Background:Coronavirus disease 2019 (COVID-19) is a recent global pandemic associated with multidimensional health-related effects. In the fight against the spread of this novel pandemic, the... Show moreBackground:Coronavirus disease 2019 (COVID-19) is a recent global pandemic associated with multidimensional health-related effects. In the fight against the spread of this novel pandemic, the majority have been living under restrictive conditions during its related lockdown that has created a conducive environment for gender-based violence (GBV). Our study aimed to ascertain the burden and determinants of GBV during the COVID-19 pandemic-related lockdown and curfew (CPLC) in Uganda.Methods:We conducted a quantitative descriptive cross-sectional study in Bushenyi-Ishaka municipality, southwestern Uganda in May, 2020. This study involved 339 adult participants regardless of their gender or ethnicity. Only 12 potential respondents declined to participate in this survey.Results:The prevalence of GBV during the CPLC was 42 per cent. The majority (57%) of victims were women. More than half (54%) of the victims and survivors of GBV attributed the violence to the lockdown. The determinants of GBV included being married, using substances of abuse and having financial problems.Conclusion:The prevalence of GBV skyrocketed during the CPLC in Uganda when compared to the period prior to the pandemic. Women were significantly more affected in all aspects of GBV. Therefore, we recommend developing targeted behavioural change communication strategies based upon our findings. Show less
Sultanov, M.; Zeeuw, J. de; Koot, J.; Schans, J. van der; Beltman, J.J.; Fouw, M. de; ... ; Stekelenburg, J. 2022
Background: High-risk human papillomavirus (hrHPV) testing has been recommended by the World Health Organization as the primary screening test in cervical screening programs. The option of self... Show moreBackground: High-risk human papillomavirus (hrHPV) testing has been recommended by the World Health Organization as the primary screening test in cervical screening programs. The option of self-sampling for this screening method can potentially increase women's participation. Designing screening programs to implement this method among underscreened populations will require contextualized evidence. Methods: PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC) will use a multi-method approach to investigate the feasibility of implementing a cervical cancer screening strategy with hrHPV self-testing as the primary screening test in Bangladesh, India, Slovak Republic and Uganda. The primary outcomes of study include uptake and coverage of the screening program and adherence to follow-up. These outcomes will be evaluated through a pre-post quasi-experimental study design. Secondary objectives of the study include the analysis of client-related factors and health system factors related to cervical cancer screening, a validation study of an artificial intelligence decision support system and an economic evaluation of the screening strategy. Discussion: PRESCRIP-TEC aims to provide evidence regarding hrHPV self-testing and the World Health Organization's recommendations for cervical cancer screening in a variety of settings, targeting vulnerable groups. The main quantitative findings of the project related to the impact on uptake and coverage of screening will be complemented by qualitative analyses of various determinants of successful implementation of screening. The study Continued from previous page) will also provide decision-makers with insights into economic aspects of implementing hrHPV self-testing , as well as evaluate the feasibility of using artificial intelligence for task-shifting in visual inspection with acetic acid. Show less
This book explores the effects of war and displacement on the South Sudanese Zande, a people frozen in time by the classical anthropology of Edgar Evans-Pritchard. The research started in Western... Show moreThis book explores the effects of war and displacement on the South Sudanese Zande, a people frozen in time by the classical anthropology of Edgar Evans-Pritchard. The research started in Western Equatoria State, South Sudan, at a time of hopeful reconstruction (2014-2015). Yet after war resumed in 2015, nearly a million South Sudanese refugees fled to neighbouring Uganda – and so the study continues with South Sudanese Zande refugees there (2015-2019). Based on hundreds of inter views with refugees and stayees, chiefs and elder s, government officials and former combatants, and ordinary people, this book places conflict, confusion, and the search for continuity at the heart of the historical ethnography of the South Sudanese Zande. The book focuses on the ties between people, between people and land, and the competing efforts to control those ties. These three foci relate to proto-legal questions that underpin human society: Who are we? To whom and where do we belong? And whose authority do we accept? This study shows that these foundational questions gain new salience in times of crisis, as people turn to nostalgia and utopia to escape present despair. Show less
