Introduction
The Transcultural Psychosocial Organization (TPO) Uganda is a Nonprofit Organization that started operations in Uganda in 1994 and is registered with the NGO Board of the Ugandan Ministry of Internal Affairs under license No. s 5914/1095. TPO became a local NGO in 2002 and only maintains parental linkages with its head office in the Netherlands. ITC has been partnering with TPO and TPO-Uganda since 2004. ITC, as the subject matter expert and primary content provider, has worked with TPO in each TPO country to design, train and evaluate such programs focusing specifically on child protection and women’s rights/gender-based violence. This country sheet is only one example of the programs TPO/ITC operated or continues to operate in Eastern Uganda.
ITC as the subject matter expert and primary content provider has worked with TPO in each TPO country to design, train and evaluate such programs focusing specifically on child protection and women’s rights/gender-based violence.
TPO specializes in providing psychosocial care to victims of conflict and manmade disasters in communities undergoing conflict as well as those in post conflict situations.
In Uganda, TPO has provided direct services to the refugees and national communities in the Westnile districts of Adjumani, Moyo, Arua and Yumbe districts. TPO uses a community based approach in delivering its service, with emphasis on building local capacity for self-help by working within existing community structures, beliefs, culture and traditional helping mechanisms. TPO trains and employs local paraprofessional ‘counselors’ that deliver services to those in need.
The problems that are assisted by the TPO network of community based helpers include emotional disturbance, trauma, depression and the breakdown in the normal functioning of an individual, family and community in armed conflict as well as the distress from loss of family bread winners through death, abduction and displacement, the risk of re-traumatization especially in camp conditions and the fear for re-abduction due to the lack of security of person.
TPO interventions are categorized into 3 thematic areas:
- Preventative Interventions – include community awareness raising and education workshops on common community problems e.g HIV/AIDS, domestic violence, conflict resolution/peace building, rape & defilement, alcohol abuse, life skills etc
- Curative & Rehabilitative Interventions – include psychosocial support and counseling to individuals, families and groups in difficult circumstances. In addition, TPO provides specialized psychiatric treatment to those that require medication.
- Capacity building interventions – include psychosocial skills training and provision of technical support for subcounty and district workers, Civil Society Organizations that want to mainstream and/or integrate psychosocial interventions in their programs. Training for community empowerment and self-reliance targets community leaders, teachers, women & youth leaders, and volunteers among others.
Background to the project
TPO is proposing to intervene in the districts of Soroti, Katawi and Kaberamaido located in Eastern Uganda, in April 2004. Acholi and Lango regions in Northern Uganda have suffered 17 years of armed rebellion perpetuated by the Lords Resistance Army (LRA). Local communities have been displaced and approximately 800,000 people have been living in camps for the past ten years. This conflict has brought untold suffering to the people of this region and its effects will definitely take a long time to heal. It is also estimated that over 10,000 children have been abducted since the war started and forced to fight alongside the rebels.
Since mid –2003, this fighting has escalated into the neighboring Teso region which is made up of mostly Soroti, Katakwi and Kaberamaido but Soroti district has suffered the biggest toll from this incursion by the LRA, with over 300,000 people displaced and living in temporary camps in Soroti. Schools have been displaced and many residents seek refugee in the city centre at night often referred to as ‘night stayers’
Unfortunately unlike the Acholi region, which has benefited from the presence of several NGOs supporting government in providing humanitarian assistance, the Teso region apart from the intermittent raids by the karamojong cattle warriors, has enjoyed relative peace and development and therefore interventions by humanitarian organisations were not justified. The district authorities are now faced with a sudden crisis that they cannot ably cope with on their own and even then lack capacity to do so.
Presently UNICEF and WFP are some of the notable UN agencies that have intervened in the provision of Water & Sanitation facilities, temporary education structures and food. Some Non food items have been donated by World Vision Uganda and the Red Cross Society.
Situational Analysis
TPO carried out a community psychosocial needs assessment in the districts of Katakwi, Soroti and Kaberamaido from January 19th – 24th 2004. The aim of the assessment was to gather information on the nature of psychosocial problems prevalent in these districts from the onset of the insurgency mid last year, so that TPO could design an intervention plan.
Again from the 22nd – 28th February, TPO participated in another needs assessment coordinated by UNOCHA and Unicef. This assessment was broader and covered wider sector areas of intervention beyond only psychosocial support. Organizations that participated in this assessment included TPO, CONCERN, DFID, Action Against Child Abuse and Neglect (AACAN), Christian Childrens Fund (CCF), Katakwi Childrens Voice (KCV) and Unicef. The district Probation and Social Welfare Officers also participated.
The findings below were common within both assessments.
Problems faced by children
Community members, leaders and NGO workers interviewed pointed out that trauma and post -traumatic stress, were the biggest problems faced by children due to the traumatizing events that were inflicted upon them by the rebels and by some witnessing traumatic events meted out by the rebels. The community social fibre as well as traditional support systems have been disrupted and in some cases completely broken down. Children are forced to live in camps and this coupled with the poor living conditions in the camps has increased the risk of re-traumatization.
