A matter of… horns!

 

This is a beautiful exemplar of Ankole cow found in Lake Mburu National park. The Ankole cattle are common in the eastern part of Africa mostly  around Lake Victoria. The immense horns that crown the head of these animals are a source of pride for the cattle owners. 

OVERCOMING THE FEAR TO LIVE POSITIVELY

Article published on issue 32 of African Woman (www.africanwomanmagazine.net)

Finding out that you are HIV-positive transforms your life, and often also the lives of people around you. But it does not have to be the death sentence it invariably was in the first days after the virus was identified.

by Claudia Giampietri

 

When she heard that she was HIV positive,  Maria Assumpta Nankya was convinced that she was about to die and was waiting passively for that moment. “But time was passing and I wasn’t dying. Then, I realised that I was not going to pass away any time soon.”

Maria, an HIV-positive mother of two, discovered that she was HIV positive accidentally. “I contracted malaria and my best friend insisted that I go to the hospital and test for HIV. I followed my friend’s advice willingly but the result came as a great shock: I did not expect to be positive. I remember I was terrified and left the hospital as soon as the doctor told me the result, without waiting for counselling. Once back home, I started selling my property, packed my stuff and took my children to the village where my relatives live. I left my husband when I discovered I was HIV positive. I did not have the courage to tell him.”

As time passed and she felt fine, Maria returned to the city, where the doctors prescribed antiretroviral drugs (ARVs). After three months, she developed an annoying rash which made her scratch frantically, and Maria decided to stop the treatment without consulting a doctor. “No matter where I was or what I was doing, I had to scratch! It was unbearable, so I stopped taking medicine.” Some time later, community workers from a clinic heard about Maria from other patients, and visited her. “They came and asked me whether I was taking the treatment and I lied to them, hiding the drugs in the cupboard.”

Maria was afraid of what her neighbours would say if they found out that she was HIV positive, so she did not tell anyone, not even her boyfriend. “I was afraid I’d be rejected if I confessed to being HIV positive, so I hid the truth. Then I realised that I was behaving irresponsibly and one day I disclosed my status to my boyfriend and asked him to test. Fortunately he was negative, but he left me.”

By the time Maria started the treatment again, she had managed to overcome her fear of stigma, thanks to the help she received from the clinic, where she was given the opportunity to receive training to become a community worker. She now works for Kawempe Home Care, an HIV/AIDS clinic in Kampala. She cares for the clients of the clinic who live in her area: “My duties consist in making sure that the patients take their drugs by checking on them weekly, telling people about HIV/AIDS as well as alerting the doctor of the clinic, Dr Samuel Guma, when he needs to do home visits.”

“My work is to tell people to take drugs and to educate the community about the virus in order to fight stigma. I lied about my status for a long time, until I started asking myself: ‘How could I tell people to take drugs when I myself am not doing it?’ I am immensely grateful to the doctor and colleagues I work with because, by giving me the chance to help people affected by this disease, they also made me understand the importance of taking drugs and caring for myself.” From waiting passively for her death and fearing stigmatisation, Maria has learnt to be responsible for her own life, on which her two children depend completely.

THE COUNSELING THAT CHANGES LIVES

“Discovering to be HIV positive is shocking, – says Alicitidia Tusime, a 26-years-old counsellor at the clinic Kawempe Home Care in Kampala – thus, pre and post-test counseling are two fundamental moments that can help the person to accept the diagnosis.”

“Before the test, the counsellor assesses the risk factors that may have been exposed a person to HIV. Once the test is done, we try to help people accept the result.” Alicitidia says that the secret to live positively with HIV/AIDS starts with the acceptance of the diagnosis and includes a healthy life and planning for the future.

“I believe that counselors can improve lives. Many patients I counseled came back to me and said: ‘If it was not for you I wouldn’t be taking drugs and would be dead by now.’ Thanks to the counseling, HIV/AIDS patients pick up the lost hope and find their way to get along with their life.”

POOR SUFFER MORE

Coping with the challenges of HIV infection are even greater for people who were struggling to survive even without the additional burden of illness. When HIV/AIDS enters into a household, it can lead to a dramatic increase in poverty.  In the first place, the virus deprives families of the income earners. As one parent dies, and then another, the children are left in the care of grandparents or family members, who were struggling to make ends meet themselves. In extreme cases, children have to fend for themselves.

A study in South Africa carried out by the Africa Centre for Health and Population Studies found that already poor households coping with members who are sick from HIV or AIDS reduce spending on necessities: almost half of households reported sometimes having insufficient food. Another consequence of AIDS in poorer families is that children – especially girls – are removed from school. School uniforms, fees and transport become unaffordable, and caring for the sick family member, and also trying to earn some money, becomes the children’s full time activity.

I joined Maria Assumpta on one of her home visits, to Jeff and Ruth Sentan.* Jeff is 15; his father died of AIDS-related complications when Jeff was 10. He lives with his mother Ruth, who is HIV positive. Jeff cannot go to school: since the death of his father, he has become the family’s breadwinner and he has to provide for his desperately thin and sick mother. They are squatters and live in a big, empty house still under construction north of Kampala. “The house does not belong to us,” explains Jeff, who sits on a mat close to his mother in the darkness of their room. “The owner didn’t have the money to finish the house and we are living in here without knowing when and if we will have to leave.”

Every morning after breakfast Jeff leaves his mother to go to the market, where he watches people buying and selling, and he waits while leaning against a wall. He waits for a small truck that comes to the market every day, filled with goods. Jeff has an agreement with the driver, who lets him take the leftovers once most of the food is sold. “There is not much left, maybe some bread, cabbage, salad, or eggs if it’s my lucky day,” Jeff says. Ruth is very proud of having such a loving and caring sun, but she also feels sorry because she is unable to send him to school. “My husband fell sick,” Ruth recounts. “He refused to test for HIV. When I tested I discovered I was positive, and only then my husband confessed that he had had affairs with other women. I was furious with him, not only because he had been unfaithful, but because he had infected me.”

That same year Ruth’s husband died and she started working to provide for her child: “I was doing laundry for other people to selling cassava chips on the streets. But I became so thin and weak that the owner of the shop sent me away, saying that nobody would come to buy from me as I looked unhealthy. People stopped giving me their clothes to wash and I ended up jobless.” Without enough money for rent, Ruth and Jeff left the house where they used to live and became squatters whose only possessions are two mats, a couple of pots and few pieces of clothes.

Ruth had become weaker and was bedridden by the time Maria reported her case to the doctor of the clinic. Ruth has started taking ARV medication, but she has not recoved sufficient physical strength to work, and her survival depends entirely on her son. “Being poor in the city is different to being poor in the country,” Jeff says, referring to his grandparents who live in a remote village. “In the village you can grow your own food and you can build a small house. In the city we cannot have a garden because we do not own the land. Everything is more expensive and poor people have a very hard time.”

Jeff, who speaks with the voice of a young boy and has the look of an old man, confesses that he wishes he could have continued studying. “I fear that the only thing I can do is wait for my turn to collect the leftovers. As soon as my mother gets better and no longer needs daily assistance, I will look for a job, so that I will be able to buy what I am now forced to beg for.”

After Maria Assumpta has asked Ruth a few questions concerning her health and has checked whether she is taking the drugs properly, we leave mother and son in the house, and start the walk back to the main road.

IGNORANCE IS DEADLY

In Sub-Saharan Africa, unprotected sex is the main cause of HIV transmission. Women are at higher risk as they are, biologically, more susceptible to infection from heterosexual intercourse than men are. (According to Global Health Report, the female genital tract offers a greater exposed surface area than that of males, and therefore women are exposed to greater risk of infection with every exposure.) Besides, women are seldom able to negotiate condom use, are more often subjected to forced sex.

Fear of rejection and stigma often holds people back from revealing their HIV status. This fear is believed to be the main reason why people are reluctant to be tested, to take antiretroviral drugs or disclose their HIV status to lovers, family or friends.  If you have unprotected sex without disclosing your status to your lover, you are endangering his or her life by exposing him/her to HIV.

In Sub-Saharan Africa, 22 million people live with HIV, in other words, 67% of the total of 33 million. The epidemic varies significantly from country to country in both scale and scope.

According to UNAIDS data form 2008, among the East African countries the prevalence of HIV/AIDS is Uganda is comparatively smaller then in the neighbouring countries. Uganda is often held as the model in the campaign against HIV/AIDS. Nevertheless, nearly one million people currently live with HIV in Uganda. After dropping dramatically in the 1990s, adult national HIV prevalence in Uganda has stabilised at 5.4%. In Uganda the number of people infected is around 940 thousand, with 77 thousand deaths caused by AIDS. The highest HIV/AIDS prevalence rate is in the war-affected Northern Uganda, where 69% of all deaths are caused by AIDS-related diseases, three times more than the casualties due to military confrontations. It is estimated that more than half of all girls abducted by rebels were infected during captivity. Widespread displacement, poverty, prostitution, sexual abuse, unfaithfulness and the lack of a healthcare infrastructure are all factors responsible for the spread of the epidemic.

In Kenya, between 1.6 and 1.9 million people are HIV positive and more than one million have died of AIDS, leaving between 900,000 and 1,4 million AIDS orphans. In Tanzania about 1.4 million people are living with HIV, and about 110,000 have died of AIDS-related causes.