Chronic respiratory disease (CRD) is a silent, ongoing pandemic. It disproportionally affects low-resource settings. Tobacco smoke and kitchen smoke (caused by the use of solid fuels and... Show moreChronic respiratory disease (CRD) is a silent, ongoing pandemic. It disproportionally affects low-resource settings. Tobacco smoke and kitchen smoke (caused by the use of solid fuels and inefficient stoves) are major risk factors. Evidence-based solutions to CRD often fail to be effective, as they misalign with local needs and then fail to be implemented. This thesis focused on how lung health solutions can be implemented successfully by capitalising on the local needs.Within the Horizon2020 FRESH AIR implementation research project, we first studied local settings in Kyrgyzstan, Uganda, Greece, and Vietnam. For example, we found that COPD in the highlands of Kyrgyzstan occurred three times more frequently than in the lowlands, partly due to higher levels of kitchen smoke. We discovered the high indirect burden of asthma and COPD, by their impact on work- and daily activities. We also found that many communities and their health workers mistook CRD for infectious disease like tuberculosis. Based on these findings and on implementation literature, we then designed several practical tools addressing critical factors for implementation success of lung health interventions. These evidence-based tools can facilitate implementation success, thereby optimising the use of already scarce resources and benefitting health outcomes. Show less
‘Resilience’ is trending in development theory and practice, where it is often measured using countable socio-economic outcomes. This paper draws on ethnographic research with South Sudanese Zande... Show more‘Resilience’ is trending in development theory and practice, where it is often measured using countable socio-economic outcomes. This paper draws on ethnographic research with South Sudanese Zande refugees in Kiryandongo Refugee Settlement, Uganda, to show a different and often overlooked perspective; that of elderly refugee women. Having lived through decades of war and displacement, these women have developed a rich body of knowledge about suffering, coping, and resilience. Mixing idioms, folktales, and anecdotes, they teach youth not to focus on outcomes or ‘big dreams’, but on a stoic acceptance of loss and perpetual precarity. They advise actions like farming, childcare, and faith. Even so, suffering and coping are socially conditioned and policed, and the intimate circle harbours both protection and dangers, like witchcraft. The women’s accounts contrast bleakly with up-beat neoliberal developmentalism which sees cash-infused ‘resilience’ as the key to refugees’ self-reliant futures. Show less
War ravaged northern Uganda for over two decades after its start in 1986. During this time, over 80 per cent of the Acholi population living there was internally displaced. This occurrence has... Show moreWar ravaged northern Uganda for over two decades after its start in 1986. During this time, over 80 per cent of the Acholi population living there was internally displaced. This occurrence has disrupted social life in more ways than often acknowledged in policymaking and discourse surrounding displacement. This book draws focus on the personal experiences of people who moved to Pabo – the former site of one of the displacement camps – during the war, and who have not left this place since. Using data from life histories collected in Pabo during seven months of fieldwork, it explores motivations for non-return and shows that displacement is more than a forced move from one geographical location to another; it involves economic, social, and cosmological considerations and touches upon identity and belonging. This book also explores the long-term effects of displacement on life by zooming in on social relations within the household. Using the concept of anomie, it is argued that, in this particular post-conflict context, social guidance on desirablegoals and accepted behaviour is diminished and there is a discrepancy between goals that are still valued and the means available to achieve them. Building upon the life histories, the argument is constructed that the situation of anomie has contributed to intergenerational friction and to families breaking up. The goal of this book is to lay bare the interface between structure and agency, and to counter the trend of turning internally displaced people as well as refugees into abbreviations and subjects without a voice.Dutch summary: Meer dan twee decennia lang is het noorden van Oeganda geteisterd door de oorlog die daar in 1986 begon. In deze periode raakte meer dan 80 procent van de Acholi-bevolking in deze regio ontheemd. Ondanks dat dit niet altijd erkend wordt in het beleid en de discussies omtrent ontheemding, laat dit werk zien dat deze gebeurtenis het sociale leven in vele opzichten heeft ontwricht. Dit boek vraagt aandacht voor de persoonlijke ervaringen van mensen die naar Pabo – de locatie van één van de vele voormalige vluchtelingenkampen – zijn getrokken tijdens de oorlog en die hier niet meer weg zijn gegaan. Door middel van tijdens veldwerk verzamelde levensverhalen worden motivaties om niet terug te keren blootgelegd. Dit laat zien dat ontheemding meer is dan een gedwongen geografische verplaatsing; ontheemding betreft economische, sociale en kosmologische overwegingen en raakt aan identiteit en een gevoel van verbondenheid. Hiernaast onderzoekt dit boek de langetermijn effecten van ontheemding door in te zoomen op de sociale relaties binnen huishoudens. Door het concept ‘anomie’ te gebruiken, wordt beargumenteerd dat er, in deze specifieke context, een verzwakt sociaal kader is wat betreft levensdoelen die nagestreefd zouden moeten worden en wat acceptabel gedrag is om deze doelen te verwezenlijken. Bovendien laat het zien dat er een gat is ontstaan tussen doelen die worden gezien als belangrijk en de middelen die beschikbaar zijn om deze doelen te behalen. De levensverhalen tonen aan dat deze situatie van anomie heeft geleid tot intergenerationele wrijving en tot het uiteenvallen van families. Dit boek legt het spanningsveld tussen structuur en zelfbeschikking bloot, en gaat in tegen de trend die vluchtelingen maakt tot nummers of mensen zonder stem. Show less
