The effect of the aggressive rapes left me with constant chest, back and abdominal pain. I get some treatment but still, from time to time it starts all over again. It was terrible (Woman discussing the effects of civil war during a Kamuli Parish focus group).
Amongst the issues treated as private matters that cannot be regulated by international norms, violence against women and women's health are particularly critical. The essays in "Violence and Health" argue for the recognition of these as human rights issues (Peters & Wolper, 1995:17).
This paper will describe the resulting long-term health needs of women wartorture survivors of the civil war years in Luwero District, Uganda. To do this sections of case studies from interviews carried out in Kikamulo Sub-County, Luwero, are utilised. The effects of gender-based violence and torture and its long term, severe and enduring impact on women's health will be highlighted. In 1994, the Centre for Health and Human rights at Harvard University led the first international conference on health and human rights. This recognised that human rights are an essential pre-condition for physical and mental health. Women's resulting health needs following war, including the urgent need for reproductive and gynaecological health services, are argued to be a fundamental human right which should be upheld through the legal mechanisms available. The paper suggests ways of assisting the women war survivors of Luwero and concludes that to be successful integrated health interventions for war-torture survivors need to be combined with the further collective legal, social and political empowerment of women and address the health inequalities and discriminations that exist.
Keywords: women, war, Uganda
Uganda has experienced civil wars since gaining independence in 1962. Between 1981 and 1986 gross violations of human rights occurred during the protracted bush war against Obote's regime (6). This involved Museveni's army and had its starting base in Luwero District. Hence, this area, which became known as the Luwero Triangle, was particularly affected. Although Luwero is now relatively peaceful, research has shown the population still suffers physical and psychological effects (Musisi, Kinyanda, Liebling, Kiziri-Mayengo & Matovu, 1999). There is also an absence of literature on the treatment of women war-torture survivors in Uganda.
In 1998, Isis-WICCE, an international women's non-government organisation organised a Ugandan-led project with women war survivors in Luwero District. The funding was obtained from Medica Mondiale. A multidisciplinary team of health workers provided medical, psychological and gynaecological services to 237 war-affected women in Luwero. This intervention was provided by Isis-WICCE, African Psycare Research Organisation, APRO, including psychiatrists, social workers and psychologists, as well as members of the Counselling Service at Makerere University. APRO is a Ugandan-based organisation whose main function is to conduct research, training and provide mental health services, particularly to war-torture survivors in Uganda. The Association of Obstetricians and Gynaecologists of Uganda, AGOU, also provided screening and interventions. The first part of the intervention involved screening 48 women war survivors over a period of three days at a health centre in Kikamulo sub-county, Luwero. This screening involved an assessment of demographic information, experiences during the war and resulting effects, including post traumatic stress. This study found most of the women were tortured during the war, and 54.4% suffered sexual violence including rapes, being abducted as sex slaves, forced marriages to abductors, and other violations. Of the women screened 54.2% had post traumatic stress, as well as physical and gynaecological health difficulties as a result of their experiences. …