176 research outputs found
War related sexual violence and it's medical and psychological consequences as seen in Kitgum, Northern Uganda: A cross-sectional study.
No full textBACKGROUND: Despite the recent adoption of the UN resolution 1820 (2008) which calls for the cessation of war related sexual violence against civilians in conflict zones, Africa continues to see some of the worst cases of war related sexual violence including the mass sexual abuse of entire rural communities particularly in the Great Lakes region. In addition to calling for a complete halt to this abuse, there is a need for the systematic study of the reproductive, surgical and psychological effects of war related sexual violence in the African socio-cultural setting.This paper examines the specific long term health consequences of war related sexual violence among rural women living in two internally displaced person's camps in Kitgum district in war affected Northern Uganda who accessed the services of an Isis-Women's International Cross Cultural Exchange (Isis-WICCE) medical intervention. METHODS: The study employed a purposive cross-sectional study design where 813 respondents were subjected to a structured interview as part of a screening procedure for an emergency medical intervention to identify respondents who required psychological, gynaecological and surgical treatment. RESULTS: Over a quarter (28.6%) of the women (n = 573) reported having suffered at least one form of war related sexual violence. About three quarters of the respondents had 'at least one gynaecological complaint' (72.4%) and 'at least one surgical complaint' (75.6%), while 69.4% had significant psychological distress scores (scores greater than or equal to 6 on the WHO SRQ-20). The factors that were significantly associated with war related sexual violence were the age group of less than or equal to 44 years, being Catholic, having suffered other war related physical trauma, and having 'at least one gynaecological complaint'. The specific gynaecological complaints significantly associated with war related sexual violence were infertility, chronic lower abdominal pain, abnormal vaginal bleeding, and sexual dysfunction. In a multivariable analysis the age group of less than or equal to 44 years, being Catholic and having 'at least one gynaecological complaint' remained significantly associated with war related sexual violence. CONCLUSION: The results from this study demonstrate that war related sexual violence is independently associated with the later development of specific gynaecological complaints
Editorial: Mass trauma and mental health in Africa
No full textNo Abstract Available
African Health Sciences Vol.4(2) 2004: 80-8
Stigma towards people with mental illness: a cross-sectional study among nursing staff in health facilities in Amolatar district, Uganda
No full textIncludes bibliographical referencesIntroduction: Mental health of Ugandans could be improved through mainstreaming the services into primary care systems. Nurses constitute a high percentage of the workforce in health; therefore they can significantly contribute towards several experiences by patients with mental illness. Stigma towards mental illness and individuals living with mental illness is among the major hindrances to effective mental health service delivery amongst healthcare workers. Therefore it is important for stigma to be explored among general nurses as mental health services are being integrated into the primary health care. The aim of this study was to explore stigma among general nurses towards mental illness and individuals living with mental illness. Methods: This was a cross-sectional quantitative study. Self-administered questionnaires were distributed to nurses working in Amolatar district health facilities that measured knowledge, attitudes and behaviour towards individuals living with mental illness, in addition to their familiarity with a person with mental illness. Descriptive statistics were used to determine the extent to which stigma was reported in this population. Bivariate and multivariate analyses were done using linear and logistic regressions to identify the predictors of the knowledge, attitudes and behaviours of nurses regarding mental illness and individuals living with mental illness. Results: Sixty-three general nurses participated in the study. Most of the participants identified schizophrenia as an SMI, however 79% considered stress to be mental illness and only a quarter of respondents scored above 80% on knowledge about mental illness. Most of the participants believed that psychotherapy was the most effective treatment for mental disorders. The nurses were benevolent (mean 3.06, s.d 0.29) and showed acceptance towards mental health services and individuals living with mental illness in the community (mean 3.56, s.d 0.30) however the nurses tended towards authoritarianism (mean 3.74, s.d 0.34) and social restrictiveness (mean 2.98, s.d 0.27). Level of contact with individuals living with mental illness predicted community mental health ideology and authoritarianism. No demographic variables were associated with level of knowledge using MAKS score and intended behaviour using RIBS tool. Conclusion: This study has provided some of the first data on stigma among primary health care nurses towards people with mental illness in Uganda and has added to knowledge of stigma towards people with mental illness by health care providers in LAMIC. Many of the findings were positive and bode well for the planned integration of mental health in primary health care. The negative findings of this study have shown that there are many areas for improvement which could be tackled by interventions such as public and community education, and in-service training regarding causes and management of mental disorders. Further research could be done to understand more about the negative attitudes found in many LAMIC
War Traumatisation and Its Psychological Consequences on Women of Gulu District
No full textMost of the respondents in the study had experienced at least one torture event. The commonly reported physical torture experiences included beating and kicking, forced hard labor, deprivation of food, water and medicine, and tying (Kandoya).
