Journal of Conventional Weapons Destruction

Volume 5 Issue 1 The Journal of Mine Action Article 7

April 2001

Mine/UXO Casualties and Casualty Surveillance in Cambodia

Reuben McCarthy Handicap International

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Recommended Citation McCarthy, Reuben (2001) "Mine/UXO Casualties and Casualty Surveillance in Cambodia," Journal of Mine Action : Vol. 5 : Iss. 1 , Article 7. Available at: https://commons.lib.jmu.edu/cisr-journal/vol5/iss1/7

This Article is brought to you for free and open access by the Center for International Stabilization and Recovery at JMU Scholarly Commons. It has been accepted for inclusion in Journal of Conventional Weapons Destruction by an authorized editor of JMU Scholarly Commons. For more information, please contact [email protected]. McCarthy: Mine/UXO Casualties and Casualty Surveillance in Cambodia

Mine casualty data gathering was lance system, which concentrated on commune, district and provincial Mine/UXO Casualties initiated in Cambodia by the Mines monitoring ongoing mine incidents. level, as reported by MAG, CMAC Advisory Group (MAG) in 1994. In The intention was to provide up-to­ and the HALO Trust. Additionally, and Casualty Surveillance in Cambodia early 1995, the Cambodian Mine dare data on incidents and casualties the results of HIICRC's national Action Centre (CMAC) began a pilot and to facilitate the prioritization, survey of mine victims have enabled Handicap International's Reuben McCarthy details the combined efforts of HI, project for casualty data gathering. planning and evaluation of mine the division of Cambodia into Following the pilot project, the activity related activities. operationally high and low incident the Cambodian Red Cross and UNICEF in Cambodia. Putting faces with statistics, was outsourced by CMAC to CRC It was perhaps a unique feature villages, districts, communes and he gives the how, when and where of mine/UXO incidents in the country. and HI. The two agencies were of casualty data gathering in provinces, according to the number of considered appropriate for the task in Cambodia that it combined survey casualties recorded by the survey. view of their work with the survivors with surveillance. The combined data Finally, an analysis of the history of of mine accidents, because of the sets enabled a comprehensive picture the conflict in Cambodia, and areas national coverage of the CRC and its of the circumstances of mine incidents known to have experienced large extensive network of volunteer health and occurrences offatal and non-fatal amoums of armed conflict, influenced workers, and due to HI's ongoing role injuries caused by mines and UXO the choice of sites. in mine action in Cambodia and throughout Cambodia. The Following the recommendations experience in the development of documented history allowed patterns of a Mid- Term Review of MAG and indigenous organizations. to be traced in the rate and type of HIICRC's projects by UNICEF4 in Starting in September 1995, HI mine injuries and established means early 1999, MAG began to transfer the and the CRC took full responsibility for advocating the interests of an responsibility of its project ro HI/CRC for the project on behalf of CMAC, enormous number of mine accident to enable greater standardization and in four provinces of Cambodia. The survivors. At the same time, the use of the CRC volumeer network in partnership involved CRC under­ surveillance of ongoing incidents data gathering. By November 1999, taking data gathering in provincial enabled the effective prioritization of the transfer was complete, and HI/ locations and HI providing training mine action resources and established CRC was conducting data gathering and technical support in the establish­ a baseline for measuring the in all of MAG's coverage areas, in ment of the data gathering system, effectiveness of different