Real Risk

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ISASTERS CAN HAPPEN

to anyone, anywhere and at any

time. Katakwi district, located in northeastern Uganda,

is one of the areas where war and cattle rustling from the

neighbouring Karimajong warriors have displaced more than 1

million people. The Lord Resistance Army has been fighting the

Ugandan Government for the past 20 years, and has since spilled

over to the northeastern town of Katakwi. Meanwhile, the

Karimajong neighbours have raided people in this district for the

past 40 years or so. As a result, thousands have been displaced

to secure areas but little did they know that they were creating a

suitable environment for another form of disaster – disease.

Internally displaced people’s (IDPs) camps are highly

congested, making the occupants prone to various diseases.

United Nations agencies have worked closely with the Ugandan

Government to see that people in camps try to live better lives.

The research detailed here was focused on malaria, cholera and

sexually transmitted diseases. Malaria and AIDS were found to

be very common, whereas cases of cholera were not mentioned

by anyone in the camps despite the fact that few of the people

living there used toilets.

The World Health Organization, along with the Ministry of

Health, were giving out Homapaks containing treated mosquito nets

and anti-malarial drugs to pregnant mothers. Food was given by the

World Food Programme (WFP), and clean water in the form of bore-

holes was provided by the Lutheran World Federation, an

international organization working in the district. Nearly all camps

had boreholes as the source of water and this has indeed been essen-

tial to people’s health standards.

Local community contribution

The community fully participated in all the training workshops,

which were conducted in the local language by trained camp leaders.

Although the pregnant women were given mosquito nets, many of

them did not use them, giving the reason that they would be suffo-

cated. On the other hand, most people on the drugs that were given

never completed the full course of medication, leading to resistance

in the disease-causing organisms and hence ‘drug resistance.’ It

emerged that some people preferred fetching their drinking water

from the unprotected springs, claiming that this natural water has

all the minerals flowing freely in it, unlike the borehole water. Little

do they know that the human waste deposited all over the bushes

runs into the springs when it rains. This was noted when most of

the people from the camps confessed that, due to scarcity of pit

latrines, they regularly visited the bushes to deposit their waste.

However, even the few pit latrines seen in the camps were in very

bad shape and usually overflowed when it rained.

On talking to local leaders, it was suggested that if land is avail-

able, they could mobilize families to construct pit latrines which

were practical and affordable. However, this would involve having

the landowners’ permission. Two families said that they were very

willing to construct pit latrines, but the landowners only leased

them a small piece of land on which to construct a shelter for accom-

modation and nothing else.

The main social activity among the adults in the camps is drink-

ing alcohol. People start drinking as early as 0900 hours until late at

night. This leads to increased promiscuity and defilement, and has

increased the prevalence of sexually transmitted diseases. The only

drug shop that sells condoms reported that only 3 per cent of the total

population in camps uses condoms. Most people cannot afford them

and others feel that wearing condoms may introduce other diseases

to them. So the Directorate of Health Services under the Ministry of

Health is setting up committees in camps to educate the population

about the dangers of unprotected sex and excessive drinking.

Raymond Okello, the district health inspector, said that sex-related

cases have slowly but steadily been dropping after the establishment

of health committees. He said changing attitudes, especially among

rural illiterate people, is an uphill task that takes a lot of patience.

The information acquired through the various training projects for

disaster risk reduction and management led to the introduction of

the Ministry of Disaster Preparedness in Uganda. Through this

ministry, with the help of UN agencies, community leaders have

tried their best to educate people on disaster preparedness and

hence to reduce deaths by some of the diseases commonly mani-

fested in IDP camps.

Community participation may lead to disaster

(disease) reduction in camps: the role of the

Ugandan Government and United Nations

Prossy Namuwulya and Trevor kaita Tumwesige

An unprotected spring, another source of water

Photo: Peter Magelah