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Published in: Conflict and Health 1/2014

Open Access 01-12-2014 | Research

After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda

Authors: Katherine A Muldoon, Godfrey Muzaaya, Theresa S Betancourt, Mirriam Ajok, Monica Akello, Zaira Petruf, Paul Nguyen, Erin K Baines, Kate Shannon

Published in: Conflict and Health | Issue 1/2014

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Abstract

Background

Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated.

Methods

This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as ‘reintegrated’ if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated.

Results

From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988–2010 for an average length of one year, the median age of abduction was 13 years (IQR:11–14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from those who self-reintegrated (p > 0.05).

Conclusions

Over 40% of female abductees in this sample had accessed a reintegration program, however significant differences in mental health were not observed between those who accessed a reintegration program and those who self-reintegrated. The successful reintegration of combatants and abductees into their recipient community is a complex process and these results support the need for gender-specific services and ongoing evaluation of reintegration programming.
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Literature
2.
go back to reference Muggah R: No magic bullet: a critical perspective on disarmament, demobilization and reintegration (DDR) and weapons reduction in post-conflict contexts. Round Table. 2005, 94: 239-252. 10.1080/00358530500082684.CrossRef Muggah R: No magic bullet: a critical perspective on disarmament, demobilization and reintegration (DDR) and weapons reduction in post-conflict contexts. Round Table. 2005, 94: 239-252. 10.1080/00358530500082684.CrossRef
3.
go back to reference Inter-Agency Working Group on DDR: Integrated Disarmament Demobilization and Reintegration Standards. 2006, New York City: United Nations Inter-Agency Working Group on DDR: Integrated Disarmament Demobilization and Reintegration Standards. 2006, New York City: United Nations
4.
go back to reference De Vries H, Wiegink N: Breaking up and going home? Contesting two assumptions in the demobilization and reintegration of former combatants. Int Peacekeep. 2011, 18: 38-51. 10.1080/13533312.2011.527506.CrossRef De Vries H, Wiegink N: Breaking up and going home? Contesting two assumptions in the demobilization and reintegration of former combatants. Int Peacekeep. 2011, 18: 38-51. 10.1080/13533312.2011.527506.CrossRef
5.
go back to reference Pham PN, Vinck P, Stover E: Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord’s resistance army in northern Uganda. BMC Psychiatry. 2009, 14: 1-14. Pham PN, Vinck P, Stover E: Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord’s resistance army in northern Uganda. BMC Psychiatry. 2009, 14: 1-14.
6.
go back to reference Silberman L: Hague child abduction convention turns twenty: gender politics and other issues, The New York Univ. J Int Law Polit. 2000, 33: 221-225. Silberman L: Hague child abduction convention turns twenty: gender politics and other issues, The New York Univ. J Int Law Polit. 2000, 33: 221-225.
7.
go back to reference Mckay S: Reconstructing fragile lives: girls’ social reintegration in northern uganda and sierra leone. Gend Dev. 2004, 12: 19-30.CrossRef Mckay S: Reconstructing fragile lives: girls’ social reintegration in northern uganda and sierra leone. Gend Dev. 2004, 12: 19-30.CrossRef
8.
go back to reference Betancourt TS, Borisova I, de la Soudiere M, Williamson J: Sierre Leone’s child soldiers: war exposure and mental health problemsby gender. J Adolesc Heal. 2011, 49: 21-28. 10.1016/j.jadohealth.2010.09.021.CrossRef Betancourt TS, Borisova I, de la Soudiere M, Williamson J: Sierre Leone’s child soldiers: war exposure and mental health problemsby gender. J Adolesc Heal. 2011, 49: 21-28. 10.1016/j.jadohealth.2010.09.021.CrossRef
9.
go back to reference United Nations: In-depth study on all forms of violence against women, Volume 41974. 2006, New York City: United Nations, 1-139. United Nations: In-depth study on all forms of violence against women, Volume 41974. 2006, New York City: United Nations, 1-139.
