Gun Violence, Disability
and Recovery
CATE BUCHANAN
SURVIVING GUN VIOLENCE PROJECT
About the book
 Foreword by José Ramos-Horta, Nobel Peace Prize
Laureate (1996), President of Timor-Leste (2007–12) and a
survivor of gun violence.
 Stories and reflections from over 35 survivors of gun
violence from all over the world.
 Over 45 practitioners and professionals contributed
thematic and country chapters and sections.
 Over 65 peer reviewers from a variety of disciplines.
 Endorsed by over 20 disciplinary experts, gun violence
survivors and eminent individuals.
The book at a glance
 Thematic chapters: Victims’ rights and international
standards; Traumatic injuries; Rehabilitation/recovery;
Social protection
 Country studies: Guatemala, Somalia, South Africa,
Canada, India
 Shorter ‘Spotlights’: Colombian victims’ law; Gun
violence and masculinity; Assistance to survivors in peace
agreements; Massacre in Guyana; El Salvador’s gun tax and
victims’ services; profiles of survivors; and other themes.
 A pioneering annex identifying international standards
relevant to survivors of gun violence.
Why just focus on gun violence?
 Gun violence is a unique phenomena for 4 key reasons:
-The ‘tool’ can be used legally or illegally; it is the misuse
that ultimately counts
-Global saturation of the ‘tool’; 875 million small arms
-Injuries are unpredictable, varied and frequently lead to
major impairments
-Of all the forms of ‘armed violence’ (landmines, cluster
munitions, bombs), gun violence is killing and maiming the
largest number of people all over the world in situations of
war, peace, conflict, crime
Key issues
1. Beyond hospital: We need to understand what is happening
for people once they leave hospital – rehab, care, social
protection, health and social outcomes.
= Research, mapping and planning is important.
2. Gun violence survivors face double penalty: physical
and mental victimisation + stigma associated with perceptions
of criminality. Guns evoke anxiety, fear & blame.
= Research and guidance is valuable.
3. No appetite for new international norms.
= Implement exisiting standards at the national level, build
good practice. Most promising norms come from criminal
justice, women’s rights and anti-torture, disability rights.
‘But what about the numbers?’
 Ratios of death to injury vary and are highly context-specific (e.g.




Type of transport to hospital, city vs rural, quality of trauma care)
3 times as many injuries to deaths is typically accepted/often noted
Small Arms Survey estimates that 2-7 million people are living with
gunshot injuries worldwide, but this excludes many types of gunrelated victimisation
We suggest the real number is likely far higher because: certain
victimisation difficult to document; psychological effects poorly
understood and systematically under-reported; ‘brandishing’ hard
to capture; sexual violence at gunpoint challenging to record
Fatality figures also problematic: Very hard to capture the deaths
several years later that are attributable to gun violence; “Slow
homicide” from preventable secondary health conditions
Recommendation 1: Trauma/Emergency care
Effective trauma care
can reduce levels of
impairment.
 Audits of trauma care
systems—including transport
to medical facilities, mental
health support, professional
training curricula – in line
with World Health Assembly
resolutions –May 2014
 First responder training and
support in communities with
violent “hot spots” or
neighbourhoods
Young lad with multiple wounds, Guatemala. (Daniel Leclair, Reuters, 2004)
Recommendation 2: Rehabilitation and
Psychosocial support
Rehabilitation out of reach
to many survivors.
 Establish and/or strengthen
quality rehab programmes
 Ensure a continuum of
support to community-based
rehabilitation, and peer
support processes
 Detect & respond to trauma,
grief, and mental health on a
continuum in hospital
settings, in the criminal
justice system and in the
community
 Support to caregivers
Suzy, 27, was hit in the spinal column by a stray bullet in her
neighborhood, Paraíso II in Guatemala City.
(Heidi Schumann, 2006)
Recommendation 3: Peer support initiatives
Peer support can improve
health and social
outcomes.
 Connecting hospitals with
local peer support initiatives
 Inclusion and funding of
peer support initiatives in
programming to reduce gun
violence
 Evaluation of peer support
efforts to gather evidence on
good practice
Alex Galvez, Director of the Transitions Foundation, member of
the national wheelchair users basketball team in Guatemala.
(Heidi Schumann, 2006)
Recommendation 4: Caregiving
Caregiving is overlooked partly
due to the private unrecognised
labour of women & girls.
 Creation of a “carer’s pension” in
social protection systems
 Including full costs of care in
estimates on the cost of armed
violence, factoring in the gender
dimensions
Carlos, age 25, from El Salvador, who was shot in the back
at age 21 by gang members whom he knew. Carlos
becoming paraplegic put an economic strain on the family as
his wife Evelyn juggles caring for him and for their child, as
well as trying to earn money. It also put a strain on their
relationship, with Carlos sometimes taking out his anger and
frustration on Evelyn.
Recommendation 5: Social protection
Extend social
protection measures.
