2014 To Walk the Earth in Safety: Africa

Report
Bureau of Political-Military Affairs
September 30, 2014


Past and ongoing conflicts have littered many African countries with explosive remnants of war (ERW) contamination and flooded the continent with licit and illicit small arms and light weapons (SA/LW). Remaining from conflicts that ended years ago, extensive landmine and ERW contamination in several African countries hinders economic development and continues to kill and injure innocent civilians. The flow of illegal weapons across borders in North and Central Africa fuels cross-border violence and threatens national reconciliation and stability.

Additionally, the lack of safe ammunition storage practices has caused dozens of catastrophic explosions at munitions storage depots. Also known as “dangerous depots,” these storage facilities are filled with aging and improperly stored and secured munitions, which have the potential to cause even more casualties on an annual basis than landmines. With extensive U.S. support, many African nations have reduced the risk of unplanned explosions in their storage depots, while simultaneously increasing their capacity to safely and securely store needed munitions.

Since 1993, U.S. conventional weapons destruction programs have provided more than $344 million for 32 countries in the region. Almost 20 years of sustained support from international donors, including the United States, has helped Mozambique stay on track toward achieving landmine impact-free status in 2015. The significant U.S. contributions to landmine and ERW clearance have drastically reduced casualty rates and opened millions of acres for productive development

Angola

In 2002, Angola resumed recovery efforts after four decades of internal conflict. Every province in Angola is contaminated with mines and explosive remnants of war (ERW), and it is the most mine-affected country in Africa. Angola also has the greatest number of different types of landmines—more than 115 at last count—increasing the difficulty of humanitarian demining efforts. After almost 20 years of humanitarian demining support from the U.S. and international community, over half of all mine-contaminated areas have been cleared. This support includes the release of 49 percent of mined and suspected hazardous areas (SHA) identified during the 2007 Angola Landmine Impact Survey. Though reporting discrepancies between national demining programs and nongovernmental demining organizations operating on the ground makes accurately estimating the total affected area in Angola difficult, the Angolan government is working to correct these discrepancies. The Landmine and Cluster Munition Monitor identified 2,857 mine/ERW casualties from 2000 through 2012, although total casualty estimates range from 23,000 to 80,000. Angola estimates that hundreds of thousands of small arms and light weapons (SA/LW) are in less than secure government stockpiles.

Date: 10/02/2013 Location: Angola Description: Darren Manning on a site visit - State Dept Image
PA/WRA’s Darren Manning on a site visit to Angola to see the positive effects of the U.S. Humanitarian Demining Program. [State Dept. Image]

From 1993 to 2013, the United States invested more than $105 million in Angola, of which more than $86 million came from the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA). Projects supported with these funds focused on clearance and safe disposal of landmines and unexploded ordnance (UXO), improving the lives of victims of landmine/UXO incidents, improving access to land and infrastructure, destroying unstable, excess, and poorly secured SA/LW and munitions, and the development of the host nation conventional weapons destruction capacity.

In FY2013, PM/WRA allotted $6 million to support minefield and battle area clearance, UXO destruction, and mine risk education (MRE), and to destroy excess, unstable, and obsolete SA/LW and munitions. PM/WRA provided funding to the following international nongovernmental organizations:

• The HALO Trust (HALO) cleared high- and medium-impacted communities, surveyed and/or re-surveyed SHAs, conducted MRE, performed UXO/ERW clearance in Benguela, Bié, Huambo, and Kuando Kubango provinces, and safely destroyed SA/LW and munitions throughout Angola.

• MAG (Mines Advisory Group) continued demining high- and-medium impacted communities, surveyed SHAs, and provided MRE in Moxico province.

• Norwegian People’s Aid continued work in the Malanje, Zaire, and Uige provinces to clear high- and medium-impacted communities, survey/re-survey SHAs, conduct MRE, and perform UXO/ERW clearance.

Also in FY2013, the U.S. Department of Defense’s Humanitarian Demining Research and Development (HD R&D) Program provided over $1.3 million in funds and new technology to support mine action assistance in Angola. Angola continued operations in FY2013 with previously provided technology valued at $850,000.

