Bomb fragments a pain in our flesh, say LRA war survivors

On the evening of May 14, 1993, Uganda People’s Defence Forces (UPDF) soldiers raided Boli pii Village in Paibona Parish, Gulu District.
The raid was prompted by a tip that the UPDF received alleging that there were Lord’s Resistance Army (LRA) rebels camped in one of the homesteads adjacent to a creek. 
Joyce Aloyo’s family lived in the village at the time.
She says on the fateful night, her parents instructed her and her siblings to lock themselves in one of the huts in their compound. This, according to her parents, was safer than trekking 8km to Paibona Trading Centre, which was well-guarded. This is where the community often went to seek shelter at night during such incidences.

 “Once the rebels passed by, they would ignore your compound thinking the occupants have fled to safety,” Ms Aloyo says.
 She says moments after locking themselves in the hut, they heard rebels speaking in hushed voices after which a fierce exchange of gunfire erupted.  
“All we knew was that the rebels were on our side and the UPDF soldiers were hitting them from across the stream on the other side,” she adds. 
Ten minutes later, a grenade was tossed into the hut. 
“I don’t know what happened but I regained my senses three days later and found that I was admitted to Awach Health Centre,” Ms Aloyo says.

As she writhed in pain, her father told her that the grenade killed one of her brothers and left her seriously injured.
He further said the grenade was meant for the rebels. 
Ms Aloyo’s wounds were quite severe and for the first six months, she was attended to by surgeons at both Gulu Hospital and St Mary’s Hospital Lacor. 
“There was no improvement on each side and my mother contacted organisations like AVSI [Foundation] to support me at the Orthopaedic Unit of Gulu Hospital but the wounds were not healing,” she says.
 She adds that a non-governmental organisation (NGO) procured crutches for her and paid her monthly medical bills for nearly five years. The organisation, however, later halted the support.  
The organisation suggested that Ms Aloyo should get amputated but she refused. 

“I still wanted to live with all my limbs. However, they did not tell me that to treat my wound, [bomb] fragments that got stuck in my leg had to be removed,” she says. 
She adds that her mother sought support from other organisations but many said they were financially constrained.  
Despite the pain, Ms Aloyo continued with her studies and in 2004 completed Primary Seven. 
“I struggled, my foot got swollen and it hurt and leaked. I could not sit from morning to noon in class. I would study for half a day and return home to boil water and do dressing because the wound was not healing, while fellow pupils bullied me,” Ms Aloyo says. 

“In the class, I could not sit on the desk, I would move with a sack and put in front of the class and sit down because the condition could not allow me, it would pain a lot. Most pupils would abuse me seriously, and the toilet system at school was the worst challenge,” she adds. 
Ms Aloyo says in 2009, an organisation offered to treat war victims at Lacor Hospital. 
However, when she went for the surgical camp to remove the bomb fragments in her right leg and correct her metatarsals (bones in the feet), she was shocked to learn that she had to pay Shs27m for the surgery. 

“I returned home and told my grandmother that I had given up on life. However, later that year, the National Union of Disabled Persons in Uganda (NUDIPU) enrolled me on life skills training during which I learnt hairdressing and acquired a certificate.”  
She, however, says it is difficult for her to do the job because of her injuries.
 “I have gone for radiography at Lacor Hospital many times and the doctors have barred me from sitting or standing for too long because of the damage in both my right leg and the waist.” 
A medical x-ray film generated from Lacor Hospital recently indicates that the unrepaired damage in her right leg has progressively caused damage to muscles in her waist and groin such that it continues to aggravate her movement. 

Ms Aloyo says she got married but it did not last. She had two boyfriends after that but the relationships did not last.
“At my last home in Bungatira Sub-county, the man’s relatives openly chased me away from home. He was a boda-boda rider and they would storm into my house and remove food forcefully,” Ms Aloyo says.  
She has three children but says she can barely take care of them. 
“They feed and clothe themselves. They have to study and be treated when they are ill but it has been a battle that I failed to fight. The children are now moving around in homesteads digging and weeding in people’s gardens, fetching water and doing all sorts of petty things just to secure food for a day,” she says.
 “If only the government or a well-wisher came out to support her to pay for her medical treatment, support her children in school, and help her with other needs, she would be better,” Ms Margaret Aneno, Aloyo’s aunt and caretaker said. 
 In 1993 while returning home from Orom Trading Centre in Kitgum District in the afternoon, Mr Alfred Otema and his two brothers walked into a rebel ambush. 

