War In Northern Uganda Research Articles

Cango Lyec (Healing the Elephant): HIV Prevalence and Vulnerabilities Among Adolescent Girls and Young Women in Postconflict Northern Uganda.

Adolescent girls and young women younger than 25 years (AGYW) account for disproportionate HIV infections in sub-Saharan Africa. Impacts of war in Northern Uganda continue to affect HIV-related health and wellbeing of young people postconflict. Prevalence and incidence of HIV infection were estimated, and factors associated with HIV prevalence among sexually active AGYW in Northern Uganda were investigated. Cango Lyec is a cohort involving conflict-affected populations in Northern Uganda. Nine randomly selected communities in Gulu, Nwoya, and Amuru districts were mapped. House-to-house census was conducted. Consenting participants aged 13-49 years were enrolled over 3 study rounds (2011-2015), of whom 533 were AGYW and had ever had sex. Data were collected on trauma, depression, and sociodemographic-behavioral characteristics. Venous blood was taken for HIV and syphilis serology. Multivariable logistic regression determined baseline factors associated with HIV prevalence. HIV prevalence among AGYW was 9.7% (95% CI: 7.3 to 12.6). AGYW living in Gulu (adjusted risk ratio, aRR: 2.48; 95% CI: 1.12 to 5.51) or Nwoya (aRR: 2.65; 95% CI: 1.03 to 6.83) were more likely than in Amuru to be living with HIV. Having self-reported genital ulcers (aRR: 1.93; 95% CI: 0.97 to 3.85) or active syphilis (aRR: 3.79; 95% CI: 2.35 to 6.12) was associated with increased risk of HIV infection. The likelihood of HIV was higher for those who experienced sexual violence in the context of war (aRR: 2.37; 95% CI: 1.21 to 4.62) and/or probable depression (aRR: 1.95; 95% CI: 1.08 to 3.54). HIV incidence was 8.9 per 1000 person-years. Ongoing legacies of war, especially gender violence and trauma, contribute to HIV vulnerability among sexually active AGYW. Wholistic approaches integrating HIV prevention with culturally safe initiatives promoting sexual and mental health in Northern Uganda are essential.

Intimate Enemies and Intimate Allies: Land Conflicts and Microreconciliation After War in Northern Uganda

Land conflicts after war in northern Uganda have been given scholarly attention, often taking different directions. This article focuses on microreconciliation at the local level to unpack how people who returned to their ancestral lands are faced with the challenges of re-establishing intimacy after years of encampment during the war. Juxtaposing the notions of intimate enemies and intimate allies, I illustrate how intimacy and reconciliation may be difficult to achieve between families, clans and neighbours. Witchcraft accusations is not a new phenomenon but I show how accusations are used in new ways as strategies to outlaw and excommunicate others from customary land. Dividing land, another strategy to create closeness or distance between kith and kin is often seen as a solution to land conflicts even though it goes against the clan rules that used to govern Acholi society before the war.

Resilience among Children Born of War in northern Uganda

The literature on children born of conflict-related sexual violence, or Children Born of War (CBOW) is dominated by accounts and perceptions of suffering and risks that they experience both during and after armed conflict. In contrast, this article focusses on nuanced experiences of CBOW after suffering adversities. The study applies the culturally sensitive revised 17-item Children and Youth Resilience Measure (CYRM-R) to 35 CBOW conveniently sampled from a population of those born to former forced wives of the Lord's Resistance Army (LRA) and another population born between 1993 and 2006 as a result of sexual violence perpetrated by cattle raiders in northern Uganda. Following the analysis of the CYRM-R scores, eight participants representing different quartiles, different scores on the relational/caretaker and personal resilience sub scales were identified to take part in a subsequent semi-structured interview process. The aim was to examine how CBOW in northern Uganda demonstrate resilience, the factors that influence their resilience experiences, and what it means for the broader concept of integration. Overall, CBOW are not merely stuck in their problems; past and present. Rather, findings indicate CBOW are confronting the realities of their birth statuses, and making the best use of their resources and those within the wider environment to adapt and overcome difficulties.

The meaning of land and place for children born of war in northern Uganda

ABSTRACT The abduction and forced marriage of females was a key military strategy of the Lord’s Resistance Army (LRA) during northern Uganda’s civil war (1986–2007). Thousands of abducted girls became pregnant from sexual violence, giving birth to large numbers of children born of war. This article explores the experiences of 85 children born in LRA captivity, with a particular focus on the implications and meaning of both land and place. In the aftermath of the war, these children have been compelled to integrate into families and communities that often reject them because of their birth origins, identities, and former LRA affiliation. Facing multiple post-war challenges including poverty, and discrimination, many participants sought to retrace and reconnect with their paternal families to secure a better future. We highlight the important role of both land and place in the lives of children born in LRA captivity, particularly as it relates to belonging, social acceptance, and financial security. We conclude with a discussion of the potential risks and benefits of family tracing endeavors with children born of war in northern Uganda.

