Beyond Modern Science: Ryemo Gemo (Chasing Away Evil Spirits), Tradition and Faith during the COVID-19 Pandemic among the Acoli in Northern Uganda

Suicide is a public health problem in Uganda among indigenous societies, and different societies manage its aftermath differently. To explore how the Acholi in Northern Uganda manage the aftermath of suicide. We conducted a qualitative study in Gulu district, a post-conflict area in Northern Uganda. We conducted a total of four focus group discussions (FGDs) and 12 key informant (KI) interviews. KI interviews were conducted with community leaders, while the FGDs were conducted with members of the general population. We analysed the data by means of Grounded Theory. Our findings indicate that rituals form a large part in managing suicide among the Acholi. Study communities practised distancing (symbolically and physically) as a way of dealing with the threat of suicide. Distancing was organized into two broad themes: affect regulation and securing future generations. It is recommended that public health interventions should utilize cultural institutions in the prevention of suicide.

BackgroundAccording to World Health Organization (WHO) estimates, 80 % of the population living in rural areas in developing countries depends on traditional medicine for their health needs, including use during pregnancy. Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited and that some herbal products may be teratogenic, data on the extent of use of herbal medicines by women during pregnancy in the study setting is largely unknown. We determined the prevalence and factors associated with herbal medicine use during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda.MethodsThis was a descriptive cross-sectional study which involved 383 women attending postnatal care across four sites in Gulu district using quantitative and qualitative methods of data collection. A structured questionnaire was used to collect quantitative data while qualitative data were obtained using focus group discussions and key informant interviews. The selection of the study participants was by systematic sampling and the main outcome variable was the proportion of mothers who used herbal medicine. Quantitative data was coded and entered into a computerized database using Epidata 3.1. Analysis was done using Statistical Package for Social Scientists version 13, while thematic analysis was used for qualitative data.ResultsThe prevalence of herbal medicines use during the current pregnancy was 20 % (78/383), and was commonly used in the second 23 % (18/78) and third 21 % (16/78) trimesters. The factors significantly associated with use of herbal medicines during pregnancy were perception (OR 2.18, CI 1.02-4.66), and having ever used herbal medicines during previous pregnancy (OR 2.51, CI 1.21-5.19) and for other reasons (OR 3.87, CI 1.46-10.25).ConclusionsThe use of herbal medicines during pregnancy among women in Gulu district is common, which may be an indicator for poor access to conventional western healthcare. Perception that herbal medicines are effective and having ever used herbal medicines during previous pregnancy were associated with use of herbal medicines during current pregnancy. This therefore calls for community sensitization drives on the dangers of indiscriminate use of herbal medicine in pregnancy, as well as integration of trained traditional herbalists and all those community persons who influence the process in addressing the varied health needs of pregnant women.

Since mid 1990s, Uganda has had an estimated 1.6 million internally displaced persons (IDPs) in the northern and eastern districts. A major cause of morbidity and mortality amongst children in displaced settings is protein energy malnutrition. To estimate the prevalence of and describe the risk factors for protein energy malnutrition among under five years old children living in internally displaced persons camps in Omoro county Gulu district. This was a cross sectional study undertaken among internally displaced people's in Omoro county, Gulu district during 13 - 23(rd) September 2006. Anthropometric measurements of 672 children aged 3 - 59 months were undertaken and all their caretakers interviewed. The anthropometric measurements were analyzed using z-scores of height-for-age (H/A) and weight-for-height (W/H) indices. Qualitative data were collected through 6 focus group discussions, key informant interviews and observation. Data were captured using Epi Data version 3.0 and analyzed using EPI-INFO version 3.3.2 and SPSS version 12.0 computer packages respectively. ResultsThe prevalence of global stunting was found to be 52.4% and of global acute malnutrition 6.0%. Male children are at risk of being stunted Adjusted OR 1.57 95% CI 1.15-2.13; p value=0.004. Children in the age group 3 - 24 months were at risk of acute malnutrition Adjusted OR 2.78 95% CI 1.26-6.15; p value=0.012 while de-worming was protective Adjusted OR 0.44 95% CI 0.22-0.88; p value=0.018. The main sources of foodstuff for IDPs include food rations distributed by WFP, cultivation and purchase. There is high prevalence of protein energy malnutrition (stunting) among children in the internally displaced people's camps in Gulu district. Male children are at an increased risk of stunting while children aged between 3 - 24 months are at an increased risk of suffering from acute malnutrition. Stakeholders including local government and relief organizations should intensify efforts to improve the nutritional status of IDPs especially children in the camp settings. The quantity of and access to household food supplies, health education on infant and child feeding and integrated management of childhood illnesses (IMCI) activities in the camps should be strengthened.

