GULU, UGANDA — In her 71 years of life, Josephine Abalo has lived through murderous dictatorships and three Ugandan wars.
The most recent war continues to impact the mental health of the people of Gulu, Abalo’s hometown in northern Uganda, which was the epicenter. In 1987, Joseph Kony formed an armed group known as the Lord’s Resistance Army to protect his Acholi people from an autocratic government. But what started as a noble idea soon became an organization that attacked civilians, including fellow Acholi. For two decades, the armed group killed people and kidnapped children to serve as soldiers and sex slaves, according to Human Rights Watch.
The group hasn’t attacked northern Uganda since 2006, and many people it abducted as children were rescued and returned home as adults. Some came with children born in captivity. Abalo says her daughter, who was rescued, brought home a son named Salim Opoka.
Children like Opoka and their mothers continued to face stigma. They were called children of murderers. Those born to daughters were not allowed to inherit property in their maternal homeland, according to Acholi culture. But Abalo, who is widowed, recently authorized 20-year-old Opoka to build a house on her land because he knew no other home.
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Abalo’s decision to go against tradition reopened the wounds of a war she thought was in the past. On that fateful day, Opoka started construction because he had time due to the latest coronavirus lockdown. His 25-year-old cousin, Joseph Opio, the son of Abalo’s son, stabbed and killed him.
“He had always called [Opoka] the son of LRA murderers and argued he had no right to build here,” Abalo says, cupping her chin with her right hand. “He is now in prison.”
Economic hardships and anxiety caused by the coronavirus lockdowns have led to a spike in domestic assaults, murders and suicides in the region. Although cases of domestic violence have soared worldwide during the pandemic, experts say the risk is higher in places like northern Uganda, which were already struggling with war-related mental health issues. Last year, the Aswa region, where Gulu is located, recorded 59 murders by domestic violence, an increase of 18% from 2019 and higher than any region in the country, according to the Uganda Police Force 2020 Crime Report.
David Ongom Mudong, the assistant superintendent of police and public relations officer for the Aswa-Gulu region, acknowledges that officials are grappling with rising rates of family violence. “People assault others,” Mudong says. “Suicide rates are high.”
Winfred Aciro, the acting country director of Thrive Gulu, a local nongovernmental organization that supports people who lived through the latest war, says people dealing with the trauma of war can be easily provoked by stressful events that aren’t necessarily related to it, like the coronavirus pandemic.
“Many haven’t healed from that wound, so any small thing that comes can trigger them,” Aciro says.
A 2010 study by the University of California, Berkeley, found that more than half of people in northern Uganda lost a household member to the war, and 67% witnessed murders, rapes and beatings. The conflict killed more than 100,000 people and displaced 2.5 million, according to the United Nations.
Although Opio was never abducted, he witnessed massacres and abductions when he was 3 years old, Abalo says. He grew into a young man who preferred to be alone. He was easy to provoke. She remembers him once chasing a neighbor’s son with a machete. But the thought of him committing murder never occurred to her.
With movement restrictions, fewer people have been able to access psychological counseling. Counseling centers have been converted to COVID-19 treatment wards, says Derrick Kizza Mbuga, a psychologist and the executive director of Mental Health Uganda, a nonprofit organization that advocates for people with mental illness.
“COVID-19 has opened up wounds of the war that were yet to heal,” he says.
Dr. Hafsa Lukwata, acting assistant commissioner for mental health and control of substance abuse at the Ministry of Health, acknowledges that mental health units were turned into COVID-19 treatment centers but says the ministry converted some outpatient facilities into mental health centers to offset the loss. “In Gulu, for example, we are using the eye unit,” she says.
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Economic hardships brought on by the pandemic also have rendered many people jobless and homeless, which impedes their recovery from trauma, Mbuga says. Due to the effects of the pandemic, Uganda’s economy grew by only 2.9% in 2020, down from 6.8% in 2019, according to the World Bank. The country doesn’t have unemployment insurance, says Aggrey Kibenge, the permanent secretary in the Ministry of Gender, Labour and Social Development.
“We have instead prioritized programs targeting all individuals irrespective of employment status,” he says.
Mental health experts are now scrambling to serve their clients and protect the gains they made before the pandemic, says Aciro of Thrive Gulu. Her organization now offers online and telephone counseling. “We are also training people on basic techniques, so they can provide first-aid counseling in their communities and refer complicated cases to us,” she says.
As Abalo contemplates visiting her grandson in prison when movement restrictions are lifted, she says she can’t stop thinking about how much heartache could have been prevented by getting him help.
“We just never realized he needed psychological support,” she says, almost in a whisper, shaking her head.
Apophia Agiresaasi is a Global Press Journal reporter based in Kampala, Uganda. She specializes in reporting on health and politics.