”The Third Time Janus Died”: Resilience and Dependencies In Coping With Adversity During And After Civil War In Northern Uganda

ABSTRACT This article critically explores how local notions of coping and resilience among former forcibly recruited children and youth in the war-affected Acholi region resonate with established conceptualisations of resilience in resilience research that primarily originate from a US context. Based on 12 months of fieldwork in urban and rural Acholi contexts, the analysis shows how poverty, corruption, and the presence of international humanitarian organisations in the urban context, create dependencies that diminish community resilience in the Acholi region. The findings call for optimising the balance between emic and etic perspectives in resilience studies as well as in humanitarian interventions.

“They Now Know That They Are Children of War”: Forcibly Abducted Mothers and Fathers Balancing Disclosure and Silencing to Their Children Born of War in Northern Uganda

In recent years, scholars have emphasized the need for a relational understanding of the impact of collective violence pointing to the myriad interconnections between individual and communal experiences and consequences. These interconnections are particularly strong in the (re)integration of formerly abducted children and youth, and their children born of war, since various social, relational and cultural processes play a key role in their wellbeing and healing. One example is the way in which trauma communication is shaped by culture and context, and intersects at the level of the individual and the collective. In this paper, we will explore how forcibly abducted mothers and fathers in post-conflict Northern Uganda perceive the trauma communication about the context in which their children born in forced captivity were conceived. Case study research was used to understand the dynamic trajectories of this trauma communication, placing parents' experiences within broader life histories, and the social and relational context. Repeated interviews were performed with six mothers and four fathers who became parents in forced captivity with the Lord's Resistance Army (LRA). Central in the participants' stories is their agency in the careful, individual choice “to be silent” or “not to be silent” toward their children, family and community members. However, these choices are shaped—and often restricted—by the relational and cultural context. A dynamic interplay of several factors, such as the age of the child, the emotional impact of disclosure, a lack of resources and support in the upbringing of children, identity and belonging, and perceived or potential future stigmatization are explored in this paper. Trauma communication can be seen as a socially negotiated choice, interacting in a complex dialectic relationship between silencing, disclosing, forgetting and remembering. As such, the study revealed important insights into post-conflict healing and reintegration in the day-to-day lives of formerly abducted children and youth, and their children born of war, on an individual and collective level.

The enduring consequences of conflict-related sexual violence: a qualitative study of women survivors in northern Uganda

BackgroundOne in three women in northern Uganda report having suffered from conflict-related sexual violence (CRSV), including forced marriage and rape. Research on the long-term effects of CRSV on the health and social well-being of survivors is scant, but crucial to informing policy and improving programs tailored to conflict-affected communities. Understanding women’s perceptions of and experiences with CRSV, especially related to the persistent health and social challenges they continue to face, is critical for developing effective and targeted interventions.MethodsWe worked with a local, survivor-led organization to recruit participants purposively from three post-conflict districts in northern Uganda: Gulu, Lira, and Pader. Women who had experienced CRSV and who were 18 years of age or older were eligible to participate. We asked participants open-ended questions about their experience with CRSV, including how it continues to affect their health and social well-being, any impact it had on their relationships, and if they faced barriers to accessing services. We transcribed, translated, and uploaded interview responses to the qualitative data analysis software MAXQDA and analyzed data thematically using a modified approach to grounded theory.ResultsWe conducted 30 interviews between October 2016 and March 2017. All participants reported experiencing forced marriage, rape, or forced pregnancy. Over two-thirds of participants said they continued to face physical and psychological issues, including untreated sexually transmitted infections, anxiety, and depression. Almost half of the women faced challenges with maintaining links with family members, stigma related to their experiences during abduction that also extended to their children born in captivity, and difficulty with accessing and affording health care. Barriers to seeking care included fear of disclosure and being unable to find services. Women identified peer-support from other survivors as a key coping mechanism.ConclusionsWomen survivors continue to face multifaceted health and social problems in the post-conflict period. Most health-related programs that were set up at the end of the war in northern Uganda are no longer available. Increasing access to care, particularly services tailored to treating chronic reproductive health issues and mental health, is paramount for women survivors in northern Uganda and other conflict-affected regions.