In FY2013, in partnership with HALO, HD R&D began a trial of Mine Stalker, an armored tractor with the latest generation of ground-penetrating radar panels and automatic target recognition algorithms to detect minimum-metal anti-tank (AT) mines on roads.

HD R&D and HALO continued an operational field evaluation of the Rotary Mine Comb (RMC). The RMC’s intermeshing tines extricate large buried objects, including AT mines, from the soil and push them to the side of the host vehicle’s path. The RMC locates mines that are otherwise undetectable on roads that, although previously cleared by heavy detonation trailers, continue to have AT mine accidents. Since 2008, HALO has cleared 47 kilometers (29 miles) of road and removed 106 low-metal AT mines that metal detectors cannot find. The road will reconnect more than 200,000 people in southeast Kuando Kubango province with the rest of Angola when clearance is completed.

Democratic Republic of the Congo

Two decades of armed and proxy conflict with neighboring states and non-state actors (NSA) in Democratic Republic of the Congo (DRC) killed more than five million Congolese and left the country contaminated with landmines and explosive remnants of war (ERW). Old munitions put nearby communities in danger from accidental explosions. NSAs in northern, southern, and eastern provinces of DRC continue to terrorize residents and conduct occasional cross-border raids. The conflicts in DRC and the surrounding region have resulted in a large black market of small arms and light weapons (SA/LW), and porous borders with neighboring countries facilitate weapons smuggling. This illicit SA/LW trafficking poses a significant threat to regional stability.

Date: 10/02/2014 Location: Democratic Republic of the Congo Description: Children walk past UXO © Photo by Sean Sutton/MAG
Children walk past marked unexploded ordnance in the Democratic Republic of the Congo. [Photo by Sean Sutton/MAG]

Since 2002, the United States has provided more than $9.7 million in funding for conventional weapons destruction (CWD) efforts, including humanitarian mine action, in DRC. This support has allowed for the destruction of more than 140,000 SA/LW, 950 tons of munitions, 345 anti-tank mines, 2,007 anti-personnel mines, and 14 man-portable air defense systems (MANPADS); improved DRC’s physical security and stockpile management (PSSM) capacity; and supported the DRC government’s capacity to mark and trace all state-owned weapons. In FY2013, PM/WRA invested $1 million to fund the following CWD efforts:

MAG (Mines Advisory Group) deployed weapons and ammunition destruction teams, destroying 10,000 SA/LW and 75 tons of surplus, unstable, at-risk, and obsolete munitions throughout North and South Kivu provinces.

DanChurchAid cleared ERW contaminated areas, conducted surveys, and provided mine risk education in South Kivu province.

Mozambique

Date: 10/02/2014 Location: Mozambique Description: HALO deminer using detection system © Photo courtesy of HALO
A HALO deminer shown in Mozambique using the Handheld Standoff Mine Detection System. [Photo courtesy of HALO]

In 1992, at the end of over 30 years of conflict, Mozambique’s landmine and explosive remnants of war (ERW) problem was one of the most severe in the world. However, two decades of U.S. and international support has significantly reduced Mozambique’s landmine contamination. Mozambique’s National Institute for Demining reported in August 2013 that 8.2 million square meters (3.2 square miles) of land remain contaminated in 221 suspected hazardous areas. Mozambique’s remaining landmine contamination is along the Mozambique-Zimbabwe border, and Mozambique plans to be mine impact-free by 2015. Mozambique is on track to be the first “heavily-mined” country to achieve mine impact-free status.

From 1993 to 2013, the United States invested more than $53.8 million in Mozambique for the clearance and safe disposal of landmines and unexploded ordnance (UXO) to improve the lives of victims of landmine/UXO accidents, to increase access to land and infrastructure, and to support the development of host nation conventional weapons destruction capacity. Of these funds, the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) provided more than $32.5 million.

In FY2013, PM/WRA provided $3 million to The HALO Trust (HALO) to support manual and mechanical clearance of mine-impacted communities in the Manica and Tete provinces to facilitate Mozambique’s 2014 goal of becoming mine impact-free.