CDC planning trial for mysterious nodding syndrome

The study, Conspicuously Absent: Women’s Role in Conflict Resolution and Peace Building in Northern Uganda in the Context of United Nations Resolution 1325. The research was carried out in war ravaged Acholi sub region covering the districts of Amuru, Gulu, Kitgum and Pader because they are located in the centre of Northern Uganda conflict between the Government and the rebels commonly known as the Lord’s Resistant Army (LRA). The main objective of the study was to locate women in conflict situations and assess their contribution. The study methodology is qualitative and builds upon a review of related literature, oral interviews, questionnaires and focus group discussions with men and women who participated in the study. The major research finding reveals that women played a big role in peace building and conflict resolution, but their involvement remained unrecognized. Worst still, the northern Uganda women appeared not linked with the growing number of women led initiatives internationally, nationally and sub-national levels. The lack of recognition of women’s roles makes women invisible actors in peace processes taking place in northern Uganda. The study concludes that including women in the formal peace process, while not a goal in itself, is symbolic and significant step in the promotion of women’s justifiable participation in peace building and conflict transformation processes. The study makes recommendations to enhance women’s capacity to contribute to peace processes formally and informally. Key words: Conflict mitigation, conflict resolution, gender, resolution 1325, peace-building, Lord’s Resistant Army (LRA), sub- region.

As increasing international and local efforts focus on scaling up access to antiretroviral treatment (ART) in sub-Saharan Africa the United Nations High Commissioner for Refugees (UNHCR) Medecins Sans Frontieres and the Joint United Nations Program on HIV/AIDS have increasingly advocated that the lack of essential medicines in conflict settings including ART is a violation of human rights. HIV infection and armed conflict are disproportionately represented in sub-Saharan Africa with women and children experiencing the largest burden of harms and adverse health outcomes due to both HIV infection risk and impact of conflict. Given emerging disparities in access to ART among HIV-positive women in conflict zones there is an urgent need to reconsider the impact of conflict on HIV infection. Importantly recent evidence suggests that there may be a protective effect of armed conflict on HIV prevalence as a result of reduced mobility and urbanization disruption of sexual networks and decreased casual consensual sex. At the same time substantial evidence suggests an increased vulnerability to HIV in conflict settings among women and children due to widespread human rights violations rape as a weapon of war forced occupational exposure the need for women to turn to sex work to support themselves and their families (i.e. survival sex) and reduced access to HIV prevention and reproductive health services. Regardless inequitable access to ART scale up in conflict zones suggests a need to re-examine the complex relationship between conflict and HIV infection. (excerpt)

This study examines the historical relationship between land conflicts and Balaalo factor in Northern Uganda from 1986 to 2023. The qualitative research and historical design was adopted in the study. Data was collected using key informant interviews, focus group discussions, and in-depth interviews with community members, district administrators, non-Balaalo migrants, and Balaalo pastoralists. A sample size of 155 participants was interviewed. These included; the Balaalo (15), non-Balaalo migrants (15), cultural leaders (05), local area politicians (10) as key informants, and the local community members (110) from the three respective districts. The findings reveal a complex interplay of socio-political, economic, and cultural factors shaping land disputes and Balaalo’s involvement in the region. The historical land dispossession of Balaalo pastoralists, within and outside Uganda, and the political and economic shifts, triggered their migration and settlement in Northern Uganda. Elite Balaalo, leveraging ethnic, political, and military connections, are key actors in land acquisition and resource exploitation in the region, exacerbating tensions with local communities. This study highlights the need for comprehensive reforms in land governance, community dialogue, livelihood diversification, law enforcement, cultural sensitivity, and sustainable development planning to address underlying causes of land conflicts and promote peaceful coexistence in the region

