By Dinnah Nabwire on July 18, 2019

Of invisible scars unveiled: A call for psychosocial support to survivors of sexual violence in Uganda’s conflict-affected areas.

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It starts between 3 and 4am every night. I have never slept the same since then. I frequently hear their loud noises as they roughed me up”. This is how Lanyero (name changed), 52 years introduced me to her story during one of my field visits where I interact with and document community voices. She was gang-raped by 10 rebels in 2004 as she left the camp to look for food in the villages of Awach sub-county, Gulu district.

Despite receiving help from one non-profit organisation to treat physical injuries sustained from the incident, Lanyero still endures prolonged flashbacks, nightmares and fresh memories of it 14 years later.

Hers is no single case. She is one of hundreds of women and men who suffer conflict-related sexual violence with visible andinvisiblescars lasting over decades. While there is no whole statistical figure of how many people have suffered sexual violence in all of Uganda’s conflicts, research points to segments of affected populations.

In Northern Uganda for instance, Amone P’Olak (2016) found that 65% of formerly abducted girls who suffered sexual violence in rebel captivity sustained severe psychological effects. Worse still, the Lord’s Resistance Army (LRA) was known to employ acts of militarised masculinitiesto feminisemen. This was through forcing them to have sex with other men or with inanimate objects like banana stems, or to rape women in the presence of their husbands or family members.

The World Health Organization directly links conflict-related sexual violence with psychological wellbeing and social functioning of survivors. In addition to Lanyero’s listed psychological experiences, survivors are known to suffer rape trauma syndrome, post-traumatic stress disorder and depression in the short run and chronic headaches, alcohol and substance abuse disorders, suicidal ideation and self-harm in the long run.

The government of Uganda has undertaken several policy efforts towards prevention and response to gender-based violence (GBV) in all its forms. This includes specific guidelines developed on psychosocial support for GBV survivors. The question, however, is whether these policies, designed from a general health systems approach to “reach every Ugandan”, actually impact women and men in Lanyero’s situation?

Unlike everywhere else in Uganda, addressing psychosocial effects of sexual violence in post-war areas like Luweero, the LRA-hit regions and refugee communities present unique needs, challenges and opportunities.

While current guidelines focus on response, there is opportunity to design specific guidelines for these fragile areas and incorporate strategies to address psychological drivers of GBV. This aligns with the national commitment to zero tolerance for sexual violence, expressed in the 2011 Kampala Declaration.

Further still, while important aspects like social support are highlighted as crucial psychosocial support anchors for survivors in the current guidelines, it must be acknowledged that these are often broken and require additional reconstruction efforts to yield impact for most survivors in conflict-affected areas. Moreover, investing in separate guidelines seeks to benefit a wider range of often left out groups. This includes 1.2 million refugees hosted in Uganda and 50% of people (UNDP, 2015) in the areas of the Peace Recovery and Development Plan (PRDP), among other conflict-affected parts of the population sustaining psychological effects of conflict and other critical events.

Moreover, decades of peace and security breakdown in the Greatlakes region marked by systematic acts of conflict related sexual violence warrant futuristic survivor-centered policies for prevention and response as Uganda leads regional humanitarian response while rebuilding stability in its own fragile areas.

Even more, this will make recovery, reconciliation and forgiveness – which are crucial for resilience, social functioning and guaranteeing non-reoccurrence of similar conflict drivers – a reality for populations living Lanyero’s story.

Written by Dinnah Nabwire

Y4P Fellow 2019

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