Many of the Kampala's July terrorist bombing victims may be far from real healing despite some being treated of the physical wounds obtained at the scene. The claim according to Francis Mugoga, the director of the Uganda 7/11 Survivors' Network is true because eight years after, the victims did not get the necessary psychological treatment they needed.
After the incident, the victims formed an association that would help them in the healing process but did not get support from anywhere else.
Mugoga says, "Many times people have tried to talk to the people in our association but we are still traumatised about being in the media yet nothing is done. I do not think some of us can talk about the incident freely because we did not receive the psychological treatment that would otherwise prepare us to talk."
He thinks that psychological treatment is not something that was handled wholesomely. A few days after the incident, the Uganda Counselling Association held critical incident stress management counselling sessions aimed at stabilising the victims and showing support.
According to Henry Nsubuga, a counselling psychologist who was the president of the association at the time of the incident, trauma is a very serious psychological problem that can trigger other additional disorders like alcoholism and suicidal tendencies if not well managed and treated.
He says, "We had a psychological debriefing, a brief psychological intervention which was aimed at making the victims to stabilise emotionally, think properly and to find a secure place that would protect them from further trauma and harm."
In the next year, the association held a four days' camp for the victims to help them stabilise mentally. However, since different victims were impacted differently, some people needed more therapy sessions yet others need shorter durations depending on individual ability to cope with traumatic situations.
The association classified some victims as mildly affected and those that they thought had been affected greatly and needed more healing time had longer sessions with therapists that would treat them on individual basis.
Kizito Wamala, a clinical psychologist at Centre for Victims of Torture says, there were resource limitations since the initiative was taken on by basically NGOs and the victims did not receive enough treatment they should have gotten.
He says, "The debriefing was not as intensive and only a few people who were considered to be greatly affected were called for about three or four sessions of counselling. In my experience however, these are very few sessions and may not be helpful at all if it is psychological trauma. This is not ample time for the people to have healed from such an experience and many of the victims did not receive the therapy they should have got."
Did they all need therapy?
Kizito says we cannot underrate the capacity of human beings to cope and recover naturally because majority of them may have recovered even without enough therapy.
"Generally, about 40 per cent of the people who suffer post traumatic experiences often heal on their own provided they have a good environment and are not exposed to continued trauma. They will recover naturally."
Like the physical trauma, some people are able to get healed from trauma without the emotional treatment but the extent to which they suffered matters in their healing or if there are people they are able to speak to.
"Some people however may not be able to heal especially if they remain in the same environment; they do not have someone to speak to like a family or friend and maybe lack the general capacity to meet daily needs," he says.
Nsubuga remarks that, complications that result from the traumatic experiences should not be down played in such situations because it has a big impact on the physical wellbeing of a person.
In such cases, going to the same scene, sound or colour can trigger fast breathing, shivering and some people may suffer lack of sleep, nightmares, hallucinations, poor appetite, sexual problems, chest, spinal or heart problems, and general body weakness that the victim may complain about.
Importance of the treatment
When the trauma is there, people develop a reaction towards the incident. It could be fear for something they used to do but they do not find joy in doing it anymore. This is the reason they need help. This shows that these people are not well and they need the treatment to make their life normal again.
Kizito says, "The condition may hinder victims from leading a normal life thereafter, prohibit them from doing so many useful things not because they cannot but due to fear from what happened. Some may not even go out of the house because they are scared of a reoccurrence of the same incident. The danger is already gone but someone has it in their mind that the danger is still waiting for them."
The treatment helps such people to see life differently and have a new meaning. Just as it is important to treat physical ailments, so is it with the trauma.
After receiving several sessions of the therapy, the terms of termination of a trauma victim from the treatment programme are dependent on a number of factors according to Nsubuga.
"It could be about the number of times they have been exposed to the experience, other conditions that have developed in relation to the traumatic experience for example depression or anxiety while others may not suffer as many of these disorders," he says.
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Generally, the facilities for psychological treatment in Uganda are few and specialised trauma treatment centres are even fewer. Majority of these centres are human rights based within certain mandates so they work on certain groups of people as a response to an incident and not with the general population.
"There are NGOs that treat trauma like African Centre for treatment and rehabilitation of Torture Victims (ACTV) in Kampala, Centre for Victims of Torture (CVT) in Northern Uganda, Victims Voice (VIVO), Makerere University Counselling Centre and these places have skilled therapists. These organisations offer free psychological therapy if the victim lies in their jurisdiction," says Kizito.
Butabika hospital is the only free place where everyone can go for trauma treatment. Many people however are scared of going there because mental illness is stigmatised in this country but it is like any other body illnesses are treatable.
Other consultations can be done through the Uganda Counselling Association, Uganda Clinical Psychology Association, Nakasero hospital or by privately hiring a psychologist for basic treatment. The cost ranges between Shs 50,000 to Shs100,000 per session depending on the consultant you want.