War and reintegration for girls and young women in northern Uganda: A scoping review

BackgroundDuring the civil war in northern Uganda (1986–2006), thousands of girls were abducted into rebel and government forces. Most of the females who were not abducted lived in abhorrent conditions in camps for internally displaced people (IDP). As the war was drawing to a close, reintegration programs emerged and some continue today. ObjectiveUsing a feminist lens, we conducted a scoping review to examine the literature written about these girls and young women. The impetus for this research was to determine the breadth of literature available; compare how this population is represented in the academic, practitioner and popular literature and to analyse how this representation may be impacting reintegration programming. MethodsKey words were entered into 14 academic databases, search engines and practitioner websites. Articles were included if they covered the recruitment, retention, return, and/or reintegration of formerly abducted and/or war-affected girls and women and if they were published between 2005 and 2019. A total of 112 articles were categorized and coded according to topics, themes and theoretical approaches. ResultsBased on the findings of this scoping review, it appears that many articles describe formerly abducted and war-affected young women from a deficit-based perspective, while relatively fewer articles are written with a strength-based, resiliency-focused lens. ConclusionBased on our analysis, we argue for a more nuanced representation of women formerly engaged with armed groups, and argue for a gendered, inclusive approach to reintegration programming.

Cango Lyec (Healing the Elephant): Chronic Hepatitis B Virus among post-conflict affected populations living in mid-Northern Uganda.

BackgroundThe legacy of war in Northern Uganda continues to impact people’s health and wellbeing in the Acholi region. Despite increasing attention to Hepatitis B Virus (HBV) in Uganda and globally, concerns remain that unique drivers of infection, and barriers to screening, and treatment, persist among those affected by conflict.MethodsCango Lyec (Healing the Elephant) cohort survey involved conflict-affected adults aged 13–49 in three mid-Northern Uganda districts (Gulu, Amuru and Nwoya). Baseline (2011–2012) samples were tested for HBV surface antigen (HBsAg), HBV e-antigen (HBeAg), antibodies to HBV surface antigen (HBsAb), antibodies to HBV e-antigen (HBeAb), and antibodies to HBV core antigen (HBcAb). All HBsAg positive samples were tested for IgM antibodies to HBV B core antigen (HBc-IgM) and where available, >6-month follow-up samples were tested for HBeAg and HBV DNA. Data were analyzed using STATA 15 software. Logistic regression accounted for variance due to complex two-stage sampling that included stratification, unequal selection probabilities and community clustering. Odds ratios measured effect potential risk factors associated with chronic HBV infection.ResultsAmong 2,421 participants, 45.7% were still susceptible to HBV infection. HBsAg seropositivity was 11.9% (10.9–13.0), chronic HBV was 11.6% (10.4–12.8), acquired immunity resulting from vaccination was 10.9%, and prior natural infection was 31.5%. Older age (OR:0.570; 95%CI:0.368–0.883) and higher education (OR:0.598; 95%CI:0.412–0.868) were associated with reduced odds of chronic HBV infection. Being male (OR:1.639; 95%CI:1.007–2.669) and having been abducted (OR:1.461; 95%CI:1.055–2.023) were associated with increased odds of infection. Among women, having 1 or 2 pregnancies (compared to none or >2) was associated with increased odds of infection (OR:1.764; 95%CI:1.009–3.084).ConclusionChronic HBV is endemic in Gulu, Amuru and Nwoya districts. Recommended strategies to reduce post-conflict prevalence include establishment of Northern Uganda Liver Wellness Centres, integration of screening and treatment into antenatal care, and roll out of birth-dose vaccination.

NTRK2 methylation is related to reduced PTSD risk in two African cohorts of trauma survivors

Extensive pharmacologic, genetic, and epigenetic research has linked the glucocorticoid receptor (GR) to memory processes, and to risk and symptoms of posttraumatic stress disorder (PTSD). In the present study we investigated the epigenetic pattern of 12 genes involved in the regulation of GR signaling in two African populations of heavily traumatized individuals: Survivors of the rebel war in northern Uganda (n = 463) and survivors of the Rwandan genocide (n = 350). The strongest link between regional methylation and PTSD risk and symptoms was observed for NTRK2, which encodes the transmembrane receptor tropomyosin-related kinase B, binds the brain-derived neurotrophic factor, and has been shown to play an important role in memory formation. NTRK2 methylation was not related to trauma load, suggesting that methylation differences preexisted the trauma. Because NTRK2 methylation differences were predominantly associated with memory-related PTSD symptoms, and because they seem to precede traumatic events, we next investigated the relationship between NTRK2 methylation and memory in a sample of nontraumatized individuals (n = 568). We found that NTRK2 methylation was negatively associated with recognition memory performance. Furthermore, fMRI analyses revealed NTRK2 methylation-dependent differences in brain network activity related to recognition memory. The present study demonstrates that NTRK2 is epigenetically linked to memory functions in nontraumatized subjects and to PTSD risk and symptoms in traumatized populations.

