Unexploded ordnance (UXO) including cluster bomblets (Figure 5) left behind after air strikes in Laos, including the Plain of Jars (Figure 6), is a very serious problem. These bomblets were designed as weapons to explode over time with some detonating immediately and others sequentially later. The surviving bomblets can explode when handled, making them a potential threat to military personnel and civilians. In effect, these UXOs function like land mines. In Vietnam, people are still being killed or maimed as a result of ordnance left by the Vietnamese and US military forces after the Vietnam War. Hundreds of people are injured or killed yearly by unexploded ordnance left from the Second Indochina

War [6] . In the 1960s and 1970s, 260 million cluster submunitions were dropped on Laos. One-third of these bomblets failed to detonate and continue to pose a danger [7] .

Cluster bombs are designed to spread smaller munitions over a wide area [8] . They are known as bomblets or submunitions. Cluster bombs can be launched from the sea or ground or dropped from the air releasing over a wide area hundreds of bomblets. They were previously used in World War II for the purpose of destroying combatants or multiple dispersed military targets.

When a cluster bomb is detonated, anyone in the area can be seriously hurt or killed. Many of the bomblets fail to explode immediately and annually can kill or injure people [9] . A significant number of bomblets do not detonate on impact. The submunition failure (dud) rate, according to the International Committee of the Red Cross, varies from 10% to 40%.

Use of these weapons during the Second Indochina War (Figure 7), resulted

in thousands, and sometimes millions, of highly unstable and unexploded submunitions [9] . Cluster munitions pose a potential danger to civilians living in areas (Figure 8) where cluster bombs were used. The cluster munitions that remain in the landscape are small, colorful and have unusual shapes. Unexploded bomblets appear to children to be toys (Figure 9) and curious children often pick them up and are killed or maimed [9] .

The editor of the 2022 Cluster Munition Monitor [9] , Loren Persi, said: “It is a terrible reminder of the dire need for rapid clearance of contaminated areas, age-appropriate education on the risks of unexploded bomblets, and greater dedicated support to the victims and their families. Children were the primary victims of cluster bombs.” In 2021, The Landmine and Cluster Munitions Monitor, a group that does research on behalf of the International Campaign to Ban Landmines-Cluster Munitions Coalition Civilians [9] , said: “that of 141 casualties from cluster bomb remnants, 97% were civilians, and two-thirds of those were children”.

One hundred and twenty-three countries are members of the Convention on Cluster Munitions since 2008 [9] . The 2010 international treaty bans the production, stockpiling, use and transfer of cluster munitions in all circumstances and requires relevant states to implement victim assistance measures.

Because cluster bombs (Figure 9) used released many bomblets over wide areas in Laos and Cambodia, they posed risks to civilians during and after the attacks. Unexploded bomblets have killed or maimed Laos and Cambodia civilians and other unintended targets more than 50 years after the war ended. Cluster munitions have been costly to locate and remove [9] . The failure (dud) rate of cluster bomblets during the Second Indochina War was approximately 40 percent.

A wide variety of bomblets were developed as cluster munitions during the Vietnam Era. Some on hitting the ground would send out trip wires and act as a mine exploding when stepped on. Others were fused to penetrate vehicle armor, but the majority were anti-personnel. Cluster bombs consist of a hollow shell canister (Figure 10) and contain up to 2000 submunitions or bomblets. The bomblets themselves may be fitted with small parachute streamers or retarders to slow their descent. This feature gave the aircraft time to leave the blast area [8] [10] . Anti-personnel cluster munitions use explosive fragmentation to destroy unarmored targets or kill troops. During the Second Indochina War, many thousands of tons of bomblets were dropped on Vietnam, Laos, and Cambodia [11] .

Cluster bombs pose a risk to civilians since they leave behind a wide area with many unexploded bomblets. The unexploded submunition can remain dangerous for decades after the end of a conflict. For example, cluster bombing of Laos (Figure 9) by the United States stopped in 1973; however, cluster munitions and other unexploded ordnance continue to annually cause between 50 and 100 Laotian civilian casualties [4] [5] [6] [7] .