Nortier, J.; Hummelen, J.; Camp, E. van de; Sauerwein, T.; Pickering, A. 2021
Als je deze podcast luistert via je mobieltje, dan zitten daar wel honderd verschillende grondstoffen in. Ook zeldzame grondstoffen, die kleinschalig en soms illegaal worden gemijnd in... Show moreAls je deze podcast luistert via je mobieltje, dan zitten daar wel honderd verschillende grondstoffen in. Ook zeldzame grondstoffen, die kleinschalig en soms illegaal worden gemijnd in verschillende Afrikaanse landen. Grondstoffen die rebellengroepen financiëren en soms gewonnen zijn met kinderhanden. Dit onderwerp is een echt Africast-onderwerp, want onze blik, vanuit Europa, is volgens onze gasten gebaseerd op vooroordelen en heel eenzijdig. De twee wetenschappers van vandaag gaan ons alles vertellen over grondstofwinning en we nemen Uganda en Ivoorkust als casus. Onze gasten deze week zijn Esther van de Camp (PhD Candidate aan de Universiteit Leiden) en Titus Sauerwein (PhD Candidate aan de University of Surrey) Hosts: Joeri Nortier & Jos Hummelen Mede mogelijk gemaak door Netherlands-African Business Council (NABC) Muziek door Alisdair Pickering Show less
Ruzibiza, Y.; Berckmoes, L.H.; Neema, S.; Reis, R. 2021
This paper explores how Burundian adolescents in the Nakivale refugee settlement, Uganda, experience umwidegemvyo, loosely translated as “freedom”, with regard to their sexuality. We draw on... Show moreThis paper explores how Burundian adolescents in the Nakivale refugee settlement, Uganda, experience umwidegemvyo, loosely translated as “freedom”, with regard to their sexuality. We draw on ethnographic research conducted between August and November 2017 with adolescents aged 13–19 years. Our research included in-depth individual interviews, focus group discussions, and participant observation. We present a context-sensitive appreciation of “freedom” and its social implications for adolescents’ sexual and love relationships. We show how adolescents attribute their sexual experiences and practices, including experimental sex, stress-relief sex and transactional sex, to the freedom experienced in the refugee context. Yet they also view this freedom with ambivalence: while some degree of freedom is desirable, too much is referred to in terms of kutitabwaho n’ababyeyi, loosely translated as “parental neglect”, implying a lack of parental involvement, care and provisioning. Show less
Background: It is proposed that helminth exposure protects against allergy-related disease, by mechanisms that include disconnecting risk factors (such as atopy) from effector responses.Objective:... Show moreBackground: It is proposed that helminth exposure protects against allergy-related disease, by mechanisms that include disconnecting risk factors (such as atopy) from effector responses.Objective: We aimed to assess how helminth exposure influences rural-urban differences in risk factors for allergy-related outcomes in tropical low- and middle-income countries.Methods: In cross-sectional surveys in Ugandan rural Schistosoma mansoni (Sm)-endemic islands, and in nearby mainland urban communities with lower helminth exposure, we assessed risk factors for atopy (allergen-specific skin prick test [SPT] reactivity and IgE [asIgE] sensitization) and clinical allergy-related outcomes (wheeze, urticaria, rhinitis and visible flexural dermatitis), and effect modification by Sm exposure.Results: Dermatitis and SPT reactivity were more prevalent among urban participants, urticaria and asIgE sensitization among rural participants. Pairwise associations between clinical outcomes, and between atopy and clinical outcomes, were stronger in the urban survey. In the rural survey, SPT positivity was inversely associated with bathing in lakewater, Schistosoma-specific IgG4 and Sm infection. In the urban survey, SPT positivity was positively associated with age, non-Ugandan maternal tribe, being born in a city/town, BCG scar and light Sm infection. Setting (rural vs urban) was an effect modifier for risk factors including Sm- and Schistosoma-specific IgG4. In both surveys, the dominant risk factors for asIgE sensitization were Schistosoma-specific antibody levels and helminth infections. Handwashing and recent malaria treatment reduced odds of asIgE sensitization among rural but not urban participants. Risk factors for clinical outcomes also differed by setting. Despite suggestive trends, we did not find sufficient evidence to conclude that helminth (Sm) exposure explained rural-urban differences in risk factors.Conclusions and clinical relevance: Risk factors for allergy-related outcomes differ between rural and urban communities in Uganda but helminth exposure is unlikely to be the sole mechanism of the observed effect modification between the two settings. Other environmental exposures may contribute significantly. Show less
.Responses to the article: "Struggling to be a “happy self”?: psychotherapy and the medicalization of unhappiness in Uganda" written byJulia Vorhölter.
