MOZAMBIQUE: Help for landmine victims hard to come by

Photo: Guy Oliver/IRIN

Helena Numaio lost both her legs and a finger to a landmine when she was 12 years-old

MAPUTO, 5 November 2009 (IRIN) - Helena Numaio was 12 years old in 1990 when she lost both her legs and a finger in a landmine explosion while collecting firewood in the Moamba district of Maputo Province, Mozambique.

The landmine put an end to her education. Nearly 20 years later Numaio has fled an abusive marriage and now is solely responsible for bringing up her three children aged five, eight and 10. She sells food and second-hand clothes on the streets of the capital, Maputo, to make a living.

Mozambique's only local NGO dedicated to assisting victims of landmines and unexploded ordnance, RAVIM, gave her a wheelchair in 2007 and she went back to school, but had to withdraw after two years. The fees were US$4 a year, but an extra levy of $2 a month to pay for the after-hours security guard at the local school meant she would have to choose between providing for her children and improving her education.

"Before getting the wheelchair I was dependent on others to take me anywhere," Numaio told IRIN. The wheelchair enabled her to set up a small business, but the city's broken roads and sidewalks were unforgiving, and the wheelchair that had given her a new lease on life now stands immobile.

Emmanuel Mounier, seconded to RAVIM from Handicap International (HI), which works with landmine victims, told IRIN the harsh environment shortened the lifespan of crutches, wheelchairs and other aids used by the disabled, but spare parts were hard to come by and there were few specialized workshops, so repairs were expensive.

No assistance for victims

Landmines are the third leading cause of amputations in Mozambique, after diabetes and road accidents, and the threat they still pose - more than 17 years after peace came to the country following four decades of independence and civil wars - is deemed big enough for HI to spend 40 percent of its annual country budget on mine clearance.

Both conflicts saw the extensive use of landmines and HI believes that the handful of recorded victims killed or maimed each year grossly underestimates the ongoing impact of these hidden weapons.

Yann Faivre, HI's programme director in Mozambique, told IRIN that "the number of mine accidents each year are given as a minimum by the authorities, but we just don't know the number of accidents."

The situation [at orthopaedic centres in Mozambique] is not at the level of the minimum standard

There are no benefits for the survivors of landmine blasts, or those who died, or their next of kin, so there is no incentive to report incidents of landmine accidents to the authorities, Faivre said.

In one of the world's poorest nations, assistance for the disabled is often far down the list of priorities. There are government-run orthopaedic centres in the 10 provincial capitals, except Manica Province, where it is situated in Chimoio, but all share a common bond of "essential equipment not working or not being replaced," Faivre said.

"For example, in Inhambane [in central Mozambique, currently the most mined province] the [orthopaedic] centre is not open. In Beira [Mozambique's second city] the oven to make prosthetics is broken and has not been replaced," he said. "The situation [at orthopaedic centres in Mozambique] is not at the level of the minimum standard."

The majority of Mozambique's 20 million people live in rural areas, and the poor reputation of the orthopaedic centres means that "most people needing assistance don't bother to go [to the provincial capital] as they see it as a wasted and expensive journey," Faivre said.

The plight of landmine victims and the lack of assistance in many of the world's mine affected territories will be a major focus of the Cartagena Summit on a Mine-Free World, or the second five-year Review Conference of the Mine Ban Treaty, which begins on 29 November 2009 in the Colombian port city of Cartagena.

HI, which works with all disabilities, said it supported the Cartagena summit's aims of providing greater assistance to mine victims, as it might also lead to improved resources for all the disabled in impoverished countries. "No one is going to ask someone without a leg, who goes to an orthopaedic centre, how they lost it. Improved facilities will be made available for all the disabled," Faivre said.

Self help

Photo: Guy Oliver/IRIN

Paulino Alfredo Sambo lost his legs in an ambush during the civil war when he was a 15-year-old child soldier

Luis Silvestre Wamusse, national coordinator and a co-founder of RAVIM, which was established in 2005, told IRIN: "If you compare someone who was born disabled, they had no choice but to adjust to their situation. It is more difficult for someone who lived a first life as a normal person and then, from one day to another, suddenly sees their dreams broken. They have to first accept their new condition and then start their second life."

In 1984 Wamusse was a 22-year-old student in Tete Province in northwestern Mozambique, when he lost a leg and two fingers to a landmine while looking for firewood. His family brought him back to Maputo for rehabilitation. Manuel Amisse, co-founder and programme director of RAVIM, was a 26-year-old government soldier when he stepped on a mine on 11 August 1982 while on patrol in Tete.

After being evacuated by donkey cart, Amisse was eventually treated by a "not very skilled intern" in Songo, a town east of the Cahora Bassa dam, and underwent two more amputation procedures to produce a "proper stump".

"The main priorities for victims are psychological rehabilitation, the healing of the wound, and getting a prosthesis - but that first need is already not covered," Wamusse said.

In March 2007 an armoury exploded in the city of Maputo, spewing rockets, ammunition and other ordnance into the surrounding suburbs, killing more than 100 people and injuring hundreds more. RAVIM provided counselling to people who had lost limbs or sustained other injuries.

"People did not believe that we [Wamusse and Amisse] were also victims and had had limbs amputated, so we had to take off our prosthetics in the hospital and show them that we have adapted to live a normal life ... I told them, 'You lost your leg, you did not lose your life, so please do not lose your will to live'," Wamusse said.

Tales of a child soldier

Paulino Alfredo Sambo was a 15-year-old rebel soldier when he was caught in an ambush by government soldiers near Vilanculos in Inhambane Province in 1991, a year before the civil war ended. The impact of a rocket propelled grenade severed one leg below the knee and left his remaining foot in tatters. It was amputated by a nurse in a primary health care facility soon after.

Photo: Guy Oliver/IRIN

Mine victim Paulino Sambo with his wife Nilsa at their Mutola City home near the Mozambique capital Maputo

After a stint in rehabilitation and attending a government re-skilling programme for former soldiers, where he trained as a metal worker, seven years after the ambush, HI provided him with prosthetics.

"After the incident I excluded myself from society - I was ashamed of my condition - but I have accepted that I will not have legs for the rest of my life," Sambo told IRIN.

He lives with his wife, Nilsa, and three children aged two, three and four in Matola City, about 20km from Maputo. He has a lathe in the front garden and from the proceeds of his work is gradually building a family home.

The stigma associated with landmine victims and the disabled in general nearly thwarted their marriage. "Neighbours [of his prospective wife's parents] spoke against me. They told Nilsa and her parents that I would not be able to support her. I told Nilsa, 'You have the choice - I will never change."

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