BackgroundUses of indoor residual spraying (IRS), long-lasting insecticidal nets (LLINS) and treatment with artemisinin-based combination therapy (ACT) are greatly promoted in the northern part of Uganda as mitigating strategies for malaria episodes. Unfortunately, the region remains the fourth highest malaria burden in Uganda with a prevalence of 12%. This study assesses household predictors of malaria episodes in northern Uganda and their impact on malaria episodes at the household level.MethodsA cross-sectional study was conducted in four districts of Gulu, Oyam, Kitgum and Agago covering sixteen villages in northern Uganda. Data was collected through a pre-tested structured questionnaire and systematically coded for analysis using R software.ResultsIn total, 193 households were surveyed with 112 (58%) of them headed by women and 605 individuals were declared to have spent the night before the interview in the 193 households. On average, there were at least two-bed nets (317/159) per household and a total of 460 individuals out of 535 (86%) spent the night before the interview under a bed net. The usage of bed nets in the study area overall was 86% while malaria incidence was 50% higher in children than in adults. Hierarchical clustering on principal components (HCPC) categorizes households in northern Uganda into three types: 1) households that use bed nets and sleep in houses sprayed with insecticides; 2) households that use bed nets but no indoor residual spraying with insecticides and 3) households that have no bed nets and no indoor residual spraying. When given a choice between IRS and treated bed nets, 1 in 3 households preferred treated bed nets. At the same time, data suggests that bed nets were perceived as unnecessary once the IRS was applied. If true, the driving force for spraying insecticides indoors then becomes the lack of a bed net.ConclusionsMalaria episodes were strongly related to lack of bed nets or use thereof, and directly linked to the number of individuals in a household. Children were prone to malaria more than adults by a ratio of 2:1. The three categories of households in northern Uganda as revealed by HCPC provide an opportunity to tailor-make preventive/intervention malaria messages to fit the individual household clusters.

This article presents a qualitative study conducted in Gulu district, northern Uganda, in 2018 and 2019 on peacebuilding through early childhood care and education. The aim of the study was to understand the roles played by the parents and early childhood development institutions in promoting peacebuilding traits in children, which is not the norm in evidence-based studies and literature. The study was framed by the ecology-of-peace framework, the root causes or justice theory and the sociocultural theory. The study was exploratory, cross-sectional and descriptive in nature and adopted two non-probability sampling techniques, namely purposive and convenience sampling. Semi-structured primary source data were collected through key informant interviews. Other sources of data were four non-participatory observations of children in three centres and document reviews of the Ugandan National Integrated Early Childhood Development Policy and its action plan, lesson plans and the curriculum. The findings indicate that many of the core parental roles fulfil the requirements for successful peacebuilding through early childhood care and education approaches, yet have gone unnoticed in peacebuilding and early childhood care and education. The role of early childhood care and education complement that of parents in preparing children to be better citizens. Recommendations are directed to stakeholders to support early childhood care and education.

The study recognised that conflicts threaten human security in various ways. When prolonged, for example, they have a direct damage on physical infrastructure such as medical and educational facilities. Using a qualitative research approach, the study focused on Gulu district in Northern Uganda, to unearth the threats to human security as a result of the protracted Lord’s Resistance Army (LRA) conflict. The data collection methods included: Focus Group Discussions, Interviews and Document Review. Samples of 44 participants were purposively identified. From the field findings, it was discovered that the dimensions of human security threatened by conflict ranged from personal, health and community security. The study recommended that there needs to be a deliberate effort in the post-conflict period to rehabilitate infrastructure especially schools and hospitals while counselling services should be supported to mitigate the psychological effects of the conflict.

The study acknowledged economic security as part of the wider security conceptions especially in human security. Using the case of the Lord’s Resistance Army (LRA), the study brought to light the costs of conflict on economic security particularly in Gulu district, Northern Uganda. It adopted a qualitative approach and relied on primary data collection methods (Interviews, Focus Group Discussions and observation) to assess how conflict affected economic security. Field findings revealed that the conflict had tremendous effects on economic security ranging from destruction of property and loss of assets, reduction in production and persistent poverty among others. The study recommended that the government should deliberately target the most vulnerable groups for training and skilling as well as capitalization of income generating projects.