NOT THE END

Finding out that you or someone you love is HIV positive or has AIDS is never good news. It implies that your life – and the lives of those around you – will be transformed and won’t be the same again. Nevertheless, learning to live with AIDS is a process that leads the infected people to take control over their lives instead of giving up.  Every day, more people find their ways of coping with AIDS. Living positively with HIV/AIDS means realising to be still alive and make the most of life.

In Gulu, 45-year-old widow Margaret Goloba’s* life changed dramatically when she was diagnosed. Margaret and her husband, both originally from Kitgum, both fell ill in 1995. Margaret contracted the virus from her husband who had been married before, to a woman who had been abducted by rebels in her teens. Margaret’s husband decided to ignore his status and even concealed it from his second wife, until she also became positive. Social stigma, mostly caused by ignorance and prejudice, became unbearable for the couple, and they decided to leave Kitgum and move to Gulu. When Margaret’s husband died, her brother started supporting her financially. “My brother helped us with money and food until he was shot dead during a clash between rebels and government troops.” After the death of her brother, Margaret feared that she would never manage to care for her children and herself. “There was no income, children stopped going to school and we didn’t have enough food.”

Things only started improving when Margaret went to the Comboni Samaritans, a non-governmental organisation founded by the Comboni missionaries.

 “I found many other people living with AIDS, women like me who are alone and yet need to care for their children.” The Comboni give medical and psychosocial support to people with HIV/AIDS and Margaret was given a job as a tailor. “They treat me with dignity. I feel like loved and accepted.” Life is still far from perfect: being an HIV positive widow and mother of five in a war-affected area is challenging. “Every day there is a new problem to face, but I feel I gained control over my life and have learnt how to live positively with AIDS.”

 

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*    Names have been changed to protect their identity

 

HEALTH SYSTEM STRAINED BY AIDS

Unedited article published on issue 32 of African Woman (www.afrocanwomanmagazine.net)

AIDS epidemic is bringing a lot of pressure on the health sector which is congested and often unable to offer quality assistance. African Woman interviewed Dr Samuel Guma, a Ugandan HIV/AIDS specialist and director of an clinic for HIV positive patients. 

by Claudia Giampietri

 

How does HIV/AIDS affect the health systems in Sub-Saharan Africa?

The impact of the AIDS epidemic on the health sector has led to an unsustainable rise of the demand for care from HIV positive patients. It is estimated that in Sub-Saharan Africa, people with HIV related diseases occupy more than half of all hospital beds. Besides, research has suggested that on average HIV patients stay in hospital four times longer than others. Thereby, hospitals are struggling to cope, especially in poorer African countries, and people are admitted only in the later stages of the illness, and their chances of recovery are reduced.  

The impact is also on the resources to run health services and the human resources. Considering the government expenditure of less than 10$ a year on general health care for every individual, the demands the disease has brought about exceed the amount of money available.

 

Is the poor quality of the service a direct cause of the HIV/AIDS epidemic?

It is. HIV/AIDS has had a huge negative effect on the human resources. The shortage of healthcare workers is mainly due to excessive workloads, poor salaries, chronic illness and deaths of the workers due to AIDS, as well as migration to richer countries. Besides, the training of health operators is essential to deliver high quality assistance, but because of the few opportunities for comprehensive HIV/AIDS training, unfortunately, most staff lack the skills and knowledge to treat HIV/AIDS patients, and end up providing poor quality work.

 

Is there a way to decrease the burden of HIV/AIDS on the health system?

In order to decrease the burden of HIV/AIDS on the health system more efforts should be made to  encourage all citizens to test for “early” HIV, before they develop any signs or symptoms of AIDS. Early testing will ensure that those found positive are still fairly healthy and can be given appropriate treatment including antiretroviral therapy to ensure that they stay healthy and don’t get severe opportunistic infections. The more healthy the population is, the fewer the incidences of severe illnesses that may require hospital admission.

 

How can the rural areas be reached effectively?

In many Sub-Saharan countries, community based HIV care programs like the clinic I run – Kawempe Home Care – and many other referral centers that provide comprehensive care manage to reach rural areas. The blossoming synergy between the local clinics and the central hospitals cannot but help decentralising the health system lightening the hospitals’ workload. Furthermore, they are the ideal model of care for people with HIV/AIDS. Research has shown that community programs that provide physical, psychosocial, emotional and spiritual care attain very good treatment outcomes and improved quality of life.

 

Don’t these smaller clinics also risk congestion?

Yes they do, because if you are providing a good and affordable service to the community, the news spreads like “wild fire” and every one would want to benefit from the services. The problem has to be tackled at the roots with prevention and early testing. The only effective solution to avoid the congestion of the health systems and the provision of poor quality assistance would be a drastic reduction in the number of new HIV infections.

 

Who are the most vulnerable people?

The most vulnerable people are the poor, uneducated women and girls, who cannot negotiate for safe sex since they depend on the men for their survival.

Moreover, the availability of antiretroviral drugs has also caused some degree of laxity and as such there has been a tendency of many people being involved in risky sexual behaviours, since they know the medicines can help them if they get infected.

 

What else should be done to curb the number of new HIV/AIDS infections?

HIV prevention remains the single most effective way to combat the epidemic. A recent study by the School of Public health at Makerere University, found that the greatest number of new infections where among married people. This implies that people living together begin having unprotected sex without knowing their partners status, and it also shows that there could be a lot infidelity among married people. The ABC (Abstain, Be faithful, use Condoms) strategy is still helpful, however new HIV prevention messages should target the groups of people at risk, such as those with multiple partners whether causal or long term relationships like marriage or cohabiting. 

Sensitisation of the youth on modes of transmission and methods of prevention should certainly be intensified. Young people should be taught and encouraged to get to know the status of their partners before they enter sexual relationships, and should periodically continue being tested as a couple to ensure that new infections are identified early, hence protecting the HIV negative partner.

Medical male circumcision should also be scaled up countrywide, since it reduces the risk of infection in men by 60%, and this indirectly also helps to protect their female partner. Besides, the initiatives on prevention of mother to child transmission (PMTCT) should be intensified to ensure a new generation that is free of HIV.

ORPHANED BY AIDS

Unedited article published on issue 32 of African Woman(www.africanwomanmagazine.net)

AIDS has shaken the lives of many children and their families. For more than 15 million AIDS orphans, the loss of their parents marks the end of their childhood and the beginning of a life confronted by enormous challenges.

By Claudia Giampietri

 

 Statistics and figures look dull and often uninteresting. Nevertheless, data related to HIV/AIDS are staggering and manage to convey how tragic the reality is. Unsurprisingly, AIDS has some of its harshest effects on children. Every hour about 31 children die as a result of AIDS around the world. At the end of 2007 there were 2 million children living with HIV and the majority of them acquired the infection from their mothers during pregnancy, birth or brestfeeding. AIDS epidemic has created and continues to create many orphans: it is estimated that by the end of 2007 more than 15 million children had lost one or both parents as a result of AIDS. Most children affected by AIDS – 11.6 million – live in Sub-Saharan Africa, the region of the world where the virus has taken its greatest toll. Life for children can change dramatically from the moment one of the parents becomes ill. They are pushed to take on ever more responsibilities and inevitably lose their childhood becoming adults before their time. They are in charge of running the house, caring for family members and earning an income. Moreover, as soon as one or both parents fall sick, having access to proper nutrition, health care and schooling becomes the biggest challenge. Children often stop going to school for the lack of money to pay the fees and the support received by other relatives is crucial for survival. AIDS epidemic causes households to dissolve and erodes the social fabric. Inevitably, poor people are the most vulnerable and for them the effects are the most severe. In most cases, when the parents die the grandparents become the only guardians of the orphans. For the grandparents caring for their grandchildren is a strenuous task – above all when resources are limited – and for this reason, many orphans are split up and end up living with different families to avoid overburdening single members. Being separated from the siblings can increase dramatically the psychological distress in orphaned children who already experience an abnormal level of mental and emotional pressure. In a study carried out in Uganda by UNAIDS, anxiety, depression and anger were found to be more common among AIDS orphans than other children. Apparently, 12% of AIDS orphans affirmed that they wished they were dead, compared to 3% of other children interviewed. These figures mirror the cruel reality experienced by many people every day. The orphans and the family members that care for them have to cope with problems that seem too great to be overcome. In the outskirts of Kampala, I meet two brave grandparents who face the challenge of caring for their 17 grandchildren whose parents died from AIDS. Jackson Ajock* and his wife Margaret had six children that became HIV positive in their teens. Margaret remembers how shocked she felt when her first born disclosed to them to be HIV positive. “When my daughter discovered to be positive she was pregnant with her third child – says Jackson. “She became depressed, barely ate and was drinking alcohol. After giving birth, she committed suicide,” Jackson admits with a voice that betrays his deep sorrow. The story repeats itself again with their other five children, who died of AIDS in a short period of time leaving 17 orphans behind. Margaret and Jackson decided not to separate their grandchildren and have been trying their best to provide for them with the meagre income they have. Jackson owns a sewing machine and earns very little money mending clothes, while Margaret works in the fields and provides the family with some vegetables. “We never considered the option of splitting them up. I remember that after the death of their parents, strangers would knock at our door asking us to give them the elder orphans. They said that they would make them work and we would earn some money from it, but we refused. We believe that these children need to grow up together, because only if they remain united they can help each other and manage to overcome the grief caused by the death of their parents,” the grandfather states. Luckily enough, Margaret and Jackson own the two-rooms house where they live. With what Jackson earns from his work he buys sugar, milk and beans, while Margaret provides cassava and greens from the field. Feeding 19 people is the biggest daily challenge, and they confess that they manage to eat only once a day. “When the orphans came to live with us, they were often crying because they felt hungry and used to ask for food during the day. By now they have learnt to wait patiently for the meal,” Jackson says with a submissive look in his eyes. “My heart breaks at the sight of my grandchildren hungry. Margaret and I are concerned especially for the youngest one, Ivan.” Ivan is just two years old and is the only one born with HIV. “We were told that he needs to eat properly to avoid the HIV drugs to become toxic or developing opportunistic infections,” Margaret says while cuddling sleepy Ivan with motherly affection. Being the money scarcely enough to buy food, not all their grandchildren can go to school and the only two who attend classes have the school fees paid by individuals who sponsor AIDS orphans. “We wish that those who have the chance to study will be able to get a decent job and help us out in the future,” admits Jackson. The well-being of the aging couple will increasingly depend on their grandchildren, and Margaret and Jackson wish that the orphans could grow healthy and lead more comfortable lives, but above all they wish that their parents’ story won’t repeat itself.

