In-depth: Laying Landmines to Rest? Humanitarian Mine Action

UGANDA: Interview with Margaret Arach Orech, Ugandan landmine survivor

Landmine survivor Margaret Arach Orech is an ambassador for the International Campaign to Ban Landmines
NAIROBI, 1 November 2004 (IRIN) - Margaret Arach Orech is a single mother with five children. She lost her right leg when a bus she was travelling on hit a landmine. In the immediate aftermath, she was robbed and only just managed to crawl away from the bus before the fuel tank exploded. Her leg was amputated without an anaesthetic. She has adapted well to her new life, having received her first prosthesis two years ago and has given talks at national and international conference on the issue of landmines and victim assistance. In Uganda she is active with the Uganda branch linked to the International Campaign to Ban Landmines and also visits new amputees to provide emotional support and share with them her experience of recovery and rehabilitation.

In this interview with IRIN, Margaret Arach Orech offers her views on the state of victim assistance and talk about what it means to survive a landmine explosion.

QUESTION: How did you become a landmine victim?

ANSWER: I became a landmine victim through an ambush carried out by the Lord's Resistance Army (LRA) rebels while I was traveling in a public bus during the festive season of Christmas 1998.

Q: Where did it happen?

A: The incident occurred on an isolated stretch on the Kitgum-Gulu Road in northern Uganda.

Q: What kind of assistance was available for you and is this what is normally available to Ugandans who are mine victims?

A: After the incident, our immediate need (there were other injured passengers in the bus) was to get to a medical facility for emergency care. It was nearly an hour before we made it to a health unit with the help of a military truck. The army came to investigate the explosion and found us stranded in the bush.

The health unit manned by a clinical officer and nurse lacked the essential first-aid kit, but we were lucky they had anti-tetanus toxin, which was administered. We then waited for nearly six hours before a Good Samaritan offered to take us to the main hospital some 80km away. This was in a cattle truck. Finally, after another two hours, we arrived at St. Mary's Hospital Lacor, where I received all the necessary medical care at a fee for the next two months. This included x-rays, a blood transfusion, surgery, medication, physiotherapy, food rations and finally, being discharged on crutches.

Mine victims arrive or get to medical facilities in all sorts of transport, but generally at the hands of Good Samaritans and family. Ambulances are rarely seen. Transportation can be by hired vehicles, bicycles, trucks, hand made stretchers, etc.

Q: What difficulties did you face with the assistance you received?

A: The difficulties I faced with the assistance I received was learning to use the assistive devices (crutches) and paying the hospital bill.

Q: What type of assistance would you needed more of?

A: I would have needed more counseling and subsidized, or free, medical treatment as I was not in a position to pay my bills.

Q: How did your community and family receive you after the accident?

A: My family gave me all the support. My "friends" took off. I was abandoned. The community (my village) did not all support me, but some thought I have bad luck and the accident was a punishment for some wrong I did. Why me? To this day I have not yet seen some of my "friends."

Q: How were you able to overcome the social, economic and psychological difficulties after the accident?

A: I am a practicing Christian and this was my source of strength at the difficult time. I learned that we should give thanks under all circumstances and trust in the Lord. Also being a mother made me to strive for my children. I was able to get employment after one year, thus making it possible for me to earn a living and not become a dependent.

Q: How would you describe the scope of the problem of landmines today?

A: The use of landmines and unexploded ordnance (UXO), used in numerous conflicts throughout the continents, has killed and maimed thousands of innocent civilians. It has also robbed the affected communities of productive land and made them prisoners in their own land. Even though many states are signatories to the Mine Ban Treaty, some non-state actors (rebel forces) continue to use mines. Landmine survivors, the majority of whom reside in rural areas, continue to live without the knowledge of their basic human rights. They live day by day in a situation of hopelessness and are considered unvalued members of their society. They also need ongoing medical care, prosthetics, rehabilitation, and social and economic re-integration to be able to regain their position in society.

Q: What are the major challenges with mine-victim assistance since the treaty was signed?

A: The major challenges with mine-victim assistance are, first, holding governments to their commitment towards the Mine Ban Treaty on victim-assistance-related issues. To some, the issue of landmine survivors is not a priority, as compared to HIV/AIDS, malaria, etc. The second challenge is the lack of funding for victim assistance. The third challenge is the lack of accessibility to structures, information and services. The forth challenge lies in the co-ordination and collaboration among the various stakeholders. The fifth and last challenge is to achieve peace and stability for victim assistance to operate without disturbances.

Q: What types of victim assistance are lacking the most?

A: The types of victim assistance that are lacking the most are economic re-integration and psycho-socio support, so that landmine survivors may regain their position in society socially and economically as a way of improving their lives.

