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Advocacy strategy on enhancing the wellbeing of veterans with Post Traumatic Stress Disorders in Uganda
Mweru Samuel ByachiUganda Veterans Assistance Board
PTSD Advocacy strategy
What is PTSD?Shell shock or battle fatique syndrome
A condition that can develop after one has experienced/witnessed traumatic event
First brought to world attention by war veterans
May begin within 3 mths but could also take years
Families of PTSD victims can develop the disease
PTSD cont. A global problem underestimated by LDCs In the US, 200,000 veterans received
disability compensation for PTSD worth $4.3bn in 2005
11-20% of US Iraq and Afghanistan war veterans were PTSD positive
About 10% of US Gulf veterans were positive Uganda estimates are about !0% of the
veterans
Military related causes of PTSD Exposure to combat Exposure to life threatening missions Shot at, seen a buddy shot, or seen
death Military sexual trauma (sexual
harassment) Other factors such as what you do in
war, politics around the war, where it is fought, and type of enemy you face add more stress to an already stressful condition
Effects of PTSD Victim’s loss of faith for safety,
predictability or meaning in the world Haunts victim and prevents normal life Difficulty in relationships Feelings of shame, guilt, despair,
helplessness, grief/loss Poor health behavior among pregnant
women Memory loss among pregnant women
PTSD effects cont. Babies born to PTSD mothers are likely
to experience a change in at least one body chemical and later taking on the condition
Failure to engage in productive life Victims risk of higher use of cigarettes,
alcohol and marijuana Likelihood of committing crime
PTSD treatment Treatment through psychotherapy (restoring
safety feelings, calming the nervous system) Educating the victims what they are feeling Stress reducing foods also recommended Recovery involves (feeling empowered,
finding meaning in life again, re-establishing a connection to oneself and feelings for other people)
Why the PTSD advocacy strategy? WHO’s health definition(veterans not
healthy) Uganda’s 1995 constitution provides for a
right to health(yet PTSD is still a terror) Problem is big but generally faced with
silence Yet it is treatable! It is worthwhile that the advocacy aimed at
favorable policy change begins with me The challenges are surmountable
Campaign narrative for advocacy strategy
Retired Captain Moses Tabora was 10 years and illiterate when he joined the armed struggle and fought till 1995 when he left the army with one leg! Retired Sergeant Mwaka Hassan joined the rebel force when he had lost all his parents and did revenge killings whenever he could till he was discharged from the army in 1997. Retired Private Baluka Harriet was a child soldier and now has ten children each with a different father. She recently returned from Somalia as part of the Amisom troops and was diagnosed with PTSD. All these were liberators who now have become a “nuisance” through no fault of theirs.
A local song composed in Uganda describes the veterans as used condoms yet they contributed a lot in ousting the dictatorship and stopped state inspired killings then. All the three have PTSD problems but government is silent. What a pity! The families of these veterans cannot afford a smile. These veterans have unexplained behavior, make noise, issue threats, utter vulgar words and cannot fend for their families. Government had put up a law to take care of the veterans but never took this problem serious. Veterans are committing crime quite often and are jailed. Nobody ever bothers to find out what the exact problem is.
Families are resorting to witchdoctors for a remedy and others are going to Pentecostal churches for miracle cure. Yet this is a medical condition that can be addressed when government has the will to take it up, and mainstream it in its programs. The time is now for our legislators to own up this matter and make all interventions necessary to make the world of PTSD sufferers’ worthwhile if they are to measure up to the global standards pushed by the World Veterans Federation. It is your duty to make this change happen.
Brief about UVAB UVAB is a statutory body mandated to
discharge the soldiers from military service and ensure that they are sustainably reintegrated in civilian life.