aspects of addition ro nine other provinces and database and the tools for data analysis mine action programs, on a month­ municipalities, bringing the total and dissemination. Initially, the Hl/ by-month basis. Nonetheless, the dual coverage, by December 2000, to 20 CRC project was conducted in system had certain weaknesses, not the provinces and municipalities. coordination w ith MAG's project, least being the lack ofsra ndardization fn all of its aspects and phases of enabling coverage of a total of 11 of between the information collected and operation and development, mine • Landmine victims the most mine-affected provinces in the techniques for prioritizing data casualty data gathering in Cambodia in Au long Veng, Cambodia. In its formative stages, gathering. By the end of 1997, has as its central motivation the Cambodia. casualty data gathering in Cambodia however, most villages in heavily mine­ facilitation of a reduction and, c/oAP comprised both a community and affected areas had been visited by HI/ ultimately, cessation of mine and hospital level survey of accidents CRC and a national data set of UXO related casualties, through the by Reuben McCarthy, taking place during and prior to 1997, historical mine incidents was mostly collection and dissemination of timely Project Advisor, Handicap International, Belgium Mine/UXO Casualty Surveillance in Cambodia and ongoing surveillance of current finalized. and useful data on mine casualties to incidents. Subsequently, in 1998, HI/CRC mine action agencies. Moreover, a key In countries heavily contaminated with mines and From 1995 to 1997, data and MAG agreed on a common motivation of the project has been to Introduction UXO, mine casualty data2 is seen as an essential element gathering conducted by HI/CRC system of data gathering, which provide support to survivors of mine for fund raising and the effective targeting and prioritization focused on a village level survey to focused on the surveillance of currem and UXO accidents by disseminating ver the last five years Handicap lmernational (HI) of often limited resources, particularly in the areas of mine provide comprehensive baseline data or ongoing mine incidents and their information on the location and and the Cambodian Red Cross (CRC), with the awareness, mine clearance and victim assistance. Depending on the number and circumstances human casualties. Both data sets were condition of survivors to victim O technical support of UNICEF, have been involved on the scope of the information collected, mine casualty surrounding mine accidents in later merged into a single database, assistance agencies. Thus far, the in the collection, storage and dissemination of information data may also provide a useful baseline for monitoring the Cambodia, from 197 9 to 1997. established and managed by HI/CRC, project has established an effective related to the human casualties of mines and UXO in aims and effectiveness of different components of such During this period more than 35,000 and a standardized data gathering organization dedicated ro the advocacy Cambodia. The following paper provides the background projects, establish mechanisms for the direct advocacy of casualty reports were completed by form was used by both agencies. of the interests of mine victims and to the activity, its rationale and history, along with an mine affected communities, while providing valued support HI!CRC in heavily mine-affected Priority areas for data gathering were, mine affected communities. To these overview of mine/UXO casualties in Cambodia from 1998 to national and international efforrs to achieve a global provinces.3 At the same time, MAG and remain largely, determined by the ends, information provided by rhe to 1999.1 ban on the sale, use and stockpiling of landmines. established a mine incident surveil- degree of mine contamination at a project has facilitated:

