Conflict's aftermath
May 9, 2011
For Bouncer, a young Ugandan man, an already tumultuous life changed dramatically when he was 15.
He was one of hundreds of thousands of "internally displace persons" who had been forced from their home villages by the brutal acts of rebels, whose leader, Joseph Kony, said he wanted to rule Uganda according to the Biblical Ten Commandments.
One day, as he was riding his bicycle near the Apotokito refugee camp where his family had fled to escape the terror sown by Kony's Lord's Resistance Army (LRA), he hit a landmine and lost his left leg.
To this day, his other wounds have not entirely healed because he hasn't received the treatment he needs.
Scars unhealed
"I still need medical help," he said. "The wounds on my remaining foot have never really healed properly. They keep opening up."
Given the severity of his injuries, Bouncer should be going for medical check-ups at least once a month. But here in Apotokito, about 40 kilometers from the district capital of Gulu, little medical help is available.
He feels left to his own devices, abandoned by the state and even his family, as do many people – especially the old, the sick and the disabled - who were caught up in the decades of violence that plagued northern Uganda.
Two years ago, the LRA militias took their fight to the neighboring Democratic Republic of Congo and the government began dismantling many of the refugee camps in northern Uganda.
Slowly, people began returning to their villages, but - as in Bouncer's case - they often left behind those who they feared could not physically make the trek back home, a journey that often covered hundreds of kilometers.
Shame and a broken system
There are no available statistics of the number of Ugandans who are physically disabled.
Many are kept hidden away by their families, since in the Ugandan culture, having a disabled family member is a source of shame.
As a result, many disabled people can expect little or no help from their relatives, and Uganda's underdeveloped health care system is ill equipped to meet their needs.
Healthcare in Uganda is ranked as one of the worst in the world by the World Health Organization - 186th out of 191 nations.
Government health insurance is only available to members of the national insurance fund, in which only 500,000 people out of the country's 31 million are enrolled.
In 2006, the Ugandan parliament passed a bill that was meant to provide more assistance and rights to disabled people, but five years later, it has yet to become law.
"The government is slow," admitted Richard Totwong, who worked in Gulu as a representative of Ugandan President Yoweri Kaguta Museveni. "We need time in the wake of the rebel war to get long-term help to those who need it."
Help from outside
The government has been most able to help in areas where it gets support from foreign organizations working in the country.
"The Ugandan government tries to get money from outside sources, but the aid is sporadic," said Femke Bannink, from the Association of Volunteers in International Service (AVSI), an Italian group that has been in the region since 1984.
It has a strong presence in northern Uganda and runs an orthopedic clinic and workshop among other activities.
The doctors in the orthopedic clinic in Gulu treat some 430 patients every year. The service is free of charge. The government covers the costs of the infrastructure and personnel, the medical supplies are furnished by AVSI.
By working with a regional hospital, which is a public institution, AVSI aims to help the government help itself.
The organization takes care of people who were maimed and mutilated by the LRA, one of the machete-wielding rebel group's preferred tactics. Twice a year, a team of plastic surgeons from the Netherlands and Italy come to Gulu where they perform operations along with training local health care providers.
While the worst of the LRA's brutality may be in the past for many Ugandans, others here will have to live with the aftermath of the conflict for their entire lives.
Yet groups like AVSI and other aid organizations are providing some hope to people like Bouncer.
These individuals depend on outside help for their long-term health since for the time being, and likely in the near future at least, the Ugandan government will not be able to meet the health care needs of its traumatized population on its own.
Author: Friedel Taube (jam)
Editor: Nathan Witkop