GLOBEMED’S GLOBAL HEALTH EDUCATION AND LEADERSHIP DEVELOPMENT CURRICULUM
globalhealthU Track 2, Week 2
Case Study (Micro): Gulu, Uganda National Context: For 20 years (1987 - 2007) Northern Uganda was a battleground for the civil war between the Ugandan Government and Joseph Kony’s Lord’s Resistance Army. This conflict caused incredible damage to Northern Uganda, ranging from loss of economic opportunity, destruction of natural resources and infrastructure, and gross Human Rights Violations. Young children were kidnapped by the LRA to be used as child soldiers, where they suffered from physical, mental, and sexual abuse and were forced to both watch and commit atrocities. In addition, thousands of people were displaced from their homes and forced to relocate to crowded and unsanitary Internally Displaced Person (IPD) camps. Many were never able to return home to rebuild their lives. Though the war is largely over, Uganda still suffers from the scars of the conflict. This has led to an environment where human rights violations are still common and many people live in extreme poverty.
Local Context: Gulu is a town in Northern Uganda that serves as the commercial and administrative center for Gulu District. The community is mostly made up of the Acholi people, who traditionally come from the larger area of Northern Uganda, or Acholiland. This area was traumatized by about 20 years of war that resulted from political turmoil in the country and of course the insurgency led by the Lord's Resistance Army and Joseph Kony. Before that time, most families lived in their villages with a closely knit group of extended family and relatives. But because the rebels focused their attacks in the bush, these rural villages were no longer safe and families were either captured, killed, or forced to move into town or into IDP camps. Those that stayed in their villages would never sleep in their houses. Everyone had a hiding place to sleep in the bush, where they would stay the night and then return home in the morning. All of this has left many single-parent households, grandparent-headed households, and child-headed households. Additionally, many people moved into camps, which created several mixing pots of culture and ways of life. The camps are no longer recognized by the government and in the last few years people have begun to move home. But still a few people choose to stay in the camps that had not been demolished because they have gotten used to life there. Many of the huts in the camps are individually owned now, so people pay rent and stay there. The town of Gulu is developing, but despite it's size and general reputation as the major city of the the North, it is not an official city and still lacks the quality of services that we would expect in the US. It has a population of approximately 150,000 and the major languages spoken are Acholi (Luo) and English, though other parts of the North speak many different languages. The town has a high number of street children, who may have lost their parents in the war, or just got used to life in town and prefer it to the villages. NGOs and aid agencies were once extremely prevalent in Gulu. While there are still tons of NGOs remain and many that have recently started, many large projects and relief efforts have gradually been ending and leaving the region. Now, the focus has shifted to development and long-term community empowerment. Traditionally, livelihoods were based in agriculture, but because normal life was so scattered during the insurgency, most people have either taken up other occupations, or if they are still in agriculture, most are only using small-scale farming. So currently, there are several efforts to promote a return to large-scale agriculture. Additionally, many organizations focus on psychosocial support and education for youth, particularly those who are returnees or were 1
GLOBEMED’S GLOBAL HEALTH EDUCATION AND LEADERSHIP DEVELOPMENT CURRICULUM
globalhealthU born into captivity, HIV positive, or otherwise vulnerable/at-risk. Women's empowerment is also getting a lot of support, so women's microfinance groups, treatment and prevention of gender-based violence (GBV), family planning, and sexual health are just some of the hot topics. Men are also being targeted to get involved with family planning and community empowerment. An all too common problem in families is alcoholism, so even if a man is employed and is getting paid, that money may end up at the local bar, never making it home to buy food for his children.
The Major Players: Some of the major organizations working in Gulu are Save the Children, USAID, the Red Cross, Medicins Sans Frontieres, agricultural support organizations, and many others. National NGOs such as the Straight Talk Foundation (including the partner of GlobeMed at UCLA), and smaller organizations are also doing lots of work, including GlobeMed partners GWED-G and Health Alert Uganda. Community-Based Organizations (CBOs) cover lots of issues and operate in the rural and urban areas to do small scale work in the community. Unfortunately one of the biggest issues in Uganda in general is corruption, which permeates almost everything even down to some seemingly well-wishing organizations. All in all, the community in Gulu is complex, just like any other community you will find. Poverty is everywhere and most people are struggling to make ends meet, but most importantly people are trying to rebuild. Most of the elders past away with the war so there is a big challenge in rejuvenating the culture. This also caused many issues with land and property rights because many elders died before they could show their children the boundaries. Because the war was so long, many people are either glad to be going home to their villages, or have chosen to stay in town. Many have also been introduced to new business ventures and prefer to stay in town because of their businesses.
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GLOBEMED’S GLOBAL HEALTH EDUCATION AND LEADERSHIP DEVELOPMENT CURRICULUM
globalhealthU
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