Children’s management of complaints symptomatic of psychological distress: a critical analysis of the different approaches in Northern Uganda

Background: Children who participated in this study were born and lived in the context of armed
conflict. They were displaced from their homesteads to a relatively safer Gulu Municipality and immediate surroundings where they lived in night commuters’ shelters and congested camps. A substantial number of them had witnessed and experienced severe war atrocities like killings of close kin, abductions, landmine injuries, assaults and gender-based violence.
Methods: A one year ethnographic study (2004-2005) with children aged 9-16 years was triangulated
with a cross-sectional survey (N=165) to investigate common health complaints and quests for
therapy. Child-adapted qualitative methods were used, such as interviews; focus groups discussions; vignettes; and workshops were conducted to identify children’s wartime experiences, medicine use, their coping mechanisms and perspectives about how to minimise complaints symptomatic of psychological distress.
Findings: Complaints symptomatic of psychological distress included persistent headaches, cen (evil
spirits), chronic pains and aches, something painful moving around the body, cwinya cwer (sadness),
and can (psychological pain). Children used sleep medicines (Valium and Piriton), attended healing
services, used atika (Labiate species) plants in attempts to restore health. Ex-combatants were
advised to seek forgiveness and reconcile with the victims of violence.
Discussion: Health care seeking by children traumatized by war occurred in the context of medical
pluralism with the goal to restore health. Children’s perspectives did not include professional
approaches as a source for help. This study recommends comprehensive approaches to address the various chronic health problems of children and their underlying causes.