Where fear is a weapon in Uganda
Child soldier, Jimmy
Jimmy was only 10 years old when he and nine other children were abducted by the LRA. About 15 men dressed in government forces' uniforms or women's clothes attacked the village. Everybody fled in panic.
"I was left alone," Jimmy, now 12, says.
The children were moved towards southern Sudan which borders northern parts of Uganda. Taking advantage of the chaos of civil war in Sudan, it is an area where the LRA has often sought refuge. For two years Jimmy was held captive. During that time he witnessed terrible things.
"I was a scout for the commander in chief and had to walk in front on the look for government forces," Jimmy says. "I was beaten all the time and saw things I would rather not see."
Jimmy says he did not kill anybody. But he witnessed other abducted men and children being beaten with machetes, heated over the camp fire. Several were killed.
"I saw when they killed a man working in his banana tree and I saw them killing a man who tried to flee."
"We walked from early morning till late night with hardly any food. We had to eat leaves and everyone suffered (from dysentery)," Jimmy says.
His mother tells us he often has nightmares. "He can wake up in the middle of the night, jump out of the bed as if he has a gun, screaming 'Get out!'. Fortunately, these nightmares come less and less often."
MSF includes mental health in every medical activity in the camps. Jimmy receives psycho-social support through this program.
"I was still afraid when I arrived at the camp," Jimmy says.
"The children have trouble sleeping and suffer from nightmares and headaches. In addition, they struggle to adapt to life with their parents and other children at the same age," Anne Vikan explains. "They tend to be more aggressive or more reserved. These are normal reactions to something that is completely irregular. We try to help them go on through group gatherings where they can express themselves in safe surroundings.
Many children already know the social worker in the clinic. They drop by when they need an adult to talk to. Jimmy comes around quite often because he spends most of the days alone. That is not because his mother does not care, but because she spends several hours every day collecting food for her family.
Fleeing the kidnappers
MSF also sets up more informal gatherings about mental health issues in addition to group therapy and individual treatment. Fear and suspicion towards returned children are among the recurring subjects. Every returned child is welcomed but suspicion arises when rebels are nearby. Many children face being labelled "rebel" or receiving other insults from both adults and children alike.
Many child soldiers are forced to kill - sometimes even their own parents. They are severely psychologically scarred from what they have been forced to do and from what they have seen.
Amos is a teenager. He was also abducted, but returned to the camp about a year ago.
"He was exposed to the most extreme tactics of the LRA," Vikan explains. "After the abduction, he was sent back to kill his family. Amos has lost track of how many people he had to kill before he managed to escape. His brother does not want to have anything to do with him. He has no one left, no place to go and is afflicted by nightmares and deep depression. He was suicidal when MSF met him.
"We gave him a position at the clinic. That helped him to get a grip on everyday life and gave him a social network. This was a tremendous help for him. He arrives first at work and is our most eager co-worker. In addition, we help him deal with the past - but there is still a long way to go.
"In order to stay close to children like Jimmy and Amos and to help them in the most effective way, we work and live in the camps. At first, many people told us this was impossible due to the insecurity. But it proved to be no problem."
In northern parts of Uganda, women are sometimes abducted, disfigured and then released again. The aim is to scare the locals into submission. Teenager 'Akiro Grace' was taken by young soldiers when she was tending her vegetable patch outside the village. She was kidnapped together with 10 other girls.
They cut off Akiro's nose, lips and parts of her ears.
"I do not know why they did this to me," she says. This is a common LRA tactic designed to instil fear into the local population.
"MSF can refer women to a hospital in Kampala to get plastic surgery," Anne Vikan says. "I have spoken with many of them and their stories are horrifying. The more violence they have been exposed to, the more traumatized they are and the less self control they have.
"Each and everyone in this area has a story to tell. It is impossible not be touched. At first, it is hard to comprehend because their testimonies are so extreme and difficult to relate to. It is just too absurd, even though you only live a couple of kilometres away from the crime scene. Later, when you get the events in their proper perspective, you realize what they have had to live through and still have to face. It makes me angry. But still, the most important thing to focus on is the strength and willingness to survive that most people display.
"We have to focus on the things that make them stand up and go on. I know it sounds unbelievable, but people welcome us with joy and humour. I think we have a lot to learn."
Future as a driver
Jimmy managed to escape the guerrilla after two years. He arrived at a reception centre in Gulu and was later sent to the Aloi camp in Lira district where the rest of his family is located. This camp is one of the largest in North Uganda with 60,000 people. His mother says she thought she would never see him again, and was filled with happiness when she heard on the radio that he was safe.
"Taking everything into consideration, Jimmy has been lucky. His family is happy to have him back and he has got friends and a chance to receive treatment. He is resourceful and manages well," Vikan tells us.
"I would like to be a driver in the future" Jimmy says, and shows us the car he has made out of wire.