy makers and service providers develop strategies to best meet theneeds of landmine survivors.

The challenge in developing such a document is to strike the best balance between the array ofprogramming options available, something that can be an extremely complex and daunting task,especially when it is not possible to consult with all of the stakeholders in the field.

The World Rehabilitation Fund — Guidelines for the Socio-economic Reintegration of Landmine Survivors 1

Development of GuidelinesThe process involved in creating these Guidelines has benefited, not only from the aforementionedfocus group feedback, but also from extensive consultation with a wide-range of stakeholders inmultiple mine-affected countries. As such, WRF aims to offer a useful tool for those in the field whoconstantly face decisions about various programming alternatives.

The first step in developing the Guidelines involved an in-depth review of existing guidelines andpolicies on related matters such as the Guidelines for the Care and Rehabilitation for Survivors,previously mentioned, and the UN Standard Rules on the Equalisation of Opportunities for Personswith Disabilities. Using these publications as a framework, WRF staff, with consultation from thefield, developed a classification scheme and then established the core content.

A draft version of the Guidelines was published in Providing Assistance to Landmine Victims: ACollection of Guidelines, Best Practices and Methodologies, and distributed in English, French andSpanish at the May 2001 meeting of the SCVA in Geneva. Focus groups then reviewed and dis-cussed this draft to provide essential feedback and to substantiate the potential field application.

Focus Group FeedbackTargeting Cambodia, Lebanon and Mozambique, the three countries in which WRF/UNDP wasinvolved in carrying out the Socio-economic Reintegration of Landmine Survivors project, WRFconducted two focus groups in each country specifically related to the Guidelines. Of the six focusgroups, three consisted of landmine survivors and three included policy makers and service provid-ers, with the average group size being eight. The detailed responses from the groups resulted inextensive revisions to the Guidelines.

Organization of GuidelinesThe Guidelines are organized by topic into a series of Factors. The Factors are then divided intoa graduated range of options, from basic services that must be in place to provide a minimallyacceptable standard of care, through to a comprehensive listing of services that key stakeholdersconsider to be of high importance when resources are available.

The Factors themselves are divided into two major categories: “Pre-conditions for Socio-economicReintegration,” and “Target Areas for Socio-economic Reintegration”. The “Pre-condition” factorsare included since they must be in place for effective socio-economic reintegration to take place.(For example, while not directly involved in socio-economic integration, if the minima of all factorsin the pre-conditions are not provided in a timely manner, then the individual injured by a landminemay not be adequately prepared to benefit from further services).

The first major category, Pre-Conditions for Socio-economic Reintegration includes fourFactors:

• Factor 1 – Evacuation, First Aid, Emergency Care;• Factor 2 – Physical and Psychological Treatment;• Factor 3 – Medical and Psychosocial Rehabilitation;• Factor 4 – Ongoing Medical Follow-up.

The second major category, Target Areas for Socio-economic Reintegration includes fiveFactors:

• Factor 5 – Psychosocial Support;• Factor 6 – Vocational Rehabilitation;• Factor 7 – Economic Development;• Factor 8 – Education;• Factor 9 – Community Integration and Support.

2 The World Rehabilitation Fund — Guidelines for the Socio-economic Reintegration of Landmine Survivors

These Guidelines can be used as a checklist, against which policy and program developments canbe compared. It should be noted that the Guidelines are intended to describe what is minimallynecessary in the developing country context, what is desirable where resources permit, and whatis required to achieve a reasonably optimum level of services to assist in the socio-economicreintegration of landmine survivors.

It is recognized that with tremendous gaps in existing services, combined with the current realitythat only limited resources are available for victim assistance initiatives, much work will be requiredin order to achieve the standards presented in this document. The Guidelines do not constitutelevels of excellence, but rather, types of activities that should be established to begin properlyaddressing socio-economic reintegration strategies for landmine survivors.