10.
go back to reference United Nations Department of Peacekeeping Operations: Second generation disarmament, demobilization and reintegration (ddr) practices in peace operations. 2010, New York: United Nations, 1-74. United Nations Department of Peacekeeping Operations: Second generation disarmament, demobilization and reintegration (ddr) practices in peace operations. 2010, New York: United Nations, 1-74.
11.
go back to reference Betancourt TS, Borisova I, Williams TP, Meyers-Ohki SE, Rubin-Smith JE, Annan J, Kohrt B: Research Review: Psychosocial adjustment and mental health in former child soldiers - a systematic review of the literature and recommendations for future research. J Child Psychol Psychiatry. 2012, 54: 17-36.PubMedCentralCrossRefPubMed Betancourt TS, Borisova I, Williams TP, Meyers-Ohki SE, Rubin-Smith JE, Annan J, Kohrt B: Research Review: Psychosocial adjustment and mental health in former child soldiers - a systematic review of the literature and recommendations for future research. J Child Psychol Psychiatry. 2012, 54: 17-36.PubMedCentralCrossRefPubMed
12.
go back to reference Blattman C: The Survey of War Affected Youth: Research & Program for youth in armed conflict in Uganda. 2006, New York City, 1-9. Blattman C: The Survey of War Affected Youth: Research & Program for youth in armed conflict in Uganda. 2006, New York City, 1-9.
13.
go back to reference Justice and Reconciliation Project: Remembering the Atiak Massacre April 20th 1995. 2007, New York City: Liu Institute for Global Issues Justice and Reconciliation Project: Remembering the Atiak Massacre April 20th 1995. 2007, New York City: Liu Institute for Global Issues
15.
go back to reference Human Rights Watch: Abducted and Abused: Renewed Conflict in Northern Uganda, Volume 15. 2003, Washington DC, 1-77. Human Rights Watch: Abducted and Abused: Renewed Conflict in Northern Uganda, Volume 15. 2003, Washington DC, 1-77.
16.
go back to reference Berkley-Tulane Initiative on Vulnerable Populations: Abducted: The Lord’s Resistance Army and Forced Conscription in Northern Uganda. 2007, California: Berkley, 50. Berkley-Tulane Initiative on Vulnerable Populations: Abducted: The Lord’s Resistance Army and Forced Conscription in Northern Uganda. 2007, California: Berkley, 50.
17.
go back to reference Annan J, Brier M, Aryemo F: From “rebel” to “returnee”: daily life and reintegration for young soldiers in northern uganda. J Adolesc Res. 2009, 24: 639-667. 10.1177/0743558409350499.CrossRef Annan J, Brier M, Aryemo F: From “rebel” to “returnee”: daily life and reintegration for young soldiers in northern uganda. J Adolesc Res. 2009, 24: 639-667. 10.1177/0743558409350499.CrossRef
18.
go back to reference Blattman C, Annan J: The State of Youth and Youth Protection in Northern Uganda: Findings from the Survey for War Affected Youth. 2006, New York City Blattman C, Annan J: The State of Youth and Youth Protection in Northern Uganda: Findings from the Survey for War Affected Youth. 2006, New York City
19.
go back to reference Borzello A: The challenge of DDR in Northern Uganda: the Lord’s resistance army. Conflict Secur Dev. 2007, 7: 387-415.CrossRef Borzello A: The challenge of DDR in Northern Uganda: the Lord’s resistance army. Conflict Secur Dev. 2007, 7: 387-415.CrossRef
20.
go back to reference Allen T, Vlassenroot K: The Lord’s Resistance Army: Myth and Reality. 2010, London, UK: Zed Books, 288. Allen T, Vlassenroot K: The Lord’s Resistance Army: Myth and Reality. 2010, London, UK: Zed Books, 288.
21.
go back to reference Betancourt T, Bass J, Borisova I: Assessing local instrument reliability and validity: a field-based example from northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 685-692. 10.1007/s00127-008-0475-1.PubMedCentralCrossRefPubMed Betancourt T, Bass J, Borisova I: Assessing local instrument reliability and validity: a field-based example from northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 685-692. 10.1007/s00127-008-0475-1.PubMedCentralCrossRefPubMed
22.
go back to reference Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, Neugebauer R, Murray L, Verdeli H: Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA. 2007, 298: 519-527. 10.1001/jama.298.5.519.CrossRefPubMed Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, Neugebauer R, Murray L, Verdeli H: Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA. 2007, 298: 519-527. 10.1001/jama.298.5.519.CrossRefPubMed
