Refugee Crisis: Assessing the Critical Need for Care in Uganda | The Center for Victims of Torture

Refugee Crisis: Assessing the Critical Need for Care in Uganda

Tuesday, October 3, 2017

A small plot of land for crops. A home. The right to work. The right to move freely. These are some of the innovative benefits being extended to refugees in northern Uganda, who are part of a massive exodus from South Sudan. And now CVT is actively looking at ways to bring psychosocial care to so many who are in great need.

In one year, a million South Sudanese refugees have poured into Uganda, fleeing violent conflict, torture, rape and unspeakable atrocities. The UNHCR reports that 1,800 South Sudanese enter Uganda every day.

CVT has a center in Gulu, in the northern part of Uganda, where we extend care to Ugandans who survived atrocities committed by the Lord’s Resistance Army, a rebel group. The team of counselors conducts group sessions with clients and provides training to area professionals on CVT’s specialized care for survivors of torture.

As the refugee population in the region has grown in staggering numbers recently, however, CVT is active in looking at ways to extend care. Paul Orieny, Ph.D, LMFT, senior clinical advisor for mental health and Neal Porter, director of international services, traveled to Uganda in September to conduct an assessment of needs and operating logistics in the area. They first met with a number of organizations and partners in Kampala, where they particularly noted the commitment to care and sense of urgency held by these organizations.

“Uganda has been putting progressive initiatives in place,” Neal noted. “The country has unique policies toward refugees, and part of that plan is development – providing refugees with opportunities for self-sufficiency with things like plots of land for agriculture.”

Photo: refugee settlement, Bidi Bidi, Uganda

Paul commented on the passion people have to help, saying “They are realizing the need for psychosocial services to come alongside livelihood services. This big influx of people has really increased awareness of the need. And in Kampala, they also understood the need for staff support for humanitarian professionals – we didn’t ask – they mentioned it.”

Uganda is not a huge country, just a bit bigger than the state of Minnesota in terms of area. But with this massive influx, Uganda is now the #5 country in the world in numbers of refugees hosted. For a country with a total population around 41 million, this is an extraordinary circumstance, and one that Uganda is confronting in many unique ways.

Paul and Neal traveled north of CVT Uganda’s Gulu-based center to Adjumani, where they were joined by Luca Modenesi, clinical advisor for mental health, then traversing west to the Yumbe region, which runs along the South Sudanese border. They estimate that close to 600,000 refugees now live in these two areas, many in settlements. There are so many people that these settlements are now closed; no new refugees can come in except for cases of family reunification. Incoming refugees are now settled in newly opened camps in Imvepi and Rhino camp in Arua district. These too are filling up fast.

“From what we see as CVT around the world in refugee areas, it’s unique what Uganda is doing. The Ugandan government is settling people in ways that let them do agriculture. Settlements are divided into villages; over time the refugees end up with housing structures that are similar to the local structures. It’s unique,” Paul said. “Uganda is very fertile; there is a lot of rainfall so it’s very grassy and bushy. So as we traveled we were looking at residences with a lot of agricultural activities.”

“In general there is an aspiration to transition from emergency response to stable services, long-term services and less crisis mode,” Neal said. “We saw many international NGOs working there already. The government of Uganda is genuinely unique in looking for healthier way to try to solve complex problems. They want to make sure members of host communities also have access to services and employment.”

Paul and Neal observed that most of the refugees are women and children. Paul said, “In most cases the men have been killed or they are fighting in South Sudan. There is a lot of trauma; there are many people who saw their families killed, people who were tortured.”

And although many progressive policies are in place, even in these camps, sexual and gender-based violence (SGBV) is a problem, and there is tension between South Sudanese rival tribes, a spillover from the tribal-based conflict from which they fled.

“The big theme,” Paul said, “is there are no resources adequately meeting the needs. Everyone is trying, but organizations cannot reach all the camps. It is very overwhelming.”

What can the Center for Victims of Torture do next? This type of assessment is one of several steps that take place before funding is secured to work where the need is greatest, and that is where CVT will try to go. “There is trauma and torture all over the place,” Paul said. “With the refugees in northern Uganda, we could work in any of the places we looked at – all could use full CVT programs. The need is so great. Realizing that it’s unlikely we would be able to work in all settlements, we will need to decide where we feel we could have the greatest impact.”

In addition, Neal noted that there are additional needs for care. “In Kampala we learned something we had not contemplated before – the urban refugee population in Kampala has resulted in enormous need, so we can look at the possibility of services in Kampala. There are about 100,000 refugees living in the city, and life for these urban refugees is often more precarious than the camps as they have less access to services.”

Being on the ground to meet the people and see the conditions makes a huge difference for CVT when assessing where we can be most effective. Neal commented, “Before assessments, I often can feel intimidated. The crisis seems daunting, the locations feel remote, and the conditions seem harsh. Then being here makes a huge difference. Driving the roads, talking to organizations, it become clearer what CVT could do.  A way forward seems possible.”

With the current situation in Uganda, Paul said, “We could make a very valuable contribution anywhere.”


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