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Uganda is a case of midrange institutional control in which transitional justice has been subsumed within existing state institutions through a strategy of containment. In this chapter I present the Ugandan government’s strategy wherein transitional justice is enmeshed within existing structures of power, which allows the government to monitor and control the risks of norm compliance. The chapter begins with a discussion of the history of armed conflict in Uganda, particularly the war against the Lord’s Resistance Army and the government’s abuse of Acholi civilians. I then examine the government’s adaptation of transitional justice to identify and evaluate the containment strategy in which the risks of accountability are managed by integrating transitional justice into government institutions controlled through patronage, functionally rendering impunity for the state. I explore the containment strategy through three components of transitional justice in Uganda: International Crimes Division, state-regulated customary justice practices, and the National Transitional Justice Policy. To explore the strategy beyond the case of Uganda, I examine transitional justice in Côte d’Ivoire.
Now more than ever the international community plays a central role in pressing governments to hold their own to account. Despite pressure to adhere to global human rights norms, governments continue to benefit from impunity for their past crimes. In an age of accountability, how do states continue to escape justice? This book presents a theory of strategic adaptation which explains the conditions under which governments adopt transitional justice without a genuine commitment to holding state forces to account. Cyanne E. Loyle develops this theory through in-depth fieldwork from Rwanda, Uganda, and Northern Ireland conducted over the last ten years. Research in each of these cases reveals a unique strategy of adaption: coercion, containment, and concession. Using evidence from these cases, Loyle traces the conditions under which a government pursues its chosen strategies and the resulting transitional justice outcomes. This title is also available as Open Access on Cambridge Core.
1. What are the necessary issues of engagement in rural, traditional, and agricultural communities to make a change? 2. What kind of justice actions are required from social workers engaged with agrarian communities? 3. How can social work learn from different community approaches to update professional social work education, theory, and practice? Can this learning promote local solutions to local problems?
Mental illnesses constitute a large and escalating portion of the global burden of disease, particularly in low- and middle-income countries like Uganda. Understanding community perceptions towards mental illness is crucial for developing effective interventions.
Aims
To explore beliefs about the perceived causes and treatment of common mental illnesses (depression, anxiety, alcohol use disorder) and suicidality in rural eastern Uganda.
Method
Qualitative study using 31 in-depth interviews and 4 focus group discussions with healthcare workers, community health workers, community leaders and general community members in Buyende District, Uganda. Vignettes were used to depict mental illnesses to elicit perceptions, and data were analysed using the framework method.
Results
Two main themes emerged: perceived causes and treatment of mental illness. Participants identified three primary perceived causes: psychosocial (predominantly financial stress), biological and supernatural. Community support was most frequently endorsed as a perceived effective treatment, followed by biomedical interventions and alternative therapies.
Conclusions
This study identifies common beliefs regarding the causes and perceptions of mental illness in rural Uganda. The predominant focus on financial stressors as a cause of mental illness, coupled with strong emphasis and belief in the effectiveness of community-based support as treatment, highlights the need for context-specific mental health interventions.
To (1) determine how serum fatty acid (FA) levels differ by developmental stage, (2) quantify associations between perinatal HIV-related factors and PUFA levels and (3) examine the heterogeneity of these associations by developmental stage.
Design:
Cross-sectional secondary analysis of baseline data from two prospective cohorts.
Setting:
Kampala, Uganda.
Participants:
243 children (6–10 years old) and 383 adolescents (11–18 years old) were recruited at Kawaala Health Center based on perinatal HIV status. Youth (children and adolescents) were classified as: those with perinatal HIV infection (PHIV: n 212), those perinatally HIV exposed but remained uninfected (HEU: n 211) and those perinatally HIV unexposed and uninfected (HUU: n 203).
Results:
Adolescents had lower n-6 and n-3 PUFA levels than children, and among adolescents, these levels increased with age. Relative to children HUU, children PHIV had a higher triene:tetraene ratio and 20:3n-9 (indicators of essential fatty acid deficiency (EFAD)). Adolescents PHIV v. HUU had lower 20:5n-3 levels. When considering in utero/peripartum antiretroviral therapy (IPA) exposure, the FA profile was indicative of EFAD for youth PHIV with (a) no IPA exposure and (b) combination IPA exposure, whereas non-nucleoside RT inhibitor+nucleoside RT inhibitor exposure was associated with a favourable FA profile among youth PHIV and HEU (all P < 0·05).
