Psychosocial support system for 600 youths in Northern Uganda

In close collaboration with the Norwegian Refugee Council’s Youth Education Pack (YEP), vivo started up the development of a long-term psychosocial support system which has so far reached 600 war-affected youths in vocational training centres all over Uganda’s war-torn North.
YEP supports most severely affected learners, many of them formerly abducted child soldiers, within ten vocational trainings centres. Within the YEP program learners are enabled to learn practical vocational skills and catch up on academic education in order to reintegrate better within their communities after their return home.

In 2009, over a period of 6 months vivo has trained ten former teachers as counsellors. They have provided psychosocial support services to the affected learners on the spot in schools. The low threshold program is tailored not only to reduce mental health related symptoms of PTSD, depression and suicidality in NRC’s beneficiaries, but also to enhance reconciliation attempts and non-violent forms of conflict resolution strategies as well as to, overall, boost learner’s reintegration and rehabilitation. Within the current project vivo undertook not only training and supervision of trauma treatments, but also new group-based strategies to foster peace building initiatives in Northern Uganda.
vivo developed “Conflict Resolution Skills and Social Competence Trainings” promoting non-violent forms of settling disputes in learners. Based on individual life-stories, vivo also educed a peace education and human rights-focused approach called “NET truth” to encourage mutual understanding and open communication about war experiences and psychosocial needs among students. Also stigmatisation is aimed to be reduced with this approach.
A third component vivo introduced in the YEP centres was “teacher counselling” which is based on teacher’s jointly collected most prominent views on psychosocial problem fields among their students and solving strategies.

For six months, vivo-experts trained the ten new counsellors intensively in all psychosocial approaches in workshops and practical on the job trainings with extensive vivo-expert supervision. With the help of nine local vivo counsellors, the ten newly trained former teachers were so far able to carry out the above mentioned interventions with more than 600 learners who had endured gross forms of violence and human suffering during war.

400 of all students who took part in interventions were interviewed with regard to psychological problems and further psychosocial well being prior to the running of interventions. Currently, follow-ups of the treated students are conducted in order to develop a best-practice manual on psychosocial support within the educational sector in post-conflict Northern Uganda and in order to adjust the support system for future students in the most effective way.

founding and current work of vivo Uganda

vivo decided to build a permanent base in the country in 2004. Local cooperation partners and team members formed vivo Uganda, the independent sister organization of vivo, which is registered with the country’s NGO board. With vivo becoming more and more visible in Uganda, local policy makers and officials requested vivo to not only focus on refugees, but engage in helping the war-affected and displaced population of Northern Uganda. At that time virtually the entire population of Northern Uganda (about 1.8 Million) was living in Camps for Internally Displaced People (IDP camps) to be safe from attacks and abductions by Joseph Kony’s rebel movement, the Lord’s Resistance Army (LRA). The LRA abducted about 52.000 to 75.000 children and youths and forced them to be fighters, porters, cooks, servants and sexual servants. Moreover they were notorious for brutal massacres, lootings and mutilations of the civilian population. Due to security reasons vivo wasn’t able to start its work in Northern Uganda before 2005, when requests for help came again from local NGOs that were feeling helpless in dealing with former child soldiers presenting with psychological problems. This opened a new chapter of work, since nobody had ever before conducted psychotherapy with traumatized child soldiers. Clinical experts of vivo found that Narrative Exposure Therapy helped to reduce trauma symptoms in this highly war-affected group whose members are regarded as victims and perpetrators of violence at the same time [link to related publication].

Large scale epidemiologic surveys, as well as long term evaluations of treatment success, when treatments of former child soldiers were carried out by trained locals followed and vivo’s projects covered the most affected Northern Ugandan districts. vivo’s engagement was both, urgently needed and highly welcome in Northern Uganda, which convinced vivo to built up a stable base in Gulu, the main town of Northern Uganda in 2007. To date, vivo is working together with more than seven local and international NGOs in and around Gulu as well as with Gulu University. vivo is receiving referrals for trauma treatment, training and supervising staff members of partner NGOs, adjusting treatments to the local context, developing new treatment methods and modules and scientifically monitoring and evaluating the need for and effects of its programs. So far, more than 15 training courses, reaching more than 300 counselors, teachers, social workers, community volunteers and many others have been carried out. More than 4000 in depth mental health screenings were conducted by vivo’s staff and partnering NGOs to find out the scale and nature of psychological suffering and for monitoring and evaluation purposes [link to related publication] . More than 500 beneficiaries have been psychologically treated. Currently, vivo is seeking to understand the consequences of the warfare for the next generation of children, who had the chance to grow up during the ceasefire but who are confronted with the consequences of the traumatic history in their families and communities.

vivo’s initial steps in Uganda

Uganda has a long history of civil wars and has been surrounded by some of the worst conflicts in African history. As a consequence, Uganda hosts large refugee populations from many foreign countries and has to deal with the legacy of their own wars. vivo’s work in Uganda started in 1999 with the first trial of Narrative Exposure Therapy (NET) treating traumatized Sudanese refugees in Imvepi refugee camp situated in the very North of Uganda. Treatments did not only reduce symptoms of posttraumatic stress disorder, but also filled the refugees with hope, new confidence and functionality [link to related publication] . After the treatment, many were brave enough to leave the desperate camp situation and started to take care of their own livelihood.

In the early years of vivo in Uganda we continued to work with refugees which lead us to Nakivale camp in Southwestern Uganda, one of the largest refugee camps of the country, hosting refugees from many East African countries. From 2002 onwards vivo worked with Somali refugees and Rwandese genocide victims and succeeded in disseminating trauma therapy to members of the affected populations. vivo could proof for the first time that trauma treatment was highly effective when carried out by trained lay therapists [link to related publication] . This was a breakthrough, since being a mental-health expert was not an indispensable prerequisite for trauma therapy any more. Few mental health experts can train numerous laymen and –women and thus reach many more members of the war-affected populations. During this project a fruitful cooperation started with Mbarara University that is lasting up to date. Besides building local capacity through the training of local therapists this was a next important step to ensure the sustainability of vivo’s work. In the following years of the Nakivale project, vivo pioneered Narrative Exposure Therapy in victims starting from the age of 12, also with success [link to related publication] .