The psychological methods of torture reported included verbal threats, killing of relatives, detention and sleeping in the bush/swamps. Among women sexual abuse was predominant with rape, attempted rape and forced marriage being common.
The government army (NRA/UPDF) accounted for a quarter of all torture cases, and the rebel army LRA (Kony) for 70% of all torture cases meted out to the respondents. Torture usually took place at home affecting significantly more females than males. Psychiatric disorders diagnosed included post traumatic stress disorder, depression, alcohol abuse disorder, generalized anxiety disorder, panic anxiety disorder, agoraphobia, social phobia, somatoform disorder, and suicidal thoughts. In addition, impaired function was reported in work, family relationships, and sexual function. Six percent of the respondents had homicidal thoughts
Long-Term Impact of War, Civil War, and Persecution in Civilian Populations—Conflict and Post-Traumatic Stress in African Communities
No full textThis chapter describes how chronic conflict, warfare, and persecution, as lived experiences, have created significant mental distress in communities on the African continent. There is a growing body of research that highlights increasing mental distress in Africa e.g., about sexuality, health, disease, modernity, climate, politics, culture, religion, ethnicities, race, economies etc. Many of these stresses and uncertainties are driven by political persecution, war, and conflict. This has shaped many African people’s attitudes and government policies and an increasing scholarly interest in exploring these “uncertainties and mental distresses in Africa.” The chapter will show how trauma, as seen in conflict/post-conflict settings in Africa, causes significant mental stress and associated social problems as well as medically-defined PTSD syndromes, anxiety, and depression which cause much morbidity and retard development in many African communities. Taking a classical look at post-traumatic stress disorder, PTSD, the chapter explores the presentation of the various physical and mental clinical syndromes related to war-trauma on the African continent and the consequent health-seeking behaviors of the African peoples in this regard. The term “culture-bound PTSD syndromes” will be introduced and discussed in the broader context of treatment, rehabilitation, and prevention on the continent and worldwide. It will also discuss the dilemma of the vicious cycles of trauma driven by appetitive aggression in today’s Africa which portends to further retard socio-economic development and drives the trans-generational perpetuation of ethnic-based conflicts including genocides. Despite this mass traumatization, the chapter points to the virtual absence of post-conflict mental health policies in almost all African countries, hence leading to discussions of “best-practices” recommendations
<it>"They don't care what happens to us." </it>The situation of double orphans heading households in Rakai District, Uganda
No full textAbstract Background This article is based on information collected about the situation of double orphans who are heading households in Rakai District, Uganda. The information will be used as justification and guidance for planning actions to improve the situation of these and similar children. This research is thus the first step in an Action Research approach leading to specific interventions. The aim of this article is to describe the situation of these orphaned children, with an emphasis on the psychosocial challenges they face. Methods The study involved interviews, focus group discussions, observations and narratives. Forty-three heads of sibling-headed households participated. Information derived from informal discussions with local leaders is also included. The responses were analyzed using a modified version of Giorgi's psychological phenomenological method as described by Malterud 1. Results Factors such as lack of material resources, including food and clothes, limited possibilities to attend school on a regular basis, vast responsibilities and reduced possibilities for social interaction all contribute to causing worries and challenges for the child heads of households. Most of the children claimed that they were stigmatized and, to a great extent, ignored and excluded from their community. The Local Council Secretary ("Chairman") seemed to be the person in the community most responsible and helpful, but some chairmen seemed not to care at all. The children requested counseling for themselves as well as for community members because they experienced lack of understanding from other children and from adult community members. Conclusion The children experienced their situation as a huge and complex problem for themselves as well as for people in their villages. However, the situation might improve if actions focused on practical and psychological issues as well as on sensitization about the children's situation could be initiated. In addition to the fact that these children need adult guidance to become citizens who act in accordance with the expectations in their communities, material aid is important in order to reduce the children's experiences of being "different" and constantly experiencing survival anxieties. Before my parents died, I was schooling without facing any problems and my heart was at rest. When they died I went to live with Jjajja [grandmother]. She fell very sick and I came out of school for a full term to look after her. I was treating Jjajja but she was not getting better. She died...so...I got my schoolmates' books and copied notes that they had taken while I was away from school...I face the problem of not having good friends. Some see me as a disease...other people are not bad. Some call me names and say that I am stupid, that I probably inherited the stupidity from my mother or father...Ever since my parents died, I have not had peace. I spend most of the time thinking, crying and struggling within myself asking God why He really had to do such a thing and saying to myself that: "God, help me overcome these problems!" Girl, 15.</p
The fit between mental health needs and programming responses for war-affected children in northern Uganda
No full textUsing Mobile Mental Health Clinics to Increase Access to Mental Health Care in Rural Africa
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