NOERINE KALEEBA, Protector of the Rights of People with HIV/AIDS

Unedited article published on the issue 32 of African Woman (www.africanwomanmagazine.net)

Learning from her own experience Noerine Kaleeba has taught others how to live positively with AIDS. Founder of the first organisation to care for people with HIV/AIDS, Kaleeba has fought against all discriminations attached to the disease

by Claudia Giampietri

”One, two, three, sound check!” I meet Neorine Kaleeba in her two-storey house in Mukono district, less than an hour drive from Kampala. As soon as I get out of the car, I am welcomed by the loud voice of a boy checking the sound system. Noerine hastens towards me, shakes my hand, and after introducing herself explains what such powerful amplifiers are doing in her garden: ”We are going to have a disco night! Lot’s of fun ahead!” She continues talking while showing me around and introduces me to some of the members of her rather big family. The house is crowded with youngsters that will dance at the sound of music in only a few hours. These young people are some of the 44 children orphaned or made vulnerable by HIV/AIDS supported by Noerine, and 27 of these are from her immediate family. ”They are the sons and daughters of my siblings – Noerine explains – who all died one after the other from HIV/AIDS.” Anyone who listens to Noerine Kaleeba would be surprised by the confidence and intimacy she has in talking about AIDS, as if the disease that still affects nearly a million people in Uganda only, is as close to her as her own shadow. Noerine Kaleeba is known around the world as an activist for the rights of people with AIDS. She has spent more than 20 years fighting against the stigma and the discrimination attached to the disease, and in 1987 she founded TASO – The AIDS Support Organisation – the first in the whole African continent to deal with HIV/AIDS patients. Her achievements are so monumental that a prestigious Scottish University – University of Dundee – defined her as the ‘Angel of Africa’. Again, Noerine’s friend the British actress Emma Thompson puts her on top of the list of her heroes. However, the circumstances that led Noerine to become the national guardian of the rights of people with AIDS and an international spokesperson on the issue are all but easy. Noerine has always had clear ideas about her future. She was born in a polygamous family with numerous members – we are talking about 26 children with four wives – but she soon realised that what she wanted for herself was different. Noerine was convinced that only education could break the chains of tradition that wanted women married at a very young age and subordinate to their husbands. ”As a young girl I had my dreams: I wanted to go to school, live in a nice house with an upstairs, find a good man and be his only wife. I also wished to have five children. Not only one or two, and not even eleven like my mother! Five,” she admits frankly. All in all things went the way she had hoped. When Noerine was attending the physiotherapy school at Mulago hospital she met Christopher, a radiographer who would become her husband in 1975 and they had four daughters. Despite a few initial difficulties, the marriage seemed to work and they were a happy family. Until when, in 1986, Noerine got a phone call from England where her husband Christopher was studying for a Master’s degree: “Mrs Kaleeba, come quickly – the voice at the telephone urged – your husband is seriously ill!” Christopher had been admitted to the Castle Hill hospital in East Yorkshire, England, and Noerine found his conditions really critical. But what shocked her most was the diagnosis that the doctors revealed her the day she arrived. ”AIDS. They told me that my husband had tested HIV positive. I honestly could not believe what I was told and the doctors were startled too.” Noerine recalls that the first time she read something official about HIV/AIDS was back in the early 1980s and the typical profile of a person affected by HIV was: homosexual, white, from San Francisco (USA)! ”Well, Christopher was certainly not homosexual, clearly not white, and on top of that he had never been to San Francisco! Doctors were also reluctant to admit that it was AIDS. As far as they were concerned, Christopher was the first case of heterosexual HIV positive that the Castle Hill hospital ever treated.” They were trying to figure out what could have been the cause of the infection, and they suddenly remembered. In 1983 Christopher had an accident. That was a time when the war was ravaging in Uganda and blood was scarce. Those who needed transfusions had to go to the hospital with somebody with the same blood group. ”One of Chris’ brothers gave him the blood. He died a few months later possibly from AIDS but we didn’t know. It was in that period, when we were all believing that HIV/AIDS would affect only certain categories of people, like the homosexuals, that AIDS was spreading mainly through unchecked transfusions and unprotected sex.” Being diagnosed with HIV/AIDS in the 1980s was like being sentenced to death, and Noerine confesses her despair. ”I felt hopeless and anguished. Even when the results of my own HIV test came back as negative, I had little comfort from this; I could not reconcile with the idea that my husband, the father of my four little girls, was dying so young and dying of this terrible disease. So I did what many people and families faced with terminal illness do. I started looking for the ‘cure’.” The hunting for the cure for Christopher’s disease led her face to face with Jonathan Mann, ”a scientist with a heart of gold” – as Noerine likes defining him – who was working for the World Health Organisation in Geneva and had been appointed coordinator of a global programme on HIV/AIDS. The meeting with Mann changed her perspective completely. Noerine understood that there was no cure available for Christopher and accepted the fact that he would die. ”But it became also clear that the kind of cure that people with AIDS should receive is an help to restore their dignity, to live positively with a deadly diagnosis.” Noerine left Geneva feeling much stronger and both her and Christopher came to the same conclusion: something needed to be done to fight against the discrimination and the stigma that surrounded HIV/AIDS. They left England at the end of 1986 and came back to Uganda to find a grim and hostile environment. Fear and ignorance of the virus prevented friends and health personnel to care for Christopher. ”It was the worst experience of our life. Doctors and nurses did not even touch him or dare to step into his room,” Noerine recounts without hiding her anger. At that time, patients with AIDS would be dismissed and no medication was prescribed. The general attitude among doctors was: ‘it is useless to cure the symptoms of a person who is doomed to die’. ”We decided to take action and started looking for AIDS patients in the hospital. We invited them in Christopher’s room and explained them as much as we knew of the virus, and talked to them about their rights. We came to form a support group which then gave life to TASO.” Christopher passed away on January 1987 leaving up to Noerine the daunting task of continuing to fight for the cause. Soon after Christopher’s death, Noerine founded TASO along with other 16 people out of which 12 were HIV positive and died within the year. The government granted them political openness: unlike other African countries were HIV/AIDS was kept a tabu subject, Uganda was the first one to openly talk about it and take decisions to deal with the disease. Initially, the funds available from the international community were all channelled to prevention’s programmes that targeted the population not affected by the virus, and it took them a long time to change strategies. ”If you don’t give counselling to people with HIV and you don’t help them to feel that their human rights and dignity are protected, they will go ‘underground’. And since the words HIV/AIDS are not stamped on the face of those who are positive, it would be difficult to recognise them and eventually the disease would keep on spreading and killing.” AIDS, that entered Noerine Kaleeba’s life in 1983 to upset her with the death of her husband, has actually never left her. After working 13 years for UNAIDS in Geneva, Noerine has recently come back to Uganda and dedicates most of her time to the 44 orphans that live with her. ”Taking care of these young people is a challenge and my future. This favourite human being of mine – she says pointing at her first grandchild Christopher who is affected by autism – has convinced me to do something about autism and I used some of my retirement money from UNAIDS to build a centre for autistic people in Entebbe. I look very much ahead, and the biggest lesson I learnt from the past is that no matter which disease affects you or how long you have left to live: we will never find the cure to mortality, but we have the right to live a dignified life.”

Swinging in the Sun

 

Boy's swinging in Kapchorwa, Eastern Uganda

LOOKING AT THE FUTURE DESPITE A DREADFUL PAST

Part of the material included in the press folder I prepared on behalf of Horizont3000 – Austrian Organization for Develompent and Cooperation – for the Austrian Foreign Minister Mr Michael Spindelegger and his delegation who came to Uganda in July to evaluate the progress of the projects funded by the Austrian government. 

 

From the interviews with some of the beneficiaries of the PSP programme of Caritas Gulu

LILLY AJOK TELLS HER STORY OF ABDUCTION AND RETURN.

 Ajok Lilly returns from the well where she went to collect water. A walk of more than 30 minutes with a heavy jerrican loaded on her head and that her slender body seems to carry effortlessly. Inside her round-shaped house with a thatched roof she finds her husband Samson and her five children waiting impatiently for her return, hoping that the only main meal of the day will be ready soon. Lilly is a 30-years-old farmer and has been living in the same area for the last 13 years. There are other five houses not far from Lilly’s, all of them enjoying the shadow of tall palm trees that constitute the main vegetation along with bushes and a few mango trees. Twenty minutes drive from Gulu, this isolated place has for long been at risk of random attacks by the LRA rebels. Since two years, there seem to be a stable peace in Northern Uganda and many communities start feeling secure in their homes. However, Lilly cannot forget her abduction, and her 14-years-old daughter fathered by a LRA commander during her captivity is the living proof that her past was not just a nightmare. 

