Little is known globally regarding the pervasiveness and potential health impacts of substance use occurring during post-conflict transition periods as populations move from periods of conflict towards relative stability and reconstruction. Such is the case in Northern Uganda, where the protracted conflict between the Lords Resistance Army (LRA) and Government of Uganda (GoU) forces ravaged the region from 1986 until 2006 seeing the displacement of more than 1.8 million people, over 90% of the region's population. Since the cessation of conflict in 2006 and transition towards resettlement, focus has been placed on relief efforts rather than characterizing and addressing more chronic health issues. While NGOs have been expressing concerns about increases in substance use and its impact on levels of interpersonal violence and HIV in the region, effective targeted programming is severely limited due to a paucity of data on addiction behaviors in the region and post-conflict settings in general. Using mixed methodologies, a combination of qualitative and quantitative research techniques, this research project seeks to begin to understand the complex web of physical, social, and mental characteristics that influence substance use and adverse drug-related outcomes in post-conflict Northern Uganda. Through a grounded theory framework of qualitative interviews we will be able to have ongoing hypothesis generation that will help improve the quantitative mediation models to achieve a more holistic understanding of related vulnerabilities They have also been used to illuminate the processes that characterize life in dangerous places and the creative strategies people use to survive. These combined methodologies, including the use of psychometric scales, are critical to explaining the underlying reasons for elevated vulnerability and the shared experience of trauma. This will begin to allow a delineation of the underlying potentially causal factors associated with substance use, both at an individual and community level. Further this project will help to elucidate the underlying physiological and psychosocial mechanisms that underpin both transitions to substance use and health vulnerabilities resulting from it.
The intersection of war, displacement, and HIV in Northern Uganda is striking, and despite the cessation of the conflict, attempts towards reintegrating and rebuilding have been hindered by extremely high levels of residual trauma, increased substance use in the population, and increased HIV prevalence. As the first comprehensive study of its kind, this data will help to fill the substantial gaps in current epidemiological knowledge and elucidate the lingering effects of the civil war on the population. The impact of this research extends beyond the borders of Northern Uganda by contributing to the under-researched field of substance use and determinants of HIV in post-conflict settings.
