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"Humanitarian intervention Uganda."
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Exploring Intervention
Drawing on nine case studies and innovative empirical material from various regions of Uganda, this edited volume focuses on the interplay between humanitarian, economic and academic intervention on the one hand and mobility, permanent transit and (re-)settlement on the other - not least against the background of the versatile trajectories of flight and displacement and cultural practices that can be observed in the diverse environment of the country. In doing so, on a methodological level, this volume casts light on multifaceted processes of academic entanglements and knowledge production, on self-positioning processes of the researcher and the various role conflicts connected to research in complex settings.
eBook
Tolerance of Violence against Women and the Risk of Psychosocial Distress in Humanitarian Settings in Northern Uganda
Background: Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. Data and methods: we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three humanitarian districts (Adjumani, Obongi, and Lamwo) to examine the determinants of psychosocial stress. Results: experience of psychosocial distress is higher among refugees than host populations. Results indicate a higher proportion of respondents who ever experienced psychosocial stress in the 6 months preceding the survey among those who believed that a woman should tolerate violence (59% vs. 53%). Respondents who believed that a woman should tolerate violence had higher odds of experiencing psychosocial stress than their counterparts who believed a woman should not tolerate violence (OR = 6.86; 95%CI = 1.23–38.22). The likelihood to experience psychosocial stress was higher among females (OR = 6.94; 95%CI = 1.76–27.32), those with primary education (OR = 4.73; 95%CI = 1.24–18.00), and respondents with less than USD 2.7 as personal income one month before the survey (OR = 3.37; 95%CI = 1.32–8.62). Respondents who said that women should engage in income generation activities had higher odds to experience psychosocial stress (OR = 0.39; 95%CI = 0.17–0.89). Conclusion: results suggest that income and positive attitudes toward female-led income generating activities act as protective measures against psychosocial distress. Given the associations between VAW and psychosocial distress, efforts aimed at prevention and response to VAW in humanitarian settings should integrate mental health and psychosocial support interventions.
Journal Article
Measuring hope: psychometric properties of the children’s Hope Scale among South Sudanese refugee children
We investigated the psychometric properties of the Children’s Hope Scale among a sample of 1,118 South Sudanese refugee children (570 girls, 548 boys) aged 9 to 14 years displaced in Uganda. We assessed the underlying factor structure and model fit through exploratory and confirmatory factor analyses and measurement invariance by sex and developmental stage. Confirmatory factor analysis revealed good fit for a one-factor model with the error terms of items 1 and 3 and items 4 and 6 allowed to covary. There was no evidence of differential item functioning by group. Evidence from this study supports the use of a unidimensional model of hopefulness across groups and signifies the importance of confirming these properties for measures used to evaluate humanitarian interventions.
Journal Article
THE UNBEARABLE LIGHTNESS OF EX-PATS: Double Binds of Humanitarian Mobility
This article addresses legacies of national origin within global forms. Focusing on tensions related to human resources, I consider the case of the humanitarian organization Médecins Sans Frontières (MSF, or Doctors Without Borders). Since 1971, MSF has grown into a large, transnational NGO sponsoring a variety of medical projects worldwide. Amid recent efforts to \"decolonize\" its human profile, MSF has debated the appropriate role, motivation and remuneration of both international volunteers and local support staff it hires at mission sites. Given the different degrees of ease with which situated persons can travel, the organization's conflicting impulses place it in a classic double bind: to remain mobile it must limit local attachments, while to achieve equality it must embrace them. The figure of the ex-patriate thus suggests a mundane but precise measure for the threshold of inequality.
Journal Article
Screening for sexual violence against children in humanitarian settings: a feasibility study of a para-social worker-led intervention in Uganda
Background
Sexual violence against children (SVAC) is an acknowledged concern in humanitarian settings; yet, effective, tested interventions to support disclosure and access to care remain limited. This study assessed the feasibility of implementing SVAC screening, referral protocols, and service provision, in a bid to rectify these limitations within two primary schools in Uganda’s Kiryandongo Refugee Settlement.
Methods
A mixed-methods concurrent triangulation design was used to implement and assess the feasibility of a seven-month intervention (April–October 2024) in two primary schools. Para-Social Workers, trained under Uganda’s Ministry of Gender, Labour and Social Development, screened Primary 6 and 7 pupils, aged 11 to 35 years old, for SVAC. Older pupils (Primary 6–7) were selected for their perceived capacity to engage on the topic. Survivors received school-based psychological first aid and were referred to additional services as needed.
Results
The intervention demonstrated strong demand and acceptability among the target populations. All 831 eligible pupils assented to intervention participation, and the majority (96%,
n
= 794) ended up actually participating in the screening exercise. Of these, 82% (
n
= 653) disclosed experiencing SVAC, with 100% receiving care. In contrast, in the absence of screening in the 12-month period before the intervention, only 16 pupils in the same primary schools disclosed experiencing SVAC and obtained care. Stakeholders – including parents, teachers, government, and humanitarian actors – expressed strong support for expanding the model, while pupils reported high levels of satisfaction with the intervention.