BackgroundThere is continued reliance on conventional veterinary drugs including anthelmintics, to some of which resistance has developed. Loss of indigenous technical knowledge (ITK) from societies affects the opportunities for utilization of ethnopharmacological practices unless properly documented. This study was conducted to identify common traditional practices using medicinal plants against helminthosis and other livestock diseases in Mpigi and Gulu districts of Uganda.MethodsSeven focus group discussions with ten farmers per group plus 18 key informant interviews were held in each district from August to November 2011. Ranking was used to quantify disease burdens and to identify priority livestock and breeds. Samples of each plant were submitted to Makerere University herbarium for identification and documentation. The local name, relative availability and International Union for Conservation of Nature (IUCN) status were recorded.ResultsSeventy six farmers in Mpigi and 74 in Gulu were interviewed. Theileriosis and helminthosis were the most common disease conditions in cattle and goats, respectively. Forty plant species within 34 genera from 22 botanical families were identified, with 20 of these used against helminthosis. Other plants treated wounds and ecto-parasites, theileriosis, retained placenta and bovine ephemeral fever. Non-plant practices (7) and plants cited were used in combination depending on availability. Males older than 40 years had most ethnopharmacological knowledge. Most plants (75%, n = 40) were common, but 10 were rare. IUCN status was not evaluated for 95% of these plants. Conventional and traditional drug use in Gulu and Mpigi districts was different (χ2 = 24; p < 0.001). The scientific, English, Luganda and Acholi names of all plants and their availability within the communities are documented herein.ConclusionThis is the first detailed livestock-related ethnopharmacological study in Gulu district. Farmers in Uganda are still using a variety of practices to treat livestock ailments. Scientific validation and evaluation of conservation status are urgently needed to ensure future availability and knowledge about these plant resources.

The study focused on the use of green charcoal, a sustainable cooking fuel made from agricultural residues, in Gulu District, to highlight the experiences households have encountered, from a gender perspective. The study followed a cross-sectional design using qualitative approach which included the use of one-on-one interviews, focus group discussions, key informant interviews, and ethnographic observations for data collection. The findings show that households in Gulu District use a combination of cooking fuels such as firewood, wood charcoal, green charcoal, or gas. Furthermore, the study established that there were cases where both men and women had shared experiences in cooking, for example, knowledge of the faster cooking rate, cleanliness, and much ash content involved while using green charcoal. However, to a larger extent, there were gendered differences in cooking activities: while women predominantly handle cooking, men often influence decisions about what and how to cook, revealing underlying gender and power dynamics within households. Key findings indicate that green charcoal is favored for its affordability relative to traditional black charcoal, prolonged burn time, and higher heat output, though it is also harder to light and produces more ash. It is particularly popular in rural Owoo Sub-County, where residents are more involved in its production compared to their urban counterparts in Gulu City. The study concluded that positive experiences with green charcoal have facilitated its adoption and recommends further actions to promote its use. These include increasing awareness of its environmental, health, and financial benefits, improving product quality, and involving women and girls as advocates to expand its utilization

Aims1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda.Study DesignThis was a cross-sectional study.Place and Duration of studyDepartments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012.MethodologyFour (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence.ResultsA total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower psychosocial competence. Factors significantly associated with non-use of alcohol were high levels of self-confidence, non-use of cannabis and kuber and age. In the alcohol user groups, a high level of coping was associated with discontinued and experimental use of drugs of abuse.ConclusionMore than two-thirds (70.1%) of young people in this study had ever used substances of abuse only once and slightly over a third had used it regularly. From the perspectives of service provision, mental health promotion and prevention of illicit substance use, school mental health programmes that target both non-users and users are recommended.

There is widespread consensus on the critical importance of addressing protection and promotion of the rights of the girl child. However, girls still bear the worst human rights abuses during armed conflict and after. This study assessed the nature of sexual violence, and its effects on and the coping mechanisms of girl mothers. Empowerment theory was used to provide a theoretical framework to inform the study. During July 2007, three focus group discussions were conducted with girls aged 15–17 years who had children born in captivity in Gulu District, Northern Uganda. Twenty key informant interviews were conducted with practitioners and opinion leaders. In addition, data were collected on the girls’ experiences, specifically abuse during and upon return from captivity.