Skip to main content
Top
Published in: BMC International Health and Human Rights 1/2012

Open Access 01-12-2012 | Research article

In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected Northern Uganda

Authors: Sheetal H Patel, Herbert Muyinda, Nelson K Sewankambo, Geoffrey Oyat, Stella Atim, Patricia M Spittal

Published in: BMC International Health and Human Rights | Issue 1/2012

Login to get access

Abstract

Background

Adolescent girls are an overlooked group within conflict-affected populations and their sexual health needs are often neglected. Girls are disproportionately at risk of HIV and other STIs in times of conflict, however the lack of recognition of their unique sexual health needs has resulted in a dearth of distinctive HIV protection and prevention responses. Departing from the recognition of a paucity of literature on the distinct vulnerabilities of girls in time of conflict, this study sought to deepen the knowledge base on this issue by qualitatively exploring the sexual vulnerabilities of adolescent girls surviving abduction and displacement in Northern Uganda.

Methods

Over a ten-month period between 2004–2005, at the height of the Lord’s Resistance Army insurgency in Northern Uganda, 116 in-depth interviews and 16 focus group discussions were held with adolescent girls and adult women living in three displacement camps in Gulu district, Northern Uganda. The data was transcribed and key themes and common issues were identified. Once all data was coded the ethnographic software programme ATLAS was used to compare and contrast themes and categories generated in the in-depth interviews and focus group discussions.

Results

Our results demonstrated the erosion of traditional Acholi mentoring and belief systems that had previously served to protect adolescent girls’ sexuality. This disintegration combined with: the collapse of livelihoods; being left in camps unsupervised and idle during the day; commuting within camp perimeters at night away from the family hut to sleep in more central locations due to privacy and insecurity issues, and; inadequate access to appropriate sexual health information and services, all contribute to adolescent girls’ heightened sexual vulnerability and subsequent enhanced risk for HIV/AIDS in times of conflict.