“The village was a target by the rebels and they had just been repelled by the soldiers. However, when we entered the ambush, all I remember was the sporadic gunshots fired at us as we fled in disarray,” Mr Otema said. 
Mr Otema was shot and lost consciousness. When he came back to his senses two days later, he found that he had been admitted at Kitgum Hospital.  
He was told that four bullets pierced his knee and two got stuck in his left femur, causing him to bleed to near death. His right leg was amputated a week later but the bullets in his left femur were never removed. 

“I have lived with it for now but this incapacitation limited my ability to achieve my vision as a young man. I never went to school and I cannot do any meaningful physical work that can earn me money for survival because I am disabled,” he said. 
Mr Otema has two wives— one in Orom, Kitgum and another in Gulu - who are taking care of him. He is a cobbler and works near Gulu Regional Referral Hospital to be able to fend for his family, which includes four children.  
 “The money I raise from mending shoes cannot pay school fees for my children. At times I go for a week without working and that is when everything becomes hell. The same money is not enough to purchase a plot of land on which these children will survive tomorrow,” he says.

In 2002, LRA rebels led by Okot Ngwinya Aye Rwota from the Sinia Brigade raided Opota Trading Centre at dawn and clobbered to death 28 locals using hoes. Their victims were sliced to pieces and survivors of the massacre were ordered to cook and eat them.
Nekolina Adong, 63, and Josephine Akullu, 58, are victims of the attack.
The duo fled the massacre but were struck by bullets, which are still lodged in their bodies. 
“I fought for my life at the time from Dr Ambrosoli Hospital in Agago for six years but eventually, it somehow healed in my body but I cannot do vigorous work and carry a weight more than 8kg as instructed by medics because it triggers the excruciating pain,” Ms Adong says.
Ms Akullu says she is yet to recover from this horrific ordeal. 
“I have not moved on. I pray that government comes in to offer us the treatment and psychosocial support in the aftermath of the massacre, I cannot walk or move for long and barely do any work,” she says.
 
War scars
Since 1986, rebel groups wreaked havoc in Acholi, Lango, Teso and West Nile sub-regions, killing thousands.
The rebel activities forced many to seek shelter in Internally Displaced Camps, whose conditions were not favourable due to congestion.  
It is estimated that more than 10,000 survivors were injured in the rebel attacks with some being permanently disfigured.
Others were victims of torture which they were subjected to by the UPDF soldiers. 
In 2018, the Feinstein International Center - Tufts University conducted a victimisation assessment survey in which their findings detailed how the LRA’s attacks directed against civilians resulted in killings, attempted murder, enslavement, torture, rape and sexual slavery among others. 

Two-thirds of the 2,605 victims sampled during the assessment had a disability and half of the disabled “could not work a lot” or they “could not work at all” as a result of injuries sustained due to the war.  
“The combination of the high numbers of war crimes committed by the LRA and the resulting physical injury and disability, poorer mental wellbeing, the stripping and destruction of their assets, and their reduced ability to carry out livelihoods has resulted in these households being unable to afford to enrol and keep their child attending school,” the report read in part. 
The report further said the victims had asked for rehabilitation, therapeutic care, livelihood support, financial restitution and compensation, and educational provision for their families. 
 

The 2006 Cessation of Hostilities Agreement between the government and the rebels marked the beginning of reconstruction interventions led by the government, development partners, civil society organisations and community-based initiatives. 
Some of the more prominent programmes include the Peace Recovery and Development Plan (PRDP) and Northern Uganda Action Fund II.  
However, these organisations have largely focussed on infrastructure development as and issue of critical human development and the rehabilitation of victims of this insurgency by providing post-trauma social and welfare support—has been pushed to the backburners. 
Despite over a decade of reconstruction interventions, a revived focus on human development frameworks remains critical in facilitating the transition from recovery to development.  
There is little support that has been provided by the government towards rehabilitating victims who have bomb fragments and bullets stuck in their bodies save for efforts by cash-strapped non-governmental organisations. 