 ”I was abducted the 3rd of October 1993. At that time I was living with my parents whose house is only few kilometres far from the house where I live now. It was a Sunday night and like every night since I can remember, we were heading to a safer spot to spend the night with other families of the neighbourhood.” Cautiously and quietly the night walkers were proceeding in the dark finding their way in the monotonous landscape of the savana where even a cat would find it difficult to claw its way through. Only once reached destination, they would relax and get some sleep. But that night of October Lilly and other seven children did not make it. 

 ”The soldiers caught us by surprise. They grabbed me and my sister, two other girls and three boys. The rebels made us walk and walk and walk in the bushes. We kept on moving for many miles and many hours, from dawn to dusk. Until we reached a rebel camp. We usually had to carry luggages and were moving continuously. There was no room for feeling tired or complaining, because they would beat us. But my feet and legs were swollen.” Fear was reigning among the abducted children. The boys were later turned into child-soldiers and soon the day came for the girls to fullfil their duties as ‘wives’ of the rebels. ”One day all the girls were lined up. The rebels were standing in front of us, busy checking our bodies to see whether we were healthy. Then, they would pick up any of us and you become the wife of the rebel that chooses you. From the day a rebel chooses his wife, the girl has to obey at his rules. I was chosen by a commander and since the day I was made his wife I had to obey him in everything. When he wanted to have sex with me, I could not refuse him or disagree.”

 One year passed. Lilly survived that time and became pregnant. She was often feeling sick, too often to be of any use for the rebels, who eventually preferred sending her back home. ”I was feeling very sick and the commander who chose me as his wife left me behind. At that time, they decided to head towards Southern Sudan and I was of litte use because I was getting weak and could not transport any luggage. I was slowing the pace of the group.” Lilly was offloaded on a road miles away from home like an unwanted and useless piece of merchandise. Lost in the bushes she walked for ten days orienting herself with the sun, until finally she managed to reach Gulu. 

  Lilly returned home after one year and two months in captivity. Her parents were overjoyed to have her back. Like anyone else who returns from captivity, she was required to report for interrogations to the governamental forces. Willing to undergo the interrogation and confident that the worst was anyway passed, Lilly reported to the UPDF officials. ”I went and I thought they would let me go back home soon. But the soldiers of the UPDF kept me in their barracks for about two months. During this period I was repeatedly raped by one of the commanders, who did not care that I was pregnant. I felt so desperate and again left without choices. The UPDF soldier used to tell me ”When you were in captivity with the LRA, did you refuse this? Why do you refuse it now?!” And he would just take what he wanted. I felt very hurt and did not have any way to rebel.” After 60 long days of further abuses, Lilly’s father took the courage and went to the UPDF barracks to ask for his daughter. ”When my father came, they finally let me go.”

 Lilly gave birth to her daughter and managed to go back to a normal life. She met Samson who later became her husband. ”He used to see me going for prayers and started talking to me, so we got to know each other. He knew I was a single mother but he ignored the fact that I had been abducted. I did not disclose to him the truth for fear of being rejected.” Samson and Lilly started living together. ”After our first child died, I told Samson about my past. I thought that the cause of the baby’s death was related to the my abduction.” In order to cleanse from her past, Lilly decided to go through a traditional ceremony, with the conviction that performing the ceremony would grant her the peaceful life that she was so badly in need of. The traditional Acholi ceremony was performed by the elders of the village in front of her family. ”I stepped on the eggs, and after a goat was slaughtered we shared the meal with my family and the rest of the community. Since that day, nothing bad has ever happened to me. The children we have had with Samson are all healthy.”

 She admits, however, that she kept on having nightmares and flashbacks. ”I was told about Caritas by a friend who was also abducted. When I went to visit Caritas office in Gulu I received a warm welcome. I told them my experience, and I was counseled and given a lot of psychological support. The caritas social workers still come to visit me from time to time and check on me. There is peace now, at least in my family and certainly more peace in my mind.”

 Lilly and Samson both work as farmers. They go every day in their garden and are able to provide some food for their numerous family but have too little money to be able to send their children to school. ”The biggest challenges now come from the children. I have five children and care for other two orphans of abducted people who never returned.” Lilly has a plan for the future and reveals that she has just started a training to learn how to handle microcredit. ”I wish I could get a loan and start a small business so to have more money to pay the school fees for my kids. In order to achieve this I need, above all, to remain healthy. And for this I pray to God.”

 

 

 

ACHOLI CLEANSING CEREMONIES ALLOW A PEACEFUL RETURN HOME

 

Acut Omer is a village 40 km far away from Gulu, in the parish of Paibona, Awach county. During the war it used to be one of the LRA bases. The clashes between the LRA and the UPDF troops forced the residents to leave their homes and find refugee in the Internally Displaced Peoples’ (IDP) camps. Since November 2008 the community of Acut Omer has gradually started leaving the camps to go back to their houses and land. However, going back to the home village is not a smooth process. People would find human bones everywhere, and even after the area has been cleaned, elders still feel the presence of the spirits of the dead ones. Many who flee the area during the war are haunted by terrible memories from the past, and going back can be a traumatizing experience.

  

On a Thursday afternoon, a group of 19 men and 18 women accompanied by a few toddlers meet to share the fears and nightmares they have. Facilitated by few members of Caritas staff, that provides them with psychosocial support, the community discusses openly about the difficulties that they encounter and that prevent them from returning home peacefully. During the meeting, the role of Caritas staff is to make sure that everyone can have a say and that the community unanimously agrees on a way forward. 

The meeting is attended by Paul Rubangakene, Caritas Project Officer, Zelinda Aromorach, Caritas Social Worker, Zacheus Otto Akena, the Caritas representative person in the community, and the Local Counselors 1 and 2 (the Local Counselors -LC- are elected democratically. LC1 represents the village, in this case Acut Omer; LC2 represents the parish, in this case Paibona; LC3 represents the sub-county, in this case Awach; LC4 represents the municipality, in this case the municipality of Gulu; and finally, the LC5 represents the district, in this case the district of Gulu). 

Paul Rubangakene opens the discussion and asks people to explain what makes it difficult to return peacefully to their houses.

Elders disclose some of their fears, visions, and nightmares which reveal how much people are still shocked by what they witnessed and experienced during the war. 

 

Aldo Opobo: ”I was in the bush close to my home. I was collecting wood to repair the house that the war destroyed. While I was walking towards the village I suddenly felt aching everywhere, as if somebody was beating me brutally with a stick. I saw people coming from every direction, and all of them were holding sticks. This lasted for a while until I realized that none was there and I was not been beaten even though I felt the pain. I was so fearful afterwards that I went back to the IDP camp.”

 

Augustino Otto: ”Not long ago, I decided to return home. I repaired my house and was settling in there. One day I was going to the well to fetch water. Before I approached the well I started hearing noises. I stopped to pay more attention, and I recognized the voices of babies crying. The cries were coming from the well and I ran away in disbelief. There were no babies really crying in the well but nobody has ever gone back there to fetch water. People abandoned that well and are now walking a longer distance to get the water.”

 

Maurina Layer: ”My house is close to the well where babies were heard crying. One night I went to bed and locked my door as usual. I turned off the candle and fell asleep. Suddenly, I was woken up by the noise of somebody outside who was trying to force my door open. I crouched in bed trembling with fear when I heard the door slam. Men with pangas appeared and threatened to chop me into pieces. I started screaming so loudly that neighbours came but I fainted before they reached. My neighbours told me that the door was open but nobody was in the house. I got so scared that I refused to live in my house and went back to the IDP camp.”

 

Alisantoriana Akello: ”I went to the garden with my children. While I was digging I sent them to a nearby place where there is a big mango tree. As soon as they left, I saw a group of rebels passing by. They called me saying ‘Mama’. I got angry and yelled at them asking what they wanted and to leave me in peace. When my children came back I went back to the house. One of my daughters who ate a mango from the tree went crazy and is mad since then. We soon realized that there was something wrong with that mango tree: surprisingly, no animals were eating its fruits. The mangoes would fall and rot on the ground without any living being eating them. This is because many people died in this area and it has not been cleansed. We believe that only an Acholi ceremony can cleanse the place and allow us to stop fearing.”

 

Young people remain silent for most of the time. Many of them were born and grew up in the IDP camps and have lost connections with their home villages and traditions. 

When the community is asked by the Caritas’ mediators what should be done in order to create a conducive environment for people to return home, the LC2, Santo Ouma, speaks on behalf of the village: ”In this very place where we are gathering today – he says pointing at a palm tree – one of the most brutal fights between LRA and UPDF took place. The entire village has served as the battle ground for confrontations between the governmental troops and the rebels. We believe that a traditional Acholi ceremony must be performed in order to cleanse the place where many atrocities have been committed and allow the souls of the dead ones to rest in peace.”

 

The community eventually chooses the elders that are going to perform the ceremony. Zacheus Otto Akena, the Caritas representative person in the community, announces the names of the five women and the three men selected. The Acholi ceremony usually needs the sacrifice of an animal and the members of the community ask Caritas to provide them with four sheeps – symbol of innocence and purity – that will be killed and cooked without salt. The elders selected will then visit the four areas of Acut Omer and tradition wants them to throw pieces of the cooked unsalted meet in different spots. The ceremony ends with the whole village sharing the remaining meat, as a symbol of solidarity and retrieved peace and balance. 