Conclusion:
In this sample, perinatal HIV status was associated with low PUFA levels, and these associations varied by developmental stage and IPA exposure type. Future research should elucidate the contribution of IPA exposure type to EFAD and the implications of these differences on growth and cognitive development.
The global utility of acceptance and commitment therapy highlights the need for adapting measures that can effectively capture the richness of psychological flexibility. One such instrument is the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT). We translated the CompACT into Luganda and adapted it for use in Uganda. The original CompACT was translated into the Luganda language and reviewed through a series of evaluations. Nine mental health professionals participated in one-on-one interviews, while a focus group of eight culturally competent laypersons provided further insights. Their feedback resulted in revisions to enhance the instrument’s clarity, relevance, acceptability and completeness. The revised version was then cognitively tested with n = 25 trainees at Makerere University. Input from these various groups was synthesized and triangulated to develop the final version. A total of 23 items were adapted to improve the comprehensibility and completeness of the scale. Overall, respondents deemed the tool clear and acceptable. This study highlights the importance of a rigorous adaptation process, including translation, expert review, cognitive testing and feedback triangulation, to ensure psychological measures remain valid and relevant across cultures. Such an approach ensures accuracy in diverse contexts and provides a model for adapting psychological instruments for non-Western populations.
This interdisciplinary qualitative research on Uganda combines an empirical approach with an analysis of theoretical studies. It argues that the retributive-oriented state justice system should take a more hybrid approach by absorbing the restorative method of traditional justice systems arbitrated by community leaders to improve the way sexual and gender-based violence (SGBV) cases of refugees and asylum-seekers are addressed. The goal is to examine the interlinkages of restorative and retributive justice and why both systems should be better integrated to enhance ways of addressing SGBV. It is argued that there will be a positive impact on people in Uganda, including refugees who have suffered SGBV, if such an integration of both systems occurs. Drawing from interviews, it uses a theoretical framework of direct, structural and cultural violence within the continuum of violence. In this context, the study argues for a hybrid approach to depatriarchalize domestic justice systems, whether retributive or restorative justice, to contribute to better and more victim-friendly systems that consider the views and hopes of SGBV survivors.
This research examines whether high temperatures and exposure to childhood rainfall and heat shocks are a cognitive drag on children in Uganda. First, it asks whether students perform worse on a test on hotter days. Second, it examines whether previous longer-term exposure to high temperatures and unusual rainfall influences current test scores and educational outcomes. The analysis shows that high temperatures on test dates harm test performance, especially for girls and children younger than ten, implying additional temperature control considerations for particular demographics. The analysis of childhood climate shocks, which employs within-parish distributions of rainfall and heat, shows that children who experience rain or heat above the $80^{th}$ percentile of the parish distribution from birth until age 4 have worse learning outcomes in math, English, or local language literacy.
Artisanal and small-scale gold mining offers opportunities to a diverse set of actors operating in formal, legal and clandestine realms. The sector has considerable expansion potential but it is hampered by corruption, illegal actors and a poorly regulated market. This chapter focuses on Artisanal and Small-Scale Miners (ASM) in Uganda, exploring ongoing tensions between ASM communities, mining firms, and the government. While enforcing health and safety laws in the extractive industry has proven challenging to departments responsible for worker health and safety, the government in Uganda is trying to establish a structured approach with detailed legal and technical collaboration between artisanal miners and technical people whose obligation is to offer legal and technical guidance in regulating ASM.