For example, TPO Uganda, in collaboration with partners such as Mental Health Uganda, has innovatively steered efforts in medication accessibility by educating beneficiaries on expenditure and medication costs.  
The initiative is termed the drug bank where it seeks to provide integrated physical and psychological rehabilitation assistance to war victims in Awach Sub-county, Gulu District and Lakwana Sub-county, Omoro District as well as Mucwini Sub-county in Kitgum District. 
During the five-year intervention, TPO Uganda conducted specialised surgical treatment in which it supported 78 females and 116 males to have bullets removed from their bodies. 
It has also been able to carry out psychosocial education in which 2,507 beneficiaries were given psychological support and another 178 treated. 

AVSI Foundation in Uganda and Refugee Law Project in the past, have also had a positive impact in supporting war-affected communities in overcoming the pain of living with the fragments in their bodies, emotional difficulties and psychological distress.  
These interventions have had positive effects on the community such as more victims can now access surgical treatment, the reduction of depression relapse, the improvement of social functioning and active engagement in community activities. 
Between 2008 and 2015, AVSI Foundation with support from the Italian government produced and gave more than 2,500 prostheses under the Gulu Regional Orthopaedic Workshop project in northern Uganda. 
 The centre provides prosthetic limbs, orthopaedic appliances, physiotherapy, counselling and psychotherapy services. 
However, most NGOs have since closed or scaled down their operations. 

Mr Fred Ngomokwe of Refugee Law Project, says victims should have their limbs replaced. 
“So, they are getting spoilt and broken while others have physically changed or grown up and the limbs cannot match their body figures and need change,” he says 
He says many victims cannot afford treatment and rehabilitation at hospitals. 
“If you are to buy the limbs, you need more than Shs1 million which cannot be afforded by the victims and if you are to go for specialised surgeries like the rectal prolapse, removal of fragments, correction of septic wounds and plastic surgeries, [it is too costly],” Mr Ngomokwe told this publication. 

Before the Covid-19 outbreak, Ms Stella Lanam, the War Victims and Children Networking director and also an LRA victim, says they were partnering with some organisations such as the Refugee Law Project (RLP) and the Centre for Victims of Torture to handle their medication and treatment to remove the bullets and splinters from victims’ bodies before the projects closed. 
“These projects recently closed and the victims are in a dire situation. If you go to Gulu Regional Referral Hospital, the situation is horrible and these health facilities cannot deal with them yet the victims do not have the funds. The government should do something to medically support these groups,” Ms Lalam says. 

Mr Ambrose Olaa, the Acholi Chiefdom premier, says they are aware of the problem.
“The issue of healing and recovery has been left upon the families unless NGOs who are now very rare pick you up for rehabilitation, we cannot do much and it, therefore means we need to have a mechanism for dealing with this problem,” he says. 
He adds that there is currently no structured method for handling such victims of war. “That is why as a chiefdom, we have been struggling to ensure that the transitional justice policy and law are enacted faster and enforced so that some of these issues around reparation, healing, and compensation can be catered for within the framework of the law unfortunately, we only have the policy now, we are struggling to ensure we have the law,” Mr Olaa says.

Govt reacts
While in Gulu City in December last year, the Internal Affairs minister, Maj Gen Kahinda Otafiire, said many Lord’s Resistance Army (LRA) war victims live horrible lives. 
“Those people are unfortunately a result of the 20 years of senseless conflict in this region, these are people who missed going to school, and their families were disrupted and have been rejected by society. You look at their past and their future, it is dark, and they are a lost generation,” he said. 
He added: “If their health were disrupted it’s not their fault, so the government should put in place programs to help them, they have no skills to put in the labour market so they devote themselves to criminal activities, and it’s the responsibility of society to rehabilitate them.”