In previous drafts of the Guidelines, WRF included two additional factors: Policy Development andLegislation and Data Collection and Dissemination. While WRF places extreme importance on thesematters, it has been concluded that the Guidelines should be confined to direct service matters.These two areas do not lend themselves to categorization in the same manner as the other factors.It should be pointed out that the Guidelines themselves could be used for both policy and toidentify areas for which data should be collected.

Policy Development and Legislation has been a major area of concern of the ICBL Working Groupon Victim Assistance (see Statement for the Second Meeting of States Parties to the Mine BanTreaty, 2002 and Victim Assistance: Contexts, Principles and Issues, 2002 for example); The LandmineMonitor (especially Landmine Monitor Report, 2000); and the UNMAS paper, Mine action andeffective coordination: the United Nations Policy.

The issue is also addressed in several articles that have appeared in The Landmine Monitor (seeespecially Eitel, 1999).

Data collection and management has been an area of intense focus with the Landmine ImpactSurvey (LIS) being a major data collection tool and the Information Management System for MineAction (IMSMA) being the most widely used management system.

Both are constructed primarily to facilitate the tasks of locating and clearing mined areas. Bothsystems are cognizant, however, of the value of gathering information to help victim assistanceefforts. The Mine Action Information Center (MAIC) at James Madison University has been consid-ering the need for data collection in the field and convened a Working Group to assess the useful-ness of data collection efforts, focusing primarily on IMSMA, although there was substantial discussionon how to supplement the limited data collected by IMSMA and how to link the IMSMA with otherdata sources (e.g., Ministry of Health data). The reader is referred to the Working Group Recom-mendations and other material from the 2002 Landmine Casualty Database Workshop, which canbe found on www.maic.jmu.edu. It should be mentioned, however, that data concerning socio-economic integration is covered only minimally in this discussion. Hopefully, MAIC will follow-upthis conference with more recommendations on data relating to the areas covered in the Guide-lines.

The LIS does consider socio-economic indicators to some extent, aiming in the survey process toidentify information on the socio-economic impacts of landmines. They also incorporate a TaskAssessment Planning procedure to help each affected community to use information to help de-velop a strategy to deal with the effects of landmines.

In addition to the data itself, there is also the need to share such information to groups concernedwith the development and implementation of services and landmine survivors themselves so thatappropriate planning and advocacy strategies can be developed. The user of the Guidelines shouldbe free to “tailor” the data to meet the needs of the interested key partners and the communitiesinvolved.


Use of Guidelines1

The Guidelines are intended for use by all mine-affected nations, whether signatories or non-signatories, and may be used in various ways, depending, in part, on the interests and needs ofdifferent user groups. They are primarily intended for policy makers and service providers inter-ested in creating substantive change in a nation affected by landmines and UXO, such as:

• Government Ministries• National and international non-governmental service organizations• Advocacy groups• Mine action centers or authorities.

Strategies for Application• The Guidelines can serve as a checklist to determine which rehabilitation and reintegration

activities are in place and to what extent, in the country or region being reviewed.

• Different sections of the Guidelines may be applied by different users, depending on their areasof responsibility and interest. For example, if a policy maker is interested in developing regula-tions for a country concerning vocational rehabilitation, items in Factor 6 inform the policymaker of the areas that should be considered. The policy maker may first wish to assure thatthe nation is compliant with the “minimum standards” before opting to put more ambitiousprogramming in place. Another approach would be to first assure that the minimum standardsare carried out in all major areas of the country before progressing to the next level. Alterna-tively, service organizations may opt to first establish programs in one part of the country tothe optimum standard and then use that as a model for future development in other regions ofthe country.

• Service providers may refer to the Guidelines in order to define their position within the largercontinuum of services necessary to assist in the socio-economic reintegration of landmine sur-vivors. The Guidelines can also help such organizations identify other complementary serviceswith which they should consider coordinated and integrated action.