In Acholi culture there are many ceremonies carried out to solve different kinds of problems. They have always been performed by the chief elders of the community since many decades, and the goal is to restore a broken balance, to forgive and forget. The one that the community of Acut Omer has chosen, was traditionally performed by the chief elders when somebody in the village was murdered. For the people of Acut Omer, the Acholi ritual that they chose to perform is believed to be a powerful and effective mean of restoring their peace of mind as well as reconciling the members of the community with the dead ones. 

DEALING WITH A WOUNDED COMMUNITY: PSYCHOSOCIAL SUPPORT PROGRAMME (PSP) OF CARITAS GULU

Part of the material included in the press folder I prepared on behalf of Horizont3000 – Austrian Organization for Develompent and Cooperation – for the Austrian Foreign Minister Mr Michael Spindelegger and his delegation who came to Uganda in July to evaluate the progress of the projects funded by the Austrian government. 

 

THE PROJECT – PSYCHOSOCIAL SUPPORT PROGRAMME (PSP) OF CARITAS GULU: DEALING WITH A WOUNDED COMMUNITY

 

Acholi Sub-region is slowly recovering after 22 years of war. The signing of the Cessation of Hostility Agreement (CHA) between the government of Uganda and the Lord’s Resistance Army (LRA) rebels on 26th August 2006 in Juba has marked the beginning of the longest period of stability and relative peace since the beginning of the conflict. 

The promising regained security has led people to start abandoning the Internally Displaced Persons’ camps (IDP camps) to return to their homes and villages. Life is beginning to normalize but the return process is all but smooth and easy. There are many obstacles that both the individuals and the communities still have to face in order to achieve a sustainable peace. 

The war has caused the displacement of up to 2 million people, scattered in the IDP camps of Gulu, Kitgum, Amuru and Pader. According to a research conducted by the London School of Hygiene and Tropical Medicine and the University of Gulu on the post-traumatic stress disorder symptoms (PTSD) and depression among IDP in Northern Uganda, it seems that ”the levels of PTSD and depression recorded in this study are amongst the highest recorded globally using similar methodologies amongst displaced and conflict-affected populations” (Source: BMC Psychiatry 2008, pg. 7; available at: http://www.biomedcentral.com/1471-244X/8/38). The study took place in November 2006 in Gulu and Amuru districts of Northern Uganda. The two districts contain an estimated 650,000 IDP which is approximately 40% of all IDP in Uganda.

Every war is primarily destructive and people’s lives in Northern Uganda have been shattered. The displacement caused by the war has also led to an erosion of the social fabric and values that used to be part and parcel of the Acholi society. The social structure in place before the war has to be rebuilt and the local government system has to be revitalized. 

Moreover, terrible atrocities have been committed during the war. Back to the villages, those who were raped, tortured, maimed, the formerly abducted persons (FAPs) and ex LRA combatants are all supposed to start living together again. 

Caritas Gulu has been working with the Acholi community since many years. Through the PSP project, Caritas Gulu aims at facilitating the return process and fostering reconciliation and peace building by reviving the existing community resources neglected during the many years of displacement in the camps, as well as the traditional Acholi reconciliation’s mechanisms to resolve conflicts. 

 

Table 1: PSP project of Caritas Gulu:

Title of the action:	Strengthening community level peace building and social support practices in Acholi region
Location(s) of the action:	12 sub-counties in remote corners of Acholi region majorly affected by community conflicts. Amuru district: Atiak and Purongo sub-counties; Gulu district: Awach and Odek sub-counties; Kitgum district: Namokora, Orom, Ogili and Lukung sub-counties; Pader district: Adilang, Atanga, Omot, and Puranga sub-counties;

 

 

The ongoing return-process from IDP camps is extremely delicate. Conflicts among returnees have several causes, and the following are some of the main challenges faced by people who leave the camps: 

 After twenty years in the IDP camps, the traditional authority as a means for social regulation has been significantly undermined, and decentralized local government structures – especially at parish level – are still weak

 Back to the villages, there is an explosion of conflicts over land properties and demarcations

 People have to deal with their traumas caused by what they have witnessed or experienced during the war, and returning home can also be re-traumatizing. Besides, sentiments of anger and vengefulness are spread in the communities that receive FAPs or ex LRA combatants back

 

 

 

 

 

 

 

 

Table 2: PSP project of Caritas Gulu – target groups and final beneficiaries:

Target group(s)

140 Local authorities (community, religious, civic & cultural leaders) 8.000 Victims of conflict (240 conflicting families, clans or communities)  500.000 Radio listeners among the Victims of conflict 6.000 Victims of conflict 300 Local authorities (Local Councillors and other  community leaders) 280 Young People, Child soldiers and Victims of conflict from Acholi region and 1600 Victims of conflict from the neighbouring communities in Southern Sudan, West Nile, Karamoja and Lango Regions 1000 Young People, Child soldiers and Victims of Conflict 1200 Victims of conflict, perpetrators and other relevant stakeholders 14 Staff of Non Governmental Organisations and 60 staff of  community based organisation

Final beneficiaries

20.000 Victims of conflict in 12 sub-counties benefiting from improved services of local authorities towards resolving conflicts 90.000 Victims of conflict in 12 sub-counties benefiting from improved services of the civic and community leaders towards resolving conflicts 8000 Victims of conflict in 12 sub-counties that will indirectly learn and possibly change their attitudes through reports and discussions 1600 Victims of conflict from the neighbouring communities in Southern Sudan, West Nile, Karamoja and Lango Regions

 

 

Local government structures need to be re-established.  

Within the camps, traditional authorities have seen their power dramatically reduced, and the social norms that ruled the pre-war society collapsed. There is a need for urgent rehabilitation of decentralized government structures. 

The Executive Director of Caritas Gulu, Komakech John Bosco Aludi, believes that in order to achieve a sustainable peace and stability within the communities, the former social strutures of governance must be empowered again. ”The local government system has to be reinvigorated and every player within the local government structure has to know their role and responsibilities – John Bosco says. ”The structure includes elders – who are highly influential within the village – local chiefs, and the Local Counselors (LC) who are elected by the people. Most of the conflicts that the communities have to solve are dealt by these parties who form the local government.” 

The PSP project of Caritas Gulu supports the re-establishment of local government structures at parish level, and helps improving the cooperation and network between local government structures and traditional leaders (elders and local chiefs). In so doing, Caritas Gulu has witnessed a substantial reduction of the informally existing system of justice (mob justice) in favour of peaceful conflict resolutions. 

”The project has an impact on the community – John Bosco adds – and it is bearing fruit. We are constantly in touch with the LCs and the local chiefs and in many places bylaws have already been set.” David Okelo, Programme Manager for Social Services of Caritas Gulu, explains that people would rather prefer solving the conflicts by involving the local government instead of going to courts: ”Notwithstanding the costs of bringing an issue to court for trial, because of the unfortunate high level of corruption in the judicial system, people tend to trust the local government which, by being local, has a level of transparency difficult to find elsewhere.”

 

Conflicts over land: re-defining the boundaries. 

One of the major causes of the conflicts is related to land issues. ”Land is really a big problem – says Ogwang Along, Programme Manager for Relief and Rehabilitation of Caritas Gulu – and is often not easy to handle. Families that return to their lands after so many years away from it, have problems in remembering the borders. Neighbours, members of the same families and clans clash over land demarcations that need to be re-defined. I would say that the land issue is the biggest challenge that the whole Acholi Sub-region is facing.” 

To help solving the conflicts, through the PSP projects, Caritas Gulu encourages communities to involve elders, local chiefs and eventually LCs. ”We mediate the meetings between the parties – adds David Okelo. ”The elders of the village and the local chiefs play a very important role since they are often the only ones who kept track and remember the demarcation of the land in their village.”

However, there is a whole generation that, besides being unaware of the land boundaries, has completely lost the skills to work the land and is often unwilling to learn, preferring the town to the countryside. ”Think of the young ones who grew up or were born in the IDP camps. They have never seen their fathers working the land and have not had the chance to learn it. Besides, they do not see the need of going back to the land and would rather prefer living close to the town centers. However, we have also noticed a ‘dependency attitude’ mainly among the youngsters, generated by the fact that in the camps food was provided and they have never had to work for it,” says John Bosco, revealing the young people are often seen as outsiders, since they refuse to go back to their families’ lands preferring the town,  but have no clue on how to provide for themselves in the city.

 

Dealing with the traumas. Healing the wounds to live together again.  

The results on exposure to traumatic events shown in Table 3 are part of the research carried out by the London School of Hygiene ad Tropical Medicine and the University of Gulu on IDP. Three quarters (75%) of respondents had witnessed or experienced the murder of a family member or a friend. Nearly two thirds (64%) of respondents had witnessed the murder of a stranger. More than half (56%) reported having been beaten or tortured. More than 40% reported having been kidnapped and 14% reported having been raped or sexually abused. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. 

 

Table 3: exposure to traumatic events. Source: BMC Psychiatry 2008, pg. 4; available at:http://www.biomedcentral.com/1471-244X/8/38

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Post traumatic stress disorder is mainly characterized by symptoms of disconnection or isolation, mistrust, and feeling of powerlessness. Among those suffering from these symptoms there are many FAPs and ex-combatants. The PSP project of Caritas Gulu focusses on the reintegration of FAPs and ex-combatants into the community, providing them with psychosocial support services to foster reconciliation. 