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• The discovery and location of new their National Level One Survey of the 1997-1998, leading to an overall reported to be casualties of mine/ Casualties in 1998-99 by Age and or unknown mined areas through Mine and UXO situation in reduction in the number of human UXO incidents in Cambodia. Of Gender Table 1 the village level identification of Cambodia. Along with agencies casualties caused by mines/UXO. these, 1,685 casualties were reported Casualties %ofTotal mine accident sites. involved in mine action, the project Despite this, mines and UXO remain in 1998, and 1,005 in 1999. • Of all casualties Ill 1998-99, 91 Men 2,020 75% • The design of appropriate mine has provided information support to one of the foremost obstacles to • In 1996, an average of 253 percent were males, while 9 percent Children <18 536 20% awareness curricula through the numerous agencies involved in mine development and are a present threat Cambodians suffered mine were females. Women 128 5% identification ofbehavior leading to victim assistance. to the lives and livelihoods of the incidents per month. In 1997, the • Among children, as among adults, Unknown 6 0.002% mine accidents and the types of From June to July 2000, people of Cambodia, particularly as rate of casualties decreased to 137 a males made up the majority of Total 2,690 100% devices causing the incidems. UNICEF supported an external they enter areas previously inacces­ month; in 1998 a slight increase was casualties. Nonetheless, girls suffered • The ability to better help determine evaluation of the HI/CRC's project. sible due to ongoing conflict. recorded and an average of 140 at a higher rate (as compared to Table 1. Total mine/UXO casualties: 7998-7 999. priorities for different mine action The evaluation focused on an analysis The following section provides an casualties per month were reported; boys) than did women (as compared program componems in different of the stated objectives of the project overview of the situation of mine while in 1999 the average decreased co men). Nineteen percent of the Injuries locations (mine awareness, survey, and the system of data gathering accidents in Cambodia from 1998 to significantly to less than 84 child casualties were girls. Among clearance, explosive ordnance employed. Overall, the recommen­ 1999. Throughout this period, HI/ casualties per month. adults, only 6 percem of recorded • From 1998-99, rhe majority of mine disposal). dations were highly positive and will CRC utilized 25 full-time data casualties were women. and UXO related injuries were • The monitoring and evaluation of serve to guide the development of the gathering staff and a coordinated • In general, adults were killed or wounds (minor and major), while mine action acnvmes. project over rhe coming years. As of network of volunteers, who reported injured four times as often as the second most frequent injury type • Increased awareness of the mine/ January 2001, the project continued incidents and casualties to the full­ children. Children (under 18 years was the amputation of one or more UXO problem facing the Cambo­ to receive the technical and financial rime staff. In partnership with MAG old)5 made up 20 percenr of all limbs. (see Table 2.) dian people, among the national and support of UNICEF, and gained and with the technical assistance of casualties. • Both mines and UXO are more likely international communities. additional financial support from the UNICEF, data gathering was under­ • Adult males, 18 to 40, suffered the to cause amputation and/or wounds • Fundraising among mine action and Ministry for Foreign Affairs of Finland taken in an array of community most from mines and UXO. to lower limbs than to any other parr victim assistance agencies through­ and the U.S. Department of Stare. senings, hospitals and physical • However, the casualty rate among of the body. out Cambodia in the interests of rehabilitation centers. Information children as a proportion of total • From 1998- 99, 20 percent of all mine victims and mine affected Mine/UXO Casualties in was gathered on the number, location casualties actually increased. casualties were reported as dying communities. Cambodia: 1998-99 and circumstances of mine incidenrs from their injuries, while 80 percent To date, the primary end users of and casualties in Cambodia through Occupation suffered non-fatal injuries. Death the data have been MAG and CMAC Cambodia is one of the most direct interviews with casualties, their was more common among elderly in the development of their mine mine-affected coumries in the world, family members, witnesses to an • In both 1998 and 1999, more adults (less than 40 years), than for action programs; the Cambodian both in terms of human casualties and incident, local authorities, hospiral civilians suffered from mines and infants, children and younger adults. Campaign to Ban Landmines (CCBL) land lost due to landmine and UXO staff or other secondary sources. UXO than did members of the • From 1979-99, 34 percent of and the International Campaign to contamination. Following nearly three military. The last year in which incidents resulted in death. Though Ban Landmines (ICBL); and decades of war, the military situation Overview of Casualties: 1979-98 military casualties outnumbered total incidents varied due to political Geospatial International in support of in Cambodia began to stabilize from civilian was 1996, and civilian and military factors, the fraction of From 1979 to 1999, a total of • Kreng Liep holds a photo of her son casualties as a proportion of total incidents that resulted in death • A young boy who 41,993 mine/UXO casualties were who was killed when he drove his ox casualties (civilian and military) are cart over an AT mine. lost his leg to a recorded in Cambodia, by HI/CRC increasing dramatically. c/o UNA-USA Debra Boyle mine blast. and MAG. • In 1999, the gap between civilian c/o ICRC/Tim Table 2 Mayer • Throughout this period, there was a and military casualties widened strong relationship between political • The decrease in mine/UXO related dramatically. 6 violence and the total number of casualties may be attributed to a • Though civilians suffered co a greater Injury Type Cases mine/UXO casualties. During multitude of factors, but the degree (in absolute numbers) than Wounds 1,597 periods of civil war casualties cessation of conflict in 1998, a members of rhe military, in relative Amputation 944 increase; during periods of relative stabilized political situation, a more terms (as a fraction of the toral (one or more limbs) peace, casualties decrease. settled population with an increased exposed population), members of Death 550 • Since the emergence of relative peace knowledge about the location of the military remained at a far greater Burns 265 and stability in Cambodia from mined areas and the mine situation risk of becoming a casualty of mines Blindness 165 1997 to 1999, mine/UXO related in general, and increased clearance or UXO than civilians, though their Deafness 164 casualties steadily diminished, activities all play an important part accidents were not always associated Paralysis 16 following a peak in 1996. in a reduction of accidents, though with military activities. Total 3,701 • From January 1998 to December no single faccor can or should be 1999, a total of 2,690 people were attributed to the reduction. Table 2.1njuries sustained: 7998-7 999 https://commons.lib.jmu.edu/cisr-journal/vol5/iss1/7 • 20. • 21 • 2 McCarthy: Mine/UXO Casualties and Casualty Surveillance in Cambodia