• Advocacy groups may use the Guidelines in a somewhat different manner. They can be used asa checklist for advocates as they campaign for the development of services to meet at least theminimum standards. Because the Guidelines are graduated, once a certain standard is achieved,the strategy of advocacy groups can mature until the optimum standards are provided. TheGuidelines offer a basis for helping these groups logically develop plans to look at supportingtheir constituency in the most helpful manner.

Another point that should be made about the Guidelines is that although they are developed forthe benefit of landmine survivors, the Guidelines are equally applicable to the needs of personswith disabilities in general and can be used as a blueprint for improving services for not only thoseinjured by landmines, but also persons with disabilities resulting from other causes.

The authors of these guidelines are: Jack Victor, President Emeritus of World Rehabilitation Fund;Steven Estey, a Canadian consultant in the field of Disability and Development; and Heather BurnsKnierim, President of World Rehabilitation Fund.


1 WRF recognizes that these Guidelines could greatly benefit from a corresponding users manual,however, such a document would be premature, as it should be based on actual field experiences.

AcknowledgementsThe authors wish to convey deep gratitude to the United Nations Foundation, who provided thefunds to undertake the Socio-economic Reintegration of Landmine Survivors project and the UnitedNations Development Programme, who entrusted the World Rehabilitation Fund with its imple-mentation.

Many individuals were involved in the development of the Guidelines, providing their feedbackthroughout, reviewing the multiple drafts and participating in focus groups.

The authors would especially like to thank Anthony Staros, WRF Senior Consultant and John Lane,who worked closely with Steven Estey, who contributed significantly as advisors on the project.

Special thanks are due to Ian Mansfield (Team Leader), Leon Terblanche and Jenni Rauch, whowere staff of the Emergency Response Division (ERD) of the UNDP at the initiation of the Socio-economic Reintegration of Landmine Survivors project and who greatly encouraged the developmentof these Guidelines.

The authors also would like to thank:

Others at UNDP who assisted in this project: Aparna Mehrotra, the former Principal Adviser for UNFoundation Affairs; as well as the current team at Bureau for Crisis Development and Recovery(BCDR) (formerly ERD) Sayed Aqa (Team Leader), Oren Schlein, Judy Grayson and MohammadYounus.

United Nations Mine Action Service personnel involved in issues of victim assistance.

WRF’s field staff: Dr. Nadim Karam, Director of WRF-Lebanon; and WRF Country Representatives—Padma Shastry-Cambodia and Eileen O’Dwyer and Charmaine Della-Vedova-Mozambique whoconvened the focus groups and ensured translation of essential documents that enabled the focusgroups to run smoothly.

Focus group participants, specifically, the landmine survivors, policy makers and service providersin Cambodia, Lebanon and Mozambique.

Focus Group Co-Facilitators: Cambodia—Rick Droz, of the National Center of Disabled Persons,and Khieu Kola and Nuon Nam of the Ministry of Social Affairs, Labor, Veterans and Youth (MOSALVY).Mozambique—J.C. Goncalves, Jr. who assisted Charmaine Della-Vedova and Lebanon—Dolly Basil.

Becky Jordan of the ICBL Working Group on Victim Assistance and Landmine Survivors Network.

Saeed Ahmad of the Survey Action Center (SAC), Judith Dunne of UNMAS and Suzanne Fiederleinof James Madison University, who were especially helpful in providing background on the currentstate-of-affairs concerning data collection.

WRF consultants: Ann Goerdt, Ghislain Moureaux, Carolyn Taylor and Rachel Thibeault.

WRF staff, with special thanks to Daisy Rodriguez and Isis Castro, and with recognition of thegeneral support by Roberta Welz; Ana Marcelino; and Allyson Brown.

Finally, the authors wish to express sincere thanks to landmine survivors from all countries for theircontinued inspiration, which motivates this work and continuously teaches WRF about what canbe achieved and all that remains to be accomplished.