The other most frequently mentioned problems in order of severity were; rape, defilement, child marriages, high school dropout rate, inadequate health care, juvenile delinquency, child abuse and neglect, child pregnancies, child labor hired out by parents in urban IDP camps, alcohol and drug abuse and high infant mortality rates.
Community responses to these emerging issues
The assessments reveal that no efforts have been made to address the above problems and no outside agencies have intervened.
Children who were abducted and rescued are not receiving any structured psychosocial support in the community. On return from the ordeal of captivity/abduction, they are yet again faced with problems in their families such as domestic violence, physical abuse, inadequate food. Consequently these children are presenting emotional symptoms of trauma; bedwetting, nightmares, withdrawal, argumentative to mention a few.
The community responds by forcing girls to marry boys when they fall pregnant and by forcing girls to return to school. They suggest that sensitization and education might help resolve this situation.
There has been a negative trend in social relations. This is due to the sharing of housing and children being exposed to family members having sexual relations. It was also observed that sexual relations between minors is said to be common and is increasing due to exposure to adult sexual behavior. Child marriages were very common in all the sites visited.
Children are not attending school due to a lack of scholastic, materials, disobedience, young girls falling pregnant, parents encouraging girls to stay home to look after young ones and to look for food in villages.
Consequently there is lack of respect for the elderly. Camp leaders as opposed to clan leaders now attend to domestic issues.
Problems related to protection of women and girls
There were no protection committees in most sites visited. LC I committees at the village level can carry out protection activities. The camp leaders explained that if they were taught/sensitized, they could establish protection committees and activities.
The principal protection problems affecting children are; sexual harassment, intercourse and irresponsible behavior with the UPDF/Arrow group, rape, forced child marriages, unwanted pregnancies, high risk of contracting HIV/AIDS, management of menstruation ( heavy/painful – possibly stress related)
Principal protection problems affecting women; domestic violence, men not taking up responsibilities of family and management of menstruation.
Community responses to these emerging issues
There is a high risk of delinquency as a big number of children is dropping out of school. Parents often force the young girls to stay home and look for food and the older girls are discouraged from attending school since many of the parents wish to marry them off.
Parents are venting out their frustration and inability to meet their family responsibilities on children. Child abuse is notably high and cases of domestic violence especially men beating their wives are very rampant.
As a result it was not surprising to note that about 30-50% of women are being deserted by their men and leaving the women the responsibility of looking after the children.
Prostitution and irresponsible sexual behavior especially among the girls and some women is increasingly becoming common. In the search for food, comfort and protection, girls are increasingly being lured into sexual relations with soldiers and men. Apart from parents trying to advise their daughters to not have sexual relations, generally there is no health education being carried out to prevent this. There is increased vulnerability to HIV/AIDs, teenage pregnancies and delinquency resulting from the irresponsible sexual behavior described above.
Intervention strategies
TPO rationalizes that whilst the humanitarian responses described above are ongoing, there is an urgent need to complement this with interventions that will mitigate the impact of the conflict on the psychological and mental well-being of the affected communities.
The aim of the proposed interventions in the short run, will be to build the resilience of the affected populations especially women and children to cope positively in the midst of the civil strife and suffering that they are experiencing, in the absence of the social support systems.
For example families that have directly suffered from the conflict in form of loss of breadwinners, abduction of their children will be supported to cope in the absence of the normal family and community support systems.
Children who have suffered trauma and been rescued from captivity will be counseled and supported to cope with the camp situations which could easily increase the risk of re-traumatization.
Programs that impart children and youth with life skills vital for their development will be undertaken to strengthen their resilience and ability to cope positively with social strife, stress, frustration, missed opportunities for school and displacement from their normal home environment.
Recreation, drama and sport activities will be started and child friendly spaces for play established in the communities.
Sensitization and education on common social problems noted in the situational analysis will be organised especially for children and women. Topics will include reproductive health, HIV/AIDS, child rights and protection, peace building to mention a few.
TPO will also embark on a systematic process of building local capacity to provide psychosocial care to people in the camps, and the night stayers in towns. TPO will work closely with local CBOs e.g AACAN (Action Against Child Abuse and Neglect), Katakwi Childrens Voice local CBOs that run reception centers in Soroti and katakwi, with the aim of strengthening and creating linkages between the centers and TPOs community based approach in family tracing, reunion and eventual resettlement. TPO has already trained 16 social workers from both AACAN and KCV aimed at building their capacity to provide psychosocial care at the reception centre.
Gradually as peace and security return to most areas, TPO will embark on rebuilding the traditional community and family support systems, working with elders, local leaders at the subcounties, health workers, teachers, CBOs and district departments etc with the aim of undertaking family reunification, reintegration and building local capacity to provide long term psychosocial rehabilitation.
ITC as the subject matter expert and primary content provider has worked with TPO in each TPO country to design, train and evaluate such programs focusing specifically on child protection and women’s rights/gender-based violence.
International Trauma Center 