 No-fault disability
insurance schemes
enable sustainable
support
 Ensure inclusion of
informal workers and
under-employed to
reduce long term social
and health care costs,
improve outcomes
Protesters carry burning crosses during a march to remember victims of
political violence in Bogota. (Fernando Vergara, AP, 6 March 2008)
Recommendation 6: Conflict and post-war
Strengthen peace
agreements and
recovery planning.
 Inclusion of a module on
disability in the Integrated
DDR Standards
 Guidance for negotiators
and mediators on peace
agreements or
implementation strategies
(e.g. Not favouring
military over civilians in
terms of services)
 Inclusion of mental health
services in relief and
recovery efforts
A doctor at the African Union peacekeeping hospital holds up an x-ray
scan of a patient injured by fighting in Mogadishu, Somalia.
(Siegfried Modala, April 2010)
Recommendation 7: Development
Include a focus on violence and
disability in development.
 Ensure development planning and
the MDGs renewal process has
interlinked focus on disability and
violence reduction and response
 Harmonise services for all survivors
of armed violence, assessing if there
is unintentional discrimination in
programmes and policies for
survivors of landmines, cluster
munitions and gun violence
Lomeruka Kristen lives in northern Uganda. Shot in the arm
with an AK-47 during a cattle raid. A widowed mother of six
children, she has had almost no support and relies on the
dwindling good will of her community. When interviewed, it
was the first time anyone had asked after her well-being in
13 years since losing her arm. (Sara Hylton)
Recommendation 8: Policing and justice systems
Improve national victims’
rights frameworks.
 Develop or update national laws in
line with relevant international
obligations, particularly 1985 UN
Declaration of Basic Principles of
Justice for Victims of Crime and
Abuse of Power
 Streamline support, e.g. Case
tracking systems to both reduce and
improve interactions with the
criminal justice system
Ronnie Fakude at bail hearing in April 2013. Paralysed
from gun violence, he has been on remand for over two
years and receives inadequate medical care in a Sth
African prison. (Photo: Carolyn Raphaely)
Recommendation 9: Perpetrators
Working with
perpetrators can be
an investment in
violence reduction.
 Evaluation of existing
initiatives
 Developing protocols for
programmes targeting
perpetrators
 Clarifying laws and
policies on access to
compensation or services
for people accused or
convicted of crime
A man shows his bullet wounds received during a gun fight in
Martissant in Port-au-Prince. Ramon Espinosa/AP, 23 January 2007
Guatemala street art. (Heidi Schumann 2006)
Recommendation 10: Research and inclusion
Get serious about inclusion
and fill the research gaps.
 Develop a strategic research
agenda
 Undertake mixed method studies
to break the data impasse on what
happens to people once they are
shot
 Inclusion relevant to many
recommendations; but specific call
here for orgs working on armed
violence reduction to assess where
they can be involving survivors
 Inclusion Principles; consultation
process in 2014
Louise Russo, who lives in Toronto, Canada, was shot and
paralysed when a bullet ricocheted into a sandwich shop she
was standing in. Louise has since gone on to become a leader
for violence prevention, establishing the organisation, Working
Against Violence Everyday (WAVE). (Carlos Osorio,
GetStock.com, 29 May 2006)
Recommendation 11: Funding streams
Remedy the lack of
support to survivors of
gun violence.
 Assess blockages in
sustainable funding
 Is the principle of nondiscrimination working if
gun violence survivors can’t
access steady funding?
 Donors (public & private)
agree to a Global Fund for
Survivors of Armed
Violence announced in
2015
Survivor of a drive-by shooting by insurgents in Kandahar,
Afghanistan. Back in hospital with an infection after having his leg
amputated at the knee. He had to travel to Karachi, Pakistan for
the amputation. (Kate Holt, 18 March 2011)
Recommendation 12: Normative frameworks
Implement what norms
exist.
 Guidance for Govt’s and
others on national
implementation of
relevant norms
 Ensure issue is included
in various national action
plans (e.g. for WHO
violence and health
campaign, CRPD, armed
violence prevention etc.)
A police patrol in the slum area of Soyapango, San Salvador, an
area dominated by gangs such as the Mara Salvatrucha and M18
gangs. (Piet den Blanken/Panos, 6 May 2005)
Recommendation 13: Gun laws
Review existing gun laws to
recognise obligations towards
survivors of gun violence.
 Direct gun sale taxes or a portion
of license and registration fees to
strengthen or create services in
the health and justice systems
 Link gun laws to other relevant
laws (e.g. victims’ rights
charters/codes, laws addressing
violence against women)
J.B. Webb Chapel Central Methodist Mission,
Johannesburg. (Dieter Telemans, Panos,
December 2000)
Buying the book
 The book is available on the SGVP site as an
ebook, in PDF form and as a paperback.
 100% of proceeds from the sale of the book
go to the Transitions Foundation in
Guatemala when you buy it from the SGVP
website.
 Visit http://survivinggunviolence.org/book/
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