Section A

Pre-conditions forSocio-economic Reintegrationof Landmine Survivors2

2 It should be noted that virtually all of the factors and activities should also beconsidered for all persons with disabilities.

Optimum

• Evacuation of landminesurvivors to area hospitalsshould be availableimmediately.

• Emergency medicine special-ists with training in treatmentof landmine injuries should beavailable.

• Telecommunication linksshould be provided betweenthe field and local clinics/hospitals.

• Surgeons should be trained incorrect procedures for theamputation of limbs necessi-tated by landmine injuries.

• Crisis counseling should beavailable to help the landminesurvivor and family to copewith the injury.

Minimum

• Persons injured by landminesmust have ready access totrained first aid practitionersin order to address immediatelife-threatening issues andminimize further consequen-tial damage.

• For rural areas, every villagemust have the capability tocontact trauma specialists torequest their intervention.

• First aid must include controlof bleeding and shock, andprovision of appropriatemedication to prevent infec-tion.

• Safe blood/serum suppliesmust be available.

• Expeditious evacuation ofpersons injured by landminesto area hospitals or clinicsmust be available.

• Amputation and other majoremergency surgery after onsetof injury must be available.

Desired

• Emergency surgery should beavailable within a day of theinjury in landmine areas.

• Properly trained personsproviding emergency inter-vention/first aid should beavailable in all communities/neighborhoods.

Goal: To reduce deaths by stabilizing medical conditions and minimizingphysical impairments that could result from injury.

Evacuation, First Aid and Emergency CareFactor 1


Optimum

• Crisis counseling should beavailable immediately afterevacuation in order to helppatients cope with psycho-logical after effects of trauma.

• A multi-disciplinary teamshould be available, includingpersonnel trained in allspecialty medical areas rel-evant to landmine injury, suchas orthopedics, pediatrics,prosthetics, internal medicine,audition and vision, etc.

Minimum

• Blood Transfusion capabilitymust be ensured.

• Where surgeons are notavailable at the evacuationstage, they must be availableas part of physical treatment,and must be trained in correctprocedures for amputation.

• Proper procedures to preventcontractures and/or furtherinfection must be followed.

Desired

• Access should be ensured tocorrective surgery includingcleaning of projectiles,debridement, pre-prostheticsre-modeling of stumps andrepair of damage to organs(e.g., intestines, eyes, genita-lia, etc).

• Access should be ensured toeye care, auditory medicalcare and other specializedsurgical and medical services.

• Access should be ensured toboth services and medicationto relieve pain.

• Access should be ensured torigid dressing materials toproperly prepare stumpsfollowing surgery.

• Counseling should be ensuredto help survivors deal withpost-traumatic stress.

• Family members should beincluded in initial discussionsabout the medical treatmentplan, including counseling,and should be fully informedas the plan is implemented.

Goal: To provide access to treatment to minimize any physical or psychologicalimpairment resulting from injury.

Physical and Psychological TreatmentFactor 2


10

Goal: To restore maximum physical and emotional functional ability forlandmine survivors, including the provision of appropriate assistive devices.

To be effective, this must be recognized as a holistic process, where some areasare best addressed by professionals, and other areas by peer support workers.Recognition that these two groups should inform, and be informed, by one an-other needs to be understood from the outset in order to ensure maximum re-sponsiveness, and benefit for survivors themselves.

Optimum

• Rehabilitation services shouldbe coordinated, ideally, underthe direction of a RehabilitationMedicine Specialist, to ensurethat there is a smooth con-tinuum of services from medi-cal treatment through voca-tional, psychological, psycho-social and independent livingrelated services.

• Rehabilitation centers shouldbe located throughout thecountry so that landminesurvivors are not separatedfrom their families for extendedperiods of time during thecritical weeks and monthsimmediately following theirinjury.