In FY2013, U.S. Africa Command deployed military explosive ordnance disposal personnel to Mozambique to conduct ERW disposal training, which included instruction in ERW education and risk reduction, first responder medical training with an emphasis on blast trauma injuries, conventional munitions stockpile assessments and training, and program assessments. Overseas Humanitarian, Disaster, and Civic Aid appropriation funded travel, supplies, equipment, and service costs totaling $440,000.

Also in FY2013, the U.S. Department of Defense’s Humanitarian Demining Research and Development (HD R&D) Program provided $159,000 to support mine action assistance in Mozambique. Mozambique continued operations in FY2013 using previously provided technology valued at $235,000.

In FY2013, in partnership with HALO, HD R&D continued an evaluation of the Handheld Standoff Mine Detection System (HSTAMIDS) and continued the evaluation of two Orbit Screens. HALO is evaluating HSTAMIDS against new mine types and terrain conditions, finding 4,107 mines in areas covering 46,000 square meters (11 acres). The Orbit Screens are clearing areas around power- line pylons, providing access to critical infrastructure. The Orbit Screens have sifted 156,000 cubic meters (204,040 cubic yards) of soil, uncovering 321 mines and items of UXO.

Senegal

The United States resumed humanitarian demining in 2013 in support of U.S. efforts to broker peace between the government of Senegal and the separatist Mouvement des Forces Démocratiques de Casamance (MFDC or Movement of Democratic Forces of Casamance), which have engaged in sporadic fighting since 1982. Although the two groups signed a peace agreement in 2005, some wings of the MFDC continued to fight. Despite this, they have maintained a de facto cease-fire since 2013 while peace negotiations are ongoing.

Date: 10/02/2014 Location: Senegal Description: Preparations for field work - State Dept Image
Preparations for a field work briefing in Senegal. [State Dept. Image]

The more than 30 years of conflict left the Casamance region littered with landmine and explosive remnants of war (ERW) contamination that continues to pose a risk to local residents and hinders badly needed economic development. On the other hand, notable humanitarian demining progress has been made since 2005. Most of the remaining landmine threat is inside MFDC-controlled areas and around Senegalese military installations.

Beginning in 2005, the United Nations Development Programme and Handicap International (HI) began a Landmine Impact Survey of Casamance, revealing 149 suspected hazardous areas in 93 communities. In 2006, reports further indicated that mines and ERW affected 90,702 people and contaminated 95 kilometers (59 miles) of paths, tracks, and roads. By the end of 2013, Norwegian People’s Aid’s (NPA) support to Senegal’s national mine action authority, along with Mechem’s, NPA’s, and HI’s survey and clearance operations, greatly contributed to determining the few remaining areas contaminated by landmines.

Since 2003, the United States has provided more than $3.5 million in funding toward mine/ERW clearance, mine-risk education, capacity building, and eliminating small arms and light weapons stockpiles.

In FY2013, the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) provided $260,000 to HI to conduct non-technical survey in Senegal’s Casamance region in support of Millennium Challenge Corporation and U.S. Department of Agriculture road construction projects that will help develop the region. This project also supports ongoing U.S. efforts to broker a lasting peace in Casamance between the government of Senegal and the MFDC.

Somalia

As a result of two decades of civil war and internal conflicts, as well as periodic border conflicts with Ethiopia, Somalia is extensively contaminated with landmines and explosive remnants of war (ERW). Several years of U.S. humanitarian demining support have reduced the amount of contamination greatly in Somaliland and led to a reduction in mine accidents. Recent political progress, which led the U.S. to formally recognize Somalia’s government in January 2013, has increased security and improved the access of the U.S. Government and its implementing partners to affected areas in and around Mogadishu. However, the non-state armed group al-Shabaab, an al-Qaida aligned terrorist group, remains a threat to Somalia and the region. Al-Shabaab militants attacked a U.N. office in June 2013.

Supplied with abandoned stockpiles of arms and munitions found among civilian populations, al-Shabaab uses asymmetrical warfare, planting improvised explosive devices and conducting ambushes. Abandoned stockpiles of arms and munitions threaten civilian populations within Mogadishu and other major cities. Trafficking illicit conventional weapons is widespread, and illegal arms proliferation continues across Somalia’s porous borders in contravention of the U.N. Security Council’s arms embargo on the country. These unsecured weapons and munitions threaten Somalia’s civilian population and regional stability.

