The rehabilitation of child soldiers: defining needs and appropriate responses.

There is growing international concern that large numbers of children are being recruited to military forces in situations of conflict around the globe, despite the fact that there are principles established in international law specifically directed against the use of children as soldiers. It has been assumed that military experience will have negative psychological effects on children, and several projects aimed at the rehabilitation of such children have been developed. We have had opportunities to examine the situation of child soldiers in Uganda, Liberia and Sierra Leone. In this article we draw attention to some of the conceptual and practical problems involved in this rehabilitative work.

Psychological responses to war and atrocity: the limitations of current concepts.

Because of the prevalence of wars, political violence and other forms of man-made disaster in Third World countries many individuals and communities suffer prolonged and often multiple traumas. In Western psychiatry certain conceptions of the response to violence and trauma have been developed, including the widely used category of post-traumatic stress disorder (PTSD). We argue that because concepts such as PTSD implicitly endorse a Western ontology and value system, their use in non-Western groups should be, atmost, tentative.

Rape as a crime of war. A medical perspective.

Although widespread, rape of women has been an underreported aspect of military conflict until recently. The current war in the former Yugoslavia has focused attention on the use of rape as a deliberate strategy to undermine community bonds and weaken resistance to aggression. In addition to providing treatment for individual survivors, the medical community has an important role to play in investigating and documenting incidents of rape. Such documentation can help to establish the magnitude of rape in war and hold perpetrators accountable. Since rape in war affects not only the individual but also the family and community to which the survivor belongs, the restoration of social and community bonds is central to the process of healing and must be addressed within the specific cultural setting.

Helping victims of violence in Uganda.

We report on a project to assist victims of war and violence in Uganda. The original aim of this project, set up by the Medical Foundation for the Care of Victims of Torture, was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in that country. We found, however, that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support and against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel, we have developed a programme of training and discussion for health workers, and a service to reach the many women who have suffered rape, and whose suffering has continued, largely ignored.

Helping victims of violence in Uganda

We report on a project to assist victims of war and violence in Uganda. The original aim of this project; set up by the Medical Foundation for the Care of Victims of Torture; was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in that country. We found; however; that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support and against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel; we have developed a programme of training and discussion for health workers; and a service to reach the many women who have suffered rape; and whose suffering has continued; largely ignored

Helping victims of violence in Uganda

We report on a project to assist victims of war and violence in Uganda. The original aim of this project; set up by the Medical Foundation for the Care of Victims of Torture; was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in the country. We found; however; that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support; this is against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel; we have developed a programme of training and discussion for health workers; and a service to reach the many women who ahve suffered rape; and whose suffering has continued largely ignored