• Training of technicians toimprove the local productionand manufacturing of assistivedevices and other accessoriesshould be ensured.

• Governments should ensurethat no one is denied devices(including prostheses, orthoses,wheelchairs, crutches, etc.) dueto cost. Additionally, varyingtypes of wheelchairs, mobilitydevices, appropriate aids andappliances (including visualand auditory) should be avail-able to suit individual needs.

• Each full-service prosthetic/orthotic service unit shouldhave at least one ISPO Cat-egory I trained prosthetic/orthotic professional who isavailable to assist technicianswith lower-level skills.

Minimum

• Landmine survivors must haveaccess to post-acute rehabili-tative care, includingprosthetics, orthotics andphysical therapy.

• Landmine survivors and theirfamilies must be included inthe planning of rehabilitationinterventions.

• Facility-based rehabilitationservices must be augmentedby appropriately trainedCommunity-Based Rehabilita-tion (CBR) workers and com-munity - based peer supportsystems, so that access toservices for persons through-out the country is maximized.

• Landmine survivors and theirfamilies must have access tothe services of individuals whohave had basic training inphysical therapy and occupa-tional therapy and/or func-tional therapy (e.g., a CBRworker or other healthworker) to provide suchsupport to the medicalrehabilitation effort.

• Landmine survivors must beshown methods of self-careand maintenance, includingthe use of aids and equip-ment, in order to functionindependently.

Desired

• A smooth and speedy con-tinuum of services should beavailable from medical treat-ment through vocational andindependent living relatedservices.

• Access to peer support work-ers must be provided to assistwith both physical (especiallyin terms of self-care andmaintenance) and psychologi-cal rehabilitation.

• Landmine survivors shouldhave access to repair, replace-ment and adjustment servicesto maintain assistive devices.

• Community-based rehabilita-tion (CBR) services should belinked to facilities with profes-sionally trained service provid-ers to ensure that backup isavailable for cases requiringprofessional expertise.

• Each full-service prosthetic/orthotic unit should have atleast one ISPO Category IItrained prosthetic/orthotictechnologist who is availableto assist technicians withlower-level skills.

Medical and Psychosocial Rehabilitation

continued on the next page

Factor 3

Minimum

• Where possible, locally pro-duced aids and equipmentmust be made available.Where this is not possible,essential aids (such asprosthetics or wheelchairs)should be imported until suchtime as local production canmeet the demand.

• Provision must be made forthe fabrication and fitting, aswell as the equitable distribu-tion of equipment/devices tothose in need, whether inurban or rural settings.

• Psychological support servicesmust be available to landminesurvivors through the provi-sion of supportive counselingby individuals trained toprovide such services, eitherpeer workers or professionals.

Desired

• Each full-service orthopedicunit should have at least oneservice provider with formaltraining in physical therapy[physiotherapy], such as aphysical therapy assistant whois available to support otherservice providers.

• Rehabilitation service provid-ers should be informed aboutother services that can benefitthe survivors and their familiesand be able to refer survivorsto those services.

Optimum

• The government shouldencourage the training andutilization of Category IIprosthetic/orthotic technolo-gists and optimize their geo-graphic distribution.

• All other prosthetic/orthotictechnicians should have ISPOCategory III certification orequivalent training.

• Each full-service orthopedicunit should have at least onephysical therapist with aprofessional degree in physicaltherapy.

• Landmine survivors shouldhave access to services pro-vided by personnel trained inother rehabilitation servicespecialties as appropriate (e.g.physical, occupational andspeech therapists).

• Each full-service rehabilitationunit should provide access topsychological counseling andsocial work support services.This should be provided bytrained personnel, who havedirect access to people with aprofessional degree in socialwork, psychology and/orcounseling.

• Governments should encouragethe training and provision ofemployment, at a locally appro-priate wage, for all majorrehabilitation service areas, suchas: physiatry, rehabilitationnursing, social work,prosthetics/orthotics, physical,occupational and speechtherapy, psychology and com-munity based rehabilitation.