”The war has caused a lot of bitterness, resentment, remorse, and revenge attitudes in the people – Paul Rubangakene, Project Officer for the Psychosocial Support Programme of Caritas Gulu, says. ”People are living in guilt and shame. Take the case of the FAPs, for instance. They were abducted by the LRA rebels and might have been forced to commit atrocities in their own villages, among their own people. Many FAPs had to kill their own fathers or mothers, rape their own sisters. Once they manage to come back, they have to live with the very community they wounded.” 

One could evenly ask: how could this ever be possible? Paul Rubangakene explains that the main goal of the PSP project is to help people who committed offences during the war to handle their sense of guilt and, meanwhile, sensitize the community in order to avoid mob justice and encourage the families to accept former abductees back. 

”Acholi people are very forgiving people – Paul continues – and the Acholi culture is very rich and has provisions to handle a lot of issues.” The PSP project revives traditional ways of peace building, including cultural dances, rituals, cleansing ceremonies to positively cope with war experiences. 

”Culture – Paul Rubangakene adds – is an important resource for the communities and it should be respected and supported wherever it does not contradict the protection of human rights.”

Father Joseph Okumu, anthropologist and ethnologist, says that in Acholi culture there are ceremonies to deal with different kind of offences, and the ceremonies were traditionally performed to re-establish the harmony among the individuals or to regain a lost peace of mind. Talking about the symbolism of the ceremonies, Father Okumu explains that they are used to cleanse persons or places. ”Take for instance the ‘mato oput’, the ceremony of reconciliation, nowadays performed to re-integrate FAPs or ex-combatants. There are different phases that the person has to go through. One of these implies the admission of guilt. The person who was abducted and possibly forced to kill or misbehave has to confess his or her guilt in front of the family. By doing this the family shares his/her burden. The ceremony eventually concludes with the sharing of the food, which is the apex of the reconciliation process. Sharing food between the offender and the offended is the proof that reconciliation has happened.”

The Acholi reconciliation ceremonies are helping many people to deal with the burden of their past deeds  allowing the wounded communities to return living together. Forgetting what has happened over the last twenty years may be very hard for those who have been affected by the war. However, forgiving each other seems to be a viable option chosen by many to restore harmony and build a sustainable peace.

 
FACTS

 The war in Northern Uganda has been Africa’s longest war. (Source: Human Rights Watch, Africa’s Longest War Still Taking Lives, 19 June 2009, available at: http://www.unhcr.org/refworld/docid/4a3f8d3c1e.html)
 Nearly two million people were displaced at the height of the civil war. (Source: United Nations Office for the Coordination of Humanitarian Affairs (OCHA), May 2008)
 About 48% of the total camp population (1.2 million at the end of 2005) remain in camps in the Acholi and Teso regions of northern Uganda. (Source: United Nations Office for the Coordination of Humanitarian Affairs (OCHA), May 2008)
 In the Acholi region, where most of the fighting took place, 18% have returned to their original home villages and another 33% are in transit camps. (Source: United Nations Office for the Coordination of Humanitarian Affairs (OCHA), May 2008)
 An estimated 1,000 people were dying each week in the IDP camps mainly due to malnutrition, AIDS, malaria and diarrhea, according to a 2005 report by the World Health Organization. (Source: World Health Organization (WHO), 2005)
 At least 66,000 people between the ages of 14 and 30 have been abducted by the rebel group Lord’s Resistance Army (LRA) during the two decades of the civil war in northern Uganda. (Source: Survey of War Affected Youth (SWAY), April 2008)
 The International Criminal Court issued arrest warrants in 2005 for Joseph Kony and four senior leaders of the LRA for Crimes against Humanity and War Crimes committed in Uganda since July 2002.
 The LRA continues to abduct children in neighboring Central African Republic, Democratic Republic of Congo, and Southern Sudan. (Source: Betty Bigombe, Distinguished Scholar, Woodrow Wilson Center, July 2008)
 
 

 

 

 

 

 

Show me your neck!

 

Maasai lady wearing a colourful Maasai necklace, Kenya

ETHICS & INTEGRITY: A MATTER OF CHOICE

Every day we take decisions. Our actions have an impact on other people’s lives and determine how ethically we behave. Every day we stand in front of a crossroad and we are left with two choices: right or wrong? 

by Claudia Giampietri

Article published on issue 30 of African Woman (http://www.africanwomanmagazine.net/)

 

Imagine the following scenario: the end of the last year of high school is approaching and the students are preparing for the final exams. One morning, the math teacher is doing some revision with his class when he receives an urgent call and exits the room. Among the students the silence falls and the atmosphere is tense. Everybody seems to be thinking the same thing but nobody dares to make a move. Until Jeff stands up and says: ”He has the final papers with him. We should have a look and copy the exercises. The teacher will never realize it if we do it quickly.” After a brief discussion on the risks involved, the classmates agree and they all hasten to copy the contents of the papers. All but one. Francesca refuses to follow them in what seems to be a blatant action of cheating. She says: ”I have been studying hard throughout the year and I want to demonstrate myself and my teacher what I can actually do. What you are doing is wrong!” Deaf to what sounds to be a call of conscience, the rest of the class puts aside any sense of guilt and starts enjoying the perspective of final outstanding marks. Now, should Francesca reveal the truth to the headmaster with the risk of punishment for her classmates?

I guess that many of us during school -  and also at work – have been daunted by such questions. Should I take a shortcut? How about revealing the truth when others involved may be punished? These are all ethical questions. Ethics is, in fact, a philosophical concept which, in very simple terms, is about what makes actions right or wrong. When applied to real-life situations we are confronted with cases such as the one described above and our reactions determine the level of integrity that we have as individuals and societies. According to a famous American law professor, Stephen Carter, integrity requires three steps: (1) discerning what is right and what is wrong; (2) acting on what you have discerned, even at personal cost; and (3) saying openly that you are acting on your understanding of right from wrong. Eventually, it seems that all is down to our capability of recognizing what is right from what is wrong. 

African Woman has interviewed Hon. Miria Matembe, the Ugandan former Minister of Ethics and Integrity from 1998 to 2003, who has been in charge of assessing and improving the level of ethics of the country during her term. 

Miria Matembe explains that the Ministry of Ethics and Integrity was created in the late 1990s in response to a big public outcry on corruption coming both from Ugandans and development partners. ”I was the first Minister of Ethics and Integrity to be appointed. In the period after the war all value-systems broke down and the president initially assigned the responsibility of fighting corruption to the vice president who then founded an anti-corruption unit. They soon realised that the anti-corruption unit was actually dealing with the symptoms instead of tackling the cause, which was a generalised absence of ethical values. It was then the Ministry of Ethics and Integrity was created.” 

Miria Matembe says that she was chosen as minister because she leads an ethical life. ”To my understanding ethics is meant to be a code of conduct, a code of rules that govern people’s behaviour.” Referring to ‘people’, Hon. Matembe has different categories in mind: those in public offices, professional bodies, and families too. 

”The hardstick for judging whether your behaviour is right or wrong is not yourself – Miria Matembe continues – but it is the expectation of the society in which we live and that determines the common good.” Hon. Matembe adds that the rules established by the society apply to a certain time and space, therefore they are subjected to changes. The role of the Minister of Ethics, for instance, is to set guidelines that would help people in public offices to behave with integrity and for the benefit of the society they are serving. 

”When it comes to professions, each one has established their own code of conducts. For instance lawyers, doctors, engineers, and media have certain rules that are set to prevent them from damaging others.” Clearly things do not always go the way they should, and the breaches of rules within professional bodies are common. When it comes to ethics in business, Matembe warns that the omnipresent risk that companies run is to choose profits at the expenses of ethics. Some experts would regard the system, that sees businesses having the only purpose of maximizing their profits, historically responsible for the collapse of big tycoons. ”Instead, a business company as much as the society – continues Miria Matembe – is an associations of human beings and it is essential that in setting their goals, companies take in considerations ethical issues.” New trends, in fact, show that in recent years there has been an increase in conscience-focused business. Corporate Social Responsibility (CSR), for instance, is a strategy ever more commonly adopted by companies around the world. CRS is a self-regulating mechanism to monitor and ensure that ethical standards and laws are respected within the business. It is a chance for the companies that embrace it to behave responsibly and act for the public interest, since their decisions have an impact on employees, consumers, communities and the environment. 

”I strongly believe that people with power, and money gives power, have a big responsibility. Business people have resources that should be used for the benefit of the community at large,” Matembe comments. 

When it comes to the difficulties that the developing world faces in defining and respecting ethical standards, Mira Matembe advocates that poor countries have much bigger challenges. ”When you are poor you don’t have much choices, and you end up doing what you would not have done,” she admits. ”That is why there is a pressing need for positive role models that encourage society to do better. The first inputs that human beings receive come from the family. If families fail in instilling ethical values, then it is predictable that society as a whole will collapse.” The temptation to behave in an unethical fashion may be grater for poor people, but that does not mean poverty exempts people from living according to the rules that govern and ensure civilised society. 

Matembe tells how her father taught her not to crave for something that he was unable to give her. Through the teachings of her father she learned to nurture a sense of contentment with what she had and avoid becoming dissatisfied with what she could not get. ”This does not mean that you should not have a vision or dreams for you future. Set your self a goal and make sure that the means through which you reach that goal are ethical.”

