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Uganda: an uncivil war

BMJ 2005; 330 doi: https://doi.org/10.1136/sbmj.0504166 (Published 01 April 2005) Cite this as: BMJ 2005;330:0504166
  1. Michael J Westerhaus, masters student in medical anthropology1
  1. 1Harvard Graduate School of Arts and Sciences, Cambridge, MA, USA

The people of Uganda, affected by decades of civil war, must make do with third rate health services. Michael J Westerhaus reflects on his time in northern Uganda and explains how it shaped his beliefs

Northern Uganda is an unsettling locale. Eighteen years of war has devastated the minds, hearts, and vitality of the Acholi people, an ethnic group who endure life amid the harshest of circumstances. The Acholi people have witnessed 20 000 of their children abducted to fight as child soldiers,1 100 000 civilian deaths, and the migration of 1.8 million people into internally displaced people's camps, with limited health and education facilities.2 Current international aid meets 43% of the amount needed to provide minimal humanitarian assistance. 3 Memories of the peace that existed nearly two decades ago create a pining for the chance to reclaim the culture, fertile lands, and comfort of security.

Institutionalised war

The war in northern Uganda results from a historical tension that has divided northern and southern Uganda since precolonial times. Colonialism institutionalised these differences by dictating distinct occupational roles. Northerners were assigned to military positions, and southerners were given privileged public service jobs. After Ugandan independence in 1962, a series of totalitarian regimes alternately representing northern and southern interests encouraged further animosity between the north and south. This antagonism led to war between the Lord's Resistance Army (LRA), primarily Acholi from the north, and the Ugandan military (UPDF), largely southerners, which continues today.

SVEN TORFINN/PANOS

Release after abduction

In early July 2004, as I neared Gulu, a town four hours' drive north of Uganda's capital, Kampala, we passed some camps for displaced people. The tarmac gradually became hemmed in by streams of children moving towards the town for safety at night.

Malaria, tuberculosis, and AIDS

The war has profoundly disrupted the provision of healthcare in Gulu. Malaria, tuberculosis, …

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