A combination of combat experience, early abduction, and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda.

Individuals who perpetrate violence may likely perceive violence as appealing and infliction of violence to derive pleasure is termed as appetitive aggression. Individuals who were abducted as children into an armed group often experience a higher number of traumatic event types, that is traumatic load and are usually socialized in a violence-endorsing environment. This study aims to investigate the interaction between age at initial abduction with that of traumatic load, and their influence on appetitive aggression along with perpetration of violent acts by former members of an armed rebel group of both sexes. Semi-structured interviews were conducted among a target group of formerly abducted rebel-war survivors (including participants with and without combat experience) from Northern Uganda. Participants included 596 women and 570 men with N = 1,166 (Mage = 32.58, SDage = 9.76, range: 18-80 years). We conducted robust linear regression models to investigate the influence of age at initial abduction, traumatic load, combat experience, and biological sex on appetitive aggression as well as their perpetrated violent acts. Our study shows, appetitive aggression and the number of perpetrated violent acts were specifically increased in individuals who were abducted young, experienced several traumatic events in their lifetime, and with previous combat experience. For perpetrated violence men showed increased levels whereas for appetitive aggression the association was independent of biological sex. Therefore, early abducted individuals with a higher traumatic load, who have combat experience, need to be given special intervention to prevent any further violence.

Cango Lyec (Healing the Elephant): HIV incidence in post-conflict Northern Uganda.

BackgroundCivil war in Northern Uganda resulted in widespread atrocities, human rights violations, and death, and caused millions to flee to internally displaced persons camps. War-related traumas combined with difficulties accessing HIV prevention and health services has led to extreme HIV-related vulnerability among conflict-affected people who survived the war. Objectives were to (1) determine HIV incidence among conflict-affected people in Northern Uganda and (2) identify vulnerabilities associated with HIV infection.MethodsThe Cango Lyec (Healing the Elephant) Project is a prospective cohort involving conflict-affected populations in three districts in Northern Uganda. In 2011, eight randomly selected communities were mapped, and a census was conducted. Consenting participants aged 13–49 years were followed over three rounds of follow-up. Longitudinal data collected included war-related experiences, sexual vulnerabilities, and sociodemographics. Blood samples were tested for HIV-1 at baseline and each 12-month follow-up. Multivariable Cox proportional hazard models determined factors associated with HIV incidence.FindingsOverall, 1920 baseline HIV-negative participants with at least one follow-up contributed 3877 person-years (py) for analysis. Thirty-nine (23 female, 16 male) participants contracted HIV during follow-up. Age- and gender-standardised HIV incidence rate was 10•2 per 1000py (95%CI: 7•2-14•0). Stratified by sex, the age-adjusted HIV incidence was 11•0 per 1000py (95%CI: 6•9-16•6) among women and 9•4 per 1000py (95%CI: 5•3-15•3) among men. Adjusting for confounders, factors associated with risk of HIV included: having been abducted (HR: 3•70; 95%CI: 1•87-7•34), experiencing ≥12 war-related traumatic events (HR: 2•91 95%CI: 1•28-6•60), suicide ideation (HR: 2•83; 95%CI: 1•00-8•03), having ≥2 sexual partners (HR: 4•68; 95%CI: 1•36-16•05), inconsistent condom use (HR: 6•75; 95%CI: 2•49-18•29), and self-reported genital ulcers (HR: 4•39; 95%CI: 2•04-9•45).InterpretationConflict-affected participants who had experienced abduction and multiple traumas during the war were at greater risk of HIV infection. Trauma-informed HIV prevention and treatment services, and culturally-safe mental health initiatives, are urgent for Northern Uganda.

Child tracing: locating the paternal homes of “children born of war”

ABSTRACT During the war in northern Uganda, thousands of women abducted as girls by the rebel group, the Lord’s Resistance Army, were released and escaped to return home, many with children born as the result of “forced marriage”. Most women and children no longer have contact with their children’s father by choice, because they are dead, or their identity is unknown. However, in some cases, mothers seek to identify and unite their children with their paternal clan. We consider the process of child tracing, present some of the reasons driving it, the diversity of cases involved and the challenges faced.