Matembe talks with a certain pride of the family model she grew up with, suggesting that the fear of shame was enough to encourage her to do the right thing. While fear of discovery is often sufficient motivation for children to act in the right way, by the time they are adults, people should have made the value of integrity their own, and should do the right thing even of no one will know.  Integrity is not a value that can be saved for times when others are around to see. Taking the right decision and making choices which are consistent with one’s values is not easy at any stage in life or status in society. Nevertheless, it remains the only viable option if we are to maintain a society that can meet the needs of all its citizens. 

 

FACT BOX 

Worldwide corruption’s index: where does Uganda stand?

Corruption is a plight for each and every country around the world. Some countries are highly affected while others seem to manage in keeping it under control. According to the Transparency International 2008 Corruption Index, Uganda is not at the very bottom but could certainly do better. The scores used indicate the degree of public sector corruption as perceived by business people and country analysts, and ranges between 10 (highly clean) and 0 (highly corrupt). 

Uganda places itself at the 126th position with a score of 2.6, between the two East African neighbouring countries: Kenya fills place 147 with a meagre 2.1, while Tanzania – which seems to be doing better – stands at position 102 with a score of 3.0.

 

And… the checklist to be always on track.

The following list has been developed by Darring Clement, a student of marketing at a Canadian university. The ‘10-Point Ethics Checklist’ is proved to be a very useful tool to verify whether we are going in the right direction, something that is good to have within reach in case we are suddenly overwhelmed by doubts on what to do.  

Here is Darring’s 10-Point Ethics Checklist. 

The Golden Rule: Would I want people to do this to me?

The Fairness Test: Who might be affected and how? Is this fair to everyone?

The ‘What if everybody did this?’ Test: Would I want everyone to do this? Would I want to live in that kind of world?

The Truth Test: Does this action represent the whole truth and nothing but the truth?

The Parents Test: How would my parents feel if they found out about this? What advice would they give me?

The Children Test: Would I be willing to explain everything about this to my kids and expect them to act in the same way?

The Religion Test: Does this go against my religion?

The Conscience Test: Does this go against my conscience? Will I feel guilty?

The Consequences Test: Are there possible consequences of this action that would be bad? Would I regret doing this?

The Front Page Test: How would I feel if my action were reported on the front page of my hometown paper?

 

 

DAVID KEZIO-MUSOKE: THE SOUL OF AN ARTIST

Despite considering himself an amateur, David Kezio-Musoke’s technique, visions, and inspirations reveal the soul of an artist who could not live without a white canvas to express himself. 

By Claudia Giampietri

Article published on issue 30 of African Woman (http://www.africanwomanmagazine.net/)

 

 

David Kezio-Musoke and I arrange to meet in Kampala on a Thursday afternoon. He welcomes me in a place where he keeps few pieces of his artistic production. Leaned against the wall of the spacious living room are five big canvas while two smaller framed paintings are placed on a couch. 

As soon as he opens the shutters and the light comes into the room, my eyes are caught by the prominent shapes of human and animal figures in the foreground of the canvas, painted with intense abstract colours vigourously stroked by a palette.

”Unfortunately, here I keep only few pieces – David says while sitting comfortably on a sofa. ”Most of my production is in Rwanda, where I work and live.”

David is a 33-years-old Ugandan journalist who is stationed in Rwanda since three years and currently works for the Kenyan Nation Media Group, representing the interests of the Daily Nation, The Monitor, and The East African in Kigali. His life is divided between mainstream journalism and an increasing commitment to what used to be his pastime: painting.  

David is a Musoga, the tribe that populates the eastern part of the Nile, and belongs to a very artistic family. ”My siblings and I are all fine artists, but only two of them studied art at a professional level. We all learnt how to draw from my mother who was a teacher but most of what I do is self-taught.” During high school – despite his teachers’ skepticism – David chose to combine art and science: ”I did physics, chemistry, biology and art at A level. In Uganda this is considered a ‘crazy choice’ because one is not supposed to mix physical sciences with humanities.” But David knew that his career would not be in any field of science and he was equally sure that the passion for art would instead remain. ”At the university, I ended up sharing the room with art students who mainly produced abstract art. These students were very hard working but I must admit that, with all due respect for the abstract artists, I do despise abstract art. I am unable to appreciate it fully. Instead, I have always had an admiration for people who produce figurative art, which is the kind of art that ‘makes sense’, that represents forms that are recognisably derived from life.”

When the moment to decide about his profession came, David followed his father’s footsteps and became a journalist. ”Before leaving for Rwanda to work for a private media house, I started writing art reviews for The Monitor in Kampala. Art is very prolific in Uganda and there used to be a lot of art exhibitions at the Italian embassy where I was always invited. Once I met a man, Pietro Averono, who influenced my way of looking at artworks. Pietro was the cultural officer at the embassy and in charge of organizing the exhibitions. He was very knowledgeable about art and I loved the way he used to appreciate it. He influenced my way of looking at pictures because he gave me the liberty of disliking a piece even if it is highly valued. I must admit that after looking at some pieces sold for hundreds of dollars sometimes I thought ‘Well, David, you could do better’.”

The freedom that David inherited from Pietro Averono’s way of looking at art has certainly encouraged him to challenge himself and boosted his confidence. 

Before moving to Rwanda three years ago, David went through a rather hard time. But the hardness in life, instead of pulling him down, made him very creative and he worked at a feverish pace. ”That was a defining moment in my art-life, when I decided to take art to a different level. Painting ceased to be simply my pastime and became more.” As soon as David reached Rwanda he invested part of his savings to set up a work space in his house in Kimironko, and started painting for the public to establish himself as an artist and making himself known. The process is not easy, but David believes that Rwanda gives many opportunities to emerging artists who are not suffocated by the wild competition present in Uganda. ”Uganda hosts many famous artists and the art-world is quite developed. In Rwanda instead, because of its recent dramatic history, art has not been promoted for many years and there has not been a market for art until recently. The country is now catching up and I hope it will be a springboard for me.” Although competition gives artists hard times, the public in East Africa enjoys artworks and is open to new emerging geniuses. ”I believe that people do not necessarily need to be experts to appreciate art. I know that this is subject to debate, but I think that when a painting captures people’s eyes, that means it is good. If people just pass by ignoring the piece, that probably means it is boring. The public’s taste is not homogeneous and I know that some people like my works while some others don’t.”

Surprisingly, despite his talent and ambitions David would rather define himself as an amateur more than an artist. He confesses that he does not paint for money and is often unable to value his paintings. Painting for David is a soul’s need, an internal drive that urges him to rush to a white canvas. ”I do what I do because it comes from my heart. When I am working on a piece I enter into another world where I cool off and abandon the other part of me. I am another person.”

What strikes me most by listening to David is the way he effortlessly manages a successful profession and an increasingly demanding dedication to art. David allows two different personalities to co-live, and openly admits that journalism and art are completely disconnected. ”You can’t look for a connection between the two. Few people among my acquaintances know that I produce art. I do feel the split, and when I am a journalist there is nothing that connects me to art, I am a completely different person.” And when I ask him what kind of person David-the-journalist is, he laughs and answers diplomatically: ”Well, maybe you should ask my colleagues.” Instead, while talking about David-the-artist he reveals to be a patient and visionary person.

”You need to be extremely patient when you start a new artwork. Oil painting takes time and  helps to define your character, to improve it, and I would certainly agree that art can be therapeutic. The process starts with the preparation of the canvas after which you draw the subject and finally add the colours, that, indeed, need time to dry. It can take you up to a month to finish one piece. And then, you look at your work from the opposite side of the room and maybe you realize you don’t like it. When this happens I need to leave the painting for few days before going back to it.”

One of the most original features of David’s paintings is the attempt to merge an exquisitely Western technique with African figures. When it comes to the technique, David says that his inspiration was the Dutch Vincent van Gogh, one of the world’s best known post-Impressionist artists. ”I bumped into Vincent van Gogh years ago while I was reading through one of my sister’s art books – David explains – and I was inspired by him. His style is by no means African and I thought I would try to blend Western technique with African figures. In that painting – David continues, pointing at one of the two framed pieces placed on the couch – I tried to reproduce van Gogh’s technique.” In fact, the technique used by David in his framed painting recalls the Dutch artist’s masterpiece Starry Night. 

Another source of inspiration for David was Philip Kwesiga, former Dean of the School of Industrial and Fine Arts of Makerere University. ”He is a master in figurative art. Thanks to him, I learnt to appreciate figurative style which should not be confused with realism. Realism represents a figure accurately in its smallest details, nearly like a photograph. Instead, in the figurative art I like and produce you can recognize the shape of a person or an animal but not their features.”

The subjects in David painting are in motion, nothing is still. ”With my art things must not be dormant, there has to be some action in the piece.” An element that gives motion to David’s pictures is the immodest use of colours, which are abstract and very intense. ”I abandoned the brushes three years ago and have been using palette knives ever since. The effect produced by the palette knife is really magic! When you use it on one side it gives a shade of colour that changes when you use it on the other side creating effects that maybe you had not thought about. I feel inspired by the colours, they ignite my imagination.” Red seems to be David’s favourite. ”I really like red and it is hard to find a piece of mine which does not have it.” Because of his fondness for the red colour – often associated with feelings of anger and annoyance – David admits that sometimes people think he may be a disturbed personality. ”I can assure you I am not,” David says  laughing amused. Red is indeed a powerful colour that evokes also passion and is believed to make the heart beat faster. ”It is a colour that shouts – David adds – and that’s why I love it.” 

