This morning we met with the Principal of the Lira campus of Gulu University. The campus is situated on the site of what was formerly the biggest campus for internally displaced persons in Uganda. The site officially closed in 2007, but many of the people who had been placed there decided to remain there as they were unable to returned to their homes due to the destruction that was wrought, or because their land was requisitioned by the Ugandan People’s Defence Force to build bases to reduce the risk of further incursions by the LRA. There are currently only 400 students enrolled at the campus, which officially opened in 2012. Elizabeth Amongi, who works as a lecturer on the campus, had kindly organized the trip. The Principal had provided his personal vehicle to come and pick us up from the Pauline Hotel and take us the 25 min drive to the campus. The campus is situated on an elevated site that commands impressive views of the surrounding countryside. Red dust rose from the uneven track as we approached a set of modern buildings scattered amongst the broad expanse of green fields. The huts of the displaced families who have made this place their home sat not too far away amidst the small plots of ploughed fields that the families farm and keep their animals.
The principal is man named Prof Ogwal (a Professor of Pharmacology who holds at MD). He had worked for much of his career at the main Gulu University campus. He explained the vision that the small team of academic staff currently based in Lira have for developing educational programmes there. Within 2 years the student numbers will rise to 2000. The Faculty of Health Sciences, which has been established and is currently training much needed midwives, will grow. In addition, a Faculty of Education will be established.
A Gulu University calendar on the wall had ‘Cultural Diversity’ emblazoned on it. Richard picked up on this. The principal provided more information about the ethnic make-up of Uganda. It seems that there are over 50 ethic groups – of which the Buganda are the biggest (representing approximately a third of the population). The Buganda people are concentrated mainly in central Uganda, and are less numerous here in the North. It seems that English serves as a unifying language that can cut across the ethnic differences. In the past Kiswahili was promoted as a language that could unify the nation. This would have the benefit of facilitating cooperation with Kiswahili speaking East African neighbours such as Kenya, Tanzania etc. However, Kiswahili was resisted by large numbers of people in Uganda as it was traditionally associated with less educated people. Luganda is the most widely spoken indigenous language spoken in Uganda, but its potential use as a National language is resisted by some ethnic groups because it is so closely associated with the Buganda. It is important to note that the school that we visited yesterday and the University we visited today only teach students using English. This highlights the challenges that health professionals might have being taught in a language that is not necessarily the first language of the people that they subsequently treat. I think this serves to highlight the ecological validity and potential utility of the research that we are conducting.
The principal was interested to learn about our academic backgrounds and responsibilities. It was great to reflect on issues related to training mental health workers to support the mental health and wellbeing in Uganda. I hope that staff from the university will be able to join us in Kigali, Rwanda from the 15th to 19th June 2015 for the ‘Global Perspectives in Mental Wellbeing’ knowledge exchange event that we are organizing there (http://global-perspectives-on-mental-wellbeing.eventbrite.co.uk. The event is very much intended to benefit people working to promote wellbeing in the Great Lakes Region of Africa. It was great to hear Richard and the Principal talk about plans to build the faculty for Education. Richard has very valuable experience of building capacity for training teachers and educationalists in places such as Greece (where he helped to establish the Open University) and Bangadesh. It seems that the conversations with the staff at the campus are only really beginning and will continue in the months to come. It is exciting to see a university campus so early in its development. Our visit concluded with Elizabeth giving us a guided tour of the Faculty of Health Sciences. We met with some of the staff there including two nurses from the US Peace Corps who are working at the University for a year. On returning to Pauline Hotel we had lunch and then spent time trying to get to emails before members of the research team started to return from the key informant interviews that they had been completing. Patrick and Elizabeth spent the afternoon trying to confirm arrangements for the Focus Group Discussions that contribute to Phase 3 of the research project.
I used the time waiting for the supervisors to return to complete the checking of the interview recordings to ask Fr Ponsiano and the research team about the Lango words that are used to describe elevated levels of distress. I was careful not to introduce terminology that is routinely used in the UK to describe and categorise complex mental health problems. ‘Awingi’ is a word that is used to descibe strange behavior, or as Fr Ponsiano puts it, someone’s ‘wires not being right’. Links were made by the group between this term and bipolar disorder. The term ‘abangbang’ is used to describe someone who is persistently flat or down. ‘Tipu kome’ can be used to describe someone who is in a chronic grieving state and translates as the ‘soul of the body being gone or destroyed’. ‘Apoa’ is a word that is apparently used for severe mental health difficulties. The team drew comparisons between this and a diagnosis of schizophrenia. When I asked about commonly regarded causes of Apoa, Fr Ponsiano mentioned the following factors along with the accompanying Lango terms: genes (‘dogola’), people with these difficulties coming to your home with it when you were young (‘twoakobo’), a curse for doing wrong (‘orogo’), stubbornly persisting with particular behaviours (‘ceno’), injuring someone else/killing a person who is experiencing madness and this madness transfering to your family (‘neko apoa’). In terms of indigenous treatment options for these forms of difficulties, the following options were highlighted: ‘Anebi’ (mix of religious and traditional healing), and ‘Ajoka’ (a witch doctor). A range of malevolent spirits and processes were also highlighted including ‘Ajok’ (witches) who can poison people through food (‘ading’), or more mysterious methods (‘acudang’). The words ‘ajok amyelo/ajok iayido’ are used to describe what are in English referred to by the Lango people as Night-dancers. These cause no actual bodily harm but do disturb sleep. It was an enlightening conversation that only got to the tip of the proverbial iceberg. There has been much to learn on this trip, and there will be much more to learn about in future visits.