Virtual reality (VR) for mental health promotion remains understudied in low-income humanitarian settings. We examined the effectiveness of VR in reducing depression with urban refugee youth in Kampala, Uganda. This randomized controlled trial assessed VR alone (Arm 1), VR followed by Group Problem Management Plus (GPM+) (Arm 2) and a control group (Arm 3), with a peer-driven and convenience sample of refugee youth aged 16–25 in Kampala. The primary outcome, depression, was measured with the Patient Health Questionnaire-9. Secondary outcomes included: mental health literacy, mental health stigma, self-compassion, mental well-being and adaptive coping. Analyses were conducted at three time points (baseline, 8 weeks, 16 weeks) using generalized estimating equations. Among participants (n = 335, mean age: 20.77, standard deviation: 3.01; cisgender women: n = 158, cisgender men: n = 173, transgender women: n = 4), we found no depression reductions for Arms 1 or 2 at 16 weeks compared with Arm 3. At 16 weeks, mental health literacy was significantly higher for Arm 2 compared with Arm 3, and self-compassion was significantly higher in Arm 1 and Arm 2 compared with Arm 3. VR alongside GPM+ may benefit self-compassion and MHL among urban refugee youth in Kampala, but these interventions were not effective in reducing depression.
Leptospira are bacteria that cause leptospirosis in both humans and animals. Human Leptospira infections in Uganda are suspected to arise from animal–human interactions. From a nationwide survey to determine Leptospira prevalence and circulating sequence types in Uganda, we tested 2030 livestock kidney samples, and 117 small mammals (rodents and shrews) using real-time PCR targeting the lipL32 gene. Pathogenic Leptospira species were detected in 45 livestock samples but not in the small mammals. The prevalence was 6.12% in sheep, 4.25% in cattle, 2.08% in goats, and 0.46% in pigs. Sequence typing revealed that Leptospira borgpetersenii, Leptospira kirschneri, and Leptospira interrogans are widespread across Uganda, with 13 novel sequence types identified. These findings enhance the East African MLST database and support the hypothesis that domesticated animals may be a source of human leptospirosis in Uganda, highlighting the need for increased awareness among those in close contact with livestock.
Cancer is associated with physical, social, spiritual, and psychological changes in patients and their caregivers. However, in sub-Saharan Africa, there is lack of evidence on the impact of gender, social norms, and relationship dynamics in the face of terminal illness. The aim of this paper is to explore how gender identity, social norms, and power relations are impacted when a person is living in Uganda with advanced cancer.
Methods
Focus groups with adult men and women living with advanced cancer in Uganda were conducted. Interviews explored the social effects of cancer and common challenges, including how both disease and treatment affect the patient and marital relationships within their families. Participants’ recommendations were sought to improve the social well-being of patients and their families. Data were analyzed using inductive thematic analysis.
Results
Men and women experienced negative changes in their roles and identities, often feeling unable to fulfill their marital duties in terms of intimacy, their social roles and responsibilities based on societal expectations. Men expressed loss of a “masculine” identity when unable to provide economically for the household. This led to tension in the familial power dynamics, contributing to relationship breakdown and gender-based violence (GBV) against spouses. Women noted challenges with parenting, relationship breakdowns, and increased GBV.
Significance of results
Gender impacts the patient and the family dynamic throughout the life course, including during advanced cancer. Patients and caregivers experience a change in their roles and identities while coping with existential distress and end-of-life tasks. Given these results, gender considerations and dynamics should be incorporated into overall palliative care provision. In addition, there is a need to integrate GBV screening and support in cancer services to address social health and safety needs in the context of serious illness.
Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.
Methods
We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders.
Results
Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality.
Conclusions
Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.
The conclusion of the book draws together the findings from the statistical analysis and the case studies, suggesting possible nuances and extensions to the theoretical framework. It further explores the financial statecraft of borrowers through short accounts of external finance and aid negotiations in Uganda, Senegal, and Laos. The chapter spells out policy implications of the argument, suggesting steps that policymakers in developing countries can take to derive the greatest benefit from their portfolio of external finance, as well as ways that traditional donor agencies can maintain and enhance their relevance. It concludes with reflections on the pertinence of the book's findings for developing countries in debt crisis, including those negotiating debt relief with diverse creditors.