During a 2016 visit to Laos, US President Barack Obama (Figure 11) said: “Given our history here, I believe that the United States has a moral obligation to help Laos heal.” He referred to America’s secret and devastating bombing of Laos during the Vietnam War in the 1960s and 1970s [12] . From 1996 to 2016, the US spent $100 million on the removal of unexploded ordnance and cluster bombs. President Obama proposed spending $90 million during the following three years [13] . President Obama stated that “Laos as the most heavily bombed nation in history. Eight bombs a minute were dropped, on average, during the Vietnam war between 1964 and 1973 - more than the amount used during the whole of World War II.”

The US Air Force dropped 260,000,000 bombs, equating to 2 million tons of ordnance during 580,344 bombing missions over Laos. Many targets were repeatedly struck as part of efforts to isolate North Vietnamese Communist forces in the south and north [12] . Anti-personnel cluster bombs were the most frequently dropped munitions. An estimated 30% to 40% of these munitions did not explode. Ten Laotian provinces (Figure 4) were described as “severely contaminated” by unexploded bombs. Mine-clearing agencies estimate that about 75,000,000 unexploded bombs and about 288,000,000 cluster munitions were left across Laos after the war. Cluster bombs scatter bomblets across a wide area and often fail to explode on impact [12] . They pose a significant threat to civilians because of both their deadly legacy and impact at the time of use. Launched, from the air or ground, cluster munitions consisted of shells that open and dispersed bomblets over a wide area. Many explosive bomblets, failed to detonate as designed, becoming landmines that indiscriminately maim and kill.

Long after a conflict ends, the unexploded ordnance poses a danger to civilians and is difficult to locate and remove. Children are attracted to the toy-like appearance of the bomblets and are at risk. The Convention on Cluster Munitions [14] banned the stockpiling, transfer and use of virtually all existing cluster munitions and required clean-up of unexploded bombs. The cluster munitions ban was adopted by 108 countries; however, it was not adopted by the US. Between 1995 and 2013, the United States spent as much on clean-up efforts in Laos as it spent in three days of bombing during the Second Indochina War. Laos is likely to ask for an extension to its commitment to find and destroy UXO. The number of casualties from air-dropped explosive devices, mostly cluster bombs, in Laos, since 1964, is estimated by the Landmine and Clustering Munitions Monitor [14] , to be approximately 50,000 Laotians. Of these about 21,000 were injured and 29,000 mostly civilian people were killed.

The threat posed by UXO stopped villagers from farming and idled vast tracts of agricultural land until they had been cleared of ordnance. [14] . President Obama’s 2016 announcement was welcomed by UXO aid agencies working to address the problem in Laos. These agencies include the Mines Advisory Group, Halo Trust, UXO Laos, Handicap International, and Norwegian People’s Aid (NPA). Simon Rea, the Mines Advisory Group country director, told the BBC “Before the president’s announcement I feared that the UXO operation in Laos would take hundreds of years” [13] [14] . After the President Obama’s Vientiane announcement Director Rea said “Now I am optimistic this can be reduced to decades”.

Likewise, Halo Trust CEO James Cowan said “The President’s announcement will have a profound effect on the Laotians. The president’s announcement is extremely good news for us and for poor families in rural areas whose lives are still blighted by UXO” [13] [14] . James Cowan said “It will help them live and farm their land in safety, as well as create opportunities for development and infrastructure. Explosive remnants of war have blighted their lives for far too long. It is a momentous step in Laos’s journey towards freedom from the deadly debris of war”.

Lucy Pinches, NPA Senior Advocacy and Research Advisor, told the BBC “Today more than ever we are getting a much better grasp of the scale of the contamination. We are using survey triangulation data to place contaminated land into blocks or boxes which can then be systematically cleared of cluster munition remnants” [15] .

Aid agencies can identify which areas of land, mostly the Ho Chi Minh Trail in the south, using newly available Pentagon bombing records. The Lao communist party headquarters in the north was bombed and likely also contain unexploded bombs. NPA Laos Country Director, Jonas Zachrisson, told the BBC that “More partnerships in the last couple of years among international clearance NGOs has greatly helped in pushing this process forward”. At the same time, he cautions that “much of the country remains unsurveyed with limited data regarding the extent, scope and nature of the problem”.

