Photos and story by Gemima Harvey

Pobuly Chanthava was digging up vegetables in 1993 when she hit a cluster bomb with her hoe.“I knew it was dangerous land and my parents warned me of this but my family is poor and we had no choice.”

The legacy of a secret war means the poorest people are the most vulnerable to unexploded ordnance (UXO). Desperation drives a search for scrap metal and necessity forces the population to farm in contaminated areas. As crutches and wheelchairs provide mobility to many affected, prosthetic legs give a chance to rebuild a normal life. However prosthetic legs need constant replacement; every year or two for adults and every three to six months for children. For some this is a simple routine and for others it’s an exercise far from reach. Medical treatment breaks a tiny budget and rehabilitation needs can be overlooked due to lack of founding. Chanthava spent one week at Sepone District Hospital, but with no available medical supplies, she was transported to Savannaket. Chanthava spent another two weeks in Savannaket before her leg was amputated. “I don’t remember much but the pain for a long time after [the accident] and having no money for medicine.” After the accident a clearing team removed 350 cluster bombs scattered across her farm. During the Vietnam War, Laos became the most heavily bombed country per capita, as the US, in their campaign to contain the spread of communism, attacked North Vietnamese supply routes that ran through Laos. What is known as The Secret War, took place from 1964 to 1973, where an estimated 580, 000 US bombing missions and approximately two-million tons of explosives dropped. Of these, 260 million were cluster bombs, with an estimated 80 million failing to explode. As a result UXO maim an average of 300 people a year in Laos. Thus Laos the most “I had to borrow money (5 million kip or about $625 US) from my sister, brother and cousin and it has taken me eight years to repay them.” “My children had to leave school for a few years because I had no money for books or to support their education.” Cooperative Orthotic and Prosthetic Enterprise (COPE) in Vientiane provide limbs, physiotherapy and rehabilitation to around 1500 people a year.  UXO survivors make up 40% of recipients and the rest seek COPE services due to polio, leprosy, accidents and disability.  COPE seeks to mitigate the impact caused by indiscriminate weapons, disease and injury on day-to-day life, assisting with ease of movement as well as occupational training. The centre is the only provider of orthotic, prosthetic and rehabilitation services in Laos. Set up in 1997, when the extent of the landmine problem was becoming recognised and people united to form the Mine Ban Treaty, COPE formed in collaboration with government, international NGO’s and local people. COPE founder Mike Boddington says the most important thing in setting up the centre was local ownership; expats would work on capacity building and teach skills to locals who would take over and run the centre. “The cost of a limb has many variables, including transport there and back, accommodation, food and carers, materials for prosthesis, medical treatment and this will vary on the type of amputation,” Mr Boddington said. “The average is $100 for the prosthesis and $300 in overheads, making it $600,000 to treat 1500 each year.” “The government can’t afford the upkeep of $400 per person needing treatment when for example an immunization costs $1, they have to make difficult decisions.” COPE addresses this by reimbursing the cost of travel and accommodation. Mike laments, many cannot come up with the costs in the first place. Aside from lacking resources, remoteness adds another element of difficulty.  An offshoot of this remoteness is resourcefulness, growing with the need for self-sufficiency. People either go without or make their own home-made limbs. These can range from a few pieces of wood and some nails, to welded metal contoured into something that resembles a foot, or a bamboo crutch fitted with cloth, many are ingenious but nonetheless uncomfortable, or heavy or awkward but these are survivors and they make do until there is help to COPE.