Preferences and Civil War in Northern Uganda: Post-Traumatic Growth Reconsidered

Abstract We exploit the largely exogenous character of abduction and displacement in northern Uganda during the recent civil war to estimate the effects of each on experimental measures of risk tolerance, altruism, trust and trustworthiness, as well as a survey measure of patience. Our analysis reveals the limitations of the ‘post-traumatic growth’ hypothesis. In most cases preferences are unaffected by these traumas and in the one domain in which we identify a significant effect, it is contrary to the hypothesis—people who were both abducted and displaced are 21 percentage points less likely to take a risk.

Place-making and the everyday lives of children born into the Lord’s Resistance Army

ABSTRACT After decades of war in northern Uganda, children born of forced marriage in the rebel group the Lord’s Resistance Army (LRA) struggle to feel belonging. Based on data collected through a longitudinal study in the urban centre of Gulu town in northern Uganda with 29 children born into the LRA, this article offers a way to understand why the children are stigmatized in the places of their everyday lives. Stigmatization in the local postwar context is defined as having a moral dimension in which the children embody the insecurity and immorality of the war. Drawing on their stories about school and church, the article argues that stigmatization of the children can be understood as a place-making mechanism in people’s efforts to reclaim former places of violence, which results in the children’s sense of exclusion. The article concludes with a reflection on the importance of research with children born of war.

Victimisation and challenges to integration: Transitional justice response to children born of war in northern Uganda

Uganda witnessed one of its worst conflicts between 1986 and 2007. The conflict in northern Uganda was between the government troops and the Lord’s Resistance Army (LRA). Serious crimes were committed against the civilian population. Women and girls were abducted by the rebels to serve as sex slaves and children were born as a result. After the conflict, these children’s integration has not been well received by their communities. It has not been properly addressed by the state operatives either. The children are dismissed as perpetrators of the conflict. Their return has been marred with stigmatisation and ostracism, forcing them to live on the margins of society. After the conflict, a National Transitional Justice Policy was passed. The overarching framework aims at addressing justice and reconciliation through inter alia social reintegration. However, it leaves an accountability gap. The framework largely departs from the needs of this particular community: acknowledging their existence and integration. The purpose of this article is to identify transitional justice opportunities and how these accommodate and advance accountability, integration and reconciliation in addressing victimisation concerns of the war children. Ultimately, it argues that addressing the abuses of the affected communities will ease social [re]integration.

Haunted Families after the War in Uganda: Doubt as Polyvalent Critique

ABSTRACT With a point of departure in a Ugandan grandmother’s questioning and critique of the state of continuing illness and misfortune in her family after the war in Northern Uganda, this article explores ideas about haunting, trauma and contagious connections in kinship. The article contributes to anthropological debates about hauntology, trauma, phenomenology and kinship. It provides a contribution to the hauntology discussion by pointing out how a phenomenological perspective can offer an indigenous polyvalent critique of kinship connections and larger political issues simultaneously. It argues against functionalist explanations of witchcraft beliefs, by drawing attention to the fact that doubt and uncertainty are central to these forms of knowledge, and therefore provide ‘not too dangerous’ ways of raising social critique. The article contributes to kinship studies, with a phenomenological perspective on the double dynamic of nutritious and poisonous connections in family relationships.

Geographical versus social displacement: the politics of return and post-war recovery in Northern Uganda

ABSTRACTThe civil war in Northern Uganda in the period 1986–2006 fundamentally altered former ways of life and created diverse and complex needs. Protracted conflict and displacement create, reveal, and enforce vulnerability, which can undermine resilience. Based on in-depth interviews with internally displaced persons and returnees, both before and after their return to Amuru District and Gulu District, this article argues that war and displacement constitute more than a temporary disruption. The physical and social wounds of war are engraved and embedded in people’s lives. Therefore, recovery interventions must take these effects into account to forge a new post-war future.

From disaster to devastation: drought as war in northern Uganda.

This paper proposes a shift from the concept of disaster to one of devastation when dealing with the destructive consequences of climate change. It argues that today, a discourse of climate-change disaster has become dominant, in which present disasters are seen as harbingers of a future of widespread climate disaster, products of a global nature in upheaval. The paper contends that one needs to go beyond the series of dichotomies that the climate-change disaster discourse relies upon: future/past, global/local, natural/social. To frame climate disaster as a product of global climate change, and conflict the product of those climate disasters, is to occlude the forms of environmental violence and experience of climate change among disaster-affected communities. Through an exploration of the drought in Uganda, the paper asserts that disaster should be understood as embedded within ongoing, longstanding, multiscalar processes of devastation produced by histories of human engagement with the environment, including that of war.

Justice and Post LRA War in Northern Uganda: ICC Versus Acholi Traditional Justice System

Justice and Post LRA War in Northern Uganda: ICC Versus Acholi Traditional Justice System