The first US president to visit Laos, President Obama, adopted a conciliatory approach. He said: “that the US bombings had destroyed villages and entire valleys, killing countless civilians”. His approach was welcomed by Laotian President Bounnhang Vorachit who enhanced mutual trust between the two countries after the devastating war. In return, President Vorchit promised, “the government will step up its efforts to locate and return US servicemen missing in the war (MIA’s)”. Since Chinese influence has grown in the region, President Obama has made improving relations with Southeast Asian nations a foreign policy priority [13] . Chinese investment is important to Communist Laos’ economy.

Lao People’s Democratic Republic (PDR) is responsible for significant numbers of cluster bomb victims and other survivors of explosive remnants of war (ERW). Lao PDR made commitments to provide victim assistance through Convention on Conventional Weapons Protocol V and victim assistance obligations under the Convention on Cluster [14] . Lao PDR ratified the Convention on the Rights of Persons with Disabilities (CRPD) on 25 September 2009.

PDR’s Action points based on findings [14] :

● “Intensify efforts to improve access to rehabilitation services from remote and rural areas, including allocating resources to bring beneficiaries for rehabilitation and ensuring that transport is available.

● Hold regular disability sector coordination meetings and link victim assistance coordination with the development of disability strategies.

● Improve state support for psychological and social assistance, including peer-to-peer counseling and survivor-driven economic activities.

● Coordinate the rapid implementation of recently adopted legislation as well as existing policies and planning that could hasten developments in the availability and accessibility of services”.

In 2015, a total of 42 casualties from unexploded bomblets and ERW were reported by the National Regulatory Authority (NRA) for the Unexploded Ordnance/Mine Action Sector in Lao PDR [14] . Of the casualties 39 were male and 19 were children [15] . By the end of 2015, The NRA had reported at least 50,612 mine/ERW including 21,082 injured and 29,530 people killed since 1964 [16] . Of the 21,082 injured, only 583 received a prosthesis. This is a huge shortfall. From 2008 to 2013, Lao PDR reported 702 victims, of which 41% were children [17] . Cluster bomblets caused 7628 casualties in the period 1964-2014 [18] . In 2012, Lao PDR estimated there were some 15,000 mine/ERW survivors still living, including approximately 2500 survivors of unexploded bomblets [19] .

Mine/ERW survivors [14] often come from ethnic minorities in the poorer remote areas of Laos PDR. The main barrier to accessing healthcare has been financial constraints. The healthcare system has remained underfunded, underdeveloped and health workers have inadequate training in treating these kinds of injuries. These shortcomings directly contributed to shortfalls in the quality of health system services [20] .

Lao PDR reported in 2014 that it still has: “a long way to go to provide support to survivors and their families. Beyond meeting their immediate emergency medical needs, very few survivors received adequate physical, psychological, or economic support” [21] .

Lao PDR reported “that there were limited resources available and that few donors made victim assistance a priority” [22] . As a result, Lao PDR could not pursue its Dubrovnik Action Plan for the time period through 2020 [23] . Lao PDR also noted that it “has a long way to go to fully achieve the victim assistance goals within the broader disability and development frameworks” [24] .

A NRA victim assistance strategic plan was adopted in February 2014. The strategic plan addresses seven sections of victim assistance implementation: “data collection; medical care; physical rehabilitation; psychological support and social inclusion; economic rehabilitation and education; legislation and policy; and coordination” [25] .

In support of the National Committee for Disabled and Elderly People (NCDE) and the victim assistance strategy the NRA [26] authorized:

● “develop a sector-wide strategy for persons with disabilities, including ERW survivors;

● cooperate with the Ministry of Labor and Social Welfare to ensure adequate vocational and other training is provided; and

● cooperate with the Ministry of Health to ensure that the physical and psychological needs of cluster munition victims and other survivors are more adequately met”.

In cooperation with COPE, the Ministry of Health provides orthotic and prosthetic services in Lao PDR under the Centre for Medical Rehabilitation and associated physical rehabilitation centers (Figure 12) [14] . Clients are reimbursed for travel costs and a small living allowance during their rehabilitation stay [27] .

In 2015, World Education and QLA provided vocational training and economic support specifically for survivors [14] [28] [29] . Survivors also received education scholarships through World Education. Laos Humanity and Inclusion (HI) initiated a project to support persons with disabilities, including survivors and their family members, with livelihood and income-generating activities [14] .