The Venom of War in northern Uganda

Over a decade into relative peace in Northern Uganda, the memory and scourge of violent wars continue to re-victimize and to generate a series of unaddressed wartime ballistic trauma among victims and survivors, as well as conflict-affected communities more broadly. Such experiences entice me to rethink and reshape my understanding of transition from war to peace in terms of a broader spectrum of forced migration and transitional justice. We need better indicators than just the absence of physical fighting and the return of the formerly displaced persons (IDPs); to my thinking the latter have been fallaciously viewed by numerous stakeholders as indicating the return of peacefulness to post-conflict northern Uganda.

In July 2018 while preparing identified and profiled victims of untreated war injuries in Pader district for medical treatment and surgical repairs at St Mary’s Hospital Lacor, it was devastating to witness the pain the clients were going through. It was as if their injuries had just happened a few minutes ago. Those affected narrated how firearm injustices are a form of venom in the society and human body. They offered themselves as critical live examples of cases of victims whose flesh and bones were rotting as if they had been bitten by the most poisonous snakes:

"When I was still a healthy young boy, I used to laugh at dogs biting their skin and rubbing themselves on the ground when they are being feasted on by parasitic ticks but little did I even imagine that I will suffer a similar problem. The reality came to pass when I was shot by bullets and a bomb whose shells got retained all over my body. Constant pain and the itchy injury wounds and scars cannot allow me [to] have any breath and I scratch my body like an animal with multiple ticks on the body in order to attain some relief."

Such survivors’ appalling ordeals reveal that the journey towards sustainable peace building and healing in war ravaged northern Uganda is still marred with a multiplicity of pricking shellshock venoms. These make it complex to debate or draw a line between who is a victim and a survivor, or to pinpoint when, decades after the violation, a conflict-affected person transitions from the state of victim to the next (whether a survivor or a victor).

During the volatile days when violations and abuses of civilian rights were at their peak, surviving abduction, torture, body mutilation, gunshot, rape, witnessing or forceful participation in tormenting innocent civilian, as well as escaping from the rebel captivity were considered victories bigger than winning an election, lottery or the most prestigious award in life.

I guess that even today many people still think that, after violent war(s), winning the war or surviving alive means victory. Yet for many affected persons the end of hostilities marks the beginning of yet another war or even terror, encompassing struggles to repress or to deal with life-threatening unhealed physical war injuries, psychological and emotional shocks, psychosocial strains, and huge socio-economic burdens. Significant numbers view their survival ‘victories’ as a liability rather than an asset as they grapple with unending signs and symptoms - including what used to be termed ‘survivor guilt’ - that render them incapable of getting closure and obtaining peace of mind. Flashbacks and regrets about surviving the cataclysm in which their loved ones perished make it challenging to turn around the feeling and come to terms with their violent past. One 59 year old, who suffers from survivor guilt following the abduction of her children by the LRA, reflected as follows;

“I see no reason for living because my future was taken away by Kony. The rebels came at night and took away all my 8 children when I was seeing. I pleaded for their release in vain but instead they slapped me on the cheek with a machete. That was the last time I saw them. God should forgive me because I failed to save them from the hands of the killers and since that time in 2003, I remember it was a Friday, I never saw them again. I don’t know whether they are alive or not. If thought never kills me, I will personally kill myself because I feel I am responsible for their abduction because they had wanted to travel to Gulu town at their Uncle’s place for refuge on Friday but I told them to first prepare and leave on Saturday, but the misfortune befell them on Friday night. The tragedy of my children keeps tormenting me day and night. I always recollect my children crying for mummy’s help. I feel whether they are dead or alive they are blaming me from wherever they would be. I wish they had either abducted or killed me instead of my children”.

Further, some war victims also keep transmitting the poison of war to their children and grandchildren in the form of narratives, tears, pain, bitterness, suicide, and endless worries and grief. This is made worse when the elderly, who traditionally were resilient helpers and custodian of advice giving and social support to adults, youth and children, become victims of circumstances and need extra support because of the impact of violent insurrections.

