Mental Illness- New war in Northern Uganda
Jul 26, 2009
FIVE years ago, rebels of the Lord’s Resistance Army (LRA) raided Dorcus Aol’s village, 30km away from Lira. <br>The rebels cut off her sister’s ears and mouth and forced Aol to seek refuge at the nearby Te Dakatal Camp.
By R. Harshbarger and Bill Oketch
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FIVE years ago, rebels of the Lord’s Resistance Army (LRA) raided Dorcus Aol’s village, 30km away from Lira.
The rebels cut off her sister’s ears and mouth and forced Aol to seek refuge at the nearby Te Dakatal Camp.
Although Aol’s most glaring problem today is famine which has reduced her family to eating one meal a day, she is suffering from yet another problem — one almost invisible, but nearly as deadly— mental illness which is linked to the trauma she went through during the war.
“I cannot forget the atrocities caused by the LRA,†says Aol. “When I think about my problems, my head almost bursts.â€
When these haunting memories occur, her four children are helpless.
“I remove all the household items and dump them in the bush, including cooked food,†she says.
During these outbursts, she might force her children to take long walks with her, which strains them.
“Sometimes our mother forces us to move with her aimlessly,†says 11-year-old Patricia Aceng, Aol’s oldest daughter.
There is a general perception in Uganda that the most visibly “mad†people are men.
However, according to psychiatrists and researchers working in Uganda, the ratio of women to men suffering from mental illness is 1:1.
Women in northern Uganda have been particularly vulnerable to mental illness which is closely linked to trauma, sexual violence and poverty.
Psychology studies in northern Uganda indicate that cases of mental illness are much higher there than in other parts of the country and at international levels.
In 2005, Dr. Emilio Ovuga, the dean of students in Gulu University, released a study that compared mental illness in Adjumani, a war-affected district in northern Uganda, with Bugiri, a relatively peaceful district in eastern Uganda.
Ovuga’s study reported much higher rates of suicidal behaviour and depression in post-conflict areas.
According to a recent survey
conducted by a team of British and Ugandan psychiatrists at Gulu University, the rate of post-traumatic stress disorder (PTSD) is higher in northern Uganda than most other places in the world.
Out of 1,200 adults assessed by mental health doctors in Amuria and Gulu districts in 2006, 57% suffered from PTSD symptoms and 63% were afflicted with depression.
Psychiatrists say over two decades of war in the north have left people traumatised.
Dr. Tom Otim, the medical superintendent at Gulu Regional Referral Hospital, says staff shortages at hospitals have left overstretched doctors and nurses struggling to treat large numbers of in-coming patients, yet the services are already limited.
“It is very common to get just two nurses attending to a crowded ward in the hospital, because the patients are too many and the hospital now serves people from Southern Sudan,†says Otim.
She adds that drugs for mental illness are very expensive making it difficult to extend services to the villages.
At the African Centre for Rehabilitation of Torture Victims in Gulu, almost 2,000 cases of mental illness have been registered since 2007.
According to Kizito Wamala, a clinical psychiatrist at the unit’s trauma centre, most of the patients they treat frequently relive past horrors related to the war.
They suffer nightmares and sleeplessness, are easily angered and tend to avoid socialising.
The lack of resources for treating mental illness in northern Uganda has had a serious impact on people’s behaviour.
A 2009 study done in Gulu by Segame Musisi of people living with mental illness, revealed that 80% were seeking treatment from traditional healers, while 20% visited hospitals or clinics.
Five percent of those sampled said they had spoken with a mental health counsellor.
The percentage of those seeking help from traditional healers was much higher than those surveyed in a study done in Soroti, where 27% were treated by traditional healers, 32% sought religious healers, and 41% visited a hospital or clinics.
“With the few mental health facilities and high costs of treatment, many people turn to traditional or faith healers for mental health care,†says Dr. Mshilla Maghanga, a professor at Gulu University’s public health department.
Christine Alanyo is a traditional healer working in a village called Paweli, in Gulu District.
In her community, those suffering from mental illness pay her sh60,000 or give her a goat in exchange for treatment.
According to Alanyo, traditional healers believe that mental illness can be caused by crimes committed by one’s ancestors, over thinking, and malaria.
For malaria, Alanyo refers her patients to conventional doctors for treatment, but uses herbs and her relationship with spirits to treat the other causes of mental illness.
“The lower health units cannot manage patients with mental illness. It is only the regional hospital in Gulu that can do that,†says Alanyo.
That is why her patients seek her advice and attention.
Preparing for the mentally ill
Help the individual create a meaningful life. Regardless of the level of mental disability, every person needs to feel comfort and joy in their lives.
Spend time singing with or reading to them. Enjoy those tiny moments.
Create a happy and safe environment. Mental problems can cause a person to feel uncertain and frightened much of the time.
Develop a daily routine that is consistent and low in stress. Everyone can benefit from having a life that is in some measure predictable.