Medical and Psychosocial Rehabilitation continuedFactor 3


Optimum

• A suitable means of communi-cation should be developed toinform survivors about im-provements and medical/technological advances thatmay be useful for them. Thiscan be done, for example,through peer support workers,national/local disability advo-cacy groups, newsletters and/or meetings in communitycenters.

• Regular outpatient follow-upclinics should be held in thecommunity.

Minimum

• Ongoing access to rehabilita-tion programs to reducefurther effects of disability andthe provision of maintenanceand repair of assistive devicesmust be available to landminesurvivors.

• Landmine survivors must haveaccess to all general healthservices, including for exam-ple: immunization programs,well-baby clinics, HIV/AIDSawareness programs, etc.

• Landmine survivors must beprovided with the skills andinformation to carry out basicmedical self-assessment.

Desired

• Repairs and replacements ofassistive devices necessary forambulation or communicationshould be provided at no costto the individual when suchrepair or replacement isnecessary for the properfunctioning of the device.

• Discharge planning shouldinvolve family members, andall involved professional andpara-professional disciplines,including peer support work-ers, community-based reha-bilitation staff and medicalprofessionals. It should alsoinclude comprehensive andrealistic steps for both fullphysical and psychosocialreintegration in to the com-munity.

Goal: To provide active monitoring of health status during the high-risk periodin the immediate years following injury and provide a point of contact fordisability-specific health issues.

Ongoing Medical Follow-upFactor 4


Section B

Target Areas forSocio-economic Reintegration

Optimum

• Programs should support thedelivery of all psychosocialservices under conditionsmost suited to each individu-al’s needs and circumstances,including home or communitysettings where appropriate.

• Programs serving women,children and the elderly,should have staff trained tounderstand the unique issuesfound within each of thesepopulations.

Minimum

• Landmine survivors must beprovided with counseling tohelp them adjust to their newsituation, including practicalcoping strategies and anunderstanding of how to setrealistic goals and persevere inachieving them.

• Hospitals treating landminesurvivors must have stafftraining in the psychologicaladjustment process and toincrease understanding of thepotential of survivors to livesuccessfully in the community.Staff also should be aware ofpractical issues, includingdiscrimination likely to befaced in communities.

• Landmine survivors must beinvolved in this trainingwherever possible so that theirexperiences can enhance thetreatment process for others.

• Peer support programs mustbe established to offer assist-ance in the hospital and afterdischarge to those who wantsuch support.

Desired

• An array of professional andpeer–based psychosocialresources should be availablefrom which landmine survi-vors can be provided with aprogram appropriate to theirindividual needs, including:

¤ Psychological counselingand social work supportservices–provided by trainedpersonnel having access topeople with a graduatedegree in social work,psychology and/orcounseling;

¤ community-based rehabili-tation (CBR) and otheroutreach services, whichshould have access to facilitybased programs withprofessional staff for back-up support;

¤ peer counseling and sup-port, which should includepractical training in settingand achieving realistic goals.This service should beavailable in home settings,if desired.

Goal: To assist landmine survivors, through a well balanced team of peer supportworkers and professionals, to resume their role in the community byhelping them to cope with psychosocial adjustment issues and assistingthem to regain and maintain a healthy and positive outlook on life.

Psychosocial SupportFactor 5


Optimum

• All industry-related vocationaltraining programs shouldhave access to job placementand job development services.

• A sensitization effort aimed atemployers should be under-taken so that landmine survi-vors are not denied opportu-nities because ofdiscrimination and/orstereotypical thinking.

• Jobs for persons with disabili-ties should be in integratedsettings and in vocations thatalso employ persons withoutdisabilities.

• Government sponsoredemployer incentives should beconsidered to ensureadequate employmentopportunities for landminesurvivors.