23.
go back to reference Betancourt TS, Meyers-Ohki SE, Charrow AP, Tol WA: Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care. Harv Rev Psychiatry. 2013, 21: 70-91. 10.1097/HRP.0b013e318283bf8f.PubMedCentralCrossRefPubMed Betancourt TS, Meyers-Ohki SE, Charrow AP, Tol WA: Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care. Harv Rev Psychiatry. 2013, 21: 70-91. 10.1097/HRP.0b013e318283bf8f.PubMedCentralCrossRefPubMed
24.
go back to reference Betancourt TS, Newnham EA, Brennan RT, Verdeli H, Borisova I, Neugebauer R, Bass J, Bolton P: Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda. J Adolesc Health. 2012, 51: 544-550. 10.1016/j.jadohealth.2012.02.010.CrossRefPubMed Betancourt TS, Newnham EA, Brennan RT, Verdeli H, Borisova I, Neugebauer R, Bass J, Bolton P: Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda. J Adolesc Health. 2012, 51: 544-550. 10.1016/j.jadohealth.2012.02.010.CrossRefPubMed
25.
go back to reference Verdeli H, Clougherty K, Onyango G, Lewandowski E, Speelman L, Betancourt TS, Neugebauer R, Stein TR, Bolton P: Group interpersonal psychotherapy for depressed youth in IDP camps in Northern Uganda: adaptation and training. Child Adolesc Psychiatr Clin N Am. 2008, 17: 605-624. 10.1016/j.chc.2008.03.002.CrossRefPubMed Verdeli H, Clougherty K, Onyango G, Lewandowski E, Speelman L, Betancourt TS, Neugebauer R, Stein TR, Bolton P: Group interpersonal psychotherapy for depressed youth in IDP camps in Northern Uganda: adaptation and training. Child Adolesc Psychiatr Clin N Am. 2008, 17: 605-624. 10.1016/j.chc.2008.03.002.CrossRefPubMed
26.
go back to reference Annan J, Blattman C, Carlson K, Mazurana D: The State of Female Youth in Northern Uganda: Findings from the Survey of War-Affected Youth Phase II. 2008, Medford, MA, 25. Annan J, Blattman C, Carlson K, Mazurana D: The State of Female Youth in Northern Uganda: Findings from the Survey of War-Affected Youth Phase II. 2008, Medford, MA, 25.
27.
go back to reference Allen T, Schomerus M: A Hard Homecoming: Lessons Learned from the Reception Centre Process in Northern Uganda: an independent study. 2006, Washington DC: United States Agency for International Development, 1-104. Allen T, Schomerus M: A Hard Homecoming: Lessons Learned from the Reception Centre Process in Northern Uganda: an independent study. 2006, Washington DC: United States Agency for International Development, 1-104.
28.
go back to reference Vindevogel S, Coppens K, Derluyn I, De Schryver M, Loots G, Broekaert E: Forced conscription of children during armed conflict: Experiences of former child soldiers in northern Uganda. Child Abuse Negl. 2011, 35: 551-562. 10.1016/j.chiabu.2011.03.011.CrossRefPubMed Vindevogel S, Coppens K, Derluyn I, De Schryver M, Loots G, Broekaert E: Forced conscription of children during armed conflict: Experiences of former child soldiers in northern Uganda. Child Abuse Negl. 2011, 35: 551-562. 10.1016/j.chiabu.2011.03.011.CrossRefPubMed
29.
go back to reference Birkeland N, Ridderbos K: Difficulties continue for returnees and remaining IDPs as development phase begins. 2010, Geneva: Internal Displacement Monitoring Centre, 1-10. Birkeland N, Ridderbos K: Difficulties continue for returnees and remaining IDPs as development phase begins. 2010, Geneva: Internal Displacement Monitoring Centre, 1-10.
30.
go back to reference Government of Uganda: UNGASS Country Progress Report: Uganda. 2010, Kampala Government of Uganda: UNGASS Country Progress Report: Uganda. 2010, Kampala
31.
go back to reference Child Soldiers International: Child Soldiers Global Report: Uganda. 2008, London UK: Coalition to Stop the Use of Child Soldiers, 1-418. Child Soldiers International: Child Soldiers Global Report: Uganda. 2008, London UK: Coalition to Stop the Use of Child Soldiers, 1-418.
32.
go back to reference Anyeko K, Baines E, Komakech E, Ojok B, Owor Ogora L, Victor L: “The cooling of hearts”: community truth-telling in Northern Uganda. Hum Rights Rev. 2011, 13: 107-124.CrossRef Anyeko K, Baines E, Komakech E, Ojok B, Owor Ogora L, Victor L: “The cooling of hearts”: community truth-telling in Northern Uganda. Hum Rights Rev. 2011, 13: 107-124.CrossRef