Date: 10/02/2014 Location: Somalia Description: HALO deminer in Somalia © Photo courtesy of HALO
A HALO deminer in Somalia conducts excavation from a signal located by a detector. The road he is clearing is located next to farmland. [Photo courtesy of HALO]

Through FY2013, the United States invested more than $18.9 million in conventional weapons destruction (CWD) programs throughout Somalia, though the bulk of this assistance was for humanitarian demining in Somaliland. Somalia received more funding outside of Somaliland for victim assistance and other programs, improving access to land and infrastructure, small arms and light weapons destruction and control, and man-portable air defense systems (MANPADS) stockpiles reduction.

In FY2013, the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) provided $3.92 million for CWD and physical security and stockpile management (PSSM) as follows :

Danish Demining Group conducted projects for MANPADS reduction and PSSM improvements.

The HALO Trust supported humanitarian mine clearance and MANPADS stockpile reduction projects as well as PSSM improvements, surveyed and re-surveyed suspected hazardous areas, and conducted mine risk education in Somaliland.

MAG (Mines Advisory Group) improved PSSM for Somaliland’s military, police, and maritime forces.

South Sudan

As a former part of Sudan, South Sudan has experienced the negative effects of war since 1956. Following Sudan’s independence from the United Kingdom and Egypt, South Sudan experienced more than two decades of civil war. These wars resulted in serious economic hardship, a lack of infrastructure development, major destruction, and the displacement of millions of people. Past and current conflicts have left a vast amount of landmines, explosive remnants of war (ERW), and small arms and light weapons (SA/LW) in South Sudan. Since South Sudan’s independence in 2011, tensions persist between Sudan and South Sudan. Inter-ethnic warfare and the presence of the Ugandan guerrilla group the Lord’s Resistance Army within South Sudan contribute to instability in the region. Landmines, ERW and an abundance of unsecured weapons pose a great risk to the safety, security, and development of vulnerable people in the world’s newest nation.

Date: 10/02/2014 Location: South Sudan Description: MAG secures the area - State Dept Image
In South Sudan, MAG secures the area and collects details. [State Dept. Image]

In the past, funds allocated for South Sudan were included in funding for Sudan. From 1993 to 2011, the South received a large majority of the more than $27.7 million provided to Sudan. Following its independence, South Sudan began receiving funds directly in FY2012. From FY2011 to FY2013, the United States invested more than $7.2 million in South Sudan for landmine and ERW clearance, victim assistance programs, improved access to land and infrastructure, and the destruction and procurement of SA/LW stockpiles.

In FY2013, the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) provided $2.5 million to South Sudan to support a combination of explosive ordnance disposal (EOD) and mine risk education (MRE) projects completed by these organizations:

• MAG (Mines Advisory Group) fielded one EOD and SA/LW integrated team assigned to the Greater Equatoria and Jonglei states.

• Norwegian People’s Aid provided three EOD and battle area clearance teams for the Greater Equatoria, Jonglei, and Upper Nile states.

In FY2013, U.S. Africa Command deployed military EOD personnel to South Sudan to conduct ERW disposal training. Training included ERW education and risk reduction, demining (survey, marking, mapping, landmine and unexploded ordnance disposal training, and quality assurance and control), first responder medical training with emphasis on blast trauma injuries, stockpile munitions assessments and training, and program assessment visits to monitor and improve all aspects of the ERW disposal program. Overseas Humanitarian, Disaster, and Civic Aid appropriation funded travel-related costs and supplies, equipment, and services expenditures totaling $459,000.

Zimbabwe

Zimbabwe’s (formerly Rhodesia’s) landmine contamination is a legacy of its independence war. Rhodesian Security Forces’ documentation indicates that they laid over 2.5 million anti-personnel (AP) mines and 76,000 AP fragmentation mines. Remaining contamination is estimated at 200 square kilometers (77 square miles) and comprises almost 600 linear kilometers (373 miles) along the Zimbabwe-Mozambique border. The Landmine and Cluster Munition Monitor reports that the National Demining Authority of Zimbabwe (NAMAAZ) estimates 1,550 people were killed and 2,000 people injured since the end of the war in the 1970s.

