Chechnya

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CONTEXT
Ten years of conflict in Chechnya  have had disastrous effects on this country and its population. Roads, water, electricity and gas supplies have been largely destroyed, public services are run down and their staff are largely demotivated and without resources.

The capital, Grozny, is almost completely destroyed. Of a pre-war population of approximately 1,200,000 people, nearly 20% are said to be refugees and, allegedly, between 10% and 20% of the population have died as a direct or indirect consequence of the conflict.

Chechnya is occupied by a federal army of 80,000 men supported by 10,000 local militiamen directly under orders of the President who is supported by Moscow. Facing them is a fragmented opposition, made up of small radical Islamic groups and supporters of the ex-President Mashkadov. The militants, numbering between 3,000 and 5,000, are entrenched in the mountains of South Chechnya. By launching direct assaults, but mainly via bomb attacks, they are causing the daily loss of human life in Government and federal security forces.

Between them is a physically and mentally exhausted population, without hope, whose main preoccupation is finding shelter, food and medication. 95% of the population live below the minimum threshold for Russian survival and their most fundamental rights are violated on a daily basis. In such a context, the populations’ mechanisms for survival as a whole have been pushed to their absolute limit.

BACKGROUND
1998: Handicap International, in partnership with CPCD (Centre for Peacemaking and Community Development, UK NGO) and ARD (Agency for Rehabilitation and Development, Chechen NGO), worked on a project to reopen the Grozny Orthopaedic Centre. But following renewed fighting in 1999, the project could not be completed.  
2000: we sent wheelchairs and walking aids to respond to the most urgent needs. 
2001: support to the medical organisations and social networks in Chechnya and Ingushetia (services for traumatology, the Grozny Centre for Orthopaedic Prosthetics, associations for people with disabilities and social protection bureaus).  
2001: Handicap International opened an office in Nazran and Grozny and distributed walking aids in Ingushetia and Chechnya, in collaboration with international NGOs, associations for disabled people and Chechen health organisations.

STRATEGY
The task of international humanitarian organisations in Chechnya is a particularly arduous one. In a security, political and operational context that is unclear and very dangerous, occasionally exploited by the parties in conflict for their own ends, they mainly implement emergency programmes that they extend year after year, that do not require huge teams and do not need large teams of international staff in the field. A small handful has offices in Chechnya and an extreme minority allows its international staff to travel occasionally within the country. 

Having recently arrived in Chechnya, Handicap International has adopted an approach based on minimising the risks taken by its teams, and its operational choices are subject to security restrictions. The priority is the effective control of human resources and equipment, as well as the development of a tight collaboration with the other humanitarian operators locally or internationally. Handicap International has chosen to focus its activity in a few key areas, to make a fast impact on the most vulnerable sector of the disabled population:

• direct individual assistance intended to rapidly improve levels of hygiene and autonomy
• supporting the medical and paramedical organisations that supply direct services to disabled people
• access for disabled people to care, existing social services and means of subsistence

ACTIVITIES
Direct assistance to disabled populations hinges on programmes for distributing mobility aids, paramedical articles and essential items as well as prosthetics for amputees, direct or indirect victims of the conflict. Our assistance complements or supplements the assistance provided by the other operators. Cases are either identified directly by our teams or are referred to us by other NGOs, local associations and Government bodies.

Supporting the medical and paramedical organisations that provide services to disabled people is the second area of our activity in Chechnya.  Two types of activity are set up:

• the provision of specialised medical equipment to trauma departments. This equipment is intended to improve their services’ surgical capabilities and reduce the risk of post-operative complications and the possible appearance of disability
• opening of and support to rehabilitation centres in hospitals and in specialised structures.

These two activities are completed with a training and information section for medical staff.

Finally, a third area is slowly being put in place, around the accessibility problems encountered by disabled people with regard to their care or to other basic services (access to buildings), to resources (training centre / Achkoi-Martan needlework workshop), to the existing social services.

BENEFICIARIES
In 2003, thanks to Handicap International’s activities:

• 1,300 disabled people received mobility aids or hygiene kits adapted to their needs
• 60 people were fitted with prostheses
• a centre for training and needlework workshop was created for disabled people (in Achkoi-Martan)
• 7 trauma departments received different types of specialised medical equipment
• 3 rehabilitation centres were opened
• the Grozny medical school resumed its rehabilitation courses for nurses
• 3 local associations for disabled people received donations of equipment and specialised training
• 70 people working in hospitals, rehabilitation centres or for local associations received specialised rehabilitation training
• different types of communication, training and awareness material was produced and distributed in Chechnya.

CONTACTS
2/1 Semyonovskaya Naberezhnaya,
Offices 711-713, 105094 Moscow – Russian Federation.
Tel/fax: (007095) 234 84 63 or 360 20 68
E-mail: hi_nazran@southnet.ru