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Mental Health in Post-War Northern Uganda Journal of Peace and Security Studies Editors: Lioba Lenhart, Editor-in-Chief Institute of Peace and Strategic Studies (IPSS), Gulu University [email protected] Susan Reynolds Whyte, Co-editor Department of Anthropology, University of Copenhagen [email protected] Published by: Institute of Peace and Strategic Studies Gulu University P. O. Box 166, Gulu – Uganda About the Journal The Journal of Peace and Security Studies (JPSS) is a peer-reviewed electronic and print journal, published by the Institute of Peace and Strategic Studies (IPSS), a multi-disciplinary academic institution at Gulu University in Uganda. The Journal reflects the multi-disciplinary focus of the Institute and publishes articles in the social sciences and humanities, broadly defined to include anthropology, sociology, political science, history, psychology, law, conflict and peace studies, religious studies and environmental studies. Articles that cut across disciplinary boundaries are particularly welcome. Uganda is a key regional focus for the Journal, but contributions from the whole East African region and beyond are encouraged as well. The Journal actively seeks to publish studies that can help to develop a broader comparative perspective on issues related to conflict, peace building, post-war reconstruction and human security in Eastern Africa and beyond. JPSS is published periodically. Volumes/numbers devoted to specific topics and edited by invited guests alternate with miscellaneous volumes/numbers. Acknowledgement IPSS and the editors of JPSS would like to thank the Danish Research Council for Development Research and the research project ‘Governing Transition in Northern Uganda: Trust and Land’ (aka ‘TrustLand’) jointly implemented by IPSS, the Department of Culture and Society of Aarhus University and the Department of Anthropology of the University of Copenhagen for financial and scholarly support. Colophon Title Journal of Peace and Security Studies (JPSS) Editorial Board Editor-in-Chief: Lioba Lenhart, Institute of Peace and Strategic Studies (IPSS), Gulu University, [email protected] Co-editor: Susan Reynolds Whyte, Department of Anthropology, University of Copenhagen, [email protected] Special numbers will have guest editors Key words Conflict, post-conflict, peace building, post-war reconstruction, human security, northern Uganda, Uganda, Eastern Africa Publisher Institute of Peace and Strategic Studies (IPSS), Gulu University Address: P.O. Box 166, Gulu, Uganda Language English (UK) ISSN Print: ....... Online: ...... Charge Free (for the on-line version) URL http://www.jpss.ug File format HTML (text/html), PDF (text/pdf), JPG (image/jpg), GIF (image/gif) Cover page and Lioba Lenhart, IPSS, Gulu University & Jeffrey Opiyo, Link Printers, Gulu, Uganda layout Website design Jeffrey Opiyo, Link Printers, Gulu, Uganda and maintenance +256(0)777500138, www.linkprinters.com Printed by Link Printers, Gulu, Uganda +256(0)777500138, www.linkprinters.com The views expressed in articles are the views of the authors and not necessarily those of the editors, publisher or Gulu University. Copyright © 2016 JPSS and the Authors Journal of Peace and Security Studies Volume 2, Number 2, August 2016, Special Issue Mental Health in Post-war Northern Uganda Guest Editors: Lioba Lenhart & Susan Reynolds Whyte Editorial Note Lioba Lenhart, JPSS Editor…………………………………………………………….... 2 Mental Health in Post-war Northern Uganda: Introduction Lioba Lenhart & Susan Reynolds Whyte, Guest Editors……….....................………….. 3 Mental Health Perceptions and Human Rights in Post-conflict Northern Uganda Kamila Krygier................................................................................................................... 6 Measuring PTSD: Circumstances, the Language of PTSD, and Prolonged States of Disorder in Northern Uganda Sung-Joon Park……........................................................................................................... 22 Forgiveness: Psychodynamic Considerations and Their Implications Adrian Sutton………………………………………………………………..................… 38 Ambiguous Void: Experiences of Loss among Families of the Missing Abductees in Northern Uganda Kamilla Bjørkøe Jensen & Mia Jess…......................……………………………………. 52 The Quest for Treatment. The Violated Body of Nodding Syndrome in Northern Uganda Karin van Bemmel......…………………………………………………………………… 63 Notes on Contributors......