Friday, May 28, 2010

Week 8 - The War Continues for Former Ugandan Child Soldiers

Location: Kampala, Uganda

This week, our School of Public Health lessons revolved around the subject of mental health in Uganda. By far, the most interesting lecture we received was on the subject of post traumatic stress disorder in former Ugandan child solders. As we learned, the forces of Joseph Kony’s rebellion movement, the Lord’s Resistance Army (LRA), have brought utter chaos and destruction to the region of northern Uganda. Over a period of roughly two decades, the LRA acted with what seemed to be a complete disregard for human life in its effort to overcome the Ugandan military. As explained by Derluyn, Broekaert, Schuyten, and De Temmerman (2004), this conflict had a significant impact on the lives of all the inhabitants of northern Uganda: “Tens of thousands of people have been killed and mutilated, hundreds of thousands displaced, and farming activities and livestock have been totally disrupted” (p. 861).

Though few in northern Uganda were left untouched by the hands of the LRA, perhaps the most detrimentally effected were the child soldiers used to fuel Kony’s campaign of terror; with more than 20,000 youths abducted to date, children comprise roughly 90% of all LRA recruits (Derluyen et. al 861).

Although a great deal of stability has come to northern Uganda in recent years, the conflict lives on in the minds of these child soldiers. Subject to sexual exploitation and abuse and forced to engage in the rape and murder of their loved ones, those children abducted by the LRA are at a monumental risk of developing a multitude of psychiatric disorders (Okello, Onen, and Musisi 225-226). Among the most common and problematic of the psychiatric disorders developed by these youths is posttraumatic stress disorder (PTSD). Defined as “an emotional illness that usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience”, those living with PTSD may find it extremely difficult to adjust to life after war (Muhwezi slide 24). In general, PTSD symptoms are grouped into three categories: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal.

Intrusive memories, or “recurrent re-experiencing” of trauma, represent one of the most troublesome symptoms of PTSD (Muhwezi slide 25). Constantly burdened with the images and sounds of acts that they witnessed and committed during wartime, former Ugandan child soldiers often experience great struggles in their efforts to look toward a new, peaceful future. In a Lancet article entitled “Post-traumatic stress in former Ugandan child soldiers”, Ilse Derluyen and colleagues outline the true prevalence of the intrusive memories symptom in LRA abductees. Out of a total of 71 respondents who completed the impact of event scale-revised (IES-R)—a self-report scale for PTSD— the mean score for the intrusion symptom was found to be 18.2 out of a maximum score of 28 (Derluyen et. al 862). Given their additional findings on the events witnessed by many child soldiers during periods of conflict, this high occurrence of intrusion may come as no surprise; Out of a sample of 301 former child soldiers, 77% had seen someone being killed during their abduction, 6% saw a member of their immediate family being killed, 39% had to kill another person themselves, and 2% had to kill an immediate family member (Derluyen et. al 861). As many former Ugandan child soldiers have had their social support networks disrupted by the very events that caused their PTSD, policy makers in the Ugandan government and humanitarian organizations must continue with their efforts to support a healing process so that former LRA abductees may cope with their painful intrusive memories in a healthy fashion (Muhwezi slide 31).

Thought the symptoms of posttraumatic stress disorder are indeed serious, a great deal of hope exists for former Ugandan child soldiers living with PTSD. One of the most effective tools in overcoming this devastating mental ailment is psychotherapy; by speaking with former child soldiers about their experiences as members of the LRA, mental health professionals can provide them with an outlet for emotions and memories that would otherwise go unexpressed. Additionally, further efforts are necessary to combat the stigmatization of child soldiers in those communities that have been devastated by the LRA. Though it may be difficult for many individuals in northern Uganda to greet the very child soldiers who killed their loved ones with open arms, the Ugandan government and the international community must work to spread awareness that these children were indeed forced to comply with Joseph Kony’s agenda.

References:
Derluyn, I., Broekaert, E., Schuyten, G., & De Temmerman, E. (2004) Post-traumatic stress in former Ugandan child soldiers, Lancet; 363: 861–63

Muhwezi, Wilson W. "Traumatization [Post Traumatic Stress Disorder – PTSD]
in Uganda." Introduction to Public Health: Module 4. Makerere University, Kampala, Uganda. 27 May. 2010. Lecture.

Okello, J., Onen, T, S., & Musisi, S. (2007). Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study. African Journal of Psychiatry. 10:225-231

No comments:

Post a Comment