In Luganda, the widest spoken minority language in Uganda, the word for photographs is 'ebifananyi'. However, 'ebifananyi' does not, contrary to the etymology of the word photographs, relate to... Show moreIn Luganda, the widest spoken minority language in Uganda, the word for photographs is 'ebifananyi'. However, 'ebifananyi' does not, contrary to the etymology of the word photographs, relate to light writings. 'Ebifananyi' instead means things that look like something else. 'Ebifananyi' are likenesses. My research project explores the historical context of this particular conceptualisation of photographs and its consequences for present day visual culture in Uganda. It also discusses my artistic practice as research method, which led to the digitisation of numerous historical collections of photographs. This resulted in eight books and in exhibitions that took place in Uganda and in Europe. The research was conducted in collaboration with both human and non-human actors. These actors included photographs, their owners, Ugandan picture makers and visitors to the exhibitions that were organised in Uganda and Western Europe. This methodology led to insights into differences in the production and uses of, and into meanings given to, photographs in both Ugandan and Dutch contexts. Understanding differences between ebifananyi and photographs shapes the communication about photographs between Luganda and English speakers. Reflection on the conceptualisations languages offer for objects and for sensible aspects of the surrounding world helps prevent misunderstandings in communication in general. Show less
This paper presents a comparative study on conceptualizations of the poorly understood nodding syndrome (NS) in Uganda and Tanzania. NS has been constructed as a biomedical category to serve global... Show moreThis paper presents a comparative study on conceptualizations of the poorly understood nodding syndrome (NS) in Uganda and Tanzania. NS has been constructed as a biomedical category to serve global health discourse as well as national contexts of managing the condition. The paper looks into the shifting meanings and conceptualizations of NS in the affected areas of Kitgum (UG) and Mahenge (TZ) district. The perceived universality of biomedical classifications is problematized as conflicting with the specific contexts of lucluc and kifafa cha kusinzia. Reconciliation proves to be challenging, poignantly evoking the cultural construction as such of any medical condition. Show less
By far the most contentious issue in the postcolonial relationship between the UK and Uganda was the 1972 expulsion of British Asians by President Amin. Although it is well documented that Idi Amin... Show moreBy far the most contentious issue in the postcolonial relationship between the UK and Uganda was the 1972 expulsion of British Asians by President Amin. Although it is well documented that Idi Amin refused to bow to international pressure to reverse this decision or extend its compliance period, our knowledge of the numerous schemes, especially the covert ones, that were considered and/or operationalized by the British government in order to influence a revision of this decision remains limited. This essay, using newly available evidence mainly from the British National Archives in London, attempts to fill this gap. Such insights enhances the utility value of this episode for our understanding of bilateral and multilateral relations among states. Show less
This essay investigates the historical background of ethnic disunity in today’s Western Uganda as part of the Great Lakes Region of East Africa. In general, there are two opposing views with... Show moreThis essay investigates the historical background of ethnic disunity in today’s Western Uganda as part of the Great Lakes Region of East Africa. In general, there are two opposing views with respect to the existence of ethnicity in precolonial times. On the one hand, social scientists state that the existence of ethnic groups is an invention of the joint work of colonial administrators and professional ethnologists. On the other hand, several scholars argue that ethnicity is an ancient phenomenon predating colonial times. In the past decades, the study into the ancient history of the Great Lakes Region has made great progress. The interdisciplinary approach of historical linguistics, history and anthropology revealed a fascinating and complex history of languages and cultures. However, the history of the different peoples who spoke these languages and built up these cultures is much less known, in particular about how they interacted with each other and how they judged socio-cultural differences. For example, what names they gave each other. This essay tries to give an impetus for further interdisciplinary research about the existence of ethnicity in precolonial times. Identity formation within and between groups is related to power structures in societies. Therefore, investigating ethnicity in precolonial times has to be carried out in the context of developing power structures. Show less