Implications of War in Northern Uganda on Mental Health

A recent issue of the Journal of the American Medical Association (JAMA) released articles dedicated to the study of conflict, human rights, and international mental health consequences. Some of the most striking papers dealt specifically with the psychological effects of war as well as the implications exposure to violent war crimes have on efforts towards peace building. Theory built off of conventional research has already established the links between external conflict and severe psychological trauma for children as well as adults. (1)

Two of the most poignant studies presented in JAMA address the consequences of the persistent conflict that has taken place since the 1980s between the Lord’s Resistance Army, Ugandan People’s Democratic Army, and the people of Northern Uganda. Internal displacement as a result of constant violence has forced local populations into overcrowded living situations, compromising the the health and safety of many of the country’s citizens. The first of those articles treating this particular subject assessed local interventions on depression and its symptoms among 314 adolescents displaced by war in Northern Uganda. (2) Utilizing locally developed screening tools, researchers studied, among other things, the effectiveness of group psychotherapy and activity-based intervention, measuring the improvement of depression symptoms and scores on anxiety and conduct problem scales. The conclusions drawn from this trial highlighted an improvement among adolescent girls who underwent group interpersonal psychotherapy. Moreover, the study stresses the need for other intervention techniques geared towards adolescent boys with depression.

The second article entitled, “Exposure to War Crimes and Implications for Peace Building in Northern Uganda,” presented a unique and interesting perspective on the challenges of implementing peace measures in a population long exposed to war crimes. The study targeted the prevalence of post-traumatic stress disorder (PTSD) and depression in Northern Uganda. Moreover, it measured the response individuals affected by either PTSD or depression had towards peace initiatives. Using the rates of exposure to trauma and resulting beliefs concerning peace in the region, the authors of the study concluded that, “respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.” (3)

Although this post treats both studies in extreme brevity, an underlying message concerning health concerns and war remains discernible. Public health in areas of conflict, crisis, and disaster has long been sidelined in deference to “hard politics.” The implications of these and other areas of research suggest, however, that the relationship between health and conflict must be explored further.

To get a full account of these and other studies, please refer to the Journal of the American Medical Association: August 1, 2007, Vol 298, No. 5.

References

(1) Joanna Santa Barbara. The Psychological Effects of War on Children. War and Public Health. Ed. Barry S. Levy and Victor W. Sidel. Oxford: Oxford University Press. American Public Health Association, 2000.

(2) P. Bolton, J. Bass, T. Betancourt, L. Speelman, G. Onyango, K.F. Clougherty, R. Neugebauer, L. Murray, H. Verdeli. Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda: A Randomized Controlled Trial. Journal of the American Medical Association. Vol. 298, No. 5. August 1, 2007.

(3) P. Vinck, P.N. Pham, E. Stover, H.M. Weinstein, Exposure to War Crimes and Implications for Peace Building in Northern Uganda. Journal of the American Medical Association. Vol. 298, No. 5. August 1, 2007.