Conclusions

Conflict prevention planners, resettlement programme developers, and policy-makers need to recognize adolescent girls affected by armed conflict as having distinctive needs, which require distinctive responses. More adaptive and sustainable gender-sensitive reproductive health strategies and HIV prevention initiatives for displaced adolescent girls in conflict settings must be developed.
Literature
1.
go back to reference Liebling-Kalifani H, Marshall A, Ojiambo-Ochieng R, Nassozi M: Experiences of women war-torture survivors in Uganda: implications for health and human rights. Journal of International Women’s Studies. 2007, 4: 1-17. Liebling-Kalifani H, Marshall A, Ojiambo-Ochieng R, Nassozi M: Experiences of women war-torture survivors in Uganda: implications for health and human rights. Journal of International Women’s Studies. 2007, 4: 1-17.
2.
go back to reference Bolton P, Base J, Betancourt T, Speelman L, Onyango G, Clougherty K, 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, Base J, Betancourt T, Speelman L, Onyango G, Clougherty K, 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
3.
go back to reference Westerhaus MJ, Finnegan AC, Zabulon Y, Mukherjee JS: Framing HIV prevention discourse to encompass the complexities of war in northern Uganda. Am J Public Health. 2007, 97: 1184-1186. 10.2105/AJPH.2005.072777.CrossRefPubMedPubMedCentral Westerhaus MJ, Finnegan AC, Zabulon Y, Mukherjee JS: Framing HIV prevention discourse to encompass the complexities of war in northern Uganda. Am J Public Health. 2007, 97: 1184-1186. 10.2105/AJPH.2005.072777.CrossRefPubMedPubMedCentral
4.
go back to reference Dolan C: Social torture: the case of Northern Uganda. 1986–2006. 2009, USA: Berghahn Books Dolan C: Social torture: the case of Northern Uganda. 1986–2006. 2009, USA: Berghahn Books
5.
go back to reference Nannyonjo J: Conflicts, poverty and human development in Northern Uganda. Helsinki, Finland: Paper for WIDER Conference on Making Peace Work: 2004 June 4–5 Nannyonjo J: Conflicts, poverty and human development in Northern Uganda. Helsinki, Finland: Paper for WIDER Conference on Making Peace Work: 2004 June 4–5
6.
go back to reference Westerhaus M: Linking anthropological analysis and epidemiological evidence: formulating a narrative of HIV transmission in Acholiland of northern Uganda. Journal of Social Aspects of HIV/AIDS. 2007, 4: 590-605. 10.1080/17290376.2007.9724881.CrossRefPubMed Westerhaus M: Linking anthropological analysis and epidemiological evidence: formulating a narrative of HIV transmission in Acholiland of northern Uganda. Journal of Social Aspects of HIV/AIDS. 2007, 4: 590-605. 10.1080/17290376.2007.9724881.CrossRefPubMed
7.
go back to reference Mazurana D, Mckay S: Girls in fighting forces: policy and program recommendations. 2004, Ottawa, Ontario: Report Supported by CIDA’s Child Protection Research Fund Mazurana D, Mckay S: Girls in fighting forces: policy and program recommendations. 2004, Ottawa, Ontario: Report Supported by CIDA’s Child Protection Research Fund
8.
go back to reference Fabiani M, Nattabi B, Pierotti C, Ciantia F, Opoi AA, Musinguzi J, Ayella EO, Declich S: HIV-1 prevalence and factors associated with infection in the conflict-affected region of North Uganda. Confl Heal. 2007, 1: 1-8. 10.1186/1752-1505-1-1.CrossRef Fabiani M, Nattabi B, Pierotti C, Ciantia F, Opoi AA, Musinguzi J, Ayella EO, Declich S: HIV-1 prevalence and factors associated with infection in the conflict-affected region of North Uganda. Confl Heal. 2007, 1: 1-8. 10.1186/1752-1505-1-1.CrossRef
9.
go back to reference Women’s Commission for Refugee Women and Children: No safe place to call home: Children and adolescent night commuters in Northern Uganda. 2004, New York, USA: Women’s Commission for Refugee Women and Children Women’s Commission for Refugee Women and Children: No safe place to call home: Children and adolescent night commuters in Northern Uganda. 2004, New York, USA: Women’s Commission for Refugee Women and Children
10.
go back to reference Ward J, Marsh M: Sexual violence against women and girls in war and its aftermath: Realities, responses, and required resources. Brussels, Belgium: Briefing paper for Symposium on Sexual Violence in Conflict and Beyond: 2006 June 21–23 Ward J, Marsh M: Sexual violence against women and girls in war and its aftermath: Realities, responses, and required resources. Brussels, Belgium: Briefing paper for Symposium on Sexual Violence in Conflict and Beyond: 2006 June 21–23
11.