Many trauma survivors to whom Refugee Law Project offers trauma counseling and preparatory sessions before accessing medical treatment in Lacor Hospital report daily doses of uncontrollable emotional and psychological pain. Traumatic war memories have become like a daily bread in their lives. Many sufferers feel as though the war is still active and endless, yet these beliefs are psychological symptoms of unresolved issues.

During numerous consultations with mental health and transitional justice practitioners in northern Uganda on transitional justice issues, post-conflict rehabilitation needs resurface again and again. There is wide-spread acknowledgement that this is a daunting problem across the conflict-affected communities. As one transitional justice practitioner remarked during one of the engagements;

“Survivor’s guilt is a real problem here. These people lack closure to make the difference between the past and current life. Many former child soldiers returned home with a lot of hopes that their safety and general wellbeing will be enhanced. They anticipated that when they return, medical support will be provided freely to them so that they heal, but only to find the opposite. Many are still living with bullets and other war remnants stuck in their bodies and others are suffering from different physical disabilities and vulnerabilities that are not attended to. They are not seeing any reparation or compensation coming, and we (stakeholders) keep them in false hope. Some hear that RLP has provided surgical support to 10 victims but they feel they are not being reached. JRP has provided livelihood support to a group of women and majority can’t access such support. Even the psychosocial counseling support approach cannot effectively help them heal because stakeholders are distant away from the victims/community thus other factors in the environment outweigh the counseling interventions. You counsel a victim for one or two hours and the rest of the hours, days and weeks, the person is predisposed to stigma and mass blame over past atrocities. Some support has also turned out to be a source of stigma - the community members feel their tormentors are being rewarded by NGOs or government yet they are the cause of their suffering. For these reasons, stakeholders should focus not only on the victims but the general conflict-affected communities if we want to combat survivor guilt and the rampant suicide”.

Pacification of war shocks should ideally begin with comprehensive rehabilitation of war damages in the lives and wellbeing of the affected people, and pursuit of post-violation justice needs so that people get to feel safe again, begin to enjoy their human rights again, and strive to lead dignified lives irrespective of the individual or collective impacts of the war suffered. Our experience suggests that comprehensive rehabilitation of war victims has enormous potential for addressing cross and trans-generational trauma with high potentials of promoting sustainable recovery and healing, reconciliation, reintegration, harmonious co-existence and sustainable peace building with self and others.

As such, I keep wondering; Why have national and international advocacy and public outcry for comprehensive rehabilitation policies and programs for post-conflict communities across Uganda are yet to yield any credible fruit, but initiatives for prosecuting alleged perpetrators of the violence such as the International Criminal Courts (ICC) and International Crimes Division (ICD) of the High Court quickly gained fame and operational capacity? This takes us back to the question of “whose justice?” (whether for the victims or perpetrators?) and whether to “prosecute crimes or right the wrongs?” committed. I am not praying for doom but rather throw a puzzle: what kind of judgement will happen if victims of injustices living with critical untreated war injuries and ailments die or are disabled to the point that they cannot stand in courts as witnesses to testify?

Culturally, the calmness of the land relied heavily on environmental indicators such as; the aroma and ambiance from trees and plants; birds singing and nesting around trees surrounding homesteads; beer parties and ceremonies conducted under cool trees after communal work; availability and proximity of medicinal trees/plants and forests for healing; hunting expeditions in communal forested hunting grounds reserved strictly for hunting and wildlife preservation.

Should psychosocial support practitioners adopt and adapt the legal strategy of internationalization of crimes such as “genocide”, “war crimes” and “crimes against humanity”? Should psychosocial and mental health jargons and paradigms have “mental health, psychosocial and medical problems of international nature”, “injury against humanity”, “psychosocial problem beyond social order”, “war trauma beyond human order” so as to gain national and international attention for urgent actions?