33.
go back to reference McMullen JD, O’Callaghan PS, Richards JA, Eakin JG, Rafferty H: Screening for traumatic exposure and psychological distress among war-affected adolescents in post-conflict northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2012, 47: 1489-1498. 10.1007/s00127-011-0454-9.CrossRefPubMed McMullen JD, O’Callaghan PS, Richards JA, Eakin JG, Rafferty H: Screening for traumatic exposure and psychological distress among war-affected adolescents in post-conflict northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2012, 47: 1489-1498. 10.1007/s00127-011-0454-9.CrossRefPubMed
34.
go back to reference Betancourt TS, Brennan RT, Rubin-Smith J, Fitzmaurice GM, Gilman SE: Sierra Leone’s former child soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry. 2010, 49: 606-615.PubMedCentralPubMed Betancourt TS, Brennan RT, Rubin-Smith J, Fitzmaurice GM, Gilman SE: Sierra Leone’s former child soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry. 2010, 49: 606-615.PubMedCentralPubMed
35.
go back to reference Betancourt TS, Borisova II, Williams P, Brennan RT, Whitfield TH, de la Soudiere M, Williamson J, Gilman SE: Sierre Leone’s former child soldiers: a follow-up study of psychosocial adjustment and community reintegration. Child Dev. 2010, 81: 1077-1095. 10.1111/j.1467-8624.2010.01455.x.PubMedCentralCrossRefPubMed Betancourt TS, Borisova II, Williams P, Brennan RT, Whitfield TH, de la Soudiere M, Williamson J, Gilman SE: Sierre Leone’s former child soldiers: a follow-up study of psychosocial adjustment and community reintegration. Child Dev. 2010, 81: 1077-1095. 10.1111/j.1467-8624.2010.01455.x.PubMedCentralCrossRefPubMed
36.
go back to reference Betancourt TS, Agnew-Blais J, Gilman SE, Williams DR, Ellis BH: Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010, 70: 17-26. 10.1016/j.socscimed.2009.09.038.PubMedCentralCrossRefPubMed Betancourt TS, Agnew-Blais J, Gilman SE, Williams DR, Ellis BH: Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010, 70: 17-26. 10.1016/j.socscimed.2009.09.038.PubMedCentralCrossRefPubMed
37.
go back to reference Accorsi S, Fabiani M, Nattabi B, Corrado B, Iriso R, Ayella EO, Pido B, Onek PA, Ogwang M, Declich S: The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS. Trans R Soc Trop Med Hyg. 2005, 99: 226-233. 10.1016/j.trstmh.2004.09.008.CrossRefPubMed Accorsi S, Fabiani M, Nattabi B, Corrado B, Iriso R, Ayella EO, Pido B, Onek PA, Ogwang M, Declich S: The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS. Trans R Soc Trop Med Hyg. 2005, 99: 226-233. 10.1016/j.trstmh.2004.09.008.CrossRefPubMed
38.
go back to reference Henttonen M, Watts C, Roberts B, Kaducu F, Borchert M: Health services for survivors of gender-based violence in northern Uganda: a qualitative study. Reprod Health Matters. 2008, 16: 122-131. 10.1016/S0968-8080(08)31353-6.CrossRefPubMed Henttonen M, Watts C, Roberts B, Kaducu F, Borchert M: Health services for survivors of gender-based violence in northern Uganda: a qualitative study. Reprod Health Matters. 2008, 16: 122-131. 10.1016/S0968-8080(08)31353-6.CrossRefPubMed
39.
go back to reference Horn R: Coping with displacement: problems and responses in camps for the internally displaced in kitgum, northern Uganda 1. Intervention. 2009, 7: 110-129. 10.1097/WTF.0b013e3283302714.CrossRef Horn R: Coping with displacement: problems and responses in camps for the internally displaced in kitgum, northern Uganda 1. Intervention. 2009, 7: 110-129. 10.1097/WTF.0b013e3283302714.CrossRef
40.
go back to reference Nathan N, Tatay M, Piola P, Lake S, Brown V, Tassy S, Polski L, Banet J, Gorincour G: High mortality in displaced populations of northern Uganda. Lancet. 2004, 363: 5736.CrossRef Nathan N, Tatay M, Piola P, Lake S, Brown V, Tassy S, Polski L, Banet J, Gorincour G: High mortality in displaced populations of northern Uganda. Lancet. 2004, 363: 5736.CrossRef
Metadata
Title
After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda
Authors
Katherine A Muldoon
Godfrey Muzaaya
Theresa S Betancourt
Mirriam Ajok
Monica Akello
Zaira Petruf
Paul Nguyen
Erin K Baines
Kate Shannon
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2014
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/1752-1505-8-5

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