go back to reference Mock NB, Duale S, Brown LF, Mathys E, O’Maonaigh HC, Abul-Husn NK, Elliot S: Conflict and HIV: a framework for risk assessment to prevent HIV in conflict-affected settings in Africa. Emerg Themes Epidemiol. 2004, 1: 1-16. 10.1186/1742-7622-1-1.CrossRef Mock NB, Duale S, Brown LF, Mathys E, O’Maonaigh HC, Abul-Husn NK, Elliot S: Conflict and HIV: a framework for risk assessment to prevent HIV in conflict-affected settings in Africa. Emerg Themes Epidemiol. 2004, 1: 1-16. 10.1186/1742-7622-1-1.CrossRef
14.
go back to reference Ministry of Health Uganda: Uganda HIV/AIDS Sero-Behavioural Survey 2004–2005. 2006, Kampala, Uganda: Republic of Uganda Ministry of Health Uganda: Uganda HIV/AIDS Sero-Behavioural Survey 2004–2005. 2006, Kampala, Uganda: Republic of Uganda
15.
go back to reference Spiegel PB, Bennedsen AR, Claass J, Bruns L, Patterson N, Yiweza D, Schilperoord M: Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review. Lancet. 2007, 369: 2187-2195. 10.1016/S0140-6736(07)61015-0.CrossRefPubMed Spiegel PB, Bennedsen AR, Claass J, Bruns L, Patterson N, Yiweza D, Schilperoord M: Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review. Lancet. 2007, 369: 2187-2195. 10.1016/S0140-6736(07)61015-0.CrossRefPubMed
16.
go back to reference Jewkes R: Comprehensive response to rape needed in conflict settings. Lancet. 2007, 369: 2140-2141. 10.1016/S0140-6736(07)60991-X.CrossRefPubMed Jewkes R: Comprehensive response to rape needed in conflict settings. Lancet. 2007, 369: 2140-2141. 10.1016/S0140-6736(07)60991-X.CrossRefPubMed
17.
go back to reference Hanson BW, Wodak A, Fiamma A, Coates TJ: Refocusing and prioritizing HIV programmes in conflict and post-conflict settings: funding recommendations. AIDS. 2008, 22: s95-s103.CrossRefPubMedPubMedCentral Hanson BW, Wodak A, Fiamma A, Coates TJ: Refocusing and prioritizing HIV programmes in conflict and post-conflict settings: funding recommendations. AIDS. 2008, 22: s95-s103.CrossRefPubMedPubMedCentral
19.
go back to reference Watts C, Zimmerman C: Violence against women: global scope and magnitude. Lancet. 2002, 359: 1232-1237. 10.1016/S0140-6736(02)08221-1.CrossRefPubMed Watts C, Zimmerman C: Violence against women: global scope and magnitude. Lancet. 2002, 359: 1232-1237. 10.1016/S0140-6736(02)08221-1.CrossRefPubMed
20.
go back to reference Women’s Commission for Refugee Women and Children: Against all odds: surviving the war on adolescents. 2001, New York, USA: Women’s Commission for Refugee Women and Children Women’s Commission for Refugee Women and Children: Against all odds: surviving the war on adolescents. 2001, New York, USA: Women’s Commission for Refugee Women and Children
21.
go back to reference Denzin N, Lincoln G: The SAGE handbook of qualitative research. 2005, Thousand Oaks, CA: Sage, 3 Denzin N, Lincoln G: The SAGE handbook of qualitative research. 2005, Thousand Oaks, CA: Sage, 3
22.
go back to reference Sandelowski M: Using qualitative research. Health Res. 2004, 14 (10): 1366-1386. Sandelowski M: Using qualitative research. Health Res. 2004, 14 (10): 1366-1386.
23.
go back to reference Thorne S: Interpretive description. 2008, Walnut Creek, CA: Left Coast Press Thorne S: Interpretive description. 2008, Walnut Creek, CA: Left Coast Press
24.
go back to reference Ominde SH: The Luo girl: from infancy to marriage. 1952, St. Martin’s Street, London: Macmillan and Company Limited Ominde SH: The Luo girl: from infancy to marriage. 1952, St. Martin’s Street, London: Macmillan and Company Limited
25.
go back to reference Girling FK: The Acholi of Uganda. 1960, London: Her Majesty’s Stationary Office Girling FK: The Acholi of Uganda. 1960, London: Her Majesty’s Stationary Office
26.
go back to reference Falk L, Lenz J, Okuma P: Sleepless in Gulu: a study of the dynamics behind the child night commuting phenomena in Gulu, Uganda. 2004, Kampala, Uganda: SCiU Falk L, Lenz J, Okuma P: Sleepless in Gulu: a study of the dynamics behind the child night commuting phenomena in Gulu, Uganda. 2004, Kampala, Uganda: SCiU
27.
go back to reference Cohen R: Protecting internally displaced women and children: rights have no borders. 1998, Stylus Publishing, LLC: Global IDP Survey of the Norwegian Refugee Council Cohen R: Protecting internally displaced women and children: rights have no borders. 1998, Stylus Publishing, LLC: Global IDP Survey of the Norwegian Refugee Council
28.