This chapter tests the book’s arguments in a case study from Uganda. The Ugandan government faced a series of armed rebellions throughout the country from 1986 to 2006, and it forcibly relocated civilians while fighting some rebel groups but not others. This chapter draws on a wealth of information collected during six months of fieldwork in 2016 and 2017 on how, when, where, and why authorities employed displacement. By exploiting within-case variation in the location and timing of relocation by the same government, the chapter conducts a structured, controlled comparative analysis. Drawing on original data – including archival materials, subnational violence and displacement data, and hundreds of interviews and surveys with political officials, military officers, rank-and-file soldiers, civil society groups, journalists, community leaders, and civilians – it traces the decision by Ugandan counterinsurgents to employ forced relocation, examine the observable implications of the theory, and demonstrate the assortative logic of displacement. It also shows that alternative logics are insufficient to explain variation in this case.
Population displacement is a devastating feature of contemporary conflict with far-reaching political and humanitarian consequences. This book demonstrates the extent to which displacement is a deliberate strategy of war, not just a consequence of it. Moving beyond instances of ethnic cleansing, Adam Lichtenheld draws on field research in Uganda and Syria; case studies from Burundi, Indonesia, and Vietnam; and an original dataset of strategic displacement in 166 civil wars to show that armed groups often uproot civilians to sort the targeted population, not to get rid of it. When lacking information about opponents' identities and civilians' loyalties, combatants use human mobility to infer wartime affiliations through 'guilt by location'. Different displacement strategies occur in different types of civil wars, with some relying on spatial profiling, rather than ethnic profiling. As displacement reaches record highs, Lichtenheld's findings have important implications for the study of forced migration and policy responses to it.
By the second decade of independence, Uganda’s economy groaned under the pressures of domestic misrule and international turbulence. This chapter traces the variety of popular and state reactions as price inflation and commodity shortages came to prevail. Some Ugandans experienced shortages as an affront to their ethical expectations about merit and redistribution; they accused their compatriots of misdeeds and demanded their government better manage the economy. In response, large domains of economic life were criminalized as the state tried to redirect trade toward avenues more easily taxed or regulated, including through an Economic Crimes Tribunal that indicted innumerable Ugandans. Yet, smuggling, hoarding, and overcharging proved especially bedeviling to the state, Drawing on a range of police investigations, trial records, and petitions, this chapter details the sorts of opportunistic exchanges and engagements that characterized Uganda in the 1970s, an improvisational mix of dissidence and claims-making, acquiescence and rebuke that radically challenged sovereignty and citizenship.
Beginning in the late colonial period, banking and money became a central interface between the state and its subjects, with Ugandans demanding greater access to credit. In the years after independence, the government responded to expectations of commercial liberty by using savings and loans to turn colonial subjects into credible citizens—dutiful producers of export value whose personal “banking habit” would serve the nation as a whole. Whether through the Bank of Uganda’s national currency or the Uganda Commercial Bank’s vans circling the countryside, economic citizenship tried to sidestep the nation’s lack of affective solidarities by weaving together monetary ties. For many, this was welcome, but simultaneously, these financial interdependencies limited exchange across territorial borders. As a result, some people—among them, Asians, migrants, and residents of the border regions—were cast as suspicious subverters of the nation-state. Rather than a question of merely inclusion or exclusion, this chapter shows that postcolonial citizenship worked through “enforced membership,” as national currency imposed inclusion within the state’s monopoly on valuation, sometimes with violent implications (as in the case of the 1972 expulsion of Ugandan Asians).
How can societies effectively reduce crime without exacerbating adversarial relationships between the police and citizens? In recent decades, perhaps the most celebrated innovation in police reform has been the introduction of community policing, where citizens are involved in building channels of dialogue and improving police-citizen collaboration. Despite the widespread adoption of community policing in the United States and increasingly in the developing world, there is still limited credible evidence about whether it realistically increases trust in the police or reduces crime. Through simultaneously coordinated field experiments in a diversity of political contexts, this book presents the outcome of a major research initiative into the efficacy of community policing. Scholars from around the world uncover whether, and under what conditions, this highly influential strategy for tackling crime and insecurity is effective. With its highly innovative approach to cumulative learning, this project represents a new frontier in the study of police reform.