Conclusions
Proactive SVAC screening in schools within humanitarian settings is both feasible and holds promise for effectively identifying and supporting child and adolescent survivors of sexual violence. The intervention significantly increased disclosure and service uptake and was well received by all stakeholders. Findings support the adaptation and cautious scale-up of this model in similar, carefully selected and adequately resourced, crisis-affected contexts.
Journal Article
Combining mental health and climate-smart agricultural interventions to improve food security in humanitarian settings: study protocol for the THRIVE cluster-randomized controlled trial with mothers in Nakivale refugee settlement, Uganda
Background
Climate extremes in Africa threaten the food security of war-affected refugees, who often experience mental health challenges that hinder their capacity for agricultural adaptation. Cost-effective, climate-smart farming interventions are crucial for addressing food insecurity in humanitarian contexts, yet evidence on their effectiveness is limited, and the potential benefits of integrating them with mental health interventions remain unexplored. We hypothesize that the success of agricultural interventions, especially under adversity, is influenced by mental health and psychological functioning.
Methods
This study employs a three-arm, parallel-group, cluster-randomized controlled trial (cRCT) in the Nakivale refugee settlement, Uganda. Thirty villages within the settlement will be randomized in a 1:1:1 allocation ratio to one of three conditions: Enhanced Usual Care, a Home Gardening Intervention (HGI) or HGI combined with the peer-delivered psychosocial intervention Self-Help Plus (SH + HGI). A total of 900 refugee mothers and their children (aged 3–4 years) will be enrolled, with 30 dyads per village. The primary outcome is food insecurity at 12 months post-intervention, assessed using the Food Insecurity Experience Scale (FIES). Secondary outcomes include dietary diversity, child malnutrition and mothers’ psychological distress. Data will be collected at baseline, 3-month and 12-month follow-ups. Primary analyses will use an intention-to-treat (ITT) approach.
Discussion
This study will shed light on the role of mental health in agricultural adaptation for food security, evaluating the efficacy of scalable, cost-effective interventions in a refugee setting. The findings will have implications for the design and implementation of integrated food security and mental health programs in humanitarian and other resource-constrained settings.
Trial registration
ClinicalTrials.gov NCT06425523. Registered on 24 May 2024.
Journal Article
International Responses to Mass Atrocities in Africa
Since the end of World War II and the founding of the United Nations, genocide, crimes against humanity and other war crimes-mass atrocities-have been explicitly illegal. When such crimes are committed, the international community has an obligation to respond: the human rights of the victims outweigh the sovereignty claims of states that engage in or allow such human rights violations. This obligation has come to be known as the responsibility to protect. Yet, parallel to this responsibility, two other related responsibilities have developed: to prosecute those responsible for the crimes, and to provide humanitarian relief to the victims-what the author calls the responsibility to palliate. Even though this rhetoric of protecting those in need is well used by the international community, its application in practice has been erratic at best.
InInternational Responses to Mass Atrocities in Africa, Kurt Mills develops a typology of responses to mass atrocities, investigates the limitations of these responses, and calls for such responses to be implemented in a more timely and thoughtful manner. Mills considers four cases of international responses to mass atrocities-in Rwanda, the Democratic Republic of the Congo, Uganda, and Darfur-putting the cases into historical context and analyzing them according to the typology, showing how the responses interact. Although all are intended to address human suffering, they are very different types of actions and accomplish different things, over different timescales, on different orders of magnitude, and by very different types of actors. But the critical question is whether they accomplish their objectives in a mutually supportive way-and what the trade-offs in using one or more of these responses may be. By expanding the understanding of international responsibilities, Mills provides critical analysis of the possibilities for the international community to respond to humanitarian crises.
eBook
'This is how we survived': Civilian agency and humanitarian protection
The security of civilians in contemporary conflicts continues to tragically elude humanitarians. Scholars attribute this crisis in protection to macro-structural deficiencies, such as the failure of states to comply with international conventions and norms and the inability of international institutions to successfully reduce violence by warring parties. While offering important insights into humanitarianism and its limits, this scholarship overlooks the potential of endogenous sources of protection – the agency of civilians. On the basis of a case study of northern Uganda, we identify and discuss several civilian self-protection strategies, including (a) attempts to appear neutral, (b) avoidance and (c) accommodation of armed actors, and argue that each of these is shaped by access to local knowledge and networks. We illustrate how forced displacement of civilians to 'protected villages' limited access to local knowledge and, in turn, the options available to civilians in terms of self-protection. Analyses of the intersections of aid and civilian agency in conflict zones would afford scholars of humanitarianism greater explanatory insight into questions of civilian protection. The findings from our case study also suggest ways in which aid agencies could adopt protection strategies that empower – or at least do not obstruct – the often-successful protection strategies adopted by civilians.
Journal Article