steadily declined over the en tire TableS. Cambodia border than were period. Table 5 Incident reported in 1997. This is partly associated • From 1998-99, casualties suffering activities: explained by a greater capacity of the amputation or death by mine/UXO Activity Casualties %ofTotal 1998-1999. project to collect data in these areas were geographically concentrated in in 1998 and 1999, following a the north, northwest and southeast Tampering 762 27% cessation of conflict. provinces of Cambodia, with little Military activities 514 19% • Mine incidents (excluding UXO) are variation between the two types of Traveling 498 19% more concentrated in the northwest casualty. Farming 364 14% than UXO incidents (excluding Collecting wood 264 1Oo/o mines). UXO incidents are more Medical care Collecting food 134 5% geographically spread out and a Herding 55 2% greater number of casualties • The majority of mine/UXO Fishing 49 2% involved in UXO incidents were casualties had their injuries treated Unknown 32 1% recorded on the Vietnam-Cambodia either in a provincial or district level Other 17 1% border than mines. hospital (see Table 3.). Trading 1 Oo/o • In 1998-99, Bat Dambang province • A significant minority of casualties Total 2,690 100% continued to rank as the province received no medical assistance at all , • Cheap Chea points to a landmine that recording the highest number of indicating very minor injuries or he found in his field. mine and UXO casualties (see Table c/o UNA-USA, Chim Sereivuth death at the site of the incident o r The number is not, however, • Children were more likely to be involving civilians, largely because of 6.). enroute to a medical facility. n ecessarily a reflection of the injured while tampering than were the "dry season offensives" • In 1998-99, Samlout District, in Bat • The majority of casualties received effectiveness or lack thereof of Table4 adults. 1 Adults were more likely to conducted by the military. Dambang province, recorded the first aid/care within thirty minutes orthopedic services in Cambodia, be injured while undertaking highest number of casualties. of suffering their accident. because many casualties may not Device Casualties %ofTot military or livelihood activities than Locations When Injured However, if the number of casualties • Casualties whose access to medical have been ready to receive a device Mine 1,885 70% were children. is taken as a percentage of the total facilities was between 30 minutes at the time of their interview. uxo 768 29% • Both tampering and livelihood • As in previous years, the majority of population, Veal Veaeng District, and two hours were more likely to Unknown7 37 1% activities followed the same pattern mine and UXO casualties were Pousat province, is the most affected suffer amputation than those had Cause of Injuries Total 2,690 100% in 1998 and in 1999: they fell during concentrated in the northwest of district. access in less than 30 minutes. Device the rice growing and harvest season Cambodia. This is particularly true • For the same period, Traeng • Of the 835 cases of amputation, • In 1998 and 1999, 70 percent of all Table 4. Casualty causing device: 7998-7999. and peaked during the dry season. for military casualties, while civilian Commune in Bat Dambang requiring some kind of orthopedic incidents involved mines and 29 • Military activities led to far fewer casualties covered a greater geo­ province recorded the highest d evice, a total of 449 prosthetic percent involved UXO. (see Table 4) inciden ts decrease, while UXO total casualties in 1999 than in graphic area. number of casualties. However, if devices were received by casualties. • Since 1994, incidents involving incidents tend to increase. 1998. At the same time, incidents • From 1998-99, a greater concentra­ the number of casualties is taken as UX:O have increased as a proportion involving the military followed the tion of mine and UXO casualties a percentage of the rota! co mmune of total incidents, while those Activities Associated With Incidents same seasonal patterns as those were recorded on the Thai- population, Sala Krau Commune, Table3 involving mines have decreased. • Children were more likely to be • In 1998 and 1999, the three most Medical Assistance Casualties %ofTotal injured as a result ofUXO than adults. important activities that led to mine Provincial Hospital 828 32% Table6 • In 1998 and 1999, both mines and incidents were: 1) tampering, 2) District Hospital 593 22% UXO incidents varied with the military activities, and 3) traveling None 383 14% Rank Province Total Cum Total %ofTotal Cum% season: wet season and dry season. (see Table 5.). Unknown 384 14% Casualties More casualties were reported • However, if all activities associated Army Hospital 190 7% 1 Bat Dambang 790 790 29.4% 29% during the dry season as rural with one's livelihood are taken Self-treated 104 4% 2 Banteay Mean Chey 405 11195 15.1% 44% Cambodians travel more and as they together, livelihood is the most Other 89 3% 3 Otdar Mean Chey 331 1,526 12.3% 56% seek alternative sources of income to common associated activity leading Private Clinic 59 2% 4 Preah Vi hear 281 1,807 10.4% 66% rice farming. Fewer casualties were to mine incidents, followed by Commune 51 2% 5 Si em Riep 169 1,976 6.3% 72% reported during the rice planting military and tampering. Health Centre 6 Pousat 149 2,125 5.5% 78% and harvesting seasons, when • Tampering incidents almost Traditional octor 5 0.001 o/o 7 Kampong Thorn 126 2,251 4.7% 83% populations are less mobile. exclusively involved UXO, while Wat/monks 4 0.001 o/o 8 Kampong Cham 107 2,358 4% 87% • In periods of conflict, mine incidents incidents involving mines were more Total 2,690 100% 9 Krong Pailin 97 2,455 3.6% 91 o/o Table 6. Ten most affected often associated with livelihood rise and UXO incidents decrease. In 10 Svay Rieng 49 2,504 1.8% 93% provinces for mine/UXO Ta ble 3. Medical assistance received: 1998-1999. periods of relative peace, mine activities. casualties: 1998- 1999.

