Trauma Survey of Patongo

Network for Africa works with local partners in Patongo, in the north east of Uganda, an area that was devastated by conflict for over two decades. Patongo hosted tens of thousands of refugees and was regularly raided by the brutal Lord’s Resistance Army (LRA) during a war that lasted for 22 bloody years.  The war reached into every hut and every family, with devastating results.

Thousands were killed, millions were displaced, and the LRA abducted more than 50,000 children, forcing them to be soldiers, porters and sex slaves.

• 95% of 16-35 year olds forced to hide from LRA.
• 91% of 36-45 year olds witnessed killing.
• 82% of people over 45 years old have been tortured.

Almost everyone was forced to abandon their farms to live in dismal and squalid refugee camps, where they have been for more than 20 years. The war stopped only recently and while many international NGOs have been and continue to be active in Gulu to the west, Patongo was largely neglected, as it was deemed to be too dangerous.

At the end of 2010 Network for Africa’s partners in Patongo undertook a confidential survey of individual stakeholders to get a complete picture of people’s experiences during and since the war, and to properly measure the scale of the resulting needs. It was felt that Network for Africa and its partners would be better able to respond to local needs if we had an accurate picture of what aspects of the war individuals had experienced, what types of violence had touched their families, and how they now felt about their lives and the future.

The survey was compiled by Constantine Odong, who is a well-respected community leader in Patongo, and who leads Network for Africa’s projects in the area. Mr Odong drew on similar needs assessments done by Médecins Sans Frontières and other international NGOs. He also consulted Dr Barbara Bauer, a qualified psychotherapist, who has led four workshops in Patongo, training local leaders to become lay counsellors. Working with Dr Bauer, Mr Odong has created a network of volunteer outreach counsellors (OCs) who work within their community, helping survivors understand and manage post-traumatic stress.

Before starting the survey, Network for Africa’s OC team underwent specific consultation to ensure they were satisfied that the questions were culturally appropriate for both sexes and all ages. The team was also given training in how to conduct the survey in a confidential manner without causing re-traumatisation.

Altogether 237 interviews were conducted, and results were analysed by age group and sex. Interviewees were asked about their experiences since 2004, and about their current psychological wellbeing. Interviewees were asked to respond based on their feelings within the past seven days.

Survey Findings

Young people

The largest cohort (114 interviewees) was the 16 to 35 year old group. The survey findings indicate that the war had a direct and brutal impact on almost every individual in a very personal manner. What emerges is a picture of a society in which people have been crowded together in a camp, defenceless, unable to escape the random attentions of the rebels, and constantly vulnerable to attack, torture, rape and worse. Their circumstances left them with no options to avoid the ongoing war that surrounded them. They had no resources with which to move away or protect themselves. That the war lasted 22 years explains the deep level of lingering trauma reported by half the population.

It is clear that the war reached into every hut and family: 100% of males and 92% of females reported being forced to hide. Additionally, 63% reported that they had been tortured or physically abused, while 81% had witnessed someone being tortured or abused, and 71% had witnessed a killing. Of those interviewed, 83% had experienced the disappearance or abduction of a family member, and almost everyone had been obliged to hide for long periods of time to avoid being abducted by the rebels.

Perhaps most horrifying, 25% had been forced by the rebels to kill someone, or to be killed. There was a notable disparity between the sexes, with 35% of men admitting they had been forced to kill someone, as opposed to 17% of women.

Given this disturbing history of violence very close to home, it is not surprising that those interviewed have negative feelings about their lives, themselves and their prospects. All questions about interviewees’ current situation asked them to answer based on their feelings within the past seven days. Those questioned reported feelings of worthlessness and loneliness, with 29% admitting to feeling suicidal regularly or always. Of the 16-35 age group as a whole, 40% felt hopeless about the future, while 47% of females felt hopeless regularly or all the time. This reflects the lack of development and resources in the area, and the failure of their material living conditions to improve since the war has moved elsewhere.

Of the 35% who found difficulty sleeping, the figure rose to nearly half (47%) of all women interviewed. It can be posited that people who have grown up expecting violence and danger at any moment are unlikely to quickly adapt to a relative lack of danger. It is also suggested that women have an understandably acute fear of rape and gender-based violence, with good reason.

Alcohol abuse emerges as a persistent worry to those interviewed. 52% interviewed reported problems caused by the excessive drinking of a family member regularly or always. 21% admitted that their own excessive drinking led to regular problems.

The 36 – 45 age group

This cohort consisted of 72 people, and it is apparent that since 2004 they have been exposed to even greater violence than their juniors. Among men, 91% witnessed killing, 88% witnessed torture, 86% were themselves tortured and 34% of men admitted they had been forced to kill someone.

Of this cohort, 45% reported that someone in their family had died as a result of domestic violence. Of the men who were interviewed, 37% admitted they felt suicidal regularly or always, compared to 27% of women. 66% of men in the age group said they felt hopeless regularly or all the time compared to 26% of women. There was also a disparity between the sexes in measuring those who have trouble sleeping, with 31% of men reporting problems regularly or always, compared to 24% of women. It should be noted that this age group, while feeling as depressed and hopeless as their juniors, were able to sleep better. However, they reported the same degree of problems with alcohol.

Those aged 45 and older

The experiences of the 51 people who were interviewed in this age group were generally not markedly different from the younger members of their community. However, a comparatively low 10% reported they had been forced to kill, compared to 34% or 35% of younger men. The cumulative effect of exposure to violence over such a long period resulted in 41% reporting that they felt hopeless all the time or regularly; and 47% admitted they had trouble sleeping.