Since 1997, the United States provided more than $7.1 million to Zimbabwe to build NAMAAZ’s capacity through the equipping and training of multiple military engineer companies. With the United States’ support, Zimbabwe cleared and safely disposed of landmines and unexploded ordnance (UXO) and improved access to land and infrastructure. Of these funds, the Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) provided more than $3.8 million.

In FY2013 PM/WRA provided $500,000 in assistance to Zimbabwe to support minefield and battle area clearance, surveys of suspected hazardous areas, and mine risk education projects. The HALO Trust and Norwegian People’s Aid conducted these projects. These efforts help hundreds of Zimbabweans safely develop and live on previously contaminated land, immeasurably improving their lives.

Great Lakes Region

The Great Lakes Region of Africa has experienced decades of civil war as non-state actors and neighboring countries vied for influence in the region. The Great Lakes region is still plagued by a cross-border illicit market in small arms and light weapons (SA/LW) although most major armed conflicts in the area ended in the beginning of the twenty-first century. The porous borders between Democratic Republic of the Congo (DRC), Burundi, Rwanda, and Uganda facilitate arms smuggling, and the resulting illicit SA/LW trafficking poses a significant challenge to peace-building and stability in the region.

In 2000, governments in the Great Lakes Region and the Horn of Africa sought to address the SA/LW challenge by creating the Nairobi Protocol, a plan for legislative and civil action. This agreement established the Regional Centre on Small Arms in the Great Lakes Region and the Horn of Africa (RECSA) in June 2005. The center is located in Nairobi, Kenya, and coordinates regional activities aimed at reducing the illicit proliferation of SA/LW and implementing the Nairobi Protocol. RECSA member states comprise the 15 countries that signed the Nairobi Agreement including: Burundi, Central African Republic, DRC, Djibouti, Eritrea, Ethiopia, Kenya, Republic of Congo, Rwanda, Seychelles, Somalia, South Sudan, Sudan, Tanzania, and Uganda.

The Office of Weapons Removal and Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) has provided more than $2.2 million since 2006 to RECSA. These funds have purchased 26 marking machines, providing at least two for each RECSA member state, and funded two regional training seminars on SA/LW marking. More than 350,000 SA/LW have been marked with this equipment, and Rwanda and Seychelles have finished marking all police equipment. Recently, PM/WRA has directly supported weapons marking efforts in Burundi, Tanzania, and Uganda. PM/WRA funds also facilitated SA/LW destruction activities and workshops focusing on man-portable air defense systems (MANPADS) proliferation, arms brokering, and stockpile security. As a result, all RECSA member states have agreed to adopt MANPADS control guidelines .

In FY2013, PM/WRA provided $299,500 in funding to RECSA to directly support the deployment of partner nation weapons marking teams in Burundi, Tanzania, and Uganda, support member states with refresher training and spare parts for equipment, and strengthen RECSA as an institution through administrative capacity building.

Sahel Region

The plundering of Libya’s immense small arms and light weapons (SA/LW) stockpiles from the fall of the Qadhafi regime and porous borders in the Sahel region allow violent extremist organizations (VEO) to thrive and threaten the security and stability in the region. In late 2012, a few of these VEOs assumed control of almost half of Mali. French and African Union forces intervened to help Mali regain control. Another VEO carried out direct assaults in 2013 on stockpile facilities and infrastructure in Niger. These direct attacks, along with the increase in illicit SA/LW trafficking, threaten to undermine U.S. development, foreign policy interests, and counterterrorism efforts in the Sahel region.

In late 2013, the Office of Weapons and Removal Abatement in the U.S. Department of State’s Bureau of Political-Military Affairs (PM/WRA) supported Niger in its conventional weapons destruction efforts. The government of Niger conducted a national stockpile survey identifying sites for physical security and stockpile management (PSSM) improvements and for SA/LW and munitions to destroy. With support from the United States, the government of Niger identified sites and participants for PSSM training scheduled to begin in late 2014.

PM/WRA plans to increase engagement with Niger and expand assistance to additional Sahel countries in 2014. Increased national PSSM capacity and the reduction of SA/LW available for illicit trafficking contribute to U.S. peace and security efforts.

