Not only do they increase the number of casualties during the conflicts, but they continue to terrorize, maim, kill and dismantle families and communities long after wars are over, exploding every day, decades after being planted. Besides these direct effects on health, landmines have indirect consequences from limitation of mobility, and impact on arable land. The Treaty on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-personnel Mines and on their Destruction, signed by 135 countries and ratified by 52 countries, calls upon the UN to respond to the needs of mine victims. Other preventive measures include demining and mine awareness. Humanitarian assistance in relation to mine injuries reflects in fact broader needs from a public health stand point.
Health services are usually the first target in conflicts.
In many mine affected states, as a result of several years of severe conflict, health infrastructure is very weak. Humanitarian assistance to the population living in those countries cannot and must not strictly focus on management, care and rehabilitation of mine victims only. Ethically, this would not be acceptable, as it would inevitably give preference to one category of injury compared to others. Within their respective mandates the ICRC and WHO have joined efforts to provide their technical expertise to the development of an integrated approach to mine victims. The Bern Manifesto is a concrete example of an initiative based on this premise, of a holistic and integrated public health approach to the problem of anti-personnel mine injuries, during and after a conflict, within the scope of a functioning health care system.