If we are to move in this direction, then the multiplicity of realities that has begun to unfold in post-conflict northern Uganda needs to be carefully and fully tracked to reshape programs and policy for conflict-affected people. The dynamics involved also need to be keenly followed up and taken into consideration. For example, feelings of reduced physical insecurity since the guns have fallen silent have gone hand in hand with feelings of reduced life expectancy given the daunting serious unaddressed war injuries (physical and psychological) that vividly manifest in almost all affected families in the region. With time, the body and the mind that absorbed the trauma during the insurgency are now beginning to unveil numerous realities, thereby giving the opportunity for the affected people to begin to evaluate and re-evaluate themselves more deeply than ever. The focus of interventions must also begin to change. Back then the focus was majorly on escape, survival, return and general stability of the land. However, today, the trajectory focuses more towards recovery, social cohesion and reintegration, healing, justice and development.

Sometimes I feel disempowered when over a decade into relative peace in northern Uganda, some war victims with severe untreated injuries asks for euthanasia or a “gentleman’s death” because they feel they have tried for more than ten years to persevere with the pain despite the fact that the Ministry of Health (MoH) has capacity to offer palliative care and treatment, and the potential to spearhead comprehensive rehabilitation and treatment for war victims across the country. It is sad to learn about war victims who have committed suicide because they could not access proper treatment and appropriate social support since the social system was also killed during the war. In terms of symbolic reparation, there exists a demand for support to cultural institutions; the shrines that were the heart of family and community truth telling, reconciliation and healing, and that were destroyed and burnt down during the violence, need rehabilitation. I also feel concerned when I see war victims today still cutting themselves with unsafe blades and applying local traditional herbs for pain relief. Seeing a war victim covering his/her damaged face in fear of stigma is a common phenomenon yet with appropriate treatment such as plastic surgery, such cases can recover self esteem and quality of life in dignified manner. I keep asking where are our policy makers and, now that the age limit discussions are over in the National Parliament, why don’t they embark on the long awaited Mental Health Bill and Transitional Justice Policy?

Lastly, I am optimistic that the war venoms and ballistic war traumas in northern Uganda can be properly addressed with appropriate research and interventions, as well as a community led process that fosters progressive participation of victims and the general affected populace. The RLP’s Beyond Juba Project (BJP) through the funding from The Democratic Governance Facility has proven the possibility by supporting medical treatment, surgical repairs and mental health and psychosocial rehabilitation of war victims in the region and the beneficiaries have gained significant quality of life, productivity, functionality and hope as they reestablish themselves in productive and gainful economic and social enterprises with realistic self esteem. The major challenge now is the lack of statistics for people disabled by the war and those that are still living with unhealed war injuries in conflict-affected communities across Uganda. The number can be overwhelming and shocking but the government and development partners should be able to accept the reality and devise appropriate strategies to repair the war ruins that have made many feel hopeless, helpless, desperate, destitute, disempowered, disabled, disgruntled, suicidal, angry, humiliated, shameful, blameful, guilty, stigmatized and worthless. Each of us needs to chose where we belong in terms of responding to the victim’s voices in this article: do we want to be or continue being bystanders - or would we rather be pragmatic change agents?

Remember in health, early identification and appropriate treatment of the said war venoms has higher positive long-term health outcomes than delayed or no response at all. Governmental and non-governmental stakeholders in Uganda need to urgently analyze the costs of war on affected individuals, family, community, national economy and the society as a whole so that people are able to acknowledge the differences and appreciate preventive strategies and non-violent ways of resolving conflicts. The burden of war on health indicators in the country needs to be researched and discussed to inform victim central planning, programming, policy formulation and budgetary allocations. No single strategy may be able to address the plights of war affected people in the region. Venturing into transitional justice could amplify comprehensive and integrative strategies involving identification and implementation of appropriate deliberate actions such as; reparation and rehabilitation, truth telling/commissions, memorialization, restorative and retributive justice, reconciliation, accountability, Amnesty and institutional reforms in the bid to address or respond to the impacts and legacy of violent conflicts, with the hope of envisioning sustainable peace and national reconciliation in Uganda