In FY2013, PM/WRA provided $2 million for conventional weapons destruction and PSSM in the Sahel region as follows:

• MAG (Mines Advisory Group) improved Niger’s PSSM capability, carried out destruction activities, and completed security and safety improvements to Nigerien stockpiles. PSSM projects for Chad, Mali and Senegal are scheduled to begin in 2014.

Other USG Support

The U.S. Department of Defense’s Defense Threat Reduction Agency (DTRA), U.S. Africa Command (USAFRICOM), and the Leahy War Victims Fund (LWVF) of the U.S. Agency for International Development provided additional support to other countries in Africa.

Date: 10/02/2014 Location: Burunida Description: Explosive remnants of war - State Dept Image
Boxes of explosive remnants of war awaiting disposal in Burundi. [State Dept. Image]

In September 2013, in coordination with the U.S. Office of Security Cooperation in Abuja, Nigeria, DTRA Small Arms Light Weapons (SA/LW) Program conducted two physical security and stockpile management technical seminars for the Nigerian Navy and Nigerian Army. These seminars, which were a follow-up to an April 2011 assessment of Nigerian armed forces ordnance depots, enhanced the host nation’s capacity to safely and securely store arms, ammunition, and explosives in accordance with international best practices. Twenty-nine members of the Nigerian Navy attended the first seminar and 28 members of the Nigerian Army attended second seminar.

USAFRICOM provided support to the following countries in FY2013:

Burundi: USAFRICOM deployed military explosive ordnance disposal (EOD) personnel to Burundi to conduct explosive remnants of war (ERW) disposal training. Training included ERW education and risk reduction, first-responder training with emphasis on blast trauma injuries, stockpiled conventional munitions assessments, and program assessment visits to monitor and improve all aspects of the ERW disposal program. Overseas Humanitarian, Disaster, and Civic Aid (OHDACA) appropriation funded travel-related expenses and supplies, equipment, and services (SES) costs totaling $322,000.

Chad: USAFRICOM deployed military EOD personnel to Chad to conduct ERW disposal training. Training included ERW education and risk reduction, demining (survey, marking, mapping, landmine and unexploded ordnance disposal, and quality assurance and control), first responder training with emphasis on blast trauma injuries, stockpile munitions assessments, and program assessment visits to monitor and improve all aspects of the ERW disposal program. The OHDACA appropriation funded travel-related expenses and SES costs totaling $384,000.

Kenya: USAFRICOM deployed military EOD personnel to the International Peace Support Training Center in Kenya to conduct ERW disposal training. Training included ERW education and risk reduction, first responder training with emphasis on blast trauma injuries, stockpiled conventional munitions assessments, and program assessment visits to monitor and improve all aspects of the ERW disposal program. The OHDACA appropriation funded travel-related expenses and SES costs totaling $70,000.

Namibia: USAFRICOM deployed military EOD and civil affairs personnel to Namibia to conduct infrastructure development for Namibian mine action agencies and ERW disposal training consisting of survey, marking, and mapping of ERW contaminated areas, landmine and unexploded ordnance disposal training, and quality assurance and control. The OHDACA appropriation funded travel-related expenses and SES costs totaling $151,000.

Republic of the Congo (ROC): USAFRICOM deployed military EOD and civil affairs personnel to ROC to conduct infrastructure development for ROC mine action agencies and ERW disposal training consisting of survey, marking, and mapping of ERW contaminated areas, landmine and unexploded ordnance disposal training, and quality assurance and control. The OHDACA appropriation funded travel-related expenses and SES costs totaling $371,000.

Tanzania: USAFRICOM deployed military EOD personnel to Tanzania to conduct ERW disposal training. Training included ERW education and risk reduction, demining (survey, marking, mapping, landmine and unexploded ordnance disposal, and quality assurance and control), first responder training with emphasis on blast trauma injuries, stockpile munitions assessments, and program assessment visits to monitor and improve all aspects of the ERW disposal program. The OHDACA appropriation funded travel-related expenses and SES costs totaling $274,000.

Finally, LWVF granted $1.2 million to the International Committee of the Red Cross Special Fund for the Disabled to provide prosthetics and other rehabilitation services to 23 centers in 17 sub-Saharan African countries. This is part of an ongoing $7 million effort in Africa .