Since when David stopped painting as a pastime and began creating art for the public, he had his pieces displayed at an annual exhibition at Nomo Gallery in Kampala. His plan now is to organize an exhibition in Rwanda. ”If the exhibition in Kigali goes well, I would like to show my paintings in Nairobi. I strongly believe that Kenya is ‘the’ market and as soon as I am ready I will try to penetrate it.” 

David-the-artist seems to be taking an increasingly bigger part in David’s life and I cannot but wonder what will happen to David-the-journalist. David is passionate about his profession as a journalist and would not be willing to easily give it up, but he admits, that if he was forced to choose between ‘the two Davids’, he would pick up artist. 

 

To contact David Musoke: keziodk@yahoo.com or keziomusoke@gmail.com

 

SOME OF DAVID MUSOKE’S ARTWORKS:

 

Crane, symbol of Uganda

 

 

The rhythm of the music

 

 

Elephants

 

 

Zebras

Head of… Straw!

 

Lady carrying straw on the head, north-west Tanzania

Children of Kampala

 

Children playing together in one of the neighbourhood of Kampala - Uganda

EX-LRA REBELS RETURNING HOME: WHAT’S NEXT?

Gulu – Uganda. The name of this man cannot be revealed. Neither his face. He was once a child, abducted with his brother at the age of 12 on their way from school. He spent 21 years with the rebels, becoming a military chief. He escaped from the LRA to return to Gulu – his home town in Northern Uganda – under amnesty in 2007. He found that his parents had died, his only friend is another former rebel, and has yet no idea from where to start his new life. Twenty years as a combatant makes it difficult for former rebels to re-integrate in the society. Terrible atrocities have been committed during the war. Those who were raped, tortured, maimed, the formerly abducted persons and ex-LRA combatants who return are all supposed to start living together again. Co-living in peace is the biggest challenge for the Acholi communities, and having a past as a rebel certainly does not help.

 

The following interview is an honest account of this man’s experience. It was translated and facilitated by Geoffrey Lakwonyero, one of Caritas Gulu’s social workers.

 

 Do you remember the day you were abducted?

It was in 1988. I was in school that day. After school my brother and I headed towards a river to bath. We were abducted on the way along with other two brothers. I am the only one who survived.

 How old were you?

I was 12. 

 What happened after they ambushed you?

We started moving in the bush. We were loaded with heavy luggages. I remember that the rebels were many. We kept on moving all the time. Until they started training us to become soldiers in their camps.

 Where did they train you?

We were brought to Southern Sudan. That’s where they trained us. There were many of us and we where divided in groups. Each group had an instructor. During the training they teach you how to use the weapons, how to shoot. But not only. Many other skills are involved. You must be prepared for the enemy to come at any moment, you must be on alert. Creativity is also part of the skills that a good soldiers must have. 

 What kind of relationship did you have with the other child-soldiers?

We were all like brothers and sisters. The bond among us was difficult to break, because the life of one depends on the life of somebody else. For instance if somebody is left without food, another one would share. 

 Have you ever been forced to kill one of your friends, one of the child soldiers?

When you are ordered to execute orders you have to do it, otherwise you risk your own life. In captivity there are certain rules. You are not supposed to escape for instance, so why would you? If you tried you would be killed. Usually, there are special squads for this. You have to know that when somebody escapes form captivity, the government wants you to report on everything. The rebels would kill you so to prevent you from giving sensitive information to the government.

 Though I guess that the main reason why children would escape from captivity is certainly not to reveal secret information to the government, but rather because they want to go back home!

Whether you are a child or an adult, when you return from captivity you have to report to the government. The returnees are hunted by the governamental forces that want all information. 

 You have spent 21 years in the bush. Did you become professional a soldier during this time?

Of course. When you spend so many years in the bush you become a professional. I became military director.

 What do the LRA rebels fight for?

The LRA are fighting in order to achieve peace and wealth. We fight to have a peaceful coexistence. LRA are fully aware that the government is well off. People here in Gulu are poor. LRA wants the same wealth and stability that the government enjoys. Indeed, if LRA comes to power today, for sure there will be somebody else challenging them. That’s how things work. 

 Isn’t there another way to achieve peace and wealth a part from war?

A part from war, peace can come through the peace talks. Like us here, around this table. We are discussing peacefully. Acholi have their traditions and the mato oput means reconciliation. We forgive and forget. The government is not willing to talk, they are still hunting the rebels. 

 After the Juba talks, Kony failed to appear and sign. The unsuccessful operation Lighting Thunder, conducted by Ugandan, Southern Sudanese and Congolese forces to chase Kony, ended up scattering the rebels and pushing them into DR Congo where they killed, maimed, raped and displaced innocent civilians. This seems to suggest that not even the LRA is willing to put guns down. Not so?

When the Ugandan army was chasing Kony, they were the first who went to chase for him. Unsuccessfully. Being a soldier is not easy. The LRA reacted to the governamental troops. 

 What is Kony’s vision?

Kony needs peace and wealth. He wants better living for his people. He should have power. 

 But he is using the wrong means to achieve it. By abducting children, for instance, he is hurting his own people!

This war started before Kony. LRA was there under different names before him. There were people fighting at that time. These people went back to the villages. Kony gained power but he could not fight this war alone. That’s why he has to abduct children. 

 Would you allow the LRA to abduct your children?

It’s not good to come and abduct children. But children are the most active and are full of energies. Of course it is not good because families are concerned. For instance when I came back my parents were already all dead. 

 Is religion behind the LRA philosophy?

Yes, Christianity is attached to the LRA. When we prayed we really meant it. No matter which religion you belong to, just pray. It helps a lot to bring all soldiers together. The priest helped to reconcile one another. 

 Did you use the prayers to ask forgiveness when you killed somebody?

When we were going to fight we had to pray in order to save our lives. We prayed of achieving our goal and destroy the enemy.

 How did the LRA get the food?

There are ways of getting food. In 1994 communities were contributing and supplying us with food. In Southern Sudan the Arabs would supply us. When the relations between the LRA and Sudan broke down in 2002, we had to find ways of getting the food we needed and if people in villages did not give it spontaneously we would take it by force. 

 How about the weapons?

Most of the weapons and ammunitions were taken by the UPDF soldiers. When we were fighting we would take the guns of those dead on the battlefield. Otherwise Sudan was supplying us. 

 After growing up with the rebels, did you start supporting the LRA’s cause, or in the back of your mind there has always been the wish to escape?

I was supporting the LRA cause. But I was hoping to come back one day. We spent a lot of time in Congo and Sudan, but we are neither Congolese nor Sudanese. We are Acholi and our land is here. 

 How did you escape from the LRA?

Escaping from the LRA is not easy. You cannot leave by saying goodbye. I left during night after a month of planning. When they woke up they realized that I wasn’t there and they looked for me. I was liked by many since I was a chief. 

 Why did you take this decision after so many years?

We were hoping of returning peacefully all together as a team. But when Oti Vincent – LRA second in command  and right-hand man of Kony – who was in charge of the peace talks, was killed by Kony, we realised that the Juba talks were failing and that there was not going to be any peace any time soon. So I left. 

 How has life been after captivity?

Under amnesty the government had to accept me back. That’s an achievement. The challenges come from our families. My parents died and I don’t know where to start from. As all rebels I chose my wife when I was in captivity and she is here with me and our 5 children. Food is lacking and a place to stay too. On my arrival, I went to the governamental offices. I was brought to Kampala to report. We are asked not to leave Gulu. I don’t want to go back to my villages because that’s the place where I was abducted. The government has not helped ex-combatants to re-integrate. We feel like aliens.

 Have you received any support?

Caritas has helped us. They deal with the suffering community. We got to know them during the Juba talks in Ri-Kwangba (Sudan) when Caritas Gulu was in charge of supplying food and medications to the LRA rebels and their families. The government of Sudan and the government of Uganda signed a memorandum of understanding that would allow Caritas Gulu to provide us with help. That’s when I got to know them. Once back in Gulu, Caritas Gulu helped me when I was sick and offered me psychological counselling. 

 I know that Acholi culture is very rich and you have ceremonies to cleanse people form a past of wrong-doings. Have you ever gone through a traditional Acholi ceremony?

Yes. The paramount chief performed it. We used traditional Acholi ceremonies also in the bush. For instance one day, Kony said we had go and pray. Not in the camp but in the bush. We went with him and we found a sheep. We killed the sheep and sat in a circle. Afterwards we burnt the sheep and elders from LRA took the ashes back to the camp. On the way back Kony said that no one should talk. It happened though that a boy stepped on the foot of another who broke the silence. For six months this boy did not talk. He was just pointing at things. This reveals that it was a very powerful ceremony. 

 Do you ever have nightmares or memories from the past haunting you?

Nightmares depend on the individuals’ activities. I stayed in captivity for 20 years but I was not driven mad if this is what you ask. You should not think that everyone of us is haunted by the past. It happens that I dream of myself with a gun but that’s normal, I was a soldier. 

 Do you have any plans for the future?

I want to be settled. I still don’t have a fixed place where to stay, I am roaming.

 Do you think that there is ever going to be any stable peace in Northern Uganda?

I think that there is already some peace in Northern Uganda. In many areas people are leaving the IDPs’ camps and go back to the villages. 

 Do you ever wish you were not abducted?

Yes. I think that if I had not been abducted I would have become somebody. I would have studied and become educated and achieved something in life.

 

 

Shots from Karamoja

 

Daily life in the plains of Karamoja