UVAB faces challenges of increased veterans now about one million
PTSD condition not well handled Existing law has gaps that need
amendment
Context analysis of advocacy strategy Problem affecting about 10% of the veterans Manifestations of PTSD already explained Origin of PTSD grounded in 1981-1986 war Causes of PTSD explained Limited medical interventions made Family members, community and government
most affected by problem Frequency of problem periodic or continuous PTSD impacts negatively on socio-economic and
political aspects
CAMPAIGN STRATEGIC FRAMERORKObjectives and key targets (SMART)
To push for the amendment of the UVAB Act to include the support and treatment of the Post-Traumatic Stress Disorders (PTSD) condition among ex- soldiers by 2015
To work towards a community that has favorable perceptions of PTSD sufferers and support them by 2015
Enabling easy access of PTSD services by ex-soldiers through the creation of special wings at both the regional and national psychiatric referral hospitals by 2018
Campaign strategic framework cont. Scope covers veterans countrywide and
policy makers/legislators, community leaders by 2018
Critical pathways vital for each of the three objectives as road maps
Various circles of influence at play for each objective remain almost the same because of the security nature of the vulnerable target
M&E Framework of the strategy
Objectives Desired impact
Success indicators Means of verification
Objective 1
To push for the amendment of the UVAB Act by 2015
A law that will take care of ex combatants with PTSD condition and improve their condition
Amendment tabled and discussed
Amendment passed
Bill assented to by H.E the President
Parliamentary sessions monitored
Hansard Reports
Objective 2
To work towards a community that has favorable perceptions of PTSD sufferers and support them by 2015
A civil community that fully understands the PTSD problem and be in position to sustainably address those challenges
80% of community leaders having a favorable attitude
80% of PTSD veterans receiving support from the community
Press reports
Community meetings
Radio feedback
No of veterans assisted
Objective 3
To enable easy PTSD access services through special PTSD wings in regional and national psychiatric hospitals by 2018
Hospitals with PTSD wings that make it easy for the ex-combatants to get quick attention regarding their conditions
80% PTSD wings established
80% Special wings operational
80% of PTSD cases reporting for treatment registered
Reduced violence in PTSD homes
Hospital Reports
Minutes of ministerial meetings
Campaign elements Creative brief with emphasis to background
to the problem hyping need for intervention Campaign objectives seek favorable
attitude change and actualizing the change Messaging to policy makers and other
targets focuses on need to rise to the challenge
Emotions elicited seek policy change by comparison between past and present with liberators turned into rejects
Campaign elements cont.Lobbying Importance of lobbying is critical in the policy
process from agenda setting, option formulation and implementation
My case falls at agenda setting given my targets and desired policy change
Alternatives later considered Implementation would be the dream as soon as
OPM communicates accordingly Policy brief document prepared aimed at giving
the bigger sieved picture giving solutions and recommendations and call to action
Campaign elements cont.Popular mobilization Grounds for passion for MPs done
(scratch where it itches) Go for what works not strategy per se Threats of demonstration, petition to
parliament and request to meet H.E the President
Continuous engagement of friendly forces (via dialogue, sports, media, reminders, workshops) to keep fire burning
Campaign elements cont.Media analysis Media analysis key in any campaign Done with view to getting to my objectives with cost
effectiveness, efficiency, mass audiences in a timely manner
Media channels identified and prioritized Relevant press releases issued with call to action Media relations should take mutually beneficial,
loudspeaker, agenda setter, cordial and supportive relationships
Media is supportive because of its alleged non biased nature as a fourth estate (informative, educative and entertaining roles)
Alliance building(UVAB SWOT analysis)Strengths
Skilled manpower Long serving staff at headquarters Financing availed by the donor
community for demobilization Created a favorable history of good
performance Weekly veterans radio programs (that
help in sensitization)
Opportunities
Decentralization local government policy adopted in 1997
Favorable community H.E the President is a veteran Many cabinet ministers are ex-soldiers Rt. Hon. Prime Minister is the Minister
for veterans affairs Liberalization policy Vibrant civil society
Weaknesses
Space limitations at Head Office Location on 7th Floor that is bad for
Veterans with Disabilities Current limited funding Regular staff turnover in districts
affecting district veterans office performance
Threats
Fight for control over veterans Limited legal mandate Instability in the region A non-supportive opposition in
parliament Confusion of who a veteran is Political definition of a veteran
Alliance Building cont.SWOT analysis SWOT analysis vital in the strategy to locate
our standing as an organization Opportunities and risks identified help in way
forward leading to a number of allies to fill gaps and enhance capacity
Alliances to build in this strategy include NRM Veterans League (Ruling party organ) Uganda Local Government Association (ULGA) Uganda NGOs Forum (vibrant civil society) Uganda Medical Association
Action Plan For One yearObjective Target Year 1
Desired Outcome
Activity Timeline Resources
1. Amendment of the UVAB Act
Board of directors UVAB
Board of Directors approve a board paper highlighting the need for amendment
1.1 Drafting of researched board paper 1.2 Distribution of agenda 1.5 Two (2) Board meetings called and sat
April –November 2013
Funds (facilitation) Technical staff
The Prime Minister
Board minute on amendment considered by the Rt. Hon. Prime Minister
1.1 Premier tables the need for action in the top management meeting for adoption 1.2 Need for amendment tabled in cabinet 1.3 Cabinet memo done
February 2014
Technical staff
Members of Parliament
Members of Parliament get to appreciate the dangers associated with PTSD among veterans
1.1 Conduct district veterans advisory committee meetings countrywide 1.2 Conduct workshops targeting the parliamentary defence committee and other members of parliament
January 2014
Technical staff/Facilitators Funds
2 Have a community that has favorable perceptions of PTSD sufferers.
Board of directors UVAB
Board approves expenditure on mobilization of various stakeholders
2.1 Regional officers asked to present budgets for mobilization 2.2 Budget preparation for national mobilization after receipt of
April-June 2014
Funds Technical staff
THE LAST REMARKS I AM AN IMPROVED HUMAN RESOURCE
NOWWITH ADVOCACY SKILLS TO RALLY MY TARGETS FOR CHANGE VETERANS IN UGANDA HAVE CAUSE TO
BE HOPEFUL I SAY THANK YOU TO THE COURSE
SPONSORS, COURSE ORGANIZERS, FELLOW PARTICIPANTS, VALERIE AND CO.