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Krong Pailin province, is the most Contact Information 1 Excerpts obtained from rhe report Mine & those of the U.S. Department of Stare, rhe UXO Casrlfl!ties in Cambodia: 1998-1999 ; M inistry for Foreign Affairs of Finland o r affected commune. C ambodia Mine/UXO Victim Information UNICEF. • From1998 to 1999, Ampil Village, Reuben McCarthy System (ne. Mine Incident Database Project), s The definition of a child being less rhan 18 in Bavel District, Bat Dambang Project Advisor September 2000. yea rs of age follows from the definition outl ined province, recorded the highest Handicap International 2 Unless otherwise specified, where rhe term in rhe Convention on the Rights ofChi ldren. 6 The number o f injury cases does not number of c.'lsualties with incidents "mine victim/casualty" is used alone it is taken P.O Box 838 to include UXO casualties. correspond ro rhe number of casualties because raking place in villages. 18 rue 400 3 By September 2000 rhe number of casualty many casualties suffered multiple injuries. BoengKeng Kang 1 reports reached in excess of 45,000. Injuries that led ro death are also included . Terrain Type(1998-99) Chamcar Morn 4 Ar rhe rime U N ICEF was providing financial 7 Unknown: unidentified devices often reported and technical assistance for borh MAG and HI/ by rhird parries. Sometimes fuses. Pnom Penh Cambodia C RC. In 1999, Hl/CRC received additional 8 lr was a shortfall of rhe survey questionnaire • The overwhelming majority of mine Tel: 001-23-217-300 funding support from the Ministry for Foreign and methodology during 1998 and 1999 that and UXO incidents (72 percent) Fax: 001-23-216-270 Affairs of Finland, and in 2000 from the U.S. people who may have witnessed another person occurred in three types of terrain: Email: [email protected] Department of State (Grant: S-PMHDP-00- tampering with a device and were subsequently injured in an incident were also recorded as forests, villages and fields (see Table GG-0021). The opinions, findings and conclusions contained in this paper are those tampering. 7). of rhe author and do not necessarily refl ect • Incidents raking place in fields are seasonally based and occur more frequently in the wet season, while • Mr. Phia lost his leg to a land mine. c/o UNA-USA Chim Sereivuth incidents occurring in forests occur more frequently in the dry season. Mine Incident Prevention Mined Area Marking and Mine l\1\ine/UXC> Casualties in Incidents occurring in villages, on Mine Awareness Training Clearance at the Site ofthe Incident Cambodia: 1 998- 1 999 paths and roads, or near rivers do not demonstrate any major seasonal • Eighry-rwo percent of casualties were • Only 2 percent of incident sites were vanattons. reported as not having received mine reported as being marked with awareness training prior to their official mine field markings at the incident. time of the incident. Table 7 • The results indicate either a severe • Only four percent of incident sites lack in mine awareness training, or had any previous mine clearance. Area Type Casualties %ofTotal the impression that people who • The results suggest that the majority Forest 999 38% receive mine awareness training are of incidents are raking place in areas Village 573 21o/o less likely to be involved in an not known to be mined, not Field 363 13% accident than those who do not. surveyed, or not prioritized as being Path/road 287 11o/o • Both women and children received high priority for clearance or Near river 183 7% proportionately more mine marking activities. Mountain 118 4% awareness training than adult men, • The results do not tell us what mine Near military 108 4% even though adult men are a higher action or survey activities may have base risk group, suggesting a need to been conducted following any No answer 43 2% refocus training on them. reported mine incident. Other 10 Oo/o • Assuming that a lack of mine • The Mine Incident Database Project Overgrow n area 6 Oo/o awareness among casualties indicates is performing a vital and unique D Province Bomd1fies • Tonie Scp Lake Total 2,690 100% the weakness of the activity, the function within the mine action Dstrict Casualty Numt:Ers location of casualties not having context in Cambodia and provides received mine awareness training vis­ valuable information that assists D9_g Table ?.Incident H 1o-s5 location by terrain a-vis the rate of casualties indicates different agencies and governmental bl 35-78 type: 1998-1999. a need to reconsider the concentra­ bodies in multiple areas of activity. 79-160 161 -293 • The majority of incidents (35 tion of mine awareness activities in • percent) rook place within five certain provinces of Cambodia. • Handicap International & the Cambodian Red Cross kilometers of village centers. (Chris Horwood and Andrea • For the same period, 39 percent of Crossland, External Evaluation of all casualties were reported to have UN!CEF-Supported Activities to visited the site of their accident often, Prevent Mine Incidents, June-July prior to the incident taking place. 2000). https://commons.lib.jmu.edu/cisr-journal/vol5/iss1/7 • 24. • 25 • 4