go back to reference Holst-Roness FT: Second international policy conference on the African child: violence against girls in Africa, Addis Ababa. Violence against girls in Africa during armed conflicts and crises. 2006, Geneva, Switzerland: International Committee of the Red Cross, 43- Holst-Roness FT: Second international policy conference on the African child: violence against girls in Africa, Addis Ababa. Violence against girls in Africa during armed conflicts and crises. 2006, Geneva, Switzerland: International Committee of the Red Cross, 43-
30.
go back to reference Government of Uganda: Peace development and recovery plan for Northern Uganda: 2007–2010. 2007, Kampala: Republic of Uganda Government of Uganda: Peace development and recovery plan for Northern Uganda: 2007–2010. 2007, Kampala: Republic of Uganda
31.
go back to reference Spittal PM, Muyinda H, Patel SH, Oyat G, Tebere L, Atim S, Shibru G, Axworthy L, Sewankambo NK: The Wayo programme: building on traditional assets in supporting young women and girls in the context of HIV, war, and post conflict in Northern Uganda. 2008, Ottawa, Ontario: CIDA Child Protection Research Fund Spittal PM, Muyinda H, Patel SH, Oyat G, Tebere L, Atim S, Shibru G, Axworthy L, Sewankambo NK: The Wayo programme: building on traditional assets in supporting young women and girls in the context of HIV, war, and post conflict in Northern Uganda. 2008, Ottawa, Ontario: CIDA Child Protection Research Fund
32.
go back to reference Francis O, McKibben G: Abused: Child sexual abuse in Northern Uganda. 2008, Gulu, Northern Uganda: Gulu Support the Children Organisation’s Research Team Francis O, McKibben G: Abused: Child sexual abuse in Northern Uganda. 2008, Gulu, Northern Uganda: Gulu Support the Children Organisation’s Research Team
33.
go back to reference Uganda Aids Commission: National young people HIV/AIDS communication program for young people: concept paper. 2001, Kampala, Uganda: Uganda AIDS Commission Uganda Aids Commission: National young people HIV/AIDS communication program for young people: concept paper. 2001, Kampala, Uganda: Uganda AIDS Commission
34.
go back to reference Human Rights Watch: Just die quietly: Domestic violence and women’s vulnerability to HIV in Uganda. 2003, New York, USA: Human Rights Watch Human Rights Watch: Just die quietly: Domestic violence and women’s vulnerability to HIV in Uganda. 2003, New York, USA: Human Rights Watch
35.
go back to reference Women’s Commission for Refugee Women and Children: Learning in a war zone: education in Northern Uganda. 2005, New York, USA: Women’s Commission for Refugee Women and Children Women’s Commission for Refugee Women and Children: Learning in a war zone: education in Northern Uganda. 2005, New York, USA: Women’s Commission for Refugee Women and Children
36.
go back to reference UNICEF: State of the world’s children: The multiplier effect of educating girls. 2004, New York, USA: UNICEF UNICEF: State of the world’s children: The multiplier effect of educating girls. 2004, New York, USA: UNICEF
37.
go back to reference Patel SH: The forgotten north: Increasing school enrolment of displaced girls in northern Uganda (Masters dissertation). 2006, Burnaby, Canada: Simon Fraser University Patel SH: The forgotten north: Increasing school enrolment of displaced girls in northern Uganda (Masters dissertation). 2006, Burnaby, Canada: Simon Fraser University
38.
go back to reference Machel G: Promotion and protection of the rights of children: Report of the special representative of the secretary-general for children and armed conflict. 2007, New York, USA: United Nations General Assembly Machel G: Promotion and protection of the rights of children: Report of the special representative of the secretary-general for children and armed conflict. 2007, New York, USA: United Nations General Assembly
39.
go back to reference World Health Organization: Health action in crises: Uganda. 2007, Geneva, Switzerland: WHO World Health Organization: Health action in crises: Uganda. 2007, Geneva, Switzerland: WHO
40.
go back to reference UNHCR: UNHCR’s HIV and AIDS policies and programs: HIV report. 2006, Geneva, Switzerland: UNHCR UNHCR: UNHCR’s HIV and AIDS policies and programs: HIV report. 2006, Geneva, Switzerland: UNHCR
Metadata
Title
In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected Northern Uganda
Authors
Sheetal H Patel
Herbert Muyinda
Nelson K Sewankambo
Geoffrey Oyat
Stella Atim
Patricia M Spittal
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC International Health and Human Rights / Issue 1/2012
Electronic ISSN: 1472-698X
DOI
https://doi.org/10.1186/1472-698X-12-38

Other articles of this Issue 1/2012

BMC International Health and Human Rights 1/2012 Go to the issue