• A full array of pre-vocational,vocational and job-experienceservices should be available tofit the vocational rehabilitationneeds of each landmine.survivor on an individualizedbasis.

Goal: To assist landmine survivors to either return to their pre-injuryoccupation, or prepare for and find suitable employment.

Minimum

• Vocational training programsmust be accessible tolandmine survivors in alllandmine-affected areas.

• Landmine survivors must haveaccess to counseling servicesto assist them in establishing avocational rehabilitation planthat is practical and realistic intheir personal circumstances.

• Access to existing job place-ment and recruiting servicesmust be ensured for landminesurvivors.

• Vocational training programs,including basic adult educa-tion and job skills upgradingmust be affordable andphysically accessible tolandmine survivors in alllandmine-affected areas.

• When appropriate, individualsshould be assisted to return totheir prior occupation if that istheir interest.

Desired

• Vocational training and jobplacement programs shouldseek advisory support fromemployers.

• Landmine survivors shouldhave access to case manage-ment services to assist incoordinating vocational andmedical rehabilitation pro-grams with other aspects oftheir individual rehabilitationplan to ensure that a smoothcontinuity of service can beachieved.

• In areas where there areformalized employmentopportunities, trainees shouldbe counseled on how to applyfor jobs in these industries.

• Where relevant, placementreadiness training should beavailable. This training wouldinstruct candidates in jobsearch skills, such as filling outjob applications, preparingresumes, mastering effectiveinterview techniques, etc.

• Successful placement candi-dates should receive bothshort and long-term follow-upvisits by the organization thatassisted in the placementprocess.

Vocational RehabilitationFactor 6


Optimum

• On-going technical assistanceconsultation should be pro-vided to ensure stability andgrowth of businesses devel-oped by landmine survivors.

• Efforts should be made tostimulate the development ofcooperatives or entrepre-neurial partnerships as strate-gies for improving incomeopportunities for landminesurvivors.

Minimum

• Micro-enterprise programs, aswell as other economic devel-opment efforts, must also beaccessible to landmine survi-vors.

• Micro-credit financing shouldbe available at favorableinterest rates for landminesurvivors.

• Landmine survivors shouldhave access to businesstraining programs aimed atmaximizing their efficiencyand ensuring sound businesspractices.

Desired

• Comprehensive businesstraining should be availablefor landmine survivors, includ-ing the development ofbusiness plans and otherbusiness related activities inareas such as sales, pricing,purchasing, etc.

• Business plans should includestrategies for income genera-tion that promise to result insustainable business ventures.

Goal: To assist landmine survivors to initiate and maintain their own businesses.

Economic DevelopmentFactor 7


Optimum

• At least one teacher in everyjurisdiction should havetraining in the field of specialeducation, be familiar withthe problems of all childrenwith disabilities in his/hercommunity, and be accessibleto help support other teacherswhere these skills are needed.

• All educational institutionsshould provide access tocounseling services through asocial worker, guidancecounselor or psychologist.

• Teachers with pupils in theirclasses who have special needsdue to landmine injuriesshould receive extra assistancein the classroom and/or havesmaller class sizes to allowsufficient attention to be paidto these special needs.

Minimum

• Children disabled bylandmines must have accessto educational opportunitiesin their communities.

• Landmine survivors must beable to attend regular schoolsin their own communities.

• Teachers should receivetraining in working withchildren with physical andemotional disabilities.

• Adult landmine survivors mustbe encouraged and enabledto complete formal or infor-mal educational programs.

Desired

• Children disabled bylandmines should have accessto education that providesproper support services. Thiseducation should occur in anintegrated setting.

• Teachers should receivetraining in working withchildren with physical andemotional disabilities in anintegrated setting.

• Instructors in adult educa-tional upgrading programsshould receive training ineducating students withphysical and emotionaldisabilities.

EducationGoal: To address systemic disadvantages in educational access, and enable both

children and adults disabled by landmines to full and equal educationalaccess.