Give them the tools to develop their own creativity. This gives them a sense of pride and an outlet for their hopes, fears and passions.
Integrate them with others who have similar disabilities.
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FIVE years ago, rebels of the Lord’s Resistance Army (LRA) raided Dorcus Aol’s village, 30km away from Lira.
The rebels cut off her sister’s ears and mouth and forced Aol to seek refuge at the nearby Te Dakatal Camp.
Although Aol’s most glaring problem today is famine which has reduced her family to eating one meal a day, she is suffering from yet another problem — one almost invisible, but nearly as deadly— mental illness which is linked to the trauma she went through during the war.
“I cannot forget the atrocities caused by the LRA,†says Aol. “When I think about my problems, my head almost bursts.â€
When these haunting memories occur, her four children are helpless.
“I remove all the household items and dump them in the bush, including cooked food,†she says.
During these outbursts, she might force her children to take long walks with her, which strains them.
“Sometimes our mother forces us to move with her aimlessly,†says 11-year-old Patricia Aceng, Aol’s oldest daughter.
There is a general perception in Uganda that the most visibly “mad†people are men.
However, according to psychiatrists and researchers working in Uganda, the ratio of women to men suffering from mental illness is 1:1.
Women in northern Uganda have been particularly vulnerable to mental illness which is closely linked to trauma, sexual violence and poverty.
Psychology studies in northern Uganda indicate that cases of mental illness are much higher there than in other parts of the country and at international levels.
In 2005, Dr. Emilio Ovuga, the dean of students in Gulu University, released a study that compared mental illness in Adjumani, a war-affected district in northern Uganda, with Bugiri, a relatively peaceful district in eastern Uganda.
Ovuga’s study reported much higher rates of suicidal behaviour and depression in post-conflict areas.
According to a recent survey
conducted by a team of British and Ugandan psychiatrists at Gulu University, the rate of post-traumatic stress disorder (PTSD) is higher in northern Uganda than most other places in the world.
Out of 1,200 adults assessed by mental health doctors in Amuria and Gulu districts in 2006, 57% suffered from PTSD symptoms and 63% were afflicted with depression.
Psychiatrists say over two decades of war in the north have left people traumatised.
Dr. Tom Otim, the medical superintendent at Gulu Regional Referral Hospital, says staff shortages at hospitals have left overstretched doctors and nurses struggling to treat large numbers of in-coming patients, yet the services are already limited.
“It is very common to get just two nurses attending to a crowded ward in the hospital, because the patients are too many and the hospital now serves people from Southern Sudan,†says Otim.
She adds that drugs for mental illness are very expensive making it difficult to extend services to the villages.
At the African Centre for Rehabilitation of Torture Victims in Gulu, almost 2,000 cases of mental illness have been registered since 2007.
According to Kizito Wamala, a clinical psychiatrist at the unit’s trauma centre, most of the patients they treat frequently relive past horrors related to the war.
They suffer nightmares and sleeplessness, are easily angered and tend to avoid socialising.
The lack of resources for treating mental illness in northern Uganda has had a serious impact on people’s behaviour.
A 2009 study done in Gulu by Segame Musisi of people living with mental illness, revealed that 80% were seeking treatment from traditional healers, while 20% visited hospitals or clinics.
Five percent of those sampled said they had spoken with a mental health counsellor.
The percentage of those seeking help from traditional healers was much higher than those surveyed in a study done in Soroti, where 27% were treated by traditional healers, 32% sought religious healers, and 41% visited a hospital or clinics.
“With the few mental health facilities and high costs of treatment, many people turn to traditional or faith healers for mental health care,†says Dr. Mshilla Maghanga, a professor at Gulu University’s public health department.
Christine Alanyo is a traditional healer working in a village called Paweli, in Gulu District.
In her community, those suffering from mental illness pay her sh60,000 or give her a goat in exchange for treatment.
According to Alanyo, traditional healers believe that mental illness can be caused by crimes committed by one’s ancestors, over thinking, and malaria.
For malaria, Alanyo refers her patients to conventional doctors for treatment, but uses herbs and her relationship with spirits to treat the other causes of mental illness.
“The lower health units cannot manage patients with mental illness. It is only the regional hospital in Gulu that can do that,†says Alanyo.
That is why her patients seek her advice and attention.
Preparing for the mentally ill
Help the individual create a meaningful life. Regardless of the level of mental disability, every person needs to feel comfort and joy in their lives.
Spend time singing with or reading to them. Enjoy those tiny moments.
Create a happy and safe environment. Mental problems can cause a person to feel uncertain and frightened much of the time.
Develop a daily routine that is consistent and low in stress. Everyone can benefit from having a life that is in some measure predictable.
Give them the tools to develop their own creativity. This gives them a sense of pride and an outlet for their hopes, fears and passions.
Integrate them with others who have similar disabilities.