Summary of the impact

Armed conflict does not only result in death: injury and disablement as a consequence of political violence blights the lives of many and places demands on the public purse, yet is rarely researched. Limb loss, brain injury and psychological trauma is prevalent worldwide yet often ignored in communities ruptured by conflict and war.

The work of researchers at Surrey on the needs of the injured population as a result of armed conflict in Northern Ireland has provided the first comprehensive picture of an injured population and is being used to advocate at the regional and national level for a pension for those disabled in the Troubles and for improved services.

Underpinning research

The research was commissioned and funded by WAVE Trauma Centre and the Office of the Deputy First Minister for Northern Ireland. The evidence produced by the study has been used by submitting it to the relevant government departments in Westminster, the Northern Ireland Assembly and the Commission for Victims and Survivors Northern Ireland.

Researchers at Surrey (led by Professor Breen-Smyth) have compiled and analysed the first comprehensive database of deaths in the Northern Ireland conflict (Morrissey and Smyth, 1999 Northern Ireland's Troubles: The Human Costs, London: Pluto). The spatial and demographic distribution of deaths informed the design of a quota sample and Breen-Smyth conducted 50 in- depth interviews with a cross section of injured people, their carers, service providers and policy makers and a self-completion survey of injured people (N= 80).

A subset of filmed interviews led to a 60 minute documentary film and a video archive. Surrey researchers re-analysed survey data from the Cost of the Troubles Survey (conducted by Breen- Smyth in 2000) and data from the Northern Ireland Statistics and Research Agency's (NISRA) population survey Northern Ireland Survey of Activity Limitations and Disability (NISALD) to determine the prevalence and incidence of injury in the population.

The research was the first of its kind to focus exclusively on the population of injured people. The complexity of defining injury for the purposes of the study and for policy purposes was a key finding of the research. The research was designed to inform the policy development work of Northern Ireland Assembly's Office of the First and Deputy First Minister and that of the Commission for Victims and Survivors in Northern Ireland, as they design a new comprehensive service for victims and survivors of the conflict in Northern Ireland. The research examined the demographics of the injured population and injured people's experience of traumatic injury, health, social and psychological services, the justice system, Criminal Injury Compensation, disability services and voluntary victims groups. Further research on definition and methodology is planned in association with the Oxford Research Group.

The key research outputs for policy purposes were a 95,000 word full technical report on the research and a 10,000 word summary of the research, a 60 minute documentary film and a series of journal articles the first of which is "Injured and disabled casualties of the Northern Ireland conflict: issues in immediate and long term treatment, care and support", published in Medicine, Conflict and Survival Vol. 29, Iss. 3.

The research methodology and definitional frameworks used for this particular project is now being explored for its applicability to injured people in other conflict zones. It is envisaged that the research will be extended to field test core methodological assumptions in in Pakistan, the Palestinian Occupied Territory, South Africa and Northern Ireland.

References to the research

Details of the impact

To date, the research has been used to inform the development of a `one-stop-shop' approach to victims' provision; has led to a feasibility study of provision of a pension for victims of the Troubles; generated a discussion about definitions of injury which is now recognised as an area by policy makers and politicians that requires further research and consensus building; and has been used by the Campaign for All Injured conducted by the WAVE injured group, to advance the cause of all injured people. Mr Ian Paisley Junior, MP expressed an interest in attempting to arrive at a consensual definition of injury, although in order to succeed, work of this nature has to be cross-party in Northern Ireland.

The research was initially disseminated at a public lecture on March 8^th, at the University of Surrey, chaired and introduced by Baron Alderdice who made the following opening remarks:

"Marie brings very particular skills and approaches to her work. In politics, there is an interesting division between academics and practitioners... There were in Northern Ireland a small number of academicians who tried to engage with the reality of politics, Padraig O'Malley working out of Boston... and Marie working with people and communities who were going through very traumatic experiences... her work has been substantial and significant because she brings together the research side and the big P and small P of politics... She has relentlessly pursued the truth — this is a dangerous occupation and Marie has had to face on occasion considerable attack from people who were not at all happy about some of the things that were coming to the fore..." Recorded video of Baron Alderdice's opening remarks.

Surrey's research has influenced political debate and policy making as evidenced by:

1. Testimonial by the Research Officer at the Commission for Victims and Survivors setting out how the research findings will be used to as a reference point for decisions on the delivery of services for the injured and their families. The detailed research findings were presented to a meeting of academic advisors, the sponsors and representatives of the Office of the First and Deputy First Minister on Friday April 6^th, 2012 in Belfast.
2. Testimonial from Ian Paisley Jnr, MP, MLA who, following a meeting with him on 17th May 2012, at which he was briefed on the current study and the lack of a robust definition of injury has undertaken to support further research on this.

The influence of Surrey's research in the political sphere, led to the invitation to participate in further engagement, and in turn improving the public understanding of the issue:

1. A Policy briefing for the new Commission for Victims and Survivors when the new Victims' Commissioner took office, took place on 10^th December 2012 in Windsor House, Belfast.
2. The outputs of this research were presented, alongside a petition organised by the Campaign for Recognition of Injured People advocating improved services, to the relevant government ministries in Westminster and to the Northern Ireland Assembly on 17th May, 2012. This involved a meeting with Naomi Long MP in Portcullis House, Westminster, a meeting with Vernon Coaker, Shadow Secretary of State for Northern Ireland, Member of Parliament for Gedling, (Labour) a meeting with Lord Alderdice, Northern Ireland Member of the House of Lords, (Liberal Democrat) a meeting with Gavin Williamson, Permanent Private Secretary in the Northern Ireland Office, Member of Parliament for South Staffordshire,( Conservative) a meeting with Margaret Ritchie, Member of Parliament for South Down, SDLP, a meeting with Laurence Robertson , Chair of Northern Ireland Affairs Committee, Member of Parliament for Tewkesbury, Conservative.
3. The media campaign described in point 2 coincided with a Press Launch in the Limb Centre in Musgrave Park Hospital, Belfast where Professor Breen-Smyth presented the findings to the press.
4. A series of individual briefings and meetings for Westminster MPs took place in Portcullis House, attended by a range of MPs interested in conflict related injury or in Northern Ireland.
5. The work has also been disseminated at the June 2012 conference of the Royal Geographical Society.
6. An invitation was received from the British Red Cross to present the study at their London conference on resilience on 11^th April, 2013. This conference is aimed at community groups, voluntary organisations, university and government bodies and members of the public, who have an understanding of what conditions make individuals and communities more resilient. More at http://www.redcross.org.uk/resilienceconference

Sources to corroborate the impact

a) Convenor of the Liberal Democrat Parliamentary Party (Provided statement)

b) Chair of The Study Advisory Committee (Provided statement)

c) Ian Paisely Junior, MP (Provided statement)

d) Research Officer, Commission for Victims and Survivors (Provided statement)