Factor 8


Optimum

• Technical advice and assist-ance on modifications to thehome and workplace shouldbe provided by experts,including survivors them-selves.

• Sensitization programs shouldbe designed, with major inputfrom survivors themselves,and undertaken to helpovercome attitudinal barriersin the community.

• Programs to assist landminesurvivors, including all areas ofservice covered in theseGuidelines should have specialprovisions to ensure thatneeds of women, children andthe elderly are equally ad-dressed.

• Regular circulation of publica-tions, in local language,addressing medical andcommunity living informationshould be arranged.

• Landmine survivors shouldhave ready access to peersupport through local re-sources or regular visits to orby peer workers.

• Governments should supportthe costs involved inproviding home and institu-tional access modifications.

Minimum

• Discharge planning mustinclude practical preparationof the survivor for reintegra-tion, bearing in mind personalcircumstances and likelybarriers in the home andcommunity.

• Discharge planning mustinclude practical preparationof survivor and family mem-bers for social and economicreintegration.

• Expectations and issues aboutreturning to the communitymust be reviewed by serviceproviders and the landminesurvivor, along with familymembers prior to discharge.This will include arrangementsfor land, housing, access toclean water and a healthyenvironment to the sameextent as is afforded to othercitizens of the community.

• Upon discharge from medicalcare, survivors must be re-ferred to government depart-ments and local serviceproviders appropriate for his/her needs.

• All communities affected bylandmines must have accessto either outreach programsfrom local rehabilitationservice providers or commu-nity-based rehabilitationservices.

Desired

• It should be assured thatlandmine survivors have theopportunity to participate inthe fundamental activities of anormal community life –including home, education,employment, socialization andtransportation – in facilitiesfree from physical barriers.

• Communities should partici-pate in assisting landminesurvivors to return to theirvillage and be socially andeconomically reintegrated intothe community.

• Community leaders shouldensure that landmine survivorsbe provided land rights similarto other community membersupon their return to theirhome villages.

• Families and peers should beeducated to assume support-ive roles, both to assist survi-vors to re-adapt to their familyand to help them assumeindependent roles as activecontributors to their commu-nities.

• Disability awareness pro-grams/materials should belocally-developed and makeuse of landmine survivors andother persons with disabilitiesas trainers and spokespersons.

Goal: To assist landmine survivors to return and participate fully in the life oftheir community.

Community Integration and Support

continued on the next page

Factor 9

18

Minimum

• Information about needs,reintegration strategies andpossible adjustment difficul-ties, etc. must be conveyed tocommunity leaders, localsupport workers, landminesurvivors and their families.

• Arrangements for ongoingpeer support must be made tohelp with the transition backinto the community.

Desired

• Advocacy mechanisms shouldbe developed/supported withcommunity leaders, peersupport workers, rehabilitationprofessionals and familymembers.

• The formation of self-help/self-advocacy groups of personswith disabilities, which includelandmine survivors, at thecommunity level, should beassisted.

Optimum

• Communities should beencouraged to support theintegration of persons withdisabilities into all civic andrecreational activities of thecommunity.

• Assistance should be availablefor the formation of self-sufficient organizations ofpersons with disabilities at thenational level.

Community Integration and Support continuedFactor 9


World Rehabilitation Fund386 Park Ave. South-Suite 500New York, NY 10016 USAPh: (212) 725-7875Fax: (212)725-8402E-mail: [email protected]

www.worldrehabfund.org

United Nations Development ProgrammeBureau for Crisis Prevention and RecoveryMine Action TeamOne UN Plaza, 20th FloorNew York, NY 10017Phone: (212) 906-6313E-mail: [email protected]

www.undp.org/bcpr/mineaction/index.htm

Documents

Guidelines for the Socio-economic Reintegration of Landmine … · 2010-04-08 · assistance in helping them to resume their roles as productive community members and contribu-tors