Q: What are the achievements made within victim assistance since the treaty was signed?

A: There are several achievements made within victim assistance. For one thing, the definition of victim assistance has been widened, priority areas in victim assistance have been identified, and a six-point-indicator study on victim assistance has been developed. Additionally, substantive work has been done to include landmine survivors in the Mine Ban Treaty-related meetings at the national, regional and international level. Mine affected states parties now present their status of victim assistance using the four 'P's: Progress, Priorities, Problems and Plan.

Q: What are the most immediate problems in Uganda with landmines?

A: The most immediate problem in Uganda with landmines is the continuing conflict. Forces opposed to the ruling government are using landmines and there is no control until the conflict ends. The locations of mines are unknown and affect large populations who live in IDP (internally displaced persons) camps in mine-affected areas and cannot go back to their homes until the area has been cleared and declared safe. Most affected communities need mine-risk education.

Q: What types of victim assistance is available in Uganda?

A: The types of victim assistance that are available in Uganda are emergency medical care and medical rehabilitation. There is also disability legislation is in place.

Q: What type of victim assistance is lacking?

A: The types of victim assistance that is lacking is counseling, economic re-integration and data collection.

Q: Who provides the assistance?

A: Victim assistance is provided mostly by international organizations, NGOs and UN agencies. They offer it through the existing health-service facilities in the country. Landmine victims can access medical care, but this is always at a fee and often not affordable to the rural poor.

Q: What has the Ugandan government done to meet the obligations of the Treaty?

A: The Ugandan government has, in collaboration with development partners, embarked on improving existing health facilities and construction of new ones especially in mine-affected areas. The Ministry of Health has now started participating at the intercessional meetings of the Mine Ban Treaty. The government has also put in place comprehensive legislation on disability issues and established a national council on disability.

Q: According to the Ottawa Treaty, countries are responsible for the care of landmine victims. How would you describe the compliance of the countries that have signed the treaty to provide adequate assistance?

A: Based on the indicator study done by the ICBL (International Campaign to Ban Landmines) Working Group on Victim Assistance, most states have somehow complied with the treaty in regard to victim assistance, though the level of assistance is still not adequate. This is mainly due to the economic situation of most mine-affected states.

Q: Which countries are, according to your opinion, in most need of a developed victim assistance service?

Of Signatories: Afghanistan, Angola, Burundi, Cambodia, Chad, Chile, Congo, Democratic Republic of Congo, Croatia, Djibouti, Ecuador, El Salvador, Eritrea, Ethiopia, Guinea Bissau, Honduras, Mozambique, Nicaragua, Peru, Rwanda, Senegal, Sudan, Tajikistan, Thailand, Uganda, Yemen and Zimbabwe.

Of non-Signatories: Burma, Georgia, India, Iraq, Nepal, Pakistan, Russia, Somalia, Sri Lanka and Vietnam.

Q: Do you see any problems with the current funding of landmine victims today?

A: Yes. Funding towards victim assistance is enclosed within the Mine Action Treaty and the percentage that goes towards victim assistance is not specified and it does not have a time frame.

Q: Many donors provide funding only for a short period of time, while the needs of the victim demand a much longer period. Is this something that you have experienced?

A: Personally I experienced this. Two years after my first prosthetic limb could no longer fit I needed a replacement. I was unable to get this as the only functioning orthopedic centre located in northern Uganda had run out of funding. I waited until after it got funding to resume work.

Q: Is there a preferential trend towards funding in cases of landmine victims, as opposed to victims of polio or car crashes and do you think landmine victims should get specialized assistance?

A: Landmine victims benefit from a country's existing medical facilities. There is no way a facility can be set up solely for the use of landmine victims, leaving out other persons with disabilities. Yes, I do think landmine victims should get specialized assistance. The trauma involved, its nature (deliberate act sometimes at the hand of forces that are supposed to protect the people) and the target population (rural poor), leads me to advocate for specialized assistance. At least some form of compensation would be a good way to help a landmine victim make a start after a long period in the hospital.

Q: What are your expectations of the Nairobi Summit on a Mine Free World in late November?

A: I expect a commitment by states and donors to the Ottawa Treaty and to see signatories and non-states parties joining the Mine Ban Treaty, especially Ethiopia. Additionally, I expect to see commitment by donors to the allocation of funds specifically for victim assistance and governments to increase momentum and awareness on the Mine Ban Treaty and its related activities.

Q: Has there been enough progress on the aims of the Ottawa Treaty?

A: Definitely. The fact that there are 143 or more states - I hope the Nairobi Summit on a Mine Free World is indeed a big achievement.
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A special thanks to the Mines Advisory Group and Sean Sutton for generous use of their excellent photos used extensively in this report.
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