……………………………………………………………… 79 2 JPSS, Vol. 2, No. 2, August 2016 Editorial Note The Journal of Peace and Security Studies (JPSS) is a peer-reviewed electronic and print journal, published by the Institute of Peace and Strategic Studies (IPSS) of Gulu University, Uganda. The Journal reflects the multi-disciplinary focus of the Institute and publishes articles in the social sciences and humanities, broadly defined to include anthropology, sociology, political science, history, psychology, law, conflict and peace studies, religious studies and environmental studies. Articles that cut across disciplinary boundaries are particularly welcome. Uganda is a key regional focus for the Journal, but contributions from the whole East African region and beyond are encouraged as well. JPSS is published periodically. Volumes/numbers devoted to specific topics and edited by invited guests alternate with miscellaneous volumes/numbers. Acknowledgement This Special Issue of JPSS (JPSS Volume 2, Number 2) on mental health in post-war northern Uganda is edited by Lioba Lenhart from the Institute of Peace and Strategic Studies/IPSS, Gulu University and Susan Reynolds Whyte from the Institute of Anthropology, University of Copenhagen, who have collaborated in the context of the ongoing research project ‘Governing Transition in Northern Uganda: Trust and Land’ (aka ‘TrustLand’) jointly implemented by IPSS, the Department of Culture and Society of Aarhus University and the Department of Anthropology of the University of Copenhagen. IPSS and the editors of JPSS would like to thank the contributors as well as the peer reviewers, who have to remain anonymous, for their great commitment and excellent work. Our sincere gratitude goes also to the Danish Research Council for Development Research and the TrustLand Project for financial and scholarly support. Lioba Lenhart, JPSS Editor-in-Chief Institute of Peace and Strategic Studies, Gulu University, Uganda JPSS, Vol. 2, No. 2, August 2016 3 Mental Health in Post-war Northern Uganda: Introduction Guest editors: Lioba Lenhart Institute of Peace and Strategic Studies, Gulu University, Uganda Susan Reynolds Whyte Department of Anthropology, University of Copenhagen, Denmark The two-decade war between the Lord’s Resistance Army (LRA) and the Government of Uganda (1986-2006) in the northern part of the country has taken its toll on individuals, as well as society. Tens of thousands of children and youth were abducted and recruited into the ranks of the LRA. Civilians suffered extreme forms of violence, killings, rape and mutilations. Ultimately, some ninety percent of the population of northern Uganda was forced to live in camps for Internally Displaced People (IDP). Today, after ten years of peace, the people of northern Uganda still have to cope with their difficult past. The significant rate of mental illness in post-war northern Uganda, which is among the highest worldwide (Businge 2008), can be attributed to the prolonged experience of war, internment, continuous poverty and lack of future prospects (Ssebunnya et al. 2009). Yet the weakened health care system does not recognise mental health as a priority (Kagolo 2012, Kigozi et al. 2010). Many people suffer from posttraumatic stress disorder, anxiety disorder, depression, bipolar affective disorder and schizophrenia. Substance abuse and alcoholism are widespread. The suicide rate is particularly high among young people (cf. Deleu & Porter 2011, Okudi 2014, Owich 2015, Pham et al. 2009, Roberts et al. 2008, Tumwebaze 2014, Vinck et al. 2007). Although reports and figures demonstrate the desolate situation of mentally ill people in northern Uganda, the state budget for health care and services is still insufficient to finance adequate programmes (Kigozi et al. 2010). Society lacks knowledge and understanding of the problems of mentally ill people, who are confronted with prejudice, stereotypes and stigmatisation every day. Many mentally ill people have become victims of abuse, neglect and exploitation. Families and relatives are overwhelmed and do not know how to cope with the tremendous physical and emotional demands. They sometimes restrain their mentally ill family members for hours, days, weeks and even months so that they can carry out their everyday work such as cultivating the fields, but also to protect the mentally ill from danger. Moreover, many neighbours react in a hostile way, because they fear the ‘weird and strange behaviours’ of the mentally ill, and even discriminate against family members who help care for them. Persistent abuse and stigmatisation in the workplace and school force mentally ill people to leave employment and education, which in turn reinforces the already high level of poverty among them (MDAC & MHU 2014a). Only a few people resort to biomedical psychiatric care. Mental illness is often associated with spirit possession or attributed to past offenses. For this reason, traditional healers who cast out spirits are in many cases